Nurses in Distress Everyday
Nurses seems inevitable that caring for patients in the high-stakes context of COVID-19 will take its toll on the mental health of nurses. A public health emergency on this scale makes the threat personal for nurses, as well as one they manage professionally: with inadequate and insufficient personal protective equipment (PPE) reported in many areas, nurses are anxious about their own welfare and that of their families.
Nurses make up the bulk of the healthcare workforce and are natural problem-solvers and innovators. We therefore stand out as indispensable at any time, but especially during a public health emergency. During the COVID-19 pandemic, nurses are experiencing pressure, fear, exhaustion, isolation and ongoing emotional trauma. This ongoing stress and trauma impacts your mental health, safety, and ability to provide the best possible care. Taking steps to manage your stress is just as important as taking care of your physical health! Many nurses are encountering unprecedented circumstances that may cause moral injury. This moral distress can be difficult to cope with and you may need additional support to address the damage it can cause. Symptoms of moral distress include self-criticism and intense feelings of shame, guilt, or disgust. It can also contribute to depression or post-traumatic stress disorder.
The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals worldwide. The outbreak of COVID-19 has laid unprecedented psychological stress on health workers. Medical workers have been facing enormous pressure, including a high risk of infection and inadequate protection, overwork, frustration which is causing different mental health problems such as stress, anxiety, depressive symptoms, and fear. Very little is known about the perceived risk of COVID-19, fear and psychological distress among the healthcare workers during the emergency of the COVID-19 Pandemic. Measuring and understanding mental health aspect of health workers is essential to fight COVID-19 in long turn. Thus, the study aims to find out the status of perceived risk of COVID-19, fear and psychological distress, and associated factors among healthcare workers in Nepal during COVID-19 Pandemic. It is everyone’s bounded responsibility to ensure the high morale high of the doctors,nurses, and health workers to defeat the corona virus together.Health workers knows well how to take precautions.All safety measures are being taken by hospital staff on corona virus duty assure that they do not carry any infection. The discrimination would demoralize them and derail the health sector. Health care staff are on the front-line working day and night selflessly in this nonresidential crisis. They are the heart and the soul of the war against corona virus. During this dark episode, the strength, dedication and kindness shown by doctors, nurse and healthcare workers is humbling. In different part of the world, Doctors, nurses and other health workers are lionized and cheered by homebound individual for contributing front-line defense against Covid -19.
Nurses often encounter similar situations in their careers. Despite their personal values, beliefs, and professional knowledge, they sometimes feel constrained and unable to do what they consider to be the "right thing" because of family preferences, workplace culture, lack of resources, institutional policies, and/or directives from supervisors. This phenomenon is known as moral distress. Nurses may feel alone when faced with this kind of dilemma, but the experience is believed to be part of daily professional life for some nurses. Moral distress varies between individuals depending on their own perceived obligations and values, and it has a negative impact on patient care and the nursing profession. Here, we'll examine moral distress and how nurses can address it
How COVID-19 is affecting nurses’ mental health ?
Worries and uncertainties about personal safety and the lack of PPE, workload, case complexity, skills mix, and loved ones’ health are among a vast range of stressors that cut across professional settings, Many nurses – mental health and community staff among them – have to deal with the stress of caring for patients and service users even while provision of PPE is inadequate..
Nine Healthy Ways to Deal with Distress:
1. Identify your needs.
“When we are in distress, we need something,” said Radle, who practices with Eddins at Eddins Counseling Group. She gave these examples: We may have an emotional need to feel accepted or heard. We may have a tangible need to have more help around the house. We may have an environmental need for peace and quiet. We may have a psychological need to treat ourselves with kindness. Naming your needs, Radle said, can be tough. In fact, most of her clients don’t know their needs. Instead, “They tend to get stuck on thoughts of, ‘I wish my life were different. I wish things weren’t this way. I wish I were more _____ or less ____. I just want to be happier.’”
When you’re feeling distressed, Radle suggested asking yourself: “What do I need right now?”
Your automatic response might be: “I need less stress in my life!” or “I just want to be happier!”
If so, keep asking questions: “What does that mean exactly? What does that look like? What does that feel like? What does that entail? How might that be achieved?”
2. Focus on what you want — not on what you don’t.
When thinking about your needs, it can be more helpful to focus on what you need, instead of what you don’t need, Radle said.
She gave this example: “Instead of saying, ‘I don’t want to feel lonely,’ come up with specific ways that you can feel more connected to, supported by, and engaged in your community, circle of friends, and/or family.”
3. Honor your needs.
After you discover what you need, honor it. When applicable, communicate those needs to others, Radle said.
“If you don’t clearly communicate your needs, no one will know how to support you.” We can’t expect people to read our minds, she said. “That isn’t fair to them nor to ourselves.”
4. Get moving.
“When we’re highly stressed moving can help pump more blood and oxygen to the brain and shift into our senses and surroundings to feel grounded and safe,” Eddins said. What kind of movement you do depends on your preference and circumstance. For instance, if you’re feeling distressed at 3 a.m., it can help to stretch, walk around, jog in place or even wiggle your toes, she said.
5. Develop a nurturing voice.
According to Eddins, “Your inner nurturer starts by validating what you’re feeling [and] offers comforting and soothing statements [and hope].”
She shared these examples: “You’re a good person going through a hard time. You’ll get through this. Let’s just take it one moment at a time; it will be OK.”
You also might create a compassionate figure after a kind person you know, a spiritual guide or a fictional character, Eddins said. Turn to this figure when your thoughts are judgmental or self-critical, she said.
6. Reverse the “Golden Rule.”
Radle suggested reversing the Golden Rule, which states that we should treat others the way we’d like to be treated. “I find that most of my clients are far more compassionate towards others than they are towards themselves.”
Radle defined kindness as being gentle and honest and honoring our needs. This may look different for every person.
Kindness may include asking for help or saying yes or no, she said. For instance, you say yes to a massage and no to preparing a homemade dish for the office potluck.
Kindness may include “telling yourself it’s OK that you’ve gained 10 pounds, that you’re still beautiful and still worthy of attention and affection.”
It may include “acknowledging … that you did something that was hard for you to do, even if no one else noticed or even knew that it was a challenge for you.”
It may include “forgiving yourself for making a mistake and for not being perfect.”
7. Practice a soothing gesture.
“Place your hand over your heart, imagine a positive memory you’ve had and just breathe in and out of your heart, feeling the connection between your hand and your heart,” Eddins said.
8. Practice different perspectives.
When we’re distressed, pain from the past may get reactivated, Eddins said. Then we may “create a number of stories around what is happening, which can be harmful to us and also inaccurate.”
Instead, pause. Consider what you’d say to someone in the same situation, she said. “What would you say to a child? What other perspectives are possible? Can you think of three alternate neutral or positive explanations?”
9. Ground yourself.
“If your distress is so high that you’re feeling unsafe, and unable to access your other resources, you need to ground yourself first,” Eddins said. Grounding simply means anchoring yourself back to the present moment.
Eddins shared these grounding techniques:
- Run cool or warm water over your hands.
- Notice your body, such as practicing a body scan or clenching and releasing your fists.
- Notice five things you can hear; five things you see in the room; five things you sense, such as certain textures touching your skin.
- Remember words to an inspirational song, quote or poem that helps you feel better.
- Remember a safe place and describe it in detail using your senses.
- Count backwards in 7s or 9s.
- Visualize yourself gliding away on skates, away from the pain you’re currently feeling.
- Change the TV channel to a soothing show.
- Change the radio station to something pleasant.
- Imagine a wall as a buffer between you and your pain.
(RN Puja Luitel is working in Manmohan Memorial Medical College and Teaching Hospital, Swoyambhu, Kathmandu as STAFF NURSE)
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