Ignoring The Set-Up
To be a nurse means you are choosing a career that helps the sick and dying. Because of this, trauma has been normalized in nursing and we’ve adopted a catch phrase: “I’m fine.”
My patient died— I’m fine
Got punched in the gut by a violent patient— I’m fine
Broke ribs with my bare hands trying to bring a patient back to life— I’m fine
Nurses ignore the emotional burden that death and near death experiences have on us as human beings. We have to. There is always another sick or injured patient desperately waiting in the cue. We can’t get upset at work. Patients die even if we are at 100% because modern medicine has limits. So what else can we do with our feelings?
Compassion and empathy are what make nurses great, but also contribute to our downfall.
We pour our hearts and souls into our patients and take great pride in the quality of care we provide. When our patients suffer, we suffer. When our patients die, we grieve. When a grieving widow is saying goodbye to her husband, we comfort her and then grieve in the break room.
No matter how our patients pass, even if it’s an expected death and we did everything in our power to prevent it; every death haunts us. We replay scenarios over and over. We struggle to sleep because we toss and turn ruminating on what we may have missed. But while we are still on the clock, all the emotional burdens we pick up get placed in a pile to deal with “later.”
The COVID Catalyst
When you ignore the emotional burden of regular trauma as a nurse, it is like going about your day ignoring the smoke accumulating in your home and not looking for the source. Some nurses are aware of the smoke, but blatantly ignore it. Others are oblivious to the smoke as it plumes overhead. There comes a certain point where the smoke will overpower visibility and sparks turn to flames.
Instead of a natural growth to the psychological embers, COVID swept across the country pouring gasoline on every single nurse. In the blink of an eye, visibility vanished and nurses have found themselves surrounded by unforgiving flames.
Some hospitals are being overwhelmed with patients with not enough resources and staff- Some hospitals are vacant causing layoffs
Some staff are being forced to work while COVID positive knowing very well they may be exposing their coworkers and sick patients— 161 nurses have died from COVID.
Some nurses and doctors and separated from their support system out of fear they could give it to their spouse or child— some divorce cases are weaponizing the fear of COVID to win custody battles against their ex working in healthcare.
Nurses are watching doctors who are forced to play God and determine who gets a chance to live with a ventilator and who gets to die. Nurses hold their breath as they race to put on the necessary PPE before entering the room while their patient is coding. Every second not doing CPR decreases odds of survival, but without wearing the full PPE increases nurses will end up in the next bed.
Nurses are exhausted, burning out, lacking their normal support structure, depressed, anxious, and overwhelmed. “Post” COVID stress isn’t coming, it’s already here.
5 Ways Nurses Can Combat PCS NOW!
COVID is a continuous, long-lasting, and evolving trauma that is bombarding medical professionals with physical, emotional, ethical, and moral dilemmas. All is not lost! We need to act now in order to lessen the consequences COVID has on nurses’ emotional and psychological well being.
1. Create a Self-Care Routine and give permission for someone to hold you accountable
I will be the first nurse to admit that self-care is not easy. Nurses constantly put everyone above ourselves to the point that we almost lose our identity to the job and those same tendencies overflow into our personal lives. Find something to do for yourself that recharges and/or relaxes you. Once you identify your self-care needs, COMMIT. We always “find time” to do things for our patients when that really means we stay overtime to chart or skip our breaks.
If you find yourself breaking your commitment to your self-care routine, designate someone you value to hold you accountable. It can be a family member, friend, or co-worker. It can be the sad, disappointed look your dog gives you when you don’t take him on the run you promised.
Over time with consistency, like any change, self-care will become easier and easier to do.
2. Adequate time with family and friends
What does your support system look like right now? Do you live with family or friends? Are you currently separated because of the risk of COVID exposure?
The social structure of the entire world has been altered by the pandemic. Social distancing is enforced and it’s even more restricted for healthcare workers due to the increased risk of exposure. People are afraid of catching it from us and we are afraid of unknowingly giving it to others.
Take a look at your current support structure. Who can you talk to or call? Communicate with them and if they are far away, schedule zoom or phone calls. Share your concerns, frustrations, fears, AND successes. Don’t just bottle it up. Family and friend time is KEY to keeping your sanity long-term.
If you do not have a support system and you feel you are alone at this time- you are not. Contact me. Let me walk with you through this tumultuous time.
3. Pick up a new hobby or revisit an old one
What is something you’ve always wanted to learn? The internet is a treasure trove of free teaching videos for pretty much every hobby or skill imaginable. Did you use to have a hobby that you enjoyed, but other things took priority? Pick it up again. Who knows, it might become a successful part of the self-care routine you’re making!
4. Do you have a higher power?
Do you believe in something greater than yourself? As nurses, we are taught to treat patients holistically. That means not just the physical body, but their psycho-social dynamics and spiritually as well.
If you consider yourself religious, what ties do you have to the affiliated religious community? Going to a place of worship is limited right now due to COVID, but see if they have support or small groups meeting via Zoom that you can join. If there isn’t one, start one. Get permission from the community leaders to post information about the small group information on their websites.
If you do not consider yourself religious, look online or on Facebook for a social group to join. It can provide much-needed support and distraction from the constant stress of being a nurse during a pandemic.
5. It’s Ok to say “No” to extra shifts
My favorite piece of advice: it’s ok to say “No!” When work calls or texts saying they are short and you are exhausted, were planning on doing self-care or family time, is there a small group that day, or just do not want to go in again— say NO. I give you my permission and full support.
It is not your fault that staffing is short. It is not your fault that the acuity of patients is higher than normal. You give your heart and soul to the job and need time away from the hospital in order to have the drive to keep coming back to a hectic job on your next scheduled day. No amount of money is worth your mental health. Stand up for you and your needs.
Some nurses burn out and switch specialty or location. Others switch careers entirely because the thought of rebuilding again as a nurse is too unbearable or not worth the inevitable future burns.
Conclusion
The foundation for “Post” COVID Stress in nurses has been set long before the pandemic. It’s been ignored up to this point by the sheer strength of nursing willpower to reject natural consequences trauma has on human beings. It’s a learned coping skill instilled in us from the beginning of our careers because we would not survive without it. However, lack of balancing that strong coping skill with a healthy outlet caused a smoldering of symptoms that flickered, flared, and threatened to burn down the mental health of nurses with every additional patient death, code, violent outburst, and lack of resources or support.
COVID took small existing fires nurses were successfully ignoring and turned them into raging wildfires. Nurses in some cities felt it early on, but COVID has evolved throughout the it’s timeline, reeking havoc on different cities and counties at different times. Every nurse across the globe has been negatively affected emotionally, physically, and financially by COVID. There is no end in site to this pandemic. We thought the summer heat would extinguish it. We’re already on the “second wave.” How many more waves will there be?
But let’s be honest, if there wasn’t a pandemic, we would experience other crises that would feed the fires and eat away our mental health.
As nurses, we cannot control the virus, how it affects facility budgets, or how many patients we see die from it. What we can change is our actions. Without the right kind of extinguishers our attempts to put out fires is in vain. So let’s take charge and work on combating PCS with healthy coping mechanisms. Lets commit to self-care, utilize or establish support systems, try new hobbies, lean on your Higher Power, and stand up for yourself by saying “no” when “no” is needed.
