Nursing Burnout

The warning signs were there – I felt tired more than usual, did not want to go to work, had no motivation to do additional work, nor did I enjoy the work I did do. My mind was constantly elsewhere, flitting from one subject to another, forgetting patient’s names and history. I had been picking up shifts, rarely sleeping more than six hours a night, eating infrequently, and working out less so. Consequently, the quality of my work suffered considerably and I felt miserable.

Pacifying myself with self-indulgent behaviors, I gained weight, spent less time with my family, and watched more movies and shows. The feelings of restlessness and misery would dissipate, I thought. Around the same time, my grandmother’s health declined sharply and she ended up in the hospital. Spending so much time in the hospital atmosphere was draining, but having family there was nerve-wracking in the most literal sense. I was grateful for my “nurse mindset”which allowed me to take each day at a time and prioritize my grandma’s health goals instead of becoming completely overwhelmed and breaking down.

Helping care for my grandma was a metaphorical reset button. Although I was still consistently thinking about my grandma, I returned to work with a renewed sense of purpose and vigor. Initially I discredited the experience as a mere “rough patch” at the beginning of a burgeoning nursing career. However now I wonder if I was feeling “burnt out” as all nursing students are taught may happen over the course of our nursing career.

Has this ever happened to you? What kinds of thoughts/feelings did you experience? What did you do to recover yourself?

 

NOC Shift Part I: Flipping

Flipping (verb, colloquialism): the act of adjusting the body’s circadian rhythm to being awake and functioning adequately at all hours of the night (A.K.A. the bane of my existence). There are many websites that offer tips and tricks and various techniques to flipping.

Up until last year, I had never done a night shift so I never had any reason to flip. Not to mention, I am an early bird – meaning that my body functions much better in the early morning than it does in the evening/night – and never wanted to stay up through the early morning hours. It was partially out of desperation to practice and partially out of confidence in my versatility that I accepted a night shift position as my first nursing position.

Research revealed that it would be beneficial to sleep the day of the night shift, but in all likelihood I would still have to drink plenty of coffee to help me stay awake the rest of the evening. Fortunately, I enjoy coffee and naps so I did not consider either to be problematic to my adjustment. The websites I searched did not discuss any tips or tricks in detail and I found the vagueness of the articles to be calming, implying that flipping was a rather simple process.

In all honesty, what I have learned over the past few months is more valuable than the research I came across. Every person is unique and bodies react differently to flipping. For instance, several of my dayshift colleagues started on night shift but became too ill to continue. Thankfully my body can handle night shift, but I have found I need to prepare myself mentally every shift. What is effective for one may not be effective for another, but I thought I would share how I flip.

First and foremost, I hydrate both with coffee and with water the day prior to my shift. I nap if I can during the afternoon, but I keep myself busy physically and mentally in the evening by exercising and reading. Oftentimes I will “meal prep” or prepare meals for the upcoming shifts and/or week and wash dishes, dust, and other quiet chores. Staying awake until 7am or 8am is always my goal, but I try to at least stay awake until 5am ensuring at least 8 hours of (hopefully) uninterrupted sleep. My alarm is always set for 4pm, in order to wake up slowly, eat breakfast, read, and iron my scrubs if I need to. That, ladies and gentlemen, is how I flip – it is not incredibly complicated, but it did take some trial and error to develop what works best for me.

How do you flip? Do you have any advice for anyone new to nightshift?

Studying for the NCLEX

This book has some good figures useful for visual learners. (Source)

I have spent most of my time the last month preparing for the National Council Licensure Examination (NCLEX). It is the epitome of all exams we have taken in our lives thus far. The NCLEX is the exam nursing students take to become registered nurses. As one might imagine, it’s a big deal and it takes some preparation to ensure passing.

At the beginning of fourth semester I purchased an illustrated review book that I had repeatedly checked out from the school library. I am a very visual learner so it helped me to lay out the body processes and complications that could occur.

Occasionally throughout the semester I would crack it open and study for an hour or two. It wasn’t until the middle of May that I really started to focus on my studies. By that time my clinical hours were complete, assignments submitted, and stress (almost) non-existent.

My friends and I all signed up for a review course which was scheduled for the first few days after commencement. The review was very good and really helped me focus on particular concepts instead of trying to learn and understand every illness and disease known to humankind. Take, for example, fluid volume excess (FVE). The treatments for FVE and causes of FVE are applicable to the understanding and treatment of various conditions such as heart failure and kidney failure.

I utilized this to practice answering questions. Not only does it have thousands of questions, it also has their rationales. (Source)

After the review course, it was all up to me. With the support of my family and friends, I spent at least 4-5 hours a day studying. At first it was easy, because I methodically pursued the concepts I did not yet fully understand. Once my knowledge expanded, I had a hard time figuring out what to study. It was as if I was perusing the material and not necessarily studying anymore. I turned my attention to medications and their classifications.

I knew I would never fully understand all there is to know about pharmacology, but I thought if I could distract myself (in a sense) with medications I would focus less on my mounting anxiety. It helped, but so did talking to friends that were also studying for the NCLEX and taking better study breaks.

My idea of a study break up until that point was to snack, have a mini-dance party, or browse social media. As my exam date approached, I took the opportunity to go running daily, hiking, and paddle boarding. I also spent some time in mental relaxation mode and turned reflexively to Netflix and sleep.

Overall, I felt mentally prepared for the NCLEX and that is what mattered most to me the day of the exam.

To be continued…

NICU Nursing: Taking It Slowly

The topic of neonatal intensive care nursing has been a difficult one to write about – it has literally taken me months to start this post. The reason for that is it is so near and dear to my heart and I want to do it justice in my portrayal of it. Though my experience is limited, I do want to share what I have seen so far in clinical.

An example of the isolettes our patients reside in. (Source)

As part of my senior practicum I am paired with a nurse who is responsible for teaching me and guiding me through 168 hours (or fourteen 12-hour shifts) of direct care in the neonatal intensive care unit (NICU). I am so grateful for the preceptor I was assigned! She is equal parts challenging and encouraging. My preceptor cares about the quality of care for her patients and their families and is an extremely patient teacher.

Initially I feared I would be completely unprepared for my first day of clinical, not having had a pediatric rotation. My fears were assuaged by my preceptor the first day when she looked me in the eye and told me she had not expected me to know anything and that we would take it slowly. I soon learned that “taking it slowly” was the NICU way.

I first learned the basics, such as calculating feeding rates and administering feedings and changing diapers. Simple stuff, yet I had taken for granted how incredibly important nutrition and gastrointestinal health are to the little ones. Next, I learned how to do room safety checks and deliver medications. Then I learned how to complete a head-to-toe assessment on a neonate.

(Source)

It was a frustrating process at points, but after having observed my preceptor’s nursing style I came to trust her judgment above my own. That is not to say I did not offer myself up for new experiences and opportunities to learn, but I followed her lead. I knew she only wanted the best for our patients, especially because they are a vulnerable population. My preceptor does not want me or any other new nurses to make any crucial mistakes that could harm our patients. That is why “taking it slowly” is the NICU way.

Woman Crush Wednesday #2

This week I would like to highlight an extraordinary woman who I have had the good fortune to work with and get to know more over the course of the last year. To simply say she is an exceptional nurse is to discredit her of all her other good qualities. She is kind, compassionate, and trustworthy. This woman recently started a blog of her own and has written incredibly insightful posts which I would encourage others to read. She too is a nursing student, but her posts eloquently describe the lessons we must all endure in life.

madisenstewart.wordpress.com

Studying for the NCLEX

Linfield, like many other colleges and universities, has a month-long term that spans the entire month of January. Students are able to participate in classes which may not be offered at other times in the year. For instance, my freshman year I took Latin 100 – it was the best and only Jan Term course I have taken. I was able to immerse myself in the language and spend most of my day with one of my best friends.

Unfortunately, that was the only year Jan Term was feasible for me and thus I have spent the last two years at home, biding my time until I returned for the Spring semester. The limbo I experience every year only lasts a bit before I focus on something to do with my time. Last year I spent it working on my blog, reading, and watching movies from the AFI’s 100 Best Films list with my dad.

This year I am using the copious amount of time I have on my hands to begin preparing for the NCLEX and get in a healthy workout routine. My family gave me the Illustrated Study Guide for the NCLEX-RN Exam by JoAnn Zerwekh, a book I have repeatedly checked out from the Linfield library to help me study, for Christmas and it is one of the books I am using to help me study. I also have Davis’s Q&A for the NCLEX-RN Examination by Kathleen A. Ohman to practice answering NCLEX-style questions. I have also checked out NCLEX-RN: Power Practice from the public library to practice actually taking the exam.

Although I have not entirely decided on a study strategy, I hope by beginning to study earlier than later I will be able to effectively review all the materials I need in time for the NCLEX in June. Granted, I will need a study strategy to do so, but for the time being I am reviewing material from the first year of nursing school that needs brushing up on.

If anyone has any suggestions of study strategies I would greatly appreciate the help!

2015 New Years Resolutions

I do love good lighting. Wintertime is the best time for mood lighting – and what better way to light the mood than by stringing white Christmas lights up everywhere?

My new years resolutions are based on six characteristics I would like to foster in the new year. The chosen characteristics are ones that I may have but are underdeveloped or ones that I feel I lack entirely. I have written resolutions based on the characteristics I want to exemplify – and some things I just want to accomplish.

The six characteristics are as follows:

1) Patience

One can never have enough patience. This year especially I have noticed how my patience has grown and how much I still need to improve.

2) Trust

I have been challenged more than ever to be trusting of others in my professional and personal life. I hope that in the next year I can develop a sense of trust that will enable me to care for my loved ones.

3) Wisdom

Of course, this does not simply mean “learning.” It goes without saying that my education will not end when I graduate next May. I want to develop the wisdom that comes from experiencing joy, tragedy, love, and laughter. I hope that this next year I can truly devote myself to the relationships I have previously nurtured.

4) Faith

My faith journey is a very long and twisty one. I hope that in the coming year I can foster good habits in my prayer life and pass along only the best for my friends.

5) Courage

This one is a difficult one to explain. While I may be able to advocate for my patients, I want to develop my own sense of courage. I want to be able to withdraw from relationships and revoke bad habits that hold me back from becoming the best person I can be and providing the best care I can as a nurse. This will be especially beneficial as I progress in my nursing career.

6) Compassion

The above being said, I hope to have the compassion to understand others and develop relationships that will benefit others. I want the compassion I develop to transfer to the patients I care for.

Now I know this post does not necessarily cover my new years resolutions themselves but there will be another post coming that will cover them. Although, I’m curious as to what others’ new years resolutions are… Two of my more practical ones are to exercise more regularly and finally learn how to snowboard.

The Nightmare After Christmas

This post is nothing like the movie. I just thought it was a clever title.

The night before last I had a horrific dream in which I was caring for a young patient. While I cannot remember what the patient looked like or whether the patient was male or female, I can remember the patient was kind, patient, and humorous. Suddenly, in the dream, I realized the patient was bleeding from the nose. Then I looked at the patient’s ears and they too were bleeding. Everywhere I looked, the patient was starting to bleed.

For some reason the patient did not have IV access so I tried to start an IV. I repeatedly failed and the more I tried the more the patient bled. Some how my scrubs began saturated with blood and I woke up with the same damp feeling on my skin. The smell of fear mixed with the scent of blood lingered in my nose as I rose from bed, disoriented, gasping for breath.

I do not know if others have had dreams like this (or if nightmares like mine are even remembered), but this dream hit me hard. I awoke frightened and with the heavy feeling of guilt and inadequacy which was hard to shake. Now all I want to do is study and practice my nursing skills.

As the new year draws closer I think about the changes that will occur in 2015, including receiving my BSN and RN license. I wonder if the dream was my way of preparing for the future… I obviously need to find another method of doing so.

That being said, I have been working on my New Years Resolutions and will post them within the next day or two. In the meantime, enjoy this:

Belated Merry Christmas from a student nurse!

Oh Christmas Tree, Oh Christmas Tree…

Hello everyone! It’s been a while again, hasn’t it?

I am currently sitting on a couch at home, partially watching my brother play with his train set and partially watching the Golden State Warriors vs Memphis Grizzlies (basketball) game. This past semester was wonderful – and swift! I feel proud about the hard work I have put into the semester and I actually look forward to receiving my final grades. In the meantime, I have finally returned home for a couple months to rest, refresh, renew, recharge, rejuvenate, reflect… You get the idea.

Rest. Sleeping an adequate amount every night is a major goal for these next few months. I constantly take for granted the worth of sleep in my life.

Refresh. My clinical instructor revealed that it is possible to become NIHSS-certified without having a nursing license, so I will be taking opportunity to do so in the coming months.

Renew. As Christmas approaches, the season of advent calls us to prepare ourselves for the coming of Christ – meaning we need to re-establish our relationship with God and give fresh life to our faith.

Recharge. The next couple months will give me plenty of enough time to rest my mind after giving so much of myself the last few months.

Rejuvenate. What with the majority of the coming months being the midst of the winter season, I will take advantage of the time to pamper myself.

Reflect. I cannot forget that a new year is coming, so of course I will be reflecting on the year and possibly making goals and definitely writing new ideas for the upcoming year.

All that being said, I may finally catch up on my blogging as well. Keyword: may. In any case, I hope that your holiday season (whatever it is) is going well and that you are feeling extra loved.

Wow, It’s Been A While.

Hello everyone, so sorry it’s been so long!

As some may know, I am in my third semester of nursing school. I had my obstetrics rotation in L&D and a postpartum unit earlier in the semester and am now finishing up my med-surg rotation in a stroke unit. To be completely honest, I loved working with the infants on the unit more than I did working with the mothers during labor. It emphasized my dedication towards neonatal intensive care.

I applied recently for a preceptorship with a NICU nurse in my fourth semester… I may have to wait until the beginning of February to find out whether or not I received the placement. I am not concerned, however. Wherever I end up, I will do my absolute best and learn as much as I can while I can.

This optimistic attitude extends from the positive experience I have had the last few months in clinical. I have been given great feedback and encouragement and am feeling more and more confident in my nursing practice.

In the meantime, I have been expanding my knowledge in various areas, particularly reproductive health. I had the opportunity to attend the NSFC Summit in Minneapolis and learned more about reproductive health than I have in pretty much the entire nursing curriculum. It was a wonderful experience and I am so grateful for the Nursing Students For Choice organization for putting it on.

I have also started to consider pursuing post-graduate education, although I am not entirely sold on the idea. Whatever I decide, I will be sure to blog about it.

Hopefully now that I am on Thanksgiving Break I can blog more and regain the practice of blogging nightly. No promises though!