Mental Clutter

Perhaps I have no business writing about clutter, because I am a clutterer. I’m clean. You won’t stick to any surface in our home, but you may have to move some magazines to find a spot for your glass on the coffee table.

Sometimes My Surgical Mask Feels Like a Gag by jparadisi

Sometimes My Surgical Mask Feels Like a Gag by jparadisi

The topic of clutter is larger than that unwieldy pile of unopened mail on the dining room table. In the words of Newman, the mentally unbalanced postal worker on Seinfeld, “The mail never stops. It just keeps coming.”

The relentless flood of mail is not unlike the emotional barrage facing nurses during a typical shift. The tragic diagnosis of a new patient, recurring cancer in a well-known patient, too many patients, not enough nurses, phones constantly ringing, and unfamiliar chemotherapy regimens are just part of it. Then there’s the work environment: difficult coworkers, budget cuts, and, oh, no time for lunch today. At times, it’s overwhelming.

These things create a work day mental clutter difficult to shed at the end of a shift. Mental clutter paralyzes creativity, interferes with relationships, and impedes sleep. Managing stress is essential to happiness.

Having a mental clutter shut-off switch between work and home is effective. A mental clutter shut-off switch is a ritual activity, which when performed, tells your brain that:

  1.  The shift is over.
  2. You are going home.
  3.  You are leaving the workday craziness at work.

Easier said than done, but it can be done. Don’t we teach patients methods for managing stress?

Here are ideas for creating a mental clutter shut-off switch between work and home:

  • Join a gym or yoga class near work, and avoid rush-hour traffic by exercising before driving home.
  • When driving home, turn off the car radio. Listen to soothing CDs or a book on CD, such as God On A Harley by Joan Brady. It’s the story of a nurse learning to simplify her life.
  • As soon as you get home, take a 20-minute walk. Put your walking clothes and shoes on your bed before you leave for work, so they’re ready and waiting for you.
  • Create a personal sanctuary in your home. Mine is a comfortable chair with an ottoman. Next to it are my laptop, paper, pens, a sketchpad, knitting supplies, reading glasses, and several books. A small table holds a cup of coffee or tea.
  • Limit discussions at home about work to 30 minutes. Set a timer if you have to, and then stop when time is up.
  • Limit your time watching the evening news. Avoid it before bedtime. Be informed, but remember that you can’t fix the world.

That brings me to my last point: You deliver the best care reasonably possible to your patients, but you are not responsible for their outcome. You are a nurse, not a superhero.

What would you add to this list?

Finding Self-Expression in A Profession of Permission

Nursing is a profession of permission.

I had this epiphany when a patient asked me, “Can I have a couple Tylenol for my

Twenty-One by jparadisi

Twenty-One by jparadisi 2007
Inspired by the paintings of the Chauvet Cave.

headache?” The automated medication dispensing cabinet with a drawer full of Tylenol was in plain sight, but I could not give the pills, because I did not have a doctor’s order. I called her doctor and received the order (permission) to administer it.

Anyone can walk into any drugstore in America, purchase a bottle of the stuff, and eat it at will, but in my nursing role, I cannot administer medication without an order (permission). However, there is a reason for obtaining an order first. If this patient has liver disease or allergies, and I am unaware, calling her doctor for something as simple as Tylenol may prevent a medication error; the safety net of redundancy.

On a bad day, this lack of autonomy is tiresome.

Another example is staff meetings. Someone once told me, “For God so loved the world that He did not send a committee.” I did not fully appreciate the meaning of this statement before working in healthcare. Gathering consensus among nurses is like watching a freighter turned slowly by tugboats in a narrow harbor. It seems to take forever. In my opinion, I have the answer to the problem the nurses are discussing. It’s simple and cost effective, but no, everyone needs to give his or her input and sign off on it first. By the time the change occurs, I’ve mentally moved on.

Even using the bathroom during a shift requires asking another nurse to watch your patients while you’re off the floor. Nurses ask permission to use the restroom.

Nursing is a team activity. It’s the nature of our work. As individuals, we bring our unique experiences and voices to this work. Finding a place for self-expression is vital to our humanity — the wellspring of compassion.

Where do we find creativity in a job requiring permission to use the bathroom or eat lunch — after a 12-hour shift of caring for the sick on sore feet? For many of us, home life is just as demanding — shuttling children to soccer practice and music lessons, grocery shopping, making meals, paying bills, and finishing housework. Make time for a little exercise, and you fall asleep exhausted as soon as your head hits the pillow. The next day it starts over.

“Creativity?” I hear you say. “Yeah, right after I figure out how to sustain life on Mars.”

Consider this: Self-expression is so essential that 30,000 years ago, prehistoric humans drew pictures on cave walls to tell their stories. Their daily activities revolved around survival. Food was hunted and gathered. Marauding tribes threatened to take away what small comforts they possessed. Still, they made art.

So, forget Mars and ask yourself: Where can I find self-expression in nursing?