Monday September 1st 2014

The new ‘fine’?

Nurses look at ways to move closer toward a work-life balance

Ask people how they’re doing, and the standard response these days is more likely to be “busy” than “fine.” It is a phenomenon that Suzy Harrington, DNP, RN, MCHES, chief wellness officer at Oklahoma State University (OSU), has noted over time.

“In today’s world of shrinking resources, everyone is being asked to do more,” said Harrington, an Oklahoma Nurses Association and American Nurses Association (ANA) member. “New technology helps us in many ways, but it also drives us to be busier [and extends our workday].”

And because many nurses and women are nurturing by nature, Harrington said they “give and give and give,” often to the detriment of their own health and well-being.

Board Certified Nurse Health Coach Kim Richards, RN, NC-BC, reports that nurses who attend her workshops, which are offered around the country, constantly raise the issue of work-life balance.

“Some of us can be good in one area of our lives but are really lacking in other areas,” said Richards, founder and owner of the Self-Care Academy, and a member of ANA and its organizational affiliate, the American Holistic Nurses Association.

Even nurses who focus on promoting healthy habits can find achieving a balance challenging.

Beth Battaglino, RN, acknowledges it’s a personal struggle. She had a baby a year ago, she runs a national nonprofit called HealthyWomen.org and she works as a staff nurse on a mother-baby unit. And like other nurses, she tends to be the go-to caregiver for older family members.

“It’s part of the [nurse] personality,” said Battaglino, an ANA member. “We just take on that role.”

Another case in point is Lori Lioce, DNP, FNP-BC, CHSE, FAANP, who can be considered a “poster nurse” of busy. Over the course of her career, she’s juggled the responsibilities of family, educational advancement, professional association roles, her nursing job and a family business. She has been able to make it work — sometimes better than other times — but always with strong family support and sacrifice.

“Now I’m trying to ensure more balance in my life,” said Lioce, who recently reduced her work hours by half in her roles as the simulation coordinator and faculty member at The University of Alabama in Huntsville (UAH). “I feel I can still make a difference [in nursing] while spending more time with my family and doing some things for myself.”

Clearly it’s a work in progress. She still teaches RN-to-BSN and nurse practitioner students at UAH and through Walden University, and is involved in a range of professional activities.

But on contemplating the question of balance, Lioce said: “If you keep saying yes, how do you replenish yourself — feel you have something still to give?”

Harrington, who guided the development of ANA’s HealthyNurse™ program, maintains that self-care is incredibly important.

“If we don’t take care of ourselves, we are not going to be able to give our best to our patients, our families, our coworkers and our communities,” she said.

Sharing their secrets & other strategies

Nurse wellness experts emphasize the importance of carving out time for oneself.

Battaglino’s “me” time is her running group.

“We are all in our 40s, and call our runs together our ‘therapy,’” Battaglino said. “We have the opportunity to talk and vent, and by the time it’s over, we are ready for a great day. Exercise gives me a way to regroup and refocus.”

Battaglino knows that many nurses simply have no energy for a run or any other type of exercise after working 12-plus hours or extra shifts. So to strike more of a balance, she suggests that nurses start to rethink their work schedules.

“Nurses need to learn how to say ‘no,’” she said, whether it is to picking up extra shifts or helping out with the many other requests that come their way.

“Those [added activities] take away from doing the things you want to do, like going to the park with your kids or going for a walk for yourself, which are important,” Battaglino said. “We need to understand our limits and set up parameters that safeguard our time.”

Nurses also note the insidiousness of electronic devices, which blur most everyone’s work and home lives. Battaglino urges nurses to turn those devices off at home so they are not tempted to check one more email or answer another text.

“And I don’t know anyone who really multitasks well,” she added. Battaglino also is a firm believer in scheduling and planning activities such as dinner menus for the week and alone time.

Lioce has her own personal strategies that have helped her, particularly when her life has been exceptionally hectic. She draws on the support of family, her faith, and a strong network of friends and nurse colleagues.

“My main strategy is to get one major thing done a day,” Lioce said. “I use a calendar-diary to keep track of everything. And boundaries are very important. I may block a whole day off for relaxation. And when it’s family time, I try to protect it as family time.

“It’s also important to ask for help if you need help.”

A culture of balance

“If something is not going well in the workplace, it will be carried over into your personal life and vice versa,” Richards said. “You won’t be fully present and enjoy [either aspect of your life].”

Although the days of totally separating one’s work life from one’s personal life are over, Richards suggests some mental techniques that can help create some balance. One involves practicing gratitude and mindfulness.

“When you first wake up, give yourself a couple of extra minutes to think about what you’re grateful for, and set the intention for your day,” Richards said. “Positive affirmation cards or journaling can jump-start the process. In practicing mindfulness, being fully aware of and observing the present moment can allow you to step back, breathe and absorb feelings of gratitude and appreciation. The more you do it, the easier it gets, as the brain starts to create new grooves of neural pathways.

“The key is to create rituals and routines that you can fall back on that will center you, especially if you are caught up in change and chaos.”

A nurse who attended one of Richards’ workshops shared her ritual with the nurse health coach: She sits in her car in the employee parking lot before work and visualizes writing all the things that happened at home earlier, crumpling up the list and throwing it in a garbage can. Then she’s ready for her shift. She does the same ritual before going home.

Richards also suggests playing uplifting music or interesting audio on the way to work, which can increase energy and set the tone for the day

“Giving yourself a dose of good feelings can neutralize anxiety and halt the to-do list that can trigger feelings of already being behind,” she said.

A larger strategy involves changing the workplace culture in which nurses promote shorter shifts and taking the vacation days and time off they’ve earned.

“Getting away totally is vital,” Lioce said of the importance of time off.

Richards added, “Doing four or five 12-hour shifts in a row with no break is not acceptable or healthy. Not only do we risk making errors, but also it’s the physical harm we are doing to our bodies and the emotional and mental harm we are doing to our spirits that leave us feeling depleted. We don’t have to play Joan of Arc.”

She further suggests creating a “timeout” place away from the break room where nurses can really get away. And she encourages nurses to get to know each other better personally by sharing photos on a bulletin board or talking about their interests outside of work.

“It sounds simple, but if people care about each other personally, it makes everything better,” Richards said.

Harrington, whose aim is to align and strategically coordinate OSU’s current innovative wellness program, said that nurses can advocate for programs and services at their facilities that help them get healthier and lead more harmonious lives. For example, OSU recently opened new outdoor and indoor walking paths. The university also allows flexibility in scheduling and offers more than 140 free classes, from yoga to how to de-clutter your life.

Harrington believes that having a positive attitude helps with what she prefers to call a professional-personal life balance.

“Really think about how you can embrace all the great things in your life, prioritize them and take care of yourself in a holistic, not just physical, way,” she said.

And finally, Battaglino offered this piece of advice: “We don’t have to do everything, and it doesn’t need to be perfect.”

— Susan Trossman is the senior reporter for The American Nurse.

Resources

For strategies and materials to become a HealthyNurse and create a healthy work environment, go to ANA’s website, www.anahealthynurse.org.

To help nurses with “living well” strategies for themselves and their patients, go to  www.healthywomen.org.

To learn more about self-care and Kim Richards’ self-care programs, go to self-careacademy.com.

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