Some experts in the field are consistently coming forward with books, papers and articles whose goal is to help nurses deal with bullies, bullying and harassment, and some facilities and schools of nursing are implementing educational programs to counteract this terrible mini-epidemic within our profession.

Bullies generally choose targets who are perceived as weak or vulnerable in some way, and new nurses and older nurses are frequently chosen by those who thrive on intimidating others.

We have all probably seen a bully in action, and this person may use verbal or physical intimidation or threats, passive-aggressive behavior such as ignoring the targeted nurse. Some bullies may even go out of their way to assure that the target nurse gets in trouble or lacks the support she or he needs to get their job done safely.

Speaking of safety, nurses and patients can be endangered by bullies, in that bullies can refuse to help nurses who truly need assistance with specific patient-related tasks, and this can easily result in patients not receiving proper care. When bullies refuse to help fellow nurses who are in need when conducting patient care, the nurse may then be in danger as she or he performs a task that cannot realistically be performed alone in a safe manner, and injury to the patient or the nurse may result.

Standing up to bullies can be scary, and it seems that bully nurses often hold a great deal of personal and professional power within a unit or facility. In fact, managers and administrators may themselves be afraid of the bully, giving him or her even more power as the bully gains further control by being “above the law” within the workplace.

When we stand silently in the face of bullying, we are condoning this terrible and unacceptable behavior by our very silence. If you are not comfortable confronting a bully yourself, seek allies in administrators, supervisors and coworkers who will support you in your efforts. Bullies feel empowered when they are not confronted, so we need to join together when it’s time to put a bully in his or her place.

We’ll talk more about bullying in the months to come, so stay tuned for more posts about the important contemporary workplace issue.

As nurses, we can wait to be acknowledged and thanked, and we can also (perhaps rightfully) feel disregarded when Nurses Week passes without a word. However, we can also take the opportunity to celebrate ourselves, and that is sometimes the sweetest recognition of all.

I make no apology for being a champion and cheerleader for our profession. I see nurses’ importance to the nationwide and worldwide healthcare infrastructure, and I have no doubt that nursing and nurses will play an enormous role in the success of healthcare reform in the United States.

We work hard, and we care for everyone from schoolchildren to the dying. We birth babies, give injections, practice as independent Advanced Practice Nurses, and we staff a multitude of agencies and facilities in cities, suburbs, towns and rural communities. Nurses serve in prisons, long term care facilities and doctors’ offices, and the nursing process and critical thinking skills inform our every decision and action.

Nurses are the backbone of the healthcare industry, and no matter how cliche it may sound, our importance cannot be underestimated.

How do you feel about nursing? Are you proud of your identity as a nurse? Are you burned out or feeling great? Is nursing just a job to you, or do you feel like it’s a calling or a personal mission? Do you feel appreciated or unrecognized? And do you know how important you truly are?

I would love to know how you feel about being a nurse, whether it’s negative or positive. There’s room for everyone under the nursing tent, and whether you know it or not, there are many of us who care about you, our profession, and the growth of nursing as a health, vibrant part of the healthcare infrastructure.

Let us know how you feel. And we send you our gratitude every day, not just during Nurses Week.

99 Best Journals and Publications for Nurses

“Reading scholarly publications and new research about nursing is an important way for nurses at any stage of their career to keep up with the quickly transforming field. There are hundreds of nursing journals that cater to every possible nursing specialty, and some that are more general and relevant to nurses in every niche. Reading a broad range of journals and publications on nursing is a great way for students to choose their eventual area of specialization as well. By following the research trends and innovations in various fields, a student can see which specialties have the most interest and growth potential for them.”

Nurses’ ability to earn the trust of so many people most likely comes from the fact that we perform most of the actual direct care that patients receive, thus the likelihood of deservedly earning their trust is high.

There is a great deal to be proud of during Nurses Week, and I encourage every nurse I know to honor themselves and the work that they do. You can honor yourself in any way you choose, whether it’s going out to dinner, giving yourself a pat on the back, or maybe just reflecting on what you love about being a nurse.

And if you want to really do something nice for yourself during Nurses Week, maybe you’ll want to schedule a massage, make an appointment for a haircut, buy yourself a book or CD, or take yourself to a special place you’ve been wanting to visit.

Sometimes, we nurses don’t feel altogether acknowledged for our strengths and dedication, and the Nurses Week gifts that we receive at work (if we receive any at all) can often be disappointing. Therefore, doing something special for ourselves is paramount (and a good sign of high self-esteem and self-worth).

Whether you buy yourself a special gift or simply take a moment to give yourself the acknowledgement that you rightfully deserve, it’s important to pause for the cause of Nurses Week and deeply feel how important being a nurse can be. We all choose this profession for a variety of reasons, but no matter how you got here, acknowledge that you’re here, that you do your job well, and that you recognize the importance of what you do.

Happy Nurses Week! Care for yourself well–today and every day.

Depersonalization–like we discussed last week–is one way to remain as emotionally neutral as possible, even under stress. And learning to not take things personally is a means of self-protection that can be very important when working in a setting that necessitates a great deal of person-to-person interaction.

How else can you protect yourself at work? You don’t want to wall yourself off emotionally and be an emotionless robot, but you also don’t want to be an emotional sponge who soaks up everyone’s feelings, projections and fears.

Equanimity

For me, equanimity is the energy that I like to embody at work whenever I can. Equanimity shares the same root with the word “equal”, and it’s about being equally calm and collected no matter how the outer circumstances may appear. This isn’t easy to do, but it’s a great goal to strive for.

Again, equanimity does not mean that you’re emotionless. It does mean, however, that you are able to stay centered and not get “hooked” by circumstances, other people’s words or actions, or even your own fears and feelings. This is not easy to do, but staying in that centered, calm place is healthier for you, allows you to stay focused on the task at hand, and can also have a ripple effect on those around you.

Staying Centered in the Storm

Do you know those moments when all hell breaks loose but you somehow remain calm and collected? Have you ever been present during a code and been able to remain “above the fray” and not get “hooked” into the drama of the moment yet still do your job well? (In fact, you probably did your job better than those who were in panic mode.)

Well, that ability to remain centered as the world around you becomes stormy is just what equanimity is about, and when you can practice that tool in a variety of circumstances and situations, it will increasingly become second nature.

We’ll discuss self-protection more as the months go by, so tune in again and we’ll continue to delve into ways to remain healthy, balanced and centered, even when things get crazy!

One of the first skills to master is the ability to “depersonalize” anything that happens around you–or to you. This is a very difficult skill to develop, yet it can truly be one of the keys to “keeping your head” when the going gets tough.

Depersonalization means that you have the ability to see what someone else does or says–even in relation to you–and not react to it as if it actually has something to do with you. Does this sound difficult? It is, but it’s well worth considering.

Now, I’m not talking here about the psychiatric or psychological idea of depersonalization wherein you dissociate from reality. That is “depersonalization disorder” and is a whole other kettle of fish.

What I’m talking about here is the concept of being able to separate yourself from what others do or say–or the circumstances in which you find yourself–and not take them personally. While we don’t have time and space in this short blog post to go deeply into the concept of psychological projection, suffice it to say that we humans frequently will “project” our own feelings or motivations onto others and then blame others for feelings or actions or motivations that are actually our own. (Simplistically, we could just say that what we dislike within ourselves we will very often see in others and deny that we do the very same thing ouselves!)

So, when a colleague, patient or other person treats you poorly or says something to you that “pushes your buttons”, one of the first things to do in this circumstance is to take a deep breath, refrain from reacting in any way, and consider whether what that person has said is actually true, or if perhaps they are “projecting” their own feelings (of hopelessness, powerlessness, etc) onto you without even knowing it. Chances are, if you can see that person with compassion for the wounded, confused and struggling human being that they are (as, in fact, all of us are), you may be able to “unplug” from what they have said or done and take it in stride–and in context.

Please note: this is not meant to be an excuse for the bad behavior of others, but it is meant to be a tool wherein you can disconnect from your reactions to others’ behaviors or words and protect yourself from emotional reactions that can harm you and cause you unnecessary stress.

We will discuss these ideas more in subsequent posts, and expand on the ideas of projection, self-protection and other concepts important for decreasing your levels of stress and creating more harmony for you, both in your personal and professional life.

As soon as the twin explosions rocked the area around the Boston Marathon finish line on Monday, April 15th, those nearby snapped into action and began clearing obstructions, tending to the wounded and otherwise pitching in as a chaotic scene unfolded. Videos show EMS, police, civilian bystanders and others rushing to the scene and making themselves an integral part of the spontaneous team of rescuers.

Meanwhile, reports have come in showing that off-duty hospital staff–including nurses, surgeons, doctors, and others–rushed to their respective workplaces in order to bolster overwhelmed staff who were beginning to receive reports of mass casualties being ferried to Boston area hospitals and trauma centers.

Alert to what is needed when disaster strikes, nurses and other professionals throughout the city raced to their workplaces in hopes of being of use in a moment of devastation and tragedy.

We nurses are excellently trained in the assessment of patients, but many of us are also quite skilled at assessing situations and groups. In times of crisis, it’s a powerful thing to know what one is capable of and how to utilize your skills so that they can be a force for calm and healing, even under great duress.

Taking into account what happened in Boston, do you know what you would do in similar circumstances? If you were present for a mass shooting, terrorist attack, bombing or other disaster, what personal resources would you call upon in order to be effective, calm, and useful? What skills would you like to develop so that you could be even more effective in such circumstances? How would you optimally like to react in these types of situations, and where do you feel you need more training in order to be effective when called upon?

Since we are all potential bystanders, victims, or responders in the event of mass disasters, it’s helpful to recognize our fears, acknowledge areas where we want more training or experience, and enumerate and identify those areas where we feel our skills are most developed and ready for action.

We don’t want to think that we may be witness to such devastation in our lifetime, but if we happen to be, it’s a great comfort to be prepared on all levels for such an eventuality.

Something tells me that this “oxygen mask” idea relates to nurses. Can you see how?

Nurses love to care. We love to be caring, and we love to be needed. Some of thrive on being needed, and we live for what we do. Some of us may only display that caring at work, but I bet a lot of us are needed at home too, and maybe even in our neighborhoods and communities. It feels good to be so needed and so important. But we pay a price.

Nurses who spend all of their time caring for others but not for themselves run a great risk of burnout and compassion fatigue. Nurses who live to care for others may often forget to care for themselves, burning the wick at both ends until there’s no wick left.

When a nurse has no wick left, she or he is jaded, angry, tired, burned out, and moves into that space beyond caring. Patients become numbers and diagnoses, and their faces and identities fade into the background.

The nurse with no wick left has little patience for her patients, but also for her coworkers, colleagues, family, friends, children, pets and home. She or he also has little or no patience for herself. Her needs are buried below mountains of shame, anger and the ignoring of basic necessities: rest, relaxation, leisure, fun, self-care. This burned out nurse is burnt to a crisp, and sometimes she or he is so far gone that she or he is blind what even happened, if they even recognize it at all.

So, nurses, put that oxygen mask on first. Take care of yourself, be true to your needs, allow yourself the time to rest, rejuvenate and renew yourself. Yes, you can care until the cows come home, but eventually, without adequate self-care, your caring becomes a shell of what it used to be.

Nurse, the first person to care for is yourself. And when you’re well-oxygenated and care for, the rest just comes naturally.

There’s no arguing that nurses have a lot to accomplish in the course of a shift. There’s also no arguing that the seemingly never-ending list of tasks to accomplish seems akin to the mythical Sisyphus rolling a boulder up a mountain each day, only to have it roll back down, the poor condemned man having no choice but to begin his useless task once again. (Perhaps Sisyphus may often seem like a fitting symbol for the 21st-century nurse.)

However, even as we strive to do everything that’s expected of us in terms of tasks, we also need to take a moment to connect with the person who truly makes our job exist in the first place: the patient.

This patient is not an inanimate rock that we have to roll up a hill before we give report and go home. He or she is a human being with feelings, fears and trepidations, and part of our job is to comfort, educate, reassure and otherwise connect with this person with an appropriate level of intimacy and compassion.

When we’re involved in home care, it may likely be easier to keep the patient foremost in our mind, especially since there are no colleagues, machines and sensory distractions like there are in the nursing home or hospital. In the patient’s home, there may be chaos, noise, children, visitors and pets, but it’s generally no match for the whirring energy of the hospital floor.

Meanwhile, in the hospital, there are physician rounds, overhead paging, telephones, visitors, beepers, incoming orders, codes being called, and a plethora of tasks that simply have to be accomplished, usually all at the same time.

So, no matter the venue or the location, connecting with the patient, looking into their eyes, is key, and we must “remember to remember” that the patient is the reason we’re there in the first place.

When you notice that you haven’t even looked at your patient after walking into their room, or you’ve been thinking about the patient in terms of their diagnoses rather than their personal information and history, it’s time to reconnect and remember that the nurse-patient connection is paramount, and it’s your responsibility to maintain and nurture that bond.

We adults are very good at making everything a chore. Email, bills, housework, cooking, shopping–there’s always so much to do. We even make exercise a chore by dreading going to the gym and resisting the “work” of making time for a walk in nature or a chat with a friend. This is unfortunate and sad.

Children laugh and smile hundreds of times per day, and although we adults have many responsibilities that can “assist” us in losing our laughter and our smile, scientific evidence shows very clearly that laughter and smiling have biochemical effects on our brain that can make us happier, more productive, and even longer-lived. Yes, laughter and smiling can help you to live longer and be healthier, so why not make experiences that cause you to smile and laugh a habit?

Fun can be defined differently for different people. Some of us have fun while reading a good book, listening to music, doing a crossword puzzle, or watching funny videos on YouTube. Others might have more fun swimming, walking, having a picnic, running, or playing Frisbee. While I wouldn’t recommend that all of your fun be sedentary in nature, getting some fun in every day might sometimes call for quiet home activities, while at other times the most natural thing to do is go outside and move your body.

Fun doesn’t have to take a lot of time or cost a lot of money, but it should be something that naturally becomes a part of your way of being, your “modus operandi“. If you’re new to this idea, it might mean “scheduling” fun at first–like a walk in the park or a picnic. But once you get the idea and realize how good it makes you feel, you’ll start having fun because you feel the benefits, both long-term and short-term.

So, go ahead and schedule some fun every day for the next week. Then the week after that and the week after that. Pretty soon, you’ll be addicted to fun, and the hardworking nurse will also be a healthy, vibrant person who knows how to bring more joy into his or her life–and maybe even the lives of others!