Peer Support: How much do I really need it?

This is for my fellow healthcare colleagues!

If you are a nurse, or any kind of health care practitioner, you have had a shift where you walk out of the hospital and you dread ever having to walk back through those doors. It doesn’t matter if it is because you had a really heavy assignment, an unexpected death of a patient, or bad news you had to break to a long-term patient, the end result is the same: you dread going back. What if there was a way to debrief your feelings before you walked out, throwing your stethoscope out the window?

Due to the burnout rates of our profession, and because administrators are starting to realize the impact of the everyday physical, emotional, and ethical issues that we deal with daily, some hospitals are trying different methods to support staff nurses’ emotional health and well being. The good news is that the hard work that we do is noticed and being appreciated, and that administrators are trying to help and assist with some of the stress that we endure due to our jobs. I know that most people think, if we get more staff, that will decrease our stress, and maybe it would, but shy of reimbursement costs changing, and staffing ratios dramatically increasing, what are some things that your hospital can do to help support you?

Read more here at AllNurses.com

AllNurses.com: Thank you, Florence Nightingale!

A Nurses Perspective. Around this time of year, I like think about the previous year: what has changed, what has stayed the same, and what I am truly thankful for. It is easy to have a negative day, or a positive day, and just focus on that, but it’s the big picture that is what is most important.

Read more on AllNurses.com

In Good Health

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NurseB Hallway

Preventative Care For Moms….on ScaryMommy.com

Moms (and Dads) are overworked, stressed, and care so much for others that they forget to do what they need for themselves.  Find out what you need to get checked out, and what you can hold off on at scarymommy.com

Yours In Good Health

B

A Divorcee’s Guide to Online Dating- Bloom!

Some tips for those new to the dating world: it is truly a whole new world with online dating.  It can be scary, fun, and you will have some of the best and worst experiences of your life!

Check out Nurse Bridgid featured on Bloom!Bloom Flower

 

Yours in Good Health

B

Do you know Molly? Word is she’s all around these days.

Molly is another street name, along with ecstasy, for MDMA (methylenedioxymethamphetamine) which can be ingested in powder, pill, or capsule form and it is taken orally. MDMA has been around since the early 1900’s when it was created as a weight loss drug, but it was found to create an intense sense of euphoria and some psychedelia (seeing and/or hearing things that may not be there). It regained popularity in the 1980’s in the psychiatry world when it was looked at to treat anxiety and various other disorders…but it also started becoming bigger on the streets in the 80’s and 90’s and started showing up at parties (raves), and started becoming more of a commonly used drug in the 2000’s.  There are some really legitimate reasons this drug is being studied for scientific use, even currently, but there are also some legitimate reasons that people should be wary of taking it as a street drug.Ecstasy_monogram (1)

What is the deal with Molly?

In its purest form, Molly (AKA MDMA), starts to hit within about 30-45 minutes after ingestion, peaks in about 120 minutes, and lasts usually a total of 3.5-5 hours (depending on dose, metabolism, and if you ingest other drugs as well). It creates this intense euphoria, truly the happiest you’ve ever been, with virtually no anxiety response, no fear of strangers, and actually you feel like you know people, it’s almost a false sense of intimacy. The feeling of touch is enhanced, so things feel much better when you touch them and when you are touched; many people use this as a foray into sexual enhancement and encounters they may not normally have/feel.  It is not a drug that people have no control over their actions, they are just very carefree without a worry in the world…one can understand the draw of that! There are many studies underway looking at the use of MDMA in Post Traumatic Stress Disorder (PTSD) to help prevent some of the effects of the disorder, and work through the anxiety that can occur. It has also been studied to look at sexual dysfunction and to assist in marriage therapy/counseling.

What’s the Downside?

Because the drug boosts your serotonin levels and enhances all of your happy/good time feelings, the risk is that many people don’t know they are headed for an overdose, because they feel so good, their heart rate is increased, their blood pressure is elevated, and they are usually at concerts or parties where the “vibe” is so up they don’t think anything is wrong with them. An overdose on Molly can come on pretty quickly and be tough to reverse if it’s not treated in time. Also, because you feel so amazing when you’re on it, the next day is a total downer, and people report intense depression, fatigue, anxiety, irritability, paranoia, lack of attention/motivation, GI upset, loss of appetite, and severe exhaustion. And long-term use can lead to severe depression and anxiety.

Drinking alcohol, or using other drugs along with MDMA can make it very difficult for users don’t know that they may be overheating, or losing too much sodium from excessive sweating (which can cause some serious issues in your brain and lead to death), but because the drug lasts 3.5-5 hours, many users with use other drugs along with it to enhance the “high” or make it last longer. It is a deadly combination to mix MDMA with other drugs (even alcohol) and with MDMA use estimated to be around 25 million people annually, there are a LOT of people at risk of overdose, and from the long-term side effects.

Signs of Overdose:

Disorientation, extreme confusion, hallucinations, convulsions, muscle stiffness, chest pain, heart palpitations, high blood pressure, headache, loss of consciousness, kidney failure, and coma leading to death.

The Bottom Line?

In the early summer 2013 there were three deaths within one week of each other from presumed MDMA overdose alone by college age people, and overdoses aplenty at the eletronica music festivals over the summer months, leading to some of them being cancelled….and not to mention the fact that many music artists are referencing the drug in their lyrics, it seems like Molly is only gaining in popularity. And there is NO chance I am telling anyone that MDMA is healthy to use!

Be aware of the signs of overdose and seek immediate help if you think you are overdosing, tell someone, and if you see someone you think needs help, get them the help they need by calling emergency services (911 in the US). And parents?  Talk to your college age children about the drug and the risks, it seems that among college-age students, this drug is on the rise, and is used with almost the same frequency as marijuana. If you are thinking about trying the drug, read up first, know signs of overdose, don’t take other drugs, make sure to hydrate properly, and be in a safe environment….OR just skip doing drugs, and live a clean lifestyle, truly the choice is yours!

Yours in Good Health

B

Tips to Prevent Travel Anxiety

Do you ever get really excited to go away on vacation, or go away for a long weekend, and then become totally seized with anxiety right before it’s time to go? Whether your anxiety is due to flying, packing, leaving your kids/family, animals, plants, or whatever makes your freeze up, it is a real life issue and more people than you might realize are affected by these fears, even if they don’t have a diagnosed anxiety disorder.  There are some tips that you can use to help to decrease your anxiety and make trips and traveling MUCH more enjoyable.

Pack early and prepare!

Pack early and prepare!

1. Organize: Make lists of what you need to pack and everything you need to do before you go. You will feel more in control if you know that, in advance, you made a list of everything that needed to be completed, and you took care of all of it. So you can be ready and leave for your trip, assured that you are totally prepared.

2. Medicate: If you have a diagnosed anxiety disorder, and take medications to treat it, discuss with your Healthcare Practitioner (HCP) the possibility of increasing your medication dosage in times of high stress, or when the appropriate time to dose your medication is, so that you remain calm and clear when traveling.

3. Avoid Caffeine: Caffeine can make you more anxiety ridden, even though it helps to keep you awake and give you more energy.  That extra bit of stimulant can help you finish all of your last-minute errands, but it can also cause some anxious moments.

4. Know your Triggers: What causes your anxiety?  What are your triggers?  Maybe it is that last-minute frenzy, or saying goodbye to your family….realize that and plan accordingly.  If you need more time to say goodbye, plan for it. If you need to pack way ahead of time, to ward off panic attacks and anxiety, pack two weeks ahead.  Whatever makes you the most nervous, plan for it, because you will be less anxious if you are prepared, and no one knows you better than yourself.

5. Try to Relax: Easier said than done, but try to meditate, listen to white noise, go for a long run (or whatever your preferred choice of exercise is) that morning to help clear your head. Take a bath with lavender essential oils, or get a massage; whatever techniques work for you to help ease your mind and slow/prevent anxiety attacks.

6. Be Open: Most importantly, don’t suffer alone.  If you are traveling with others, let them know that sometimes you get anxiety when traveling and let them know what they can do to help you (if even it is to leave you alone to figure it out yourself.) That way, they know what may be causing you to act a little different from your normal self, and you don’t have to feel like you are hiding anything….which can cause anxiety in and of itself!

I don’t really get anxious….unless I’m late for my flight/missing my flight; that can cause me to lose my cool! I also always feel really guilty leaving my dogs. It is totally irrational guilt because they love staying with their trainer, and they have no idea what’s going on; the stress is all me, and I project it on them, but I’ve come to realize that I do it, SO I prepare and make sure that I have them all situated, then I get back to finish packing and head to the airport with plenty of time, and I am cool as a cucumber.  All that stated, I don’t have an anxiety disorder, just normal stress, but I have learned what causes me undue stress and I work with it to decrease it as much as possible.

Traveling is never easy, but knowing what causes you to lose your cool, and preventing it, is one way to make the experience a LOT better.  And if you are someone who really freezes when traveling (due to fear of a plane, flying, etc) you can work with your HCP to try hypnotherapy, cognitive behavioral therapy, or talk therapy and see what will best fit your needs and re-train your thinking, to make traveling a breeze.

Yours in Good Health

B

May: Mental Health Awareness and Suicide Prevention Month

May is mental health awareness and suicide prevention month; many people start to feel desperate with their depression symptoms around the first couple weeks of spring. Mostly because people think once the “winter blues” are over, and spring has sprung, they will start to feel better miraculously. When that doesn’t happen, the true feelings of depression can sink in: helplessness and thoughts of harming themselves (i.e. suicide) can become overwhelming. It can be hard to see the signs in people who are really close to you, but it is important to know the signs and see them in others, as over 1 million people attempt suicide annually.

depressionWhat are some signs of Depression/Suicide?

-Clinical Depression is usually emphasized by a loss of interest in life, sadness, disinterest in previously enjoyed hobbies, difficulty concentrating, trouble with eating and sleeping.

-Thinking about death a lot (verbalizing, drawing, or referring to death a lot)

-Feelings of hopelessness or worthlessness

-Making changes to wills, plans, or making statements about not being around much longer

-A sudden switch from someone being really deeply depressed and sad to very happy

-Calling people to say goodbye

-Previous suicide attempts (50% of those with prior attempts will try again and be successful)

Risk Factors:

-Previous suicide attempts

-Family violence

-Physical or sexual abuse history

-Firearms in the home

-Chronic illness or pain

-Mental illness history

-Substance abuse problem

What do you do if you think someone is at risk?

-Listen to them, and reassure them that you care about them, you are listening, and you care. If they say that they want to kill themselves, it is an emergency, call 911 (or emergency services where you live), do not leave them alone, and remove any firearms, knives, other weapons, or drugs and alcohol.

-If they are not actively threatening but you feel they are at risk, have them call a Suicide Hotline 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255). And, assist them with finding a mental health professional and you can always start with your Healthcare Practitioner (HCP) to help with a referral.

Many times we missed the subtle signs and symptoms, especially when we are close to the victim. It has happened to me in my very own family, and right after it happened all you think about is “how did I miss the signs?? I spent so much time with them?” It’s important to remember that we all have comfort levels with people, and sometimes you are too close, it almost takes an outsider to see the situation for what it is; you are so used to the persons behaviors or traits, that it is not abnormal to you. And you might just think they are finally out of their funk when they become happy again; but really they have made a plan. It is important to not blame yourself, if someone you love takes his or her own life. It is not your fault, and the symptoms are very hard to see. What’s important is learning and seeing the symptoms in others and helping them.

Knowing when you see the symptoms, and what to do is important. So pay attention to the signs, and how you can help.

Yours in Good Health

B

Thoughts on the Marathon Monday Attack….I refuse to say Massacre

It’s so hard to put into words the range of feelings that you have after such an event, which are the same feelings that the healthcare and emergency service workers from 9/11, Katrina, and Sandy must have all dealt with.  I honestly felt that nothing like this would ever happen in Boston, I know I was living in a dreamland, and even when I was running to the Emergency Department, hearing about victims, I didn’t really believe it. I kept telling myself that it was just drama….because until I left the hospital, and my family members were telling me what they heard on the news: I had no idea what was going on.  Just as all of you at home, watching the news, had no idea what was really happening in the hospitals.

I guess I needed to believe that there weren’t bombs, that it was just a transformer that blew, because it was easier to focus on what needed to be done. I have never been prouder of the emergency response crew in this city, and especially the staff at my hospital. In the face of a complete disaster and chaos, we had organization, and saved as many lives as we could. I cannot describe what I saw, because I just don’t want to relive the horror, but the images of not only victims but their family members and what they must be going through right now: the pain, the suffering, and the loss kept me awake all night last night. I also feel like I didn’t do enough, I don’t know if anyone feels like they did enough, especially in the face of being called a hero: we did our jobs, and we did our jobs well, but we couldn’t save everyone.

We all need to remember that this is also just the beginning, there will be Post Traumatic Stress (PTSD) from this event, and if you have lost a loved one, there are resources available at the local hospitals, police stations, and there will be outreach by the city. If you need to talk to someone immediately, the help hotline is available 800-427-3606.

If you would like to help, please donate blood and/or blood products, contact the American Red Cross.  And the Salvation Army is helping victims and their families, so any extra clothes, food, etc, please contact them and see how best you can help.

You can attack us, you can say the Red Sox suck, but all you do is make the city that I love, the city that is my home, grow stronger, bond together, and help each other to overcome this tragedy. It is so unfortunate that this had to happen on one of the best days that Bostonians love to celebrate, young and old alike, and I know there is so much sadness as fall out, but I truly am proud of EVERYONE that helped victims yesterday, we faced something that we never thought we would, and we were kept safe by the men and women in law enforcement.

I saw a war zone in Boston yesterday, but I have never felt safer because of the amazing people in this city. It was an attempted massacre; we said no.

Boston, you are my home.

Yours in Good Health

B

bosotn marathon

Not enough sleep? Weight gain will become a problem.

You hear it all the time: If you don’t get enough sleep, you will gain weight. When I think about it, it doesn’t totally make sense because you aren’t sleeping, so you are being more active, right? Then I think about those days after I work a night shift, when I am getting things done in a haze, my brain is not fully functioning, and thinks happen a little bit slower, I feel miserable, and when I have a chance to stop and rest, I take it…so I begin to understand a bit more the whole weight gain portion.

sleep and weight gainWhy exactly does sleep make me gain weight?

When you do not get enough sleep, you are feeling tired and energy levels are low, leading to the use of caffeine and/or sugar to boost your energy levels to help you get through the day, which leads to energy crashes later in the day.  For those of you who exercise in the afternoon, it usually means that it doesn’t happen, because your energy is zapped. And if you are a morning exerciser, you tend to feel to exhausted to get to your workout; a lack of energy leads to a lack of drive.  And when you become dependent upon stimulants to get through the day, it can become a cycle, as sometimes you can overdo it with the caffeine and then have trouble shutting it down, even if you do have time to sleep. When you are tired and sluggish, you also tend to be more lazy; you don’t shop for healthy foods and/or cook for yourself, so you tend to eat what is available and easy.  None of these things are particularly good for your waistline.

There are two main hormones that regulate your eating cycle: ghrelin and leptin. Ghrelin is the hormone that tells you when you are hungry and you should eat, and it is at much higher levels when you are sleep deprived. Leptin is the hormone that tells you to stop eating because you are full, and unfortunately it is in lower levels when you are without sleep. A lack of exercise, high ghrelin, and low leptin levels is basically the trifecta for weight gain.

Add on top of that, your body is not functioning optimally with a lack of sleep, so it’s not just your brain that feels fuzzy, so do the cells in your metabolism, so they aren’t working at their best either. It’s not as if one night with a lack of sleep is going to make you gain 15lbs immediately, but when it becomes a cycle of sleeping less than 7-8 hours per night, and we are frequently reaching for comfort foods, eating more than we normally do, skipping on our exercise, and relying on stimulants to get through the day, it’s not healthy, and you will gain weight.

What can I do?

Cut back on the stimulants and don’t have any after 12pm, and start making a bedtime routine (essentially set a bedtime for yourself) to try to break the cycle.  Also, forcing yourself to get some exercise, even though you already feel exhausted, even if it is just a long walk, really will exhaust your body….in a good way!  It will help to relax your muscles when you are done, and get your brain ready to shut down and get a better sleep/rest. Also try to avoid heavy meals and alcohol right before bed, it can make you have troubled sleep and increase the risk of heartburn. Also, maybe a soothing lavender bath/shower before bed, to help calm your system and ready yourself for sleep.

Once you start sleeping regularly, you will feel a boost in energy, be more efficient, and be healthier.  You can get into a health and wellness cycle by getting regular exercise, and eating healthier, which will lead to a really easy drop in weight…all by making one lifestyle change!

If you DO get 7-8 hours of sleep at night but it is troubled sleep or you always still feel exhausted in the morning you should see your Healthcare Practitioner (HCP) because you may have Obstructive Sleep Apnea (OSA) or another process going on that requires a sleep study or more in-depth review.

Try to set a routine, and breaking the habit of caffeine can be miserable (I used to be a complete caffeine addict and have sleeping issues, so I KNOW how hard this is) but it is so worth it to be able to cut the cord and feel yourself without relying on caffeine and starting to be healthy again.  It seems impossible sometimes, but, I promise, it isn’t!

Yours in Good Health

B

Refocus and Trim the Fat From Your Life

I had a bit of an epiphany, as a good friend was helping me pack up and start the process to move into my new home soon: you need to trim the fat from your life. Now, in the past few years, due to various life circumstances, I have moved approximately every two years, so while I should totally be used to the process, I’m not.  I am never prepared for moves. I get anxious about having to pack, so I stare at my boxes a few days before finally kicking it  into high gear. But this time was a little different, I made a date with a friend who offered to help, we made a plan, and we attacked.

getting it done!After she left, with boxes piled high, and me getting ready to dig deep and live off of reusable plastic plates for a little while, it left only the things visible that we put in piles. We left a trash heap that was stuff I held onto that could be trashed (or recycled…just out of my house), and then there were the piles of stuff I needed to go through. Ugh. The things I need to go through is stuff I totally know I need to go through but just haven’t because I am dreading it. Why? I have no idea.  Now, I am not a hoarder by any means, but I have my box of important paperwork, and next to it, my pile of things that may be important but I just haven’t felt like going through them. So tonight, I did! And I feel amazing. I accomplished my goal of packing, and only kept the most important things, and now I have rid my life of the excess. And dealt with a bunch of things head on that I haven’t wanted to.

Physically I have trimmed the fat out of the boxes, but I also feel like this was emotionally a huge hurdle; I cut ties from my past, and now I can look forward, to my new life, in my new home.  Totally fresh and a real new start.

It got me thinking though, that I have done this at various times in my life, that I have felt that I have held onto “friends” or kept people in my life that cause anxiety/drama/stress so I try to keep them at arm’s length, maybe because of our past I feel I need to hold onto some semblance of a relationship, but it has become toxic. There have been a couple of those people in my life recently, that I have moved on from. While it is always sad to lose a relationship of any sort, it was also so cathartic. Much like throwing out some of the stuff I have been holding onto that I don’t need, getting the negative and toxic relationships out of my life has made me feel infinitely better, instantly happier, and so much more positive in every aspect of my life.

Every two years, you should re-evaluate and re-focus your life. I am not encouraging everyone to cut out everyone they are having a tiff with in their lives, but I am just thinking about ways that we can all make our lives simpler, happier, and easier. Whether it is ditching the project that you started and never finished that causes you to stress every now and again (or just getting the gumption to finish it up), or go out on a limb and do something that you’ve been wanting to try, starting that eating healthy kick, or surround yourself with positivity: trim the fat. Get the extra stuff out of your way that is preventing you from doing what is good for you, or what you want to do.  You are the only person who can make the right choices in your life to get you where you want to be; you are the master of your destiny.

Think positive.  Live positive. Be positive.

Yours in Good Health

B