Take care of your mental health
“I can’t change the direction of the wind, but I can adjust my sails to always reach my destination” (Jimmy Dean 1987.)
Please note that this article is not meant to take the place of professional support and you must seek help if you need it. There is information regarding where you can access help at the end of this article.
Registered Nurses (and healthcare workers in general) are notoriously bad at looking after themselves, preferring to put others first. Often that ends up costing them far too much, especially when it comes to their mental health. So, this article is about you, what you can do to try and help yourself, and to urge you to seek help if you need it.
Did you know that, according to the World Health Organization(WHO), mental illness is the leading cause of disability worldwide? In Canada alone it affects more than 6.7 million people. A stunning statistic shows that one in two Canadians will have (or have had) a mental illness by the time they reach 40 years of age. (cited Mental Health 101 | CAMH .) The Canadian Mental Health Association states that in any year one in five people in Canada will have a mental health illness or problem and that disability leave costs about double the amount for physical illnesses.
According to WHO, mental health is” the foundation for the well-being and effective functioning of individuals. It is more than the absence of a mental disorder; it is the ability to think, learn, and understand one's emotions and the reactions of others. Mental health is a state of balance, both within and with the environment. “
For good mental health a person needs to have bothpsychological and emotional well-being. Having that balance is vital for good overall health. Poor mental health is known to precipitate physical illness in some people.
How one perceives and deals with mental health issues variestremendously from person to person. However, there are some common threads (and tools to help) that can be discussed in general terms.
The Government of Canada lists six common factors that are necessary for mental well-being. These are namely, enjoying life, strong relationships, a sense of purpose, connection to others, a good sense of self, coping with stress. How do you fare on these?
We know that dealing with wave after wave of the Covid pandemic has been highly detrimental to the psychological and mental health of RNs in Alberta. The number of nurses expressing intentions to quit has reached as high as 50% according to a recent study from McGill University ( 0White paper (English)_Mi4 project_20201209 (mcgill.ca).) This study also found that maintaining good mental health is key to good performance and that stressors to this must be addressed.
What can you do?
One of the most important ways that you can help your mental health is by building resilience. Resilience is defined as your capacity to manage and withstand stress. It is how you are personally able to adapt to change and utilize self-care. A resilient person will have more confidence, optimism, patience, and self-awareness. They will also have relationships to others that are more appreciative, helpful, collaborative, and empathetic.
Having many risk factors in our place of work makes this particularly hard for RNs. We are often hyper-connected to our work, with an impossibly high level of demand, difficult schedules, increased requests (or mandated) overtime and an unmanageable work-life balance.
Here is how you can try and help build yours, and your co-workers, resilience:
• Be supportive of each other. If you have any concerns for yourself, or a co-worker, be pro-active in helping yourself or them. It is also important to have a supportive network outside of work, be it family, friends, or other groups.
• A culture of fairness, honesty and trust on a unit makes it a much nicer environment to work in and that is much better for the well-being of those working there.
• Be respectful to each other. Treating your team with civility, consideration and respect is so important. It fosters good relationships with your colleagues and cements psychological supports.
• Encourage each other. Give positive feedback, remind each other of the good things that happened, or the good responses you had to situations that arose on a shift.
• Learn to say no. If you really cannot manage that extra shift,then say so. If you already have too much to do don’t take on even more. It is hard when overtime is being mandatedin some places but talk to your union if you are mentally (and physically) exhausted, file an OHS concern, add in a PRC if patients are being put at risk. A work-life balance is essential to good mental health. This cannot be stressed enough.
• Acknowledge good work, both to yourself and to others.
• Appreciate each other. Every member of a team will have their strengths and weaknesses try and build on the strengths. Find out how to best make your team work well by using each other’s strengths, instead of focusing on the weaknesses.
• Be mindful if a colleague is not coping with their workload. See if you can help, or whether the work can be more evenly divided up. If you are not coping, then speak up.
• Try and create an environment on your unit where it is fine to ask questions, seek feedback, or propose a new idea without the fear of negative consequences.
Of course, there are many issues that fall on management’s shoulders but if you do your best to help build a resilient team,approaching management becomes an easier task. The old adageof strength in numbers truly applies. A workplace where staff feel able to have a say and illicit needed change is also one that is good for the mental health of those working there.
Taking care of your mental health:
On a personal level there are also things we can do to help ourselves.
• Take a break from social media and the news. Of course it is important to stay informed, but it is equally important for that not to be constant.
• Use the techniques of mindfulness that work for you, such as meditation, going for a walk, spending time with your pet, writing things down (journaling) and so on. There are many on-line resources for this, or you can ask your family Doctor or a counsellor for information.
• Try to eat healthy meals and exercise regularly. With crazyshifts that is not always easy but do your best.
• Focus on the positive things in your life and try not to dwell on the negative things too much.
• Be kind to yourself and to others and don’t compare yourself to anyone else. We all have different abilities to cope with what we are dealing with.
• It is okay to not be okay. Ask for help.
The importance of listening and language
When someone you know is struggling with their mental health it can be hard to understand what is going on. There is often the temptation to say things like “don’t worry,” “don’t be sad,” and such. Even though your intentions are good it may make that person think that you are minimizing what they are feeling.
A much better way of responding is to rephrase what they said, restating it using your own words. This can be a useful tool that makes a person feel heard, validates their concerns, and lets them know that someone is truly listening to them. For example, maybe your colleague comes to you stating that they can’t seem to get their work done in time and they’re feeling overwhelmed. You can rephrase their own words by saying “it sounds like you have a heavy workload today and that’s overwhelming.” That opens the conversation up and also shows that you have heard their concern.
Listening is a skill that we are never really taught but it can easily be learned. Being listened to is very important for a person’s mental health and being a good listener can also come with the added benefit to yourself of making you more empathetic and attentive. Being a good listener involves the following:
• Find a quiet place to talk.
• Remove distractions, such as ear buds, cell phones, the TV etc. You need to show you are there for the person who is talking to you.
• Maintain eye contact
• Make it known that you are listening by restating that you are there for that person.
• Avoid the temptation to relate their problem to you. If you’re talking more than they are then you’re not listening.
• Remember that you are not there to fix the problem but to listen to the person, be present and to understand. The power of just listening should not be underestimated.
• Beware of comments that might undercut the person. Phrases such as “you can do it, you’re strong,” or “things are worse elsewhere.” Whilst well-meaning, are not helpful.
Becoming a good and empathetic listener requires practice but it is worth taking the time to do so, both for you and others.
Compassion fatigue:
Whilst paying attention to listening and empathy it is important to note that one of the major issues faced by nurses, especially now, is compassion fatigue. We all know that there is nothing better than being able to talk to someone about your day when that person can listen, understand, and relate to you. However, with that empathy there can be a downside too, and that is where we run into compassion fatigue.
When we spend so much of our time and energy trying to listen and support others, we become exhausted ourselves. If you spend most of your time thinking about the needs and well-being of others, you can easily forget about yourself. When that happens compassion fatigue tends to set in. It is sometimes termed vicarious, or secondary trauma and it makes it harder for those affected to carry out their duties or care for their patients.
To avoid compassion fatigue, it is important to:
• Not lose sight of your own experiences when listening to others.
• Set boundaries with people. It’s okay to offer to helpsomeone find other resources for their needs than you.
• Identify your own support needs and use them.
• Recharge your own batteries. Take a vacation, spend time alone on a walk, whatever you like to do best to relax, put it on your calendar and make the time to do it.
Burnout:
Burnout is defined as emotional exhaustion, depersonalization,and reduced accomplishment. It is classified as a psychological syndrome. Whilst there are many studies that show that nurses were already experiencing burnout even before the pandemic, covid 19 and its stresses on them have intensified those feelings.Burnout is becoming a very serious issue among RNs.
The common symptoms of burnout are:
Feeling hopeless or helpless.
Pessimism or anger about your work or colleagues.
Fatigue, headaches, stomach issues, insomnia, procrastination
Changes in appetite
Lack of motivation.
Frequent sick calls or coming late/leaving early.
Self-medication (drugs or alcohol.)
Becoming withdrawn or detached from others.
Relationship problems (spouse, children, friends.)
Burnout isn’t just about hating your job, it’s a response to increased stress and fatigue. There are many causes of burnout, some examples are lack of support, compassion fatigue, excessive workload or shifts and personal stress. The best remedy for burnout is self-care. That means setting good boundaries that allow for your physical and mental well-being. These include:
Setting hard limits on anything work-related when you are at home.
Managing your shifts appropriately and not picking up too many extra ones.
Prioritizing sleep when you are exhausted.
Building healthy relationships with the rest of your team.
Avoiding work when you’re too tired.
Seeking professional help to manage mental health concerns, make use of AHS programs and other resources(see below.)
Setting healthy boundaries within the therapeutic relationship.
The pandemic has certainly increased the level of nurse burnout. Whilst it may be normal to experience short periods of high stress on a unit, it should not be constant. Of course, patient care is very important but so is your working environment and your mental health. Bottom line is that your work should not be making you ill.
Resources:
AHS has free counselling and help for staff. The informationcan be accessed through Insight, via HR, in the health and wellness section. You can also call 811 to get information.
24-hour Calgary distress centre: 403-266- 4357
Mental health helpline: 1-877-303-2642
Addiction helpline: 1-866-332-2322.
Your family Doctor may have a counsellor, psychologist or psychiatrist that works with them. If not they may have information or recommendations.
There are also many online resources too, some examples are below but please note UNA does not endorse any site, they are for information purposes only.
Mental Health Learning Series - CSPS (csps-efpc.gc.ca)
Canadian Mental Health Association / CMHA Calgary
Please take care of yourselves and if you need help, please ask for it. There is no need to feel ashamed about having a mental health illness, these are unprecedented times and too many of you have, for too long, been asked for far more than you can give.
A reminder that the UNA is also here for you, so please don’t hesitate to contact us. You can call us on (403) 670-9960, email us at LOCAL115EXEC@UNA.AB.CA or fill in an online OHS file. Your health matters to us.
By Rebecca Brown, on behalf of UNA Local 115 Communications Committee
Bibliography:
Mental health issues in Canada - Statistics & Facts | Statista
Mental Health Learning Series - CSPS (csps-efpc.gc.ca)
Workplace Mental Health - Mental Health Commission of Canada :
Avoiding Burnout As A Nurse: Mental Health Among Canada’s Nurses (wellbeingscounselling.ca)
Paraphrasing in mental health – Beyond My Label
Psychology Reveals 10 Mindfulness Techniques Most People Forget (powerofpositivity.com)