Who You’ll Hear
Kati Kleber, MSN RN CCRN-K – Nurse educator, former cardiac med-surg/stepdown and neurocritical care nurse, author, speaker
Elizabeth Mills, BSN RN CCRN – highly experienced neurocritical care nurse, current Stroke Navigator for a Primary Stroke Center
What You’ll Learn
- Appropriate Boundaries
- Self Compassion
Appropriate boundaries between home and work
- It’s very easy for our identity wrapped up in our profession.
- Especially in nursing we have a tendency to over-extend ourselves because we feel we are doing it for our patients.
- A harsh truth to understand: our employers are replaceable to us, and we are replaceable to our employers.
- Your employer is a business and they will take from you as much as you are willing to give.
It is the hospital’s job to staff the unit.
- It feels great to come in and be that extra nurse that picked-up. Your coworkers are incredibly grateful and it feels good.
- But! It’s not your responsibility to take care of your coworkers. It is your responsibility to take care of yourself.
- You need time away from work to rest and reset– it will ensure you have the focus and attention to detail that is needed when caring for the lives of your patients.
- Don’t set yourself on fire to keep others warm.
- This means becoming comfortable saying “no thanks,” and not feeling obligated to provide a reason why.
- Regulating your emotional response by recognizing an emotional stimulus, choosing to acknowledge it, and leaning into it with a balanced awareness.
- It helps you to avoid falling into the pain your patients are enduring or over-identifying with a mistake or failure.
- It’s something you must do in the moment, as you are experiencing a tough situation.
- Three components of self-compassion
- Acknowledging the difficulty of the moment and putting a name to the emotion you are feeling
- Allowing the emotion to visit you, but not hijack you
- We are all fallible humans that have imperfect life journeys.
- We tend to get lost in the negative emotion associated with a mistake or failure, and then isolate ourselves in that.
- Must conscientiously remind ourselves that everybody makes mistakes, everybody struggles.
- Warmth and gentleness towards yourself
- Saying to yourself the things you very naturally say to others when offering comfort and support
- “It’s OK, I’m gonna get through this.”
- Think of it like exercise for your brain. The more you practice it, the better you get at it and more natural it becomes.
- Nurses who frequently practice self-compassion have lower rates of burnout.
What nurse burnout looks like
- Have you become cynical or critical at work?
- Do you drag yourself to work or have trouble getting started?
- Have you become irritable or impatient with coworkers or patients?
- Do you lack the energy to be consistently productive?
- Do you find it hard to concentrate?
- Do you lack satisfaction from your achievements?
- Do you feel disillusioned about your job?
- Do you use food, drugs, alcohol, etc. to feel better or simply not feel?
- Have your sleep habits changed?
- Are you troubled by unexplained headaches, bowel problems, or other physical complaints?
How to deal with nurse burnout?
- Prevention is key!
- Start addressing the situation before you are answering yes to many/most/all of the questions above.
- Exhaustion is not the requirement for rest. It’s a sign that you’ve waited too long.
- Should not just be distractions (social media, shopping, over-indulgence) or escapes from normal life (partying, vacations).
- Genuine self-care is a lot more about rest, routine, boundaries, gratitude.
- Many of us at the bedside are experiencing secondary trauma which may be driving the burnout.
- Out of self-preservation, we cut ourselves off, which then prevents us from connecting with anything at all.
- Find out if your institution has an Employee Assistance Program (EAP). These counselors are trained to work with healthcare providers.
- Setting appropriate boundaries
- Requires developing assertiveness, to speak with respect for the other person and for yourself.
- This applies to interactions with patients, providers, and coworkers.
- If someone reaches your boundary it is up to you to inform them of that.
- “I am your nurse and I’m here to take care of you. I will treat you with respect, I ask the same in return”
- “Excuse me, the way you’re speaking to me is disrespectful and there is no need for that.”
- Don’t say “I’m sorry.” It’s tough, but you do not need to apologize to someone when they are being disrespectful to you.
- Always remain professional (do not hold a grudge or shun the person for the rest of the shift).
- Even if the interactions/requests are kind-hearted (ex: patient wanting to be friends on social media) or accepted as part of the culture of your unit (ex: coworkers talking about their sex lives) you need to find your own boundaries of what you are comfortable with and stick to them.
- Our emotions are something we feel, but they are not who we are.
- Self-compassion is being mindful, having a sense of common humanity, and practicing self-kindness.
- Set appropriate boundaries, and respect others when they do the same.
- Practicing self-compassion and setting boundaries can make this stressful and exhausting job doable.
YouTube Video of Episode
- Work/Life Balance Fresh RN Blog
- Whole Life Nurse on Instagram: instagram.com/wholelifenurse or @wholelifenurse
- Breakthrough ICU: A Crash course for New ICU Nurses discusses self-compassion and assertiveness
- Job Burnout: How to spot it and take action – Mayo Clinic
- Self-Compassion resources directly from Dr. Kristen Neff
- Buczynski, R., et. al, (2019). Clinical applications of compassion: How compassion-oriented therapies work and what makes them so effective. [Video lecture]. Retrieved from nicbam.com.
- Buczynski, R., et. al, (2019). Clinical applications of compassion: The neurobiology of compassion. [Video lecture]. Retrieved from nicbam.com.
- Decety J, Yang CY, Cheng Y. (2010). Physicians down-regulate their pain empathy response: an event-related brain potential study. Neuroimage. 2010; 50(4):1676–82. doi: 10.1016/j.neuroimage.2010.01.025
- Duarte J, Pinto-Gouveia J, Cruz B. (2016). Relationships between nurses’ empathy, self-compassion and dimensions of professional quality of life: a cross-sectional study. Int j Nurs Stud. 2016; 60:1-11. doi: 10.1016/j.ijnurstu.2016.02.015.
- Gracia-Gracia, P., & Oliv ́an-Bl azquez, B. (2017). Burnout and mindfulness self-compassion in nurses of intensive care units. Holistic Nursing Practice, 31(4), 225-233. doi:10.1097/HNP.0000000000000215