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Reconnecting with your Passion

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Sleep better

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In my work as a coach at Ginger, the topic of self-care comes up a lot. The influence of the internet has many people - especially millennials - thinking intentionally about what activities help restore their energy and lift up their moods. Myself, I'm a big advocate for cooking my own meals, cuddling with my cat, and going to the rock climbing gym. Yet, when I'm feeling low or stressed, the one thing that never fails to help me feel better is reaching out to my best friend.

In a study by the British Psychological Society, researchers found that "friendships play a vital role in helping people get through substantial challenges in life." In the workplace, research from Gallup shows that having a best friend at work is positively linked with strong employee engagement and higher productivity. Additionally, Elle editor-at-large, Melissa Harris-Perry, shares that the energy she has to teach, mentor, and advocate for her community comes from the support she receives from her friends and family. In her article, How #SquadCare Saved My Life, she writes, "Squad-care reminds us there is no shame in reaching for each other and insists the imperative rests not with the individual, but with the community. Our job is to have each other's back."

"Squad-care reminds us there is no shame in reaching for each other and insists the imperative rests not with the individual, but with the community. Our job is to have each other's back."

A common byproduct of not asking for help at work or not reaching out to one's support system in times of need is feeling isolated or alone, feelings which are, ironically, more often than not shared by colleagues and friends. While self-care activities are important, they are usually things that you're doing just for yourself and don't necessarily help with overcoming the feelings of isolation that could be adding to your stress.

Work stress is one of the biggest areas that I coach Ginger members in, and it's often related to people's desires to do well and to be seen as capable in their positions. But when this stress builds to a level that is no longer sustainable and their productivity starts to suffer, I often get asked, "How do I ask for help without seeming incompetent or like I'm not good enough at my job?"

"How do I ask for help without seeming incompetent or like I'm not good enough at my job?"

A first step to answering that question is in recognizing that struggling on your own isn't helping anything, and accepting that asking for support does not make you weak or incompetent; it's, in fact, a strength to realize when you need help and to self-advocate by asking for what you need. By reaching out and including other people in your self-care, you're better able to receive feedback and support in looking at your situation from another perspective and in considering ideas that you hadn't thought of yet. Even simply hearing that you're not alone in your struggles at work can help to relieve some stress. For these reasons, it's important to have both restorative activities to do on your own and a supportive community to turn to in difficult times.

Asking for help, support, or advice can feel uncomfortable because it requires a certain level of vulnerability. Yet, most successful leaders didn't get to where they are now without the help the people around them, proving that vulnerability and leaning on supports is a cornerstone of success and accomplishment. When asked about their success, many leaders will openly share about the influence that their mentors have had on them over the years and how they continue to turn to them today when they need advice or guidance.

For someone to be a mentor, such as a peer, they don't need to have more experience than you or necessarily be an expert on a certain topic; they can simply be someone who you respect and share common values with. By reaching out for help from a peer, you could even discover that they are going through a similar experience as you, leading you both to compare notes and give each other support, making your connection a mutually beneficial one. An important thing to remember - there are a lot of people out there who want new friends and you might be just the right person for them.

When reaching out for support, it's helpful to be clear up front and ask for what you are looking to get out of the conversation. This is especially important in new relationships to avoid miscommunications. This can mean saying something like:

"I want to tell you about my work day. There were some tough moments in there, and I could really benefit from some positive support. Could you do that for me?"

By doing this, you give the other person a heads-up so they can prepare to listen closely and you're letting them know that what you need the most is their support. If you want to get their advice or some constructive feedback on what you could be doing differently, you can ask for that too - just be prepared to be open to what you hear. When you ask directly for what you need, you're also modeling for others how to ask for help, which is helpful and supportive in itself.

If reading this is making you take a look at your relationships and you're realizing that you don't have the support network you need, it might be helpful to get into coaching or therapy to find ways of getting the support you could most benefit from. With coaching, you could discover ways to bring more supportive relationships into your life or improve the ones you already have, and in therapy, you could begin to unpack and get clear on what's keeping you from having the kinds of relationships you want most in your life.

Have you recently been promoted? Did your last project at work go really well and you're thrilled about it? Sharing good news is an important way to make sure that you're not only turning to your community in times of stress, which can hurt those relationships in the long-run. Opening up about your low points and your high points is also a way to encourage your friends and colleagues to do the same with you. The next time you're feeling down, your supports will remember the successes that you've shared with them and be able to remind you of how awesome you are.

Another important thing to keep in mind is that the way we talk about ourselves has an impact on those around us - especially for those who are in a leadership position. If you have a team that you manage or are the natural leader in your friend group, being open about mistakes, challenges, and worries shows others that it's safe for them to speak about these difficulties and normalizes having these often unspoken, yet common feelings. Additionally, sharing what you're proud of and celebrating your successes encourages others on your team and in your friend group to take pride and confidence in sharing their own accomplishments.

At its essence, squad-care is about being intentional in your relationships by reaching out to get support when you need it, showing vulnerability, sharing your successes, and giving all of the support you receive back in turn. When you focus on squad-care as a form of self-care, you can feel less stressed, more productive, and best of all, more connected to yourself and your community.

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The #1 Self-Care Strategy You Need: Strong Connections

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In my work as a coach at Ginger, the topic of self-care comes up a lot. The influence of the internet has many people - especially millennials - thinking intentionally about what activities help restore their energy and lift up their moods.

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Beautiful Relaxing Music for Stress Relief ~ Calming Music ~ Meditation, Relaxation, Sleep, Spa

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Project Helping

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The previous post outlined the basics of self care with an overview and some tips to get started. Self care is a general way of living in which you prioritize your own well being to live a more healthy life. On a deeper level, self care can be broken into three different components: Physical, Mental, and Emotional.

Physical Self Care

Physical self care involves activities that improve your physical health such as diet and exercise. It also means seeing a doctor when you are sick and taking the time to rest. Caring for your physical health might mean eating extra fruit and veggies to fuel your body, as well as staying hydrated. It is also important to stay active in a way that is fun and rewarding for you. This could be going for a walk, hiking, playing a sport you enjoy, or taking a yoga class. Remember to find the balance! While it is important to stay active, make sure to rest if your body needs it.

Mental Self Care

Mental self care involves activities that help declutter your mind and reduce your stress levels. Taking care of your mental health can seem difficult when life gets busy with work or school. By scheduling time each day to care for your mental health, you can reduce your stress and improve your overall happiness. Caring for your mental health looks different for everyone. Some easy ways to relax each day include reading a book, doing a craft, unplugging from technology, decluttering your home, taking a class, or going for a walk. There is no wrong way to take care of your mental health, as long as it makes you feel relaxed!

Emotional Self Care

Emotional self care involves caring for your emotional health in order to attain emotional well being. The key is to get in touch with your emotions. This can mean taking some time to meditate, write in your journal, practice gratitude by reflecting or sharing with others, talking with a close friend, seeing a therapist, or leaving positive notes for yourself.

If you take a few moments each day to care for your well being, then you will be rewarded with a positive outlook and improved mental health. For more tips, see Part 3: DIY Self Care Kit.

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Physical, Mental, and Emotional Self Care - Project Helping

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The previous post outlined the basics of self care with an overview and some tips to get started. Self care is a general way of living in which you prioritize your own well being to live a more healthy life. On a deeper level, self care can be broken into three different components: Physical, Mental, and Emotional.

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CVS Health commits to flattening the second curve of the COVID-19 pandemic

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WOONSOCKET, R.I. - CVS Health today announced its commitment to flattening the "second curve," the less visible but escalating mental health crisis resulting from the COVID-19 pandemic. To help address America's expanding mental and emotional wellbeing needs, the company is enhancing its nationwide mental health programming effort with new charitable investments focused on health care workers, essential workers and seniors.

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Cope with stress & stay well.

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The world as we know it has changed and we are living in unprecedented and uncertain times. COVID Coach is designed to help you build resilience, manage stress, and increase your well-being during this crisis. The app is free, secure, and helps connect you to important resources for coping and adapting during the COVID-19 pandemic. Customized tools are available to help you cope with stress, stay well, stay safe, stay healthy, stay connected, and navigate parenting, care-giving, and working from home while social distancing, quarantined, or sheltered in place. You can track your mood, visualize your progress, and find resources to seek additional help and support. No account or password is required and user data is not collected.

COVID Coach was made by the mobile mental health team of the National Center for PTSD, Dissemination & Training Division.

* Introductory walkthrough added
* Staying Balanced topics added for healthcare workers

A necessity for our new normal

As a counseling student intern, I plan on recommending this app to all my clients. I just started using it and love how it tracks everything we would be working on during sessions.

Great resources

As a therapist , I love this app! The interventions are grounded in best practices and it is really easy to use :-) great for anyone going through this pandemic

Amazing App

The is such a great app if you are going through a lot of stress

Information

Seller

US Department of Veterans Affairs (VA)

Compatibility

Requires iOS 11.0 or later. Compatible with iPhone, iPad, and iPod touch.

Copyright

© 2020 US Department of Veterans Affairs

Family Sharing

With Family Sharing set up, up to six family members can use this app.

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‎The world as we know it has changed and we are living in unprecedented and uncertain times. COVID Coach is designed to help you build resilience, manage stress, and increase your well-being during this crisis. The app is free, secure, and helps connect you to important resources for coping and adapt...

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We're offering all US healthcare professionals who work in public health settings free access to Headspace Plus through 2020.

What's going on right now is a challenge for everyone. But you, our healthcare professionals, are particularly overburdened. Headspace wants to be here for you and support you as best we can. Helping you be kind to yourself, and your own health, during this difficult time.

If you are a healthcare professional, you can redeem your subscription using your National Provider Identifier (NPI) and email address. Or, if you are a nurse and you don't have an NPI, you can provide your organization information to verify your credentials.

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Free Headspace for US healthcare professionals

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We're offering all US healthcare professionals who work in public health settings free access to Headspace Plus through 2020. What's going on right now is a challenge for everyone. But you, our healthcare professionals, are particularly overburdened. Headspace wants to be here for you and support you as best we can.

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Too busy to take care of yourself? These talks offer simple ways to stay healthy -- both emotionally and physically.

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ANA's COVID-19 Self-Care Package for Nurses (Free)

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ANA's COVID-19 Self-Care Package for Nurses (Free)

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Overview

ANA has created a care package of free courses to thank the entire nursing community supporting the COVID-19 response. As the coronavirus (COVID-19) continues to impact nurses across the globe, ANA wants to share resources to support you, your safety and the important work you do.
Register now
This care package includes the following courses:

Nursing Ethics: Strategies to Resolve the Top Ethical Dilemmas Nurses Face

Moral Resilience

Dealing with Fatigue: Strategies for Nurse Leaders

Promoting Nurse Self-Care: Emotional and Mental Wellbeing

A Nurse's Guide to Preventing Compassion Fatigue, Moral Distress, and Burnout

Benefits include:

Free CE credits

Valuable tips

24/7 online access

Key Learning Outcomes

Recognize moral distress in your nursing practice and build confidence in confronting morally complex situations to reduce moral distress and burnout

Self-identify ways to build moral resilience and reduce the physical and emotional consequences of morally complex situations

Identify the most common ethical dilemmas in nursing practice

Harness expert tips and strategies to build resilient teams

Establish leadership responsibility for identifying work environment elements contributing to fatigue

Define leadership strategies to create and sustain a safe care delivery environment

Apply strategies to identify and intervene with nursing mental health concerns, while decreasing the stigma associated with mental health conditions

Use of these or any other course(s)/material(s) does not imply eligibility for certification or successful performance on any certification exam, nor is it a requirement to qualify for individual certification.
American Nurses Credentialing Center (ANCC) does not endorse any products or services.

CE Statement
The American Nurses Association is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.
ANA is approved by the California Board of Registered Nursing, Provider Number CEP17219.

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ANA's COVID-19 Self-Care Package for Nurses

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Overview ANA has created a care package of free courses to thank the entire nursing community supporting the COVID-19 response. As the coronavirus (COVID-19) continues to impact nurses across the globe, ANA wants to share resources to support you, your safety and the important work you do.

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Strategies to Support the Health and Well-Being of Clinicians During the COVID-19 Outbreak

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Strategies to Support the Health and Well-Being of Clinicians During the COVID-19 Outbreak

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From National Academy of Medicine

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The National Academies are responding to the COVID-19 pandemic.

Even before the COVID-19 crisis, many clinicians already faced burnout, as well as stress, anxiety, depression, substance abuse, and even suicidality. Now this global public health emergency is presenting clinicians with even greater workplace hardships and moral dilemmas that are very likely to exacerbate existing levels of burnout and related mental health problems.

During this challenging time, we should all aspire to follow clear strategies, both as health care leaders and as individual clinicians, to help sustain the well-being of clinicians amidst the COVID-19 outbreak.

Value clinicians: Provide clear messages that clinicians are valued.

Communicate best practices: Communicate best practices clearly and compassionately. Manage expectations, create work schedules that promote resilience, ensure appropriate working hours with breaks, emphasize the importance of self-care, provide sufficient resources (masks, gloves, goggles, gowns, hand sanitizer, soap and water, cleaning supplies, healthy snacks, easy access to water, chargers for phones, etc.), and provide effective personal protective equipment.

Monitor and promote clinician well-being: Monitor the well-being of your clinicians proactively; identify mental health professionals and counseling options available to support them. Provide appropriate measures for personal safety, and address concerns related to clinicians' safety and the safety of their families.

Provide a supportive and blame-free work culture: Implement a psychologically safe environment for clinicians to openly discuss vulnerability, stress, burnout, and other barriers to their well-being. Encourage clinicians to report incidents, such as exposures to blood or bodily fluids from the respiratory system or to cases of violence, and to adopt measures for immediate follow-up, including support to victims.

Enable cooperation and collaboration: Institute mechanisms for cooperation and collaboration between management, clinical teams, and clinicians.

Provide a central access point for updated information, technical updates, and tools to address COVID-19: Familiarize personnel with technical updates on COVID-19 and provide appropriate tools to assess, triage, test, and treat patients and to share infection prevention and control information with patients and the public.

Ensure clinicians are not required to return to work during dire situations: Clinicians should not be required to return to a work situation where there is continuing or serious danger to life or health, until the employer has taken any necessary remedial action.

Provide appropriate resources if clinicians are infected with COVID-19: Honor the right to compensation, rehabilitation, and curative services if clinicians are infected with COVID-19 following exposure in the workplace.

Strategies for Clinicians

Meet basic needs: Eat, drink, sleep, and exercise regularly. Becoming biologically deprived is risky and may compromise your ability to care for patients.

Take breaks: Whenever possible, give yourself a rest from patient care with comforting, fun, or relaxing activities. Take walks, listen to music, read a book, write in a journal, practice breathing and relaxation techniques, or talk with friends. Taking appropriate rest leads to proper care of patients after your break.

Stay connected: Give and receive support from your colleagues to avoid isolation, fear, and anxiety. Partner with colleagues to support each other and monitor each other's stress, workload, and safety. Communicate with colleagues clearly and optimistically. Contact family and loved ones for support.

Respect differences: Recognize and respect differences in yourself, your patients, and your colleagues, such as needing to talk versus needing to be alone.

Stay updated: Rely on trusted sources of information and participate in meetings where relevant information is provided. However, avoid watching or listening to news reports 24/7. Graphic imagery and worrisome messages can increase your stress and may reduce your effectiveness and overall well-being.

Perform self check-ins: Monitor yourself over time for any symptoms of depression or stress, such as prolonged sadness, difficulty sleeping, intrusive memories, and/or hopelessness. Talk to a peer or supervisor, advise management so that they can provide support interventions, or seek professional help.

Honor your service: Remind yourself and others of the important and noble work you are doing. Recognize colleagues for their service whenever possible.

The strategies above are adapted from several resources to promote clinician well-being during COVID-19. However, they are not exhaustive. Please view these resources for more information on how to maintain the health and well-being of our health care professionals.

Share on Social Media
Change your profile picture to this graphic to show your support for clinicians during the COVID-19 crisis!
You can also use these sample tweets and graphics to share the strategies and resources across your networks.

Tweet This! Before #COVID19, many clinicians faced burnout, stress, anxiety, depression, substance abuse & suicidality. This crisis is presenting workplace hardships & moral dilemmas likely to exacerbate existing burnout levels. Support #ClinicianWellBeing: nam.edu/CWCOVID19

Tweet This! The #COVID19 crisis is presenting clinicians with even greater workplace hardships that are likely to exacerbate existing burnout levels & related mental health problems. Follow clear strategies during this challenging time to sustain #ClinicianWellBeing: bit.ly/CWCOVID19

Tweet This! We care about those taking care of us on the frontlines of #COVID19! We're making use of the resources and strategies compiled by @theNAMedicine to support the health and well-being of our clinicians during this challenging time: bit.ly/CWCOVID19 #ClinicianWellBeing

Tweet This! Check out strategies and resources for health care leaders and clinicians to support the health and well-being of those on the frontlines of #COVID19 response: bit.ly/CWCOVID19 #ClinicianWellBeing

Present on Clinician Well-Being Strategies

We've created PowerPoint slides covering these strategies for you to download and use!
Download PowerPoint

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Strategies to Support the Health and Well-Being of Clinicians During COVID-19 - National Academy of Medicine

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The National Academies are responding to the COVID-19 pandemic. Even before the COVID-19 crisis, many clinicians already faced burnout, as well as stress, anxiety, depression, substance abuse, and even suicidality.

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Stress, Coping and Living a Healthy Life at Home

Fear and anxiety about COVID-19 can be overwhelming and cause strong emotions. Learning how to cope with stress and staying healthy while at home will make you, the people you care about, and your community stronger.

Tips to stay calm during this COVID-19 outbreak

When you feel anxious, here are steps you can take to put those feelings in perspective:

Information is useful-but too much information can be unhelpful. Limit news intake to what is actually providing new information, and stick to reliable news sources. There's no benefit to watching the same news over and over.

Take the necessary and recommended precautions, but don't try to "innovate" new ones. As with all dangers, the trick is to be 'careful enough.' When we try to ensure 100% safety, we get caught up in unhelpful behaviors.

Keep up daily routines, and make changes only when necessary. Maintaining regular schedules and routines is a good way to keep anxiety at bay and feel normal. Even if some changes need to be made, maintaining the overall routine is helpful.

Don't completely isolate yourself from other people. Fear of spreading the disease can cause some people to withdraw socially, but maintaining relationships and social support are good ways to combat anxiety. Even if you are in self-quarantine or mandatory quarantine, keep up social interaction using FaceTime/Skype, phone calls, or text messages.

Limit screen time. Too much time on the phone or computer, on social media or websites, can lead to less activity and more anxiety.

More Tips to Stay Healthy at Home

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Fear and anxiety about COVID-19 can be overwhelming and cause strong emotions. Learning how to cope with stress and staying healthy while at home will make you, the people you care about, and your community stronger. When you feel anxious, here are steps you can take to put those feelings in perspective: Information is useful-but too much information can be unhelpful.

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Did you know self-compassion is the new black? Last year it was mindfulness but this year, attending without judgment is out and compassion for you as an antidote to your perceived low self-worth, failure, or any other form of suffering is definitely in. This is perfect for those of us living in the west where we are so often sick with, as meditation teacher David Loy would say, our "sense of lack." That loathing one might argue could be a result of our tendency to privilege the individual and his or her autonomy and accomplishments over the community and our interdependence. The idea that we can do everything ourselves and should is absurd. I mean, look around you. Do you have shelter and food? Did you build the former and grow the latter? Likely not, and even if you did where did you get the building materials, the seed, and tools? Our interdependence is always staring us in the face but we so easily miss it, focused on our self-importance, negative ("I'm so horrible") or positive ("I'm so great").

I have a secret I'm going to share with you that I tell the people who come to the Mindfulness-Based Cognitive Therapy groups I lead. You are not so special or so bad. I'm sorry. You are ordinary. I find that such a relief. Trying to live up to some unrealistic standard of who I should be and what I should accomplish is ultimately exhausting and demoralizing. Whose standard is it anyway? It just becomes a metaphorical stick with which we can beat ourselves when we don't meet those expectations. On top of that, it is so easy to think that being nice to ourselves is weakness or wimpy. Pulling up our bootstraps, and maintaining a stiff upper lip are ingrained in our culture. Staying with the tough familiar is often much easier than changing the way we respond.

Pulling up our bootstraps, and maintaining a stiff upper lip are ingrained in our culture. Staying with the tough familiar is often much easier than changing the way we respond.

I once attended a self-compassion workshop and found myself critical and rejecting of the exercises, thinking, "This is a bunch of crap." The idea of hugging myself or stroking my face, saying words like, "Soften, Soothe and Allow," softening around the tense areas of body, "like around the edges of a pancake," and putting my hand on my heart while recalling a difficulty made me squirm with dis-ease. I didn't want to be like a pancake. I didn't want to practice loving-kindness to myself, the people I don't like, or all beings. An acquaintance and I were talking about it and she said she often jokingly substitutes, "May all beings be peaceful" with the phrase, "May all beings have a jelly donut."

It took a while to figure out that what was underneath all of this discomfort and cynicism was the thought, "self-compassion is self-indulgence." This was an interesting recognition and invoking curiosity about this reaction led to the awareness: I don't like to be vulnerable or weak. Okay, so who does? But the reality is that we are all vulnerable creatures. In the words of a psychiatrist colleague of mine, "We are just little mammals and there are some things we should stay away from." This is good advice for many situations, one of which is our harsh stance toward self. Ask yourself, "What is the impact of all that loathing, sense of lack, and self-criticism?"

So, this is where self-compassion and ultimately compassion for others comes in, because believe me, those expectations we have for ourselves usually have their counterpart in our expectations of others. Researcher and author Kristin Neff expresses self-compassion as being composed of three parts: "self-kindness, common humanity, and mindfulness." So mindfulness isn't exactly out-it's contained in the C word. Willem Kuyken et al (2010) found that MBCT treatment effects for depression are brought about by increased self-compassion and mindfulness as well as a separation of the link between reactive depressive thinking and bad outcomes for the illness. It then stands to reason that cultivating self-compassion may result in a happier, kinder you.

Recently, I was teaching a mindfulness and self-compassion workshop (we so often do what we need ourselves) and there is a values exercise derived from Acceptance and Commitment Therapy in which you imagine you are at your own funeral and someone is giving your eulogy. You consider what you would want them to say, to help you consider how you are living or not, according to your values. We were about to do this exercise and I remembered a number of people in the group had just experienced the death of a child, partner, or parent. Amazingly, the thought came to me that given all their recent losses, it might be wise to change the exercise as follows to one taken from Solution Focused Therapy, a method of therapy that is goal oriented, focused on the future rather than the past. Many of us, when in distress, become problem-saturated. Solution Focused Therapy helps us to think about how our situations, relationships, lives, etc., could be better rather than delving into what makes them so bad.

Compassion Practice: Picture Your Best Self

Imagine your life five years from now when you are living, as you would like to be, according to your values. What will you be doing? Who will be in your life? Where will you be living? Write this letter from the future to someone important to you (living or dead, known or unknown) describing your life, as it is at that time, in exquisite detail. Take as long as you need to do this, making it as concrete as possible.

Read over the letter and extract three values that are important to you.

How close on a scale from 1 to 100 (with a 100 being completely) are you to this life you would like to be living?

What is a small, concrete thing you could do in the next 48 hours to bring you five points closer to that life? Make sure that the task is stated in positive and behavioural terms. Make sure it is achievable!

Exercises like this can bring awareness and intention to how we are living. They can help us focus on cultivating who we want to be from a place of kindness and self-care. Throw away the stick and pick up a jelly donut.

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Why Self-Compassion is the New Mindfulness - Mindful

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Did you know self-compassion is the new black? Last year it was mindfulness but this year, attending without judgment is out and compassion for you as an antidote to your perceived low self-worth, failure, or any other form of suffering is definitely in.

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Nod has been updated to help students grow and maintain strong social lives through the COVID-19 crisis. Just because we can't be together physically doesn't mean we can't be socially connected. #flattenthecurve

Download Nod

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Nod - An app to reduce loneliness on college campuses

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Nod has been updated to help students grow and maintain strong social lives through the COVID-19 crisis. Just because we can't be together physically doesn't mean we can't be socially connected. #flattenthecurve Download Nod

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Meditation for Self Love  |  Yoga With Adriene

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Practice being more mindful as our Ginger coaches guide you through 30 minutes of meditation that can help you reduce stress and feel more grounded. Open to all experience levels!

SATURDAYS AT 12PM PT / 3PM ET. FREE TO ATTEND.

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Practice being more mindful as our Ginger coaches guide you through 30 minutes of meditation that can help you reduce stress and feel more grounded. Open to all experience levels! SATURDAYS AT 12PM PT / 3PM ET. FREE TO ATTEND.

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Tools from the CDC

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Susan David: How to be your best self in times of crisis

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"Life's beauty is inseparable from its fragility," says psychologist Susan David. In a special virtual conversation, she shares wisdom on how to build resilience, courage and joy in the midst of the coronavirus pandemic. Responding to listeners' questions from across the globe, she offers ways to talk to your children about their emotions, keep focus during the crisis and help those working on the front lines.

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CHILL ZONE

Listen to audio recordings of guided relaxation and mindfulness meditations to help you get, and stay, in a more relaxed and mindful headspace.

FACING FEARS

Overcome your fears by gradually facing them in small manageable steps.

CBT-BASED TOOLS

Interactive cognitive-based tools to help you reorient your thinking, and behavioural strategies to help you take action and make lasting positive change.

QUICK RELIEF

When you need anxiety help fast, use these quick and easy tools to help you take a breath, ground yourself, shift your thinking, and take steps to cope.

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Is anxiety getting in the way of your life? MindShift™ CBT uses scientifically proven strategies based on Cognitive Behavioural Therapy (CBT) to help you learn to relax and be mindful, develop more effective ways of thinking, and use active steps to take charge of your anxiety.

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Happify: Science-Based Activities and Games

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Build skills for lasting happiness: Happify turns the latest innovations in positive psychology, CBT, and mindfulness into activities and games that help you lead a more fulfilling life.

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Check in and talk about it.

Roxane is here to be a guide on your mental health journey, wherever you're starting. She'll pop up from time to time in your Sanvello home feed to work on ways to check in, show up for yourself, and feel a little better.
Watch a preview

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Sanvello | On-demand help for stress, anxiety, and depression

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Roxane is here to be a guide on your mental health journey, wherever you're starting. She'll pop up from time to time in your Sanvello home feed to work on ways to check in, show up for yourself, and feel a little better. Watch a preview

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Download the free UCLA Mindful App for iOS and Android

With this easy-to-use app, you can practice mindfulness meditation anywhere, anytime with the guidance of the UCLA Mindful Awareness Research Center. Scientific research shows mindfulness can help manage stress-related physical conditions, reduce anxiety and depression, cultivate positive emotions, and help improve overall physical health and well-being.

Mindfulness is the practice of training the mind to be present through moment-to-moment awareness of our thoughts, feelings, body sensations and environment.Mindfulness promotes an attitude of openness, curiosity, and awillingness to be with our experience. Through regular practice, taught through this app, you can develop a meditation practice and learn to bring more mindfulness into your daily life.
This app offers:

Basic Meditations for getting started, in 14 Different languages

Wellness Meditations for people suffering from challenging health conditions

Informative videos exploring how to get started, supportive meditation postures, and the science of mindfulness

Weekly Hammer Podcasts and Drop-in Recordings -- 30 minute meditations on different themes you can search for and bookmark

A timer to meditate on your own

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With this easy-to-use app, you can practice mindfulness meditation anywhere, anytime with the guidance of the UCLA Mindful Awareness Research Center. Scientific research shows mindfulness can help manage stress-related physical conditions, reduce anxiety and depression, cultivate positive emotions, and help improve overall physical health and well-being.

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Podcast from HPNA

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In this episode of Stories from the Field, we welcome Barb Schmal, Certified Hospice and Palliative Registered Nurse, as she reflects on the impact of compassion fatigue throughout her career-long journey. She shares with us the importance of reflecting on the individual strengths that allow us to continue to do this meaningful work of caring for patients and families with serious illness. Her message of being intentional in caring for yourself will speak to us as we share Barb's journey of reflection in finding meaning and resilience in our chosen field of hospice and palliative nursing.

If you enjoyed this podcast, please donate to the foundation:
https://advancingexpertcare.org/Donate

By accessing this podcast, you are acknowledging the following disclaimer:
https://advancingexpertcare.org/PodcastCornerDisclaimer

For more information about this topic and advancing expert care, please visit the resources found at:
https://advancingexpertcare.org/PodcastCorner

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Ep. 3 - Stories from the Field with Barb Schmal

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In this episode of Stories from the Field, we welcome Barb Schmal, Certified Hospice and Palliative Registered Nurse, as she reflects on the impact of compassion fatigue throughout her career-long journey. She shares with us the importance of reflecting ...

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Drop in daily

With the Ten Percent Happier app, you'll access practical teachings alongside guided meditations to make mindfulness into a habit you carry everywhere.

Learn from the best
teachers on the planet

Our meditation teachers are renowned leaders in the field. And because everyone is different, they offer a variety of approaches so you can find the best for you.

"Having permission to sit for what ever time I can has helped me to be more regular."

"Compared to the other meditation apps out there, this one is the Rolls Royce of meditation apps."

"A friend asked me to take a two week challenge with her - now I'm hooked! Just 10 minutes a day & in such a more positive mood."

After a panic attack on live TV, ABC news anchor Dan Harris had to make some changes. Harris recounts his journey from skeptic to meditator.

Our podcasts

Ten Percent Happier publishes a variety of podcasts that offer relatable wisdom designed to help you meet the challenges and opportunities in your daily life.

The newsletter

Entertaining, insightful articles that will get your synapses firing and help you live a happier, more resilient, and more connected life.

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Ten Percent Happier: Meditation and Mindfulness to Find Happiness

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Ten Percent Happier offers courses, meditations, and expert coaching in our app to help anyone learn meditation and reduce stress. Start your journey today.

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Calm is the #1 app for sleep and meditation. Join the millions experiencing better sleep, lower stress, and less anxiety.

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We are the world's leading research and educational center of excellence on PTSD and traumatic stress.

PTSD is a mental health problem that some people develop after experiencing or witnessing a life-threatening or traumatic event. If symptoms last more than a few months, it may be PTSD. The good news is that there are effective treatments.

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Apply for and manage the VA benefits and services you've earned as a Veteran, Servicemember, or family member-like health care, disability, education, and more.

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Anxiety and Depression Association of America, ADAA

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Anxiety Disorders and Depression Research & Treatment | Anxiety and Depression Association of America, ADAA

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ADAA is an international nonprofit membership organization dedicated to the prevention, treatment, and cure of anxiety, depression, OCD, PTSD, and co-occurring disorders through education, practice, and research.

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Insight Timer - #1 Free Meditation App for Sleep, Relax & More

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The best meditation app with the world’s largest FREE library of more than 190k guided meditations, 17k teachers & the world’s most loved meditation Timer.

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The Basics

Create routines.

Daily structure is important for purpose, productivity, and momentum. Weekend structure is important to break up the week - and for leisure! Here's how to get started.

Limit news consumption.

Too much news adds to anxiety and stress. Limit yourself to one or two credible news sources daily. For example, consider subscribing to a daily email briefing and call it good; both local and national sources are available.

Stay Connected

Reach out to friends and family, both near and far.

Host virtual happy hours, games, and scavenger hunts from your home. Challenge yourself to contact people with whom you haven't talked for months. You can use video platforms, like Zoom, or just call them!

Spend quality time with household members.

Make a pizza together. Slow dance with your partner. Build a fire in the fireplace or fire pit. Organize a guitar sing-along or a drum circle. Amuse your pet with his favorite toys. Watch a slideshow of your favorite family vacation.

Stay active in your community.

Check if your favorite groups are now meeting online, including your support group, religious congregation, book club, 12-step meeting, etc. Support local businesses by live-streaming their yoga or meditation classes, or by ordering your favorite restaurant meals as takeout.

Volunteer.

Lend a hand at a local foodbank or animal shelter, or volunteer from your home. Helping feels good - and it strengthens your immune system! Check out some local opportunities.

Attend to Your Body

Get outside and connect with nature.

Garden in the yard, sit in the sun, walk barefoot in the grass. Watch the sunset, gaze at the stars in the night sky. Check out your neighborhood's parks and trails or purchase this guide for locals.

Move your body.

Go for a walk or bike ride. Stream yoga videos or workout videos. Play active video games. Get on your treadmill or stationary bike. Do some stretches. Purchase home workout equipment (like exercise bands and weighted balls) to simulate your gym routine.

Eat fresh foods.

Continue to bring home the fruits and vegetables you love (you need only wash them per the normal FDA recommendations).

Release Mental Tension

Let go.

Release ideas about what you should be doing and give yourself permission to enjoy whatever you are doing.

Laugh.

Stream stand-up comedy acts, watch some ridiculous video shorts, or listen to funny podcasts. Check out movie bloopers and auto-correct blunders. Tune into Denver's comedy radio station.

Listen to music.

Play your favorite artists on Spotify, Apple Music, or Amazon Music. Program Alexa (or your radio) to play classical music. Watch free live concerts on SongKick.

Have alone time.

Sit down with a good novel. Begin a DIY project. Create a virtual collage of images that inspire you. Add a splash of culture by touring museums online or checking out The Social Distancing Festival. Color a mandala. Do a Sudoku puzzle. Take an afternoon nap.

Relax.

Try these 1- to 3-minute breathing, mindfulness, grounding, and visualization exercises. Stream soothing nature sounds. Do guided meditations through apps or websites like Insight Timer, Calm, Headspace, or 10% Happier. Tune in here weekdays at 1pm MDT for a live daily dose of meditation and wisdom.

Keep it Real

Feel what you feel.

Anxiety, grief, frustration, uncertainty, isolation, helplessness, and being overwhelmed are common feelings right now. You are not alone! Acknowledge that you are experiencing distressing emotions. Talking, emailing, or journaling about these feelings will allow them to pass more naturally than if you let them build up. To hear how others are coping, listen to the weekly podcast At a Distance.

Do what you can.

Some things are within your control right now; but many things are not. Focus on what you can do to improve your situation and write them down; then let go of the things you cannot control. Worrying does not have the power to make anything better. Use this guide for a deeper dive.

Try different thoughts.

Try holding two feelings at once, such as "I can be anxious and I can be ok" or "This is really scary and I am safe right now" - Both/And. Another idea is to make a list of things you're grateful for - a list of what's not wrong. Include small things, like a good cup of coffee, your comfy chair, your dog's wagging tail.

Be gentle with yourself.

You may be less productive while working from home; feel your relationship is strained; find parenting is more stressful; gain weight with gyms closed and food available all day. Be compassionate with yourself! Judgments are painful and get in the way of creative solutions.

Stay present.

The first rule of difficult times is not to make things worse. Numbing behaviors will make things worse - like using alcohol or drugs, binge-eating, self-harming, compulsive online shopping or gambling, etc. If staying present is too intense, that's okay. Reach out to your mental health provider for the tools and support you need during these difficult times. You can also call or text Colorado Crisis Services 24/7 to connect with a peer or counselor.

Created in partnership with Laura Michaels, LPC, JD of Laura Michaels Counseling.

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A Stay-at-Home Sanity Guide - Common Ground Psychiatry

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Daily structure is important for purpose, productivity, and momentum. Weekend structure is important to break up the week - and for leisure! Here's how to get started. Too much news adds to anxiety and stress. Limit yourself to one or two credible news sources daily.

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Self Love Yoga  |  Full Class  |  Yoga With Adriene

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This module addresses the importance of integrating self-care strategies to manage moral distress and the impact of compassion fatigue.

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POLARIS 13 - Integrating Self-Care Strategies

Module 13: Integrating Self-Care Strategies Caring for those with serious illness can be difficult to cope with for the palliative care professional. This module addresses the importance of integrating self-care strategies to manage moral distress and the impact of compassion fatigue.

Successful completion of this module results in 2.0 hours of Nursing Continuing Education.

POLARIS Stand-Alone Individual Module Purchases: HPNA does not offer refunds or cancellation on individual stand-alone POLARIS module purchases.

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Item Detail - POLARIS 13 - Integrating Self-Care Strategies

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POLARIS 13 - Integrating Self-Care Strategies Module 13: Integrating Self-Care Strategies Caring for those with serious illness can be difficult to cope with for the palliative care professional. This module addresses the importance of integrating self-care strategies to manage moral distress and the impact of compassion fatigue.

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Happiness in Practice: Pearls for Sustainability

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Happiness in Practice: Pearls for Sustainability

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From HPNA

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Item Detail - Happiness in Practice: Pearls for Sustainability

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Happiness in Practice: Pearls for Sustainability Happiness in Practice: Pearls for Sustainability presented by Katy Lanz, DNP, AGPCNP-BC, ACHPN, FPCN. The magnitude and impact of stress and burnout have received much attention fromresearchers, however, evidence-based solutions to effectively and measurably address it have not been widely available until now.

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Supporting your mental health during Coronavirus

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Emergency Responders: Tips for taking care of yourself

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Emergency Responders: Tips for taking care of yourself

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From the CDC

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Responding to disasters is both rewarding and challenging work. Sources of stress for emergency responders may include witnessing human suffering, risk of personal harm, intense workloads, life-and-death decisions, and separation from family. Stress prevention and management is critical for responders to stay well and to continue to help in the situation. There are important steps responders should take before, during, and after an event. To take care of others, responders must be feeling well and thinking clearly.
People with preexisting mental health conditions should continue with their treatment plans during an emergency and monitor for any new symptoms. Additional information is found at the Substance Abuse and Mental Health Services Administration () website.

Substance Abuse and Mental Health Services Administration's (SAMHSA's) Disaster Distress Hotline: 1-800-985-5990 or text TalkWithUs to 66746.

People with deafness or hearing loss can use their preferred relay service to call 1-800-985-5990.

Preparing for a Response:

Try to learn as much as possible about what your role would be in a response.

If you will be traveling or working long hours during a response, explain this to loved ones who may want to contact you. Come up with ways you may be able to communicate with them. Keep their expectations realistic, and take the pressure off yourself.

Talk to your supervisor and establish a plan for who will fill any urgent ongoing work duties unrelated to the disaster while you are engaged in the response.

During a Response: Understand and Identify Burnout and Secondary Traumatic Stress

Limit your time working alone by trying to work in teams.

Responders experience stress during a crisis. When stress builds up it can cause:

Burnout - feelings of extreme exhaustion and being overwhelmed.

Secondary traumatic stress - stress reactions and symptoms resulting from exposure to another individual's traumatic experiences, rather than from exposure directly to a traumatic event.

Coping techniques like taking breaks, eating healthy foods, exercising, and using the buddy system can help prevent and reduce burnout and secondary traumatic stress. Recognize the signs of both of these conditions in yourself and other responders to be sure those who need a break or need help can address these needs.

Signs Of Burnout:

Sadness, depression, or apathy

Easily frustrated

Blaming of others, irritability

Lacking feelings, indifferent

Isolation or disconnection from others

Poor self-care (hygiene)

Tired, exhausted or overwhelmed

Feeling like:

A failure

Nothing you can do will help

You are not doing your job well

You need alcohol/other drugs to cope

Signs of Secondary Traumatic Stress

Excessively worry or fear about something bad happening

Easily startled, or "on guard" all of the time

Physical signs of stress (e.g. racing heart)

Nightmares or recurrent thoughts about the traumatic situation

The feeling that others' trauma is yours

Get support from team members: Develop a Buddy System

In a buddy system, two responders partner together to support each other, and monitor each other's stress, workload, and safety.

Get to know each other. Talk about background, interests, hobbies, and family. Identify each other's strengths and weaknesses.

Keep an eye on each other. Try to work in the same location if you can.

Set up times to check-in with each other. Listen carefully and share experiences and feelings. Acknowledge tough situations and recognize accomplishments, even small ones.

Offer to help with basic needs such as sharing supplies and transportation.

Monitor each other's workloads. Encourage each other to take breaks. Share opportunities for stress relief (rest, routine sleep, exercise, and deep breathing).

Communicate your buddy's basic needs and limits to leadership - make your buddy feel "safe" to speak up.

Read morepdf icon about the buddy system.

Responder Self-Care Techniques

Limit working hours to no longer than 12-hour shifts.

Work in teams and limit amount of time working alone.

Write in a journal.

Talk to family, friends, supervisors, and teammates about your feelings and experiences.

Practice breathing and relaxation techniques.

Maintain a healthy diet and get adequate sleep and exercise.

Know that it is okay to draw boundaries and say "no."

Avoid or limit caffeine and use of alcohol.

It is important to remind yourself:

It is not selfish to take breaks.

The needs of survivors are not more important than your own needs and well-being.

Working all of the time does not mean you will make your best contribution.

There are other people who can help in the response.

Responding to disasters can be both rewarding and stressful. Knowing that you have stress and coping with it as you respond will help you stay well, and this will allow you to keep helping those who are affected.

After the response: Family and Work-life

These are some resources responders can share with their family members and co-workers:

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Emergency Responders: Tips for taking care of yourself

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Responding to disasters is both rewarding and challenging work. Sources of stress for emergency responders may include witnessing human suffering, risk of personal harm, intense workloads, life-and-death decisions, and separation from family. Stress prevention and management is critical for responders to stay well and to continue to help in the situation.

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Andy Puddicombe: All it takes is 10 mindful minutes

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When is the last time you did absolutely nothing for 10 whole minutes? Not texting, talking or even thinking? Mindfulness expert Andy Puddicombe describes the transformative power of doing just that: Refreshing your mind for 10 minutes a day, simply by being mindful and experiencing the present moment.

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Resources from AAHPM

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Resilience and well-being is a challenge not just for those in hospice and palliative care, but for all of medicine. Although evidence suggests that organizational factors such as workflow disruptions associated with documentation in the electronic health record play a larger role than personal factors in driving clinician distress, there are things each of us can do to boost our own well-being.

These resources will help you think about new ways to build resilience for you, your team, your organization, and the healthcare community. As we work together to affect policy change and improve our systems, we hope to find ways to renew our spirit and continue to find joy in our work.

Videos and presentations

View these inspiring videos to help lift your spirits and build resilience:

View our town hall presentation slides:

Watch these online educational modules from the American Medical Association:

Articles

Read these articles and reports:

Prevalence and Predictors of Burnout among Hospice and Palliative Care Clinicians in the U.S.", Journal of Pain and Symptom Management (free to AAHPM members and journal subscribers)

It Is Like Heart Failure. It Is Chronic...and It Will Kill You": A Qualitative Analysis of Burnout Among Hospice and Palliative Care Clinicians, Journal of Pain and Symptom Management (free to AAHPM members and journal subscribers)

Help Hands Needs a Break, Too: How to Lend Support Without Burning Out, National Public Radio

The Precious Necessity of Compassion, Journal of Pain and Symptom Management (free to AAHPM members and journal subscribers)

Physician Lifestyle & Happiness Report: Physicians' Life Beyond Work, Medscape (requires free login)

National Physician Burnout and Depressions Report, Medscape (requires free login)

Charter on Physician Well-being, JAMA Network (full text requires subscription)

IHI Framework for Improving Joy in Work, Institute for Healthcare Improvement.

How Storytelling Can Help Young Doctors Become More Resilient, Harvard Business Review

Remembrance: A Self-Care Tool for Clinicians, Journal of Palliative Medicine (full text requires subscription)

Breaching the Professional-personal Boundary - An Unrecognized Risk for Burnout, New England Journal of Medicine (full text requires subscription)

External Organizations

As a member of the Council of Medical Specialty Societies, AAHPM has been actively engaged in the efforts of the National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience and has joined the network of organizations that is committed to reversing trends in clinician burnout.

Visit these sites for additional resources:

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American Academy of Hospice and Palliative Medicine

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Resilience and well-being is a challenge not just for those in hospice and palliative care, but for all of medicine. Although evidence suggests that organizational factors such as workflow disruptions associated with documentation in the electronic health record play a larger role than personal factors in driving clinician distress, there are things each of us can do to boost our own well-being.

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Emotional Coping Strategies for COVID-19

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Emotional Coping Strategies for COVID-19

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The COVID-19 novel coronavirus pandemic is turning the world, inside and outside of the hospital, upside down. Not only are oncology nurses seeing high demands at work, but changes and restrictions are being instated at home as well.

As nurses, we pride ourselves on being resilient and able to take on anything that comes our way, but this is something that none of us has ever experienced, and the unknown is stressful. Because we don't know how long the pandemic will affect our communities and patients, we must stay proactive in identifying if our stress levels are rising and finding ways to manage it before it becomes too much.

During incidents such as disasters or infectious outbreaks, healthcare workers can experience a buildup of stress that can lead to burnout or secondary traumatic stress (STS) reactions. According to results of a research review published in the Journal of Trauma Nursing, STS is "triggered from exposure to persons who have experienced trauma and from giving care to such persons." But recognizing signs of stress and using coping techniques can help.

Signs of secondary traumatic stress can manifest as:

To cope with stress, try implementing the following suggestions:

These times can be emotionally taxing, but ONS is your resource for professional support and guidance. Remember: you are not alone; we are all in this together. Check out some of ONS's self-care podcasts and articles, and learn more about COVID-19 on the ONS resource page. Finally, ask questions and discuss solutions with other nurses on the ONS COVID-19 Community so we can all figure this out together.

To discuss the information in this article with other oncology nurses, visit the ONS Communities.

To report a content error, inaccuracy, or typo, email pubONSVoice@ons.org.

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Emotional Coping Strategies for COVID-19

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The COVID-19 novel coronavirus pandemic is turning the world, inside and outside of the hospital, upside down. Not only are oncology nurses seeing high demands at work, but changes and restrictions are being instated at home as well.

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From the Supportive Care Coalition

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In a 2014 survey, 61% of over 1200 palliative care professionals self-reported "high" levels of burnout. According to the Clinician Well-Being Hub sponsored by the National Academy of Medicine, burnout is "a syndrome characterized by a high degree of emotional exhaustion and depersonalization (i.e. cynicism) and a low sense of personal accomplishment at work." Given the individual and systemic elements of burnout, efforts to lessen its occurrence must include resources to address individual well-being and organizational flourishing.

We at the Supportive Care Coalition seek to do just that -- improve professional flourishing, well-being, and overall resilience at both the personal and organizational level -- by sparking new thoughts, encouraging new practices, and deepening our self-awareness. To that end we have created the "Cultivating Professional Resilience" weekly blog. Read the blog posts on your own and journal your responses. Or, better yet, use the blog posts as a team to spark reflection and dialogue.

"We can grow stronger at the broken places" - Rachel Naomi Remen

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Caregiver Well-Being - Supportive Care Coalition

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In a 2014 survey, 61% of over 1200 palliative care professionals self-reported "high" levels of burnout. According to the Clinician Well-Being Hub sponsored by the National Academy of Medicine, burnout is "a syndrome characterized by a high degree of emotional exhaustion and depersonalization (i.e. cynicism) and a low sense of personal accomplishment at work."

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It's More Common Than Most Think

Nurses face immeasurable exposure to traumatic events in their roles as first responders and caregivers to the communities we serve. Those who work in specialty areas such as the emergency department (ED), intensive care (ICU), mental health services, and trauma are at particular risk for bearing witness to the human atrocities that can shake the psychological foundation of any person.

With care and compassion acting as the core of nursing fundamentals, who cares for the caregiver when the strain of trauma is too overwhelming? ‍

Sadly, nurses themselves are failing to recognize the illness in themselves and seek treatment.‍

For many years in American history, the concept and diagnosis of post-traumatic stress disorder (PTSD) was reserved for those brave men (and only men) who witnessed the horrific shock of war. Historians point as far back to 1597 to Shakespearean plays where symptoms of traumatic experiences are described. Even Civil War nurse Walt Whitman describes terrifying nightmares and flashbacks of the war in many of his mid-1800 writings.
‍

For men who directly experienced war, the symptoms were described as exhaustion, shellshock, combat fatigue, and "soldier's heart." It was not until the 1960s that researchers began studying the effects of trauma on the civilian population, and it wasn't until the late 1970s that the Diagnostic and Statistical Manual of Mental Health Disorders (DSM) included PTSD as a valid diagnosis.

The description for PTSD in the DSM lists, "The essential feature [of PTSD] is the development of characteristic symptoms following a psychologically traumatic event." Symptoms involve the "re-experiencing of the traumatic event, numbing of responsiveness to, or reduced involvement with, the external world, and a variety of autonomic, dysphoric, or cognitive symptoms."
‍

The Development of PTSD and PTSD in Nurses Today

As the label has evolved, the diagnosis of PTSD now includes the aftereffects of trauma associated with domestic abuse, war-zone reporting, and vicarious trauma. Loss of sleep, nightmares of the event, irritability, and frequent startling to minor noises are all well-publicized symptoms, which, if lasting more than six months, are considered diagnosable as PTSD. ‍

Other lesser-known and easily missed symptoms of nurses with PTSD can include a form of hyper-vigilance where the nurse is hyper-focused on stable patients, being irritable or frequently angry, and feeling detached from friends and family. ‍

Another subtle symptom is the nurse with an exaggerated negative belief: "If I were a better nurse, then I would have caught that patient's decline." Difficulty concentrating, avoiding certain rooms where they experienced trauma, and non-specific somatic complaints such as body aches, headaches, and lack of overall energy. Nurses with PTSD may be calling out sick more often as a protective mechanism.

And with increasing reports of a nursing shortage in the US, American nurses are only going to have more pressure put on them.

There are very few studies that seek to show the rate or potential of traumatic stress disorders in nursing. However, one study published in Depression and Anxiety (2009) noted that as many as 22% of the 810 nurses who participated in the study had symptoms of PTSD with more than 18% meeting diagnostic criteria. Richard Avila, MBA, RN, is one such nurse that was diagnosed with PTSD long after he had moved into a less-stressful role as a corrections nurse: ‍
"My first role as an RN was in correctional health... If there was a behavioral issue with the inmate, the deputies will step in and handle the patient. My next role changed everything. I was hired as the 'muscle' nurse for a high-acuity behavioral health hospital... where violence against the staff was a common occurrence. They paid well, and I worked a lot of overtime, which contributed to my burnout. I lasted a year there, but the constant stress from the patient violence got to be too much. I wasn't sleeping, I was reactive to my family and friends, and I had a hard time being in large crowds. It reminded me of how my dad described himself after coming back from Vietnam. I thought the symptoms would go away once I switched jobs, but they didn't. I finally got help from a therapist I saw weekly and was diagnosed with PTSD. I'm much better now. I work 40 hours a week (compared to 60+) and take time for relationships and more self-care activities."
Not all people who experience the same trauma event end up with symptoms of PTSD.‍

Patricia Pearson, RN, LMFT, who specializes in PTSD, states, "It is not just about the severity of the trauma experienced, but more about a person's experience of multiple traumas over time that can have a significant effect on a person with PTSD... Those nurses who have experienced complex trauma (multiple trauma's overtime), such as an abusive childhood, could be at a higher risk for PTSD."
‍

PTSD in Nursing, What Can Be Done?

Nurses experiencing PTSD need an environment where they feel heard and understood by their peers and leadership. Unfortunately, many nurses believe their suffering is prolonged when nurse managers fail to recognize PTSD and don't provide support beyond the Employee Assistance Program (EAP) referral. This can often result in alternative means of coping, sometimes taking the form of drug addiction.

Yet, most EAP clinicians aren't trained to recognize and treat trauma. According to Pearson, Eye Movement Desensitization and Reprocessing (EMDR) and Brainspotting are the gold standards for helping those suffering from PTSD process the trauma and begin to heal. If nurses suspect they have PTSD, they should seek clinicians trained in trauma therapy.

One nurse, who wished to remain anonymous, stated that, in spite of numerous traumatic births in her Midwest labor and delivery unit, peers and managers advised her to "stop talking about it." She sought treatment from a psychiatrist and, in spite of therapy and medication, still had a challenging recovery and eventually left the specialty as she continued to have fear and anxiety during routine births: ‍
"I chose to embrace this as an opportunity to bring about positive change, not only for myself but for the profession. My Master's Degree research project became focused on this area: 'Burnout, Compassion Fatigue and Vicarious Trauma among Obstetric Nurses.'"
"PTSD is not a sign of weakness," Pearson states. "It's the brain's way of protecting us from harmful experiences. The brain encapsulates the event, similar to how the body encapsulates a tuberculosis spore, yet any of our five senses can trigger the nurse to re-experience levels of the event."

While few studies validate the occurrence of PTSD in the nurses, shining a light of awareness into the dark corners of the nursing profession by openly discussing the probability and direct experiences of nurses -- whether they be of emotional, mental, or physical abuse -- is a start. ‍
‍

‍

By remaining silent about their struggles, nurses add to the stigma or "shame" of admitting psychological challenges in managing traumatic experiences.‍

Through trusting relationships with managers who are willing to dig deeper with staff on a routine basis and offer substantial debriefing sessions after traumatic events in a department (and supportive peers), PTSD symptoms can be addressed and treated in a timelier manner.

Caring for those who provide care is essential to the longevity and mental endurance of our profession.

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The Sound of Silence: The Occurrence of PTSD in Nursing - Trusted Health

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Nurses face immeasurable exposure to traumatic events in their roles as first responders and caregivers to the communities we serve. Those who work in specialty areas such as the emergency department (ED), intensive care (ICU), mental health services, and trauma are at particular risk for bearing witness to the human atrocities that can shake the psychological foundation of any person.