I can almost guarantee you that these words have passed the lips of every nurse, at some point in their career.
This topic arose following today’s diary entry: https://choosetransformation.files.wordpress.com/2019/04/100419-1.mp4
Like many nurses, I work 12.5 hour shifts. My commute is 1 hour and 10 minutes each way. I wake up at 05:00, leave the house at 05:45, I get in again at 20:15 and usually go to bed around 21:30. Therefore, on a working day I am awake (ish) and on the go for 16.5 hours with little time for anything else.
Of course there are many good features of shift work; I can work full time and only have to this absurd routine a few days/ nights each week. Sometimes I get treated to 5 or 6 days off in a row, which is a huge plus. And, I can do whatever I fancy on weekdays, without the usual weekend crowds.
However, there are down sides. Nights- Ugh (Not so bad in a row, but after a mix of days and nights I’m bordering on psychotic). Planning on attending a group on the same day each week? Forget about it. Public holidays… Hm, what are they? Social life? PAH! Who needs one…
A long shift can either fly by (usually when you’re busy) or feel like it’s dragging into next week and like any work place, there are good days and bad. Having a good team around you helps, but sometimes you just have one of those days where, no matter what you all do, everything that could go wrong, will go wrong.
I know when I’ve had one of those days, because I get home and realise that I am entirely exhausted; mentally, physically, emotionally and spiritually. I physically hurt; usually my head and my shoulders, from harbouring tension. I’m snappy, because I’ve used up all of my patience, empathy and compassion reserves, on my patients. I’m often hungry and dehydrated, because I’ve been snacking all day and haven’t stopped to have a proper meal. And more often than not, busting for the loo. I swear the bladder of a nurse can hold 2 litres more than average (though Anxiety would have you thinking otherwise).
But only when I really think about it, do I consider that it doesn’t have to be a bad day for me to feel like this afterwards. I have the honour of working with Military Veterans, living with mental health difficulties, including Anxiety Disorders, Depression and PTSD. I love my job. I can have the best day, successfully facilitate my groups, have lots of meaningful discussions and celebrate the gains that patients make in their therapy. But still get home, feeling the same way.
I thought about this after facilitating my Anxiety Management group. I like to use a glass to represent a person’s resilience and coping mechanism. First I add sand to represent early life, as certain childhood events will use up some of this space. I then add pebbles, to represent life events, such as marriage, bereavement, being made redundant. Finally, I add water, which represents negative self talk, thoughts and behaviours.
I ask how the glass of someone who has been in the Military might look different to a Civilians’ and usually, we agree that there would be a whole other layer, perhaps soil, representing Military training and Combat related experiences/ trauma.
The overall point of the exercise is to demonstrate that people do not have an infinite reserve of coping strategies and when our reserves run out, our glass will overflow and we will feel discontentment; Stress, Anxious, Depressed, even Suicidal. However, we can empty some of the contents of the glass, by ensuring there is an outlet. This might be, mindfulness, exercise, eating healthily, seeking help.
It makes me think. Working with this client group, with trauma; to be honest, any nursing setting, requires you to invest in your patients. Nurses are required to give so much of themselves, physically, mentally and emotionally and often, our own reserves are sacrificed, for the well being of patients. And it isn’t sustainable, which can leave you feeling burnt out.
Now this is the tricky bit… Having said all this and knowing what I know, have I put in place a proportionate outlet system, to balance this? Erm, no! Do I take the hour break to which I am entitled? No… I usually stay in the office eating snacks, looking at a computer screen instead! “I’ll just write up these notes”, “I could do that instead and it will free up my day tomorrow”, “It’s OK, I don’t need a break” “I don’t have time, there’s still so much to do”.
So here’s a message to anyone in a profession that involves working with people: We cannot continue to help others, if we do not help ourselves first! We are humans first, our profession second. I guess if it were a formula, it would look a bit like this:
Amount of mental, physical, emotional investment = Proportionate outlet, amount of self care required
I think I’ve finally cottoned on, to the fact that I am not a compassion machine with infinite reserves. The energy that fuels compassion is self care!
So, I’m going to take that hour in the day! I can eat, walk, meditate, listen to music, whatever! But I will turn off that computer, leave the office and make that hour my own. And if I feel burnt out at any point in the day, it’s OK for me to take myself away and enjoy a quiet moment, or talk to my Colleagues or ask for Supervision- that’s what it’s for. Being compassionate starts with me.