Self-Care Strategies for the Overworked School Nurse

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Self-Care Strategies for the Overworked School Nurse

When Giving Your All Doesn’t Feel Like Enough

Katie Frisbie, MC, LMHC

Objectives

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Identify signs of compassion fatigue and burnout and take steps to feel better

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Learn new ways to define success and feel good about the work that you do

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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

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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

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Stresses for the School Nurse

♦IEP meetings

♦Dispensing daily medications to students

♦Health Assessments

♦Parents of the students

♦Immunizations

♦Health Screenings

♦Student Study Teams

♦Frequent Flyers

♦Isolation

♦Support multiple schools

H1N1?

Heed the warning signs!

Check Your Symptoms

♦ Physical Symptoms

♦ Behavioral Changes

♦ Emotional Symptoms

♦ Thought Signs

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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

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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

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No job satisfaction

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No energy, struggle to get to work

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Less concern for detail or quality

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Feel hopeless, nothing matters

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Feel like a hamster on a wheel

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Can’t motivate self to make changes

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Doing only the minimum required

Compassion Fatigue

♦Depersonalizationmeasures an unfeeling and impersonal response toward recipients of one's service, care treatment, or instruction

♦Emotional exhaustionmeasures feelings of being emotionally overextended and exhausted by one's work

♦Personal accomplishmentmeasures feelings of competence and successful achievement in one's work

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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

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Defining Success

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You can’t be perfect 100% of the time

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You can’t please every coworker or every parent

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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

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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

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Your Own Self-Nurturing Plan

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Your plan will be personal, but here are three things that may help:

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Quiet time alone – self-reflection

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Recharge your batteries daily

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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.

Self-Care Strategies for the Overworked School Nurse