When the Shift Hits the Fan.

It is inevitable. It will happen to you.

No matter if you are a new graduate or veteran nurse, there will be that shift that will almost break you. Staffing is short. Your patient is crashing. Maybe it’s downtime to boot. The stress is overwhelming. You are heading to the med room to cry.

I have been there and shed those ugly tears. You feel like you’re drowning, and there is never enough help. I wanted to write a quick post with some advice about stress-management strategies that have helped me cope during those really hard moments when the shift is really hitting the fan.

Remember - You can’t do it all.

That moment when you start to feel like you need to clone yourself 10 times, stop and remember that you cannot do it all. THAT IS OK. You are a single human with a maximum capacity to take on tasks. Luckily, nursing is a team sport. Reach out to others and throw up the S.O.S. signal. Get some help. This is not a sign of weakness. This does not mean that you are not a good nurse. You are recognizing your limitations in the moment and putting patient safety first. It is appropriate to ask for assistance. If you try to do it all alone, you are putting yourself and your patients at risk. Don’t do it. That is never OK.

Take a deep breath. Try counting to 100 by threes.

Victor Lipman wrote for Psychology Today – “Get your body in hand first, and the mind will have a better chance to follow.” By using distraction techniques (like breathing and counting), you start to take control of yourself physically. This will help slow down your racing heart, help you avoid hyperventilation and allow you to think clearly. Nursing is a high-stress job. We are asked to do an impossible number of tasks (see the previous section) as fast as possible with less and less support. And not to mention, we are responsible for human lives. It’s normal for you to physically respond to that kind of stress. To succeed in a time of crisis, you will need to calm the body as well as the mind.

Triage. It is time to triage.

I am 100% an ER RN, so I am going to preach the importance of triaging your situation. It is time to get organized. You need to sort out what are the tasks that need your immediate attention, what you can delegate out to others, and what can go on the back burner. We already established that you cannot do it all. By triaging the urgency of your duties, you will complete the super STAT things quickly and figure out a way to get the other things finished without losing your mind. There is the possibility that you might not get it all done. And that is also OK. If all your patients are alive, your documentation is done, and no one is yelling at you, then all that extra stuff probably was not as necessary as you thought.

Don’t buy into the crazy.

When it’s busy, everyone gets stressed out. Emotions will be running high and sometimes, logic starts to fly out the window. It is SO important to not start down the road to Senselessville. Medicine has standards of care. Hospitals have policies and procedures. There is always structure to be found, even when it seems like the walls are crumbling around you. Let those rules guide you in the times of chaos. It can be very comforting (not to mention extremely helpful) to tap into those policies and procedures when the shift is blowing up. If you’re not sure if what is happening is kosher, take a minute and check the rules. You may be surprised at what you find.

Thank your coworkers.

Gratitude works magic. If you had someone come help you in a pinch, find them later and give them a “thanks” and a high-five. Nurses and other healthcare workers do not appreciate each other enough. We do some amazing work in ridiculous conditions. Find a minute to tell your colleagues that they did a good job. I find that appreciated coworkers are more apt to help in the future. 

Take time to decompress.

This is for after the shift-show has calmed down. You need to take some time to process. Whether it is in the car on the way home, in the shower after your shift or during a run the next day, find some quiet and let yourself go through the stress of the day. When we carry around too much stress, it can manifest as physical symptoms. By allowing yourself to work through the bedlam of your nurse life, you will find better balance in your personal life.

Have a great shift!

Sarah @ New Thing Nurse

About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



An Interview with the Interviewer: Elizabeth Scala

This week has been very exciting here at New Thing Nurse.

On Wednesday, April 25th, an episode of the nursing podcast "Your Next Shift", hosted by the imitable Elizabeth Scala, MSN, RN, MBA, went live. This episode features an interview with myself, your New Thing Nurse friend and founder, and Elizabeth where we talk about all things nursing, self-care, travel, rugby and of course, New Thing Nurse.

LISTEN TO MY INTERVIEW ON "YOUR NEXT SHIFT" WITH ELIZABETH SCALA HERE!!

I have never been on a podcast before, this again making me a #newthingnurse. I was SO nervous when we recorded the interview last month as I have been a fan of Elizabeth Scala's for quite some time. If you are not already familiar with her work, Elizabeth is a Johns Hopkins-trained Registered Nurse, best-selling author, keynote speaker, and consultant on burnout prevention for nurses in all specialties. She is the CEO of ElizabethScala.com and founder of The Art of Nursing - a Nurse's Week program providing education and inspiration to thousands across the country. Elizabeth also hosts the incredible podcast "Your Next Shift", where she interviews nurses from diverse roles from across the spectrum of nursing.

I mean SWOON, right? #nursecrush

In addition to inviting me to be on her podcast "Your Next Shift", Elizabeth was also game to play a little "Interview the Interviewer". Below is a brief interview between myself, Sarah @ New Thing Nurse, and the "Your Next Shift" hostess with the mostest - Elizabeth Scala, MSN, RN, MBA.


Sarah @ New Thing Nurse (NTN): I have been a big fan of yours for a long time but for those who aren't familiar with you and your work, can you introduce yourself and tell us about your work?

Elizabeth Scala (ES): Sure, Elizabeth Scala here. Professionally, I work as a Registered Nurse. Personally, I love gardening, jigsaw puzzles, my pup and dancing to jam bands all over the country! I have my dual masters' degree in nursing and business. And even though I am quite the homebody - I do love to travel and teach others.

NTN: I love hearing about other nurses' professional journeys. How did you fall into nursing? And what area of nursing did you start in?

ES: Great question! And totally worded appropriately for me. I definitely am on that "fell" into nursing. It was NOT my agenda;  growing up, hospitals would scare me! So, senior year of college I was moving into my apartment off campus with three other girls. Two of my roommates were in nursing school. One of my roommate's mothers was a nursing faculty. And the three of them, along with my own mother, decided that after I graduated with my psychology degree that I could go straight into the accelerated nursing program. I didn't have concrete plans yet after college so I thought, "Why not!?!" I started out in psychiatric nursing, worked some in the community, and am currently a research program coordinator at a large academic medical center.

NTN: The focus of New Thing Nurse is supporting nurses as they fine their "new thing". What made you step away from the bedside? And what was your first "new thing"?

ES: Gosh - what made me step away from bedside nursing was me. I wasn't taking any care of myself. My health was in the toilet; my emotions were on a roller coaster ride. I felt miserable and one night - since I RARELY slept through a night - I was having another sobbing tantrum. My husband and I both agreed that I could not keep going at the pace I was at. I needed to take a break, and I needed to focus on myself. I left my psychiatric nursing job and made a risky decision to work just part-time at a local wellness center. I was still able to work as a nurse - as they needed a RN to head up a physician referral program - so that was kind of neat! And during that time I had many "new things". To thing about what was the first... hmm. I think it was remembering that I was an athlete growing up. I loved sports, was always in good shape, and highly competitive (smile). Being at the wellness center and around all of the equipment, personal trainers, and healthy bodies - I was like "Ohhhh yeah..." It woke me up first physically to the shape I was in. After that, more and more started to unfold and I started to feel healthy, happy, and whole again.

NTN: What helped you make that transition into your "new thing"?

ES: I would say that many things helped me. My husband being supportive and allowing me to leave my full-time job with all of the perks that went along with it. Boy, I do NOT know how we made it financially - but we did! Then, my own curiosity. My own pause and need to do things that I enjoyed. Being at the wellness center, I was surrounded by resources. I asked for help, hired a trainer myself, and got back into shape. My boss at that job was super helpful. He introduced me to the concept of "coaching" and I went into a certified coaching program. Then, even one of my clients at the wellness center helped! She was a marketing specialist and started to talk to me in between her sessions about social media, blogging, and all sorts of things I never had heard of. I guess the main thing that I believe helped is an open mind and a desire to learn more. Even if I didn't know how something would work out, saying "yes" without hesitation was super productive in taking the next step!

NTN: Do you have any tips for anyone out there who might be considering jumping into a "new thing" of their own?

ES: Hmm, interesting question. I think that it depends on what their "new thing" is. For some new things, you definitely need to wait before jumping. What I mean by that is I have done a TON of things wrong in my online work. And even now, I am at a place where I am assessing and re-assessing decisions and plans. So, if you are considering a new thing that you know nothing about, do your research. Learn more before taking a plunge.

Next, I would say to the person considering a new thing... is it YOUR thing? So often we get wrapped up in what we think we "should" be doing. I think of all the dirty words - SHOULD should be at the top of the list (LOL). That being said, I mean is the new thing something that you desire or something you are going to do for someone else? I have learned along the way that when I get into something new that isn't 100% my true heart's desire... it doesn't work out all that well. Now, other "new things" that are a bit less heavy (like trying a new hobby, such as tango dancing) - for something like that, jump in head first! I do think we need to do more new things that are fun, adventurous, and will fill our spirits!

NTN: You have been a self-proclaimed warrior against nurse burnout for a long time. What drives your work to help the nursing community fight burnout? Did you have a personal experience with nurse burnout?

ES: As shared above, yes. Yes. And, yes again. In fact, to be honest, I am noticing that I may be back in burnout again. I think from everything I have shared above speaks to this questions, but to state it another way... Burnout happens when we are riding on someone else's train. When our values, desired, strengths, and assets are not being actualized. When we are living life along the "should" of what other people want and need. Now, I do agree that we all report to somebody - at work or at home. Sure, there are things that we may not 100% enjoy. And yes, work is work, and there will be stress on a job. However, when we get away from our true heartfelt desires, then we find ourselves in trouble. Couple that with working too hard, not getting a break, or forgetting to do things that are good for your mind, body, and spirit - all of this added up leads to burnout. I do agree that the workplace needs to be supportive and help us be happy and healthy professionals. At the very same time, it is up to us to stand up and take responsibility for our own well-being.

NTN: If you could give our readers your top tip or tips towards avoiding burnout, what would they be?

ES: Do what you enjoy. Set healthy boundaries. Schedule down time, me time, and non-work time. Change it up. If you are stuck in a rut - figure out why and what needs to shift. Focus on the positive. Sure, there is a tone out there that is scary, miserable, and bad. And, even through the greatest of tragedy we can learn, grow, and transform our lives. Live as much as you can in the moment. It is when our mind wanders to the "what if" or the "should, could, would" is when we get into trouble. Stop and breathe. And don't take yourself or your life so seriously. Smiling and laughing - that can be some of the very best medicine!

NTN: Do you have any "new things" on the horizon? New Thing Nurse readers want to know!

ES: I believe that I do, but most I am not even aware of yet. As I honestly (and maybe for the very first time) shared above - I am a bit into burnout right now. And, being someone that knows the signs, causes, and what to do about it - I need to stop. Really stop everything and take pause. What are my next steps? What lights me up? How can I best serve others? I can say that I have a very special course coming out soon. The content is done, and we are working on some of the aspects of how folks will be able to interact with and enjoy the program. I also know that some of my other "new things" involving ending some things that I hae been doing for several years now. In a way, ending things is the first step to the new beginnings, right?

NTN: How can our readers find out more about you and your work?

ES: Sure, well the easiest place to find me is at ElizabethScala.com. I also have a Facebook page and community. I do hang out quite a bit on LinkedIn. And, if you're looking for resources you could check out Nursing from Within or Your Next Shift - two of my very favorite books!

Oh, and I cannot believe I forgot to mention this at all so far... my podcast! Now that I am assessing where I am at and what I enjoy - I can tell you. The podcast is NOT going anywhere. I LOVE to interview other nurses - highlighting their triumphs and lifting the profession of nursing up!! So, definitely check that out. I am sure that you'll see some familiar faces, smile.

NTN: Do you have any other advice for our readers?

ES: Boy, I could go on and on, for sure. I think I shared a lot above. To close it out, just be yourself. And, if you don't know who that is or what that self wants, take the time to figure that out. First off, you will be happy that you did. Things will go so much smoother. It gets easier when you live life as your best you. If you get off course, it's all good. Even the best of us experience burnout! And guess what? We can thank it. It is that gentle reminder that we are not living life as our highest self.

Thanks for the opportunity to hang out with y'all! I hope to "see" you online. Enjoy YOUR new things!!


ISN'T SHE AMAZING??

Hear the "Your Next Shift" podcast episode featuring the interview between Sarah K. Wells, MSN, RN, CEN, CNL and Elizabeth Scala, MSN, RN, MBA in its entirety below.

A Shift In Perspective with Sarah K. Wells - Your Next Shift with Elizabeth Scala

- Sarah @ New Thing Nurse

About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



FOLLOW NEW THING NURSE ON INSTAGRAM - @NEWTHINGNURSE

The Future of Nursing is Looking BRIGHT!

The next generation of nurses is looking strong.

I had the opportunity to give a workshop to members of the East Bay Student Nurse Association in Hayward, California this week. There was a great turnout of enthusiastic recent graduates and current nursing students. They were excited. They were eager. They were looking for help on how to jump headfirst into their nursing careers.

The title of the workshop is “I survived nursing school! Now what?”. It focuses on how to navigate that stressful transition from nursing school to new grad nurse in regard to self-care, stress management and all things related to getting that first job – networking, the job search, resumes and interviews. It was a great session. The participants were so interested in how to shift from successful nursing student to successful new nurse.

I love working with nursing students. In my opinion, nursing students are the toughest, most flexible and resilient students out there. They are asked to do the impossible – manage full-time clinical rotations, class time and personal lives – all while paying for the privilege to do it. These students were no exception. They arrived telling me stories of how they juggled their clinical rotations, nurse internships, volunteer work, classes, and part-time jobs. Each of them had incredible perspectives on patient care and the ever-evolving landscape of the American healthcare system. I was overwhelmed with their passion and determined spirits. The future of nursing is looking bright.

How can we help future nurses?

The major need that I hear from nursing students everywhere is that they need more opportunities. Nursing students need good preceptors and clinical rotations. If you are approached to precept, think about offering to help. New graduate nurses need to be considered for nurse positions. There needs to be more new nurse training programs and budgets to support them. New nurses need good mentors.  If you work with a new grad nurse, offer supportive guidance and a sympathetic ear when they need to talk to someone. Help them grow and avoid the burnout that so many new graduates face in their first jobs.

Our next generation of nurses is excited to get to work. Let’s help them be the best nurses that they can be.

- Sarah @ New Thing Nurse


About the Author - Sarah K. Wells, MSN, RN, CEN, CNL is an educator, speaker, blogger and owner of New Thing Nurse, a professional and academic coaching company for the nursing world. New Thing Nurse is organized to provide support and guidance to aspiring nurses, newly graduated nurses, and veteran RNs looking to make a change in their life.

Whether it’s a new school, new job or new idea,

New Thing Nurse wants to help with your new thing!



Nurse Gratitude.

The holidays can be rough.

The hospitals are full with patients who need care, & the staffing is short because of co-workers who are not there....

This holiday season is unusual for me. I am currently with family due to illness, so enjoying doing some private duty nursing & family support this holiday season. But traditionally, this is the time of year when I like to look around the ridiculously full hospital (while I'm doing a million things, haven't had a break & may or may not have peed in the last 11 hours) & focus on all the awesome reasons why I have #nursegratitude.

What is "nurse gratitude"? Great question! Nurse gratitude is the thankful feeling that I get for all things nursing. This can be for simple things like coffee & gloves (essential for each & every shift). Or it can be for things like social workers & child life specialists who make terrible situations more manageable with their wizard-like skills (I LOVE ALL YOU SOCIAL WORKERS & CHILD LIFE FOLKS).  Today, I just wanted to focus on the general aspects of nursing that make me so full of nurse gratitude.

Here is the Top 5 on my Nurse Gratitude List  -

1. Flexibility.

This job has allowed me to travel the world, be available for my family in times of crisis, take classes & start a new business. I have worked full-time, part-time & PRN. As an ER nurse, I have worked ALLLLLL the shifts which has freed me up for many educational, personal & professional opportunities. My colleagues have been able to be daytime parents & nighttime workers, full-time students, fulfilling passion projects & a few have been seasonal athletes while still being fully employed three days a week. There are few jobs with greater flexibility than nursing. Cheers to Saturday on a Tuesday.

2. We have the best stories.

When at a party, dinner out or just a gathering of folks, nurses will always have the best stories. I hate the question, "What is the craziest thing you have ever seen?". Normal folks aren't ready for the real crazy. I usually give them a watered-down rectal foreign body story that gets a lot of giggles & then we move on. What I love is hearing that someone else is in the healthcare field & then getting to compare war stories. Healthcare workers, but nurses especially, have the best, most incredibly, "you can't make this sh*t up" stories. They are best not for general consumption, but get a few jaded nurse hearts together with a glass of whiskey or wine & the night will not disappoint.

3. Nurses are the best people.

I cannot stress enough how generally amazing the people are who are drawn to nursing. I don't know why, but they are the most passionate, hard-working & funny individuals. Almost all my friends are nurses for exactly this reason. Nurses love to help. They are driven by a crazy passion to get sh*t done. No one is better suited for a high-stress, multitasking needed situation. That's why so many are balancing kids, school & a side-hustle. And nurses are HILARIOUS. Nurses can literally be facing some of the saddest & hardest situations that life can offer, but they can make light of it all. I love me some nurses. 

4. Variety.

Have you ever seen such a variety of roles that nursing has to offer? When I meet clients who are burnt crispy & telling me that they are thinking of switching careers, I almost yell - "WHY?". There is an almost endless amount of manifestations of nursing out there. Just when I think that I've heard them all, I learn about something new. Did you know that you can be a camp nurse? Or a toxicology nurse? Or a nurse podcaster? Or an organ donation nurse? Or a nurse historian? YES!!! These are all real jobs. The list goes on & on, but I encourage you to think about your passions & do some research. There is probably an amazing fit (or at least some swag) for even your nursing & knitting interests.

5. We get to help.

We get to help people. Our patients are often in their most vulnerable time of need, as are their family, friends & other loved ones. We get to help our colleagues & communities by donating to fundraisers or working at the medic booth at the health fair. We go home & help our own relatives by taking all their calls related to - "I have this spot on my back....". Our kids & their friends come to us to help with the owies. My neighbor comes by to check in after his hip operation with questions. Nurses are helpers. I live for the helping.

This holiday season you do have the option of just dwelling on how there were three sick calls, two Code 3's in the last five minutes & a laboring mother in the waiting room (where's the partridge in the pear tree?). But why? All that would do is stress me out & make my shift that much worse. Let's choose to BUMP THAT NOISE & instead find some positivity by remembering all the reasons that we can have #nursegratitude this year.

- Sarah @ New Thing Nurse