Self-Care Strategies for the Overworked School Nurse When Giving Your All Doesn t Feel Like Enough Katie Frisbie, MC, LMHC Objectives Identify signs of compassion fatigue and burnout and take steps to feel better Learn new ways to define success and feel good about the work that you do Discuss ways to reconnect with the joy of the work that brought you into the field of School Nursing Mantra: Look Where You Want to Go You life will go in the direction that you are looking and expending your energy 1
Challenges Of the job High workload, fast pace High need for accuracy Staff shortages Vicarious trauma Stringent requirements Of the person Always puts others before self Difficulty saying no Perfectionist Consistently giving out more energy and compassion than they receive A Vulnerable Profession Insufficient time for debriefing job stress and vicarious trauma Personal history of unresolved grief/trauma Professional isolation Personal & professional value of stoicism/self-control A tendency to overuse numbing strategies A work setting that pushes nurses beyond reasonable workload limits When helpers need help Ready to help others, but resistant to asking for help As a helping professional, I should be able to help myself I know what to do I just need to do it Fear of judgment from supervisors & peers May not even recognize the problem Hear from others, You of all people should know 2
Stresses for the School Nurse IEP meetings Dispensing daily medications to students Health Assessments Parents of the students Immunizations H1N1? Health Screenings Student Study Teams Frequent Flyers Isolation Support multiple schools Heed the warning signs! Check Your Symptoms Physical Symptoms Behavioral Changes Emotional Symptoms Thought Signs 3
How do you feed your stress? The Stress Cycle Stressor Tension in body Negative Responses Discomfort & anxiety Break The Stress Cycle Recognize your signals Stop step back, breathe Ask yourself Is it important? Is it worth getting upset about? What can I do about it? Relax self-relaxation exercise Think consider options & choose 4
Bounce Back Assignment Step 1 Become physically aware. Step 2 Become emotionally aware. Step 3 Become aware of your impulses. Step 4 Become aware of consequences. Step 5 Become aware of alternate solutions. Step 6 Become aware of the benefits of the alternate solutions. Signs of burnout No job satisfaction No energy, struggle to get to work Less concern for detail or quality Feel hopeless, nothing matters Feel like a hamster on a wheel Can t motivate self to make changes Doing only the minimum required Compassion Fatigue Depersonalization measures an unfeeling and impersonal response toward recipients of one's service, care treatment, or instruction Emotional exhaustion measures feelings of being emotionally overextended and exhausted by one's work Personal accomplishment measures feelings of competence and successful achievement in one's work 5
Wellness Spectrum Stressed or Distressed Experiencing significant stressors, but work is not significantly impacted and is still rewarding Burned out/compassion Fatigue Experiencing significant stressors, work is somewhat impacted no longer brings satisfaction or fulfillment Impaired Significant negative impact on professional functioning, compromised patient care Impact 10% of all nurses are impaired at any one time 90% are not impaired and can avoid impairment with good self-care Nurses who are not impaired will do better work and will be more able to derive continued job satisfaction, avoid compassion fatigue, and remain in the field Causes of Compassion Fatigue for School Nurses Demands of the job Doing more with less More rules and regulations that require increased paperwork Unrealistic deadlines Self-imposed pressure to live up to your own high standards How we define success? 6
Defining Success You can t be perfect 100% of the time You can t please every coworker or every parent Rarely will you be able to say that you did everything you set out to do in a day So, what is success in school nursing? What is Success in School Nursing? You are a vital part of the preventative care, treatment and learning process for students Seeing students able to heal, see their lives change and see them able to learn as a result of your care Giving every person student you work with the sense that he or she is cared about no matter how difficult the situation. You are making a difference everyday! Remember the Good Stuff Calming patient s fears & establishing safety after a traumatic event or diagnosis Supporting the student learning process Helping your facility develop high-functioning, productive processes Variety, creativity, rarely boring Doing work that you love Making a difference in student s lives Helping teachers teach about health issues No night shifts at the hospital/time off 7
When that still doesn t feel like enough? Communicate your limitations Do not assume that coworkers understand the challenges you are facing Ask for help when you need it Don t wait until someone offers Address problems directly when they arise Don t personalize systemic problems Give yourself credit for what you do, instead of guilt for what you don t Facing Imposed Change Don t Rush it Expect to have a reaction Don t take it personally Go with the flow Don t go it alone Don t focus on the negative Break it up into smaller pieces Learn from it Balance your life Know that it will end Commit to Self-Nurturing How do you revitalize? Regular Exercise and consistent sleep Drink plenty of water Interests outside of work Relaxed meals Time with friends and family Spiritual activities Meditation, Yoga, Acupuncture Avoid negative conversations Vacation 8
Your Own Self-Nurturing Plan Your plan will be personal, but here are three things that may help: 1. Quiet time alone self-reflection 2. Recharge your batteries daily 3. Hold one focused, connected, meaningful conversation each day Ask yourself Where am I on the Wellness Spectrum? What are my triggers and negative behavior patterns? What are my strengths? Challenges? What are my areas of unresolved grief? What sustains me? What gives me energy? What do I need in order to feel better or avoid potential burnout/compassion fatigue? How do I define success? Partnership Exercise What is one work situation that is draining you or taking away from the joy you get from your job? How do you take part in it (what is your role) or avoid addressing the problem? What would it take for you to take steps to improve your situation or your attitude? Make a commitment to one behavioral change/step that you will make in the next week that will lead you to, or at least, a step closer to positive change in your situation. 9
Suggested Readings Blow a Bubble Not A Gasket 101 ways to reduce stress and add fun to your life, by Janie Walters Attitude is Everything 10 life changing steps to turning attitude into action, by Keith Harrell The Bounce Back Book How to thrive in the face of Adversity, setbacks, and losses, by Karen Salmansohn Quote for the Day If you want the light to keep burning, you have to continue to fill the lamp Mother Teresa Questions? 10