THE NURSE’S GUIDE TO GOOD LIVING WINTER 2011 $2.95

scrubscrubsmag.coms RNs Dish on Sex, Love and Work

Where Is God When Tragedy Strikes?

Top 10 Reasons Nurses Get Fat How to Say No to Overload

Rx for Everyday Beauty Dilemmas 7 37314 16201 7

ON THE COVER Ricki Noel Lander ® ® in Dickies Keyhole Mock scrubs [winter 2011] FREE SAMPLES of Schiff MegaRed to give to your patients. Wrap Top in Candy Orchid. Call 1-800-934-3379 (8-5 MST M-F) or visit ProSamples.SchiffMegaRed.com to request your samples today! Photography by Lionel Cassini. 2 Letter Meet some of our contributors. 5 Vital Signs News for nurses on life, style and work. 8 Finds Fun and Games Our editors went on a shopping spree just for you. 11 Scrubs Chic Clothes with a Conscience Dress to express your sense of style as well as your sensibilities. 12 All About You• Nursing a Marriage Three RNs examine their love lives, revealing lessons learned, lines drawn, even how to have great sex. Nurse or Wife? By Theresa Brown Married to the Doctor By Patricia Harman Sex and the ICU By Tilda Shalof 34 No wonder nurses 40 Hmmm, so many 20 Easy Does It get fat! Understanding decisions to make. all the reasons is more Like, after a long Quiet, Please! Tune out chaos and key into calm with nurse- than half the battle. shift...bed or gym? tested strategies for finding peace of mind and body. By Daryn Eller

ACTUAL SIZE SOFTGEL SHOWN c ntents24 On Duty • Are You on Overload? No need to let work overtake your life. A few simple steps are all it takes to ensure that doing what you love still means loving what you do. By Deb Roffe 30 Belief• Keeping My Faith When one May Reduce the Risk of Coronary Heart Disease† patient’s tragedy becomes COMPARE TO FISH OIL another’s miracle, a longtime worshipper questions the Just 1 Small Contains No Fishy ® Powerful Schiff® MegaRed contains oil from pure Antarctic krill, tiny crustaceans that Softgel Omega-3 Odor or meaning of God—and is Antioxidants thrive in the frigid waters of the Antarctic. MegaRed® provides an optimal Per Day Fatty Acids Aftertaste surprised by the answers she combination of omega-3 fatty acids, phospholipids and critical antioxidants to finds. By Cheyenne Haven MegaRed® support heart and joint health. 24 Negative self-talk Softgel ✔✔✔✔ ® Unlike fish oil, MegaRed omega-3 fatty acids are absorbed and carried to the 34 Body can sabotage all • your efforts to reach body’s cells in phospholipid form. Phospholipids form the structural basis of cell Top 10 Reasons Nurses Get Fat How to membranes, so MegaRed® phospholipids with omega-3 fatty acids are easily outsmart the career-specific challenges that your goals and Fish Oil Softgel ✔ keep stress at bay. recognized, incorporated and utilized by the body. stand between you and your thinner self. Just one small, easy-to-swallow softgel per day. Quality tested for purity. By Gary Scholar 40 Beauty and Health For more information, visit www.SchiffMegaRed.com or call 1-800-526-6251 Decisions, Decisions• Sleep or work out? Exfoliants or antioxidants? Glossy or matte lips? Scrubs sussed out all THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. THIS PRODUCT IS NOT INTENDED TO DIAGNOSE, TREAT, CURE OR PREVENT ANY DISEASE. 12 Theresa Brown at home with her the information a nurse needs. By Lesley Alderman † Supportive, but not conclusive research shows that consumption of EPA and DHA Omega-3 husband, Arthur 48 Kosowsky, after he Expressions fatty acids may reduce the risk of coronary heart disease. injured himself and The Healing Power of Painting An RN helps patients—and herself— she wondered: Am I find fulfillment through art. © 2010 Schiff Nutrition Group, Inc. 591-D1 his nurse or his wife? CLOCKWISE FROM TOP LEFT: TIA MAGALLON; GETTY IMAGES; DAN PAGE; HARRY ZERNIKE HARRY PAGE; DAN GETTY IMAGES; MAGALLON; TIA LEFT: TOP FROM CLOCKWISE •cover story [letter]

MEET SOME OF OUR CONTRIBUTORS EVERYONE ON THE SCRUBS TEAM agrees that the greatest pleasure of working on this F eminine. magazine has been our interaction with so many nurses. Over and over again, we have EDITOR-IN-CHIEF been inspired by your dedication, courage and compassion. So now, in the spirit of Catherine Ettlinger strengthening our connection, I’d like to introduce you to a few of the many talented CREATIVE DIRECTOR Maxine Davidowitz F un. people who have contributed to this issue. EXECUTIVE EDITOR Renee Schettler DIRECTOR OF PHOTOGRAPHY As she wrote “Quiet, Please!” on page 20, Daryn Eller both reported and reflected on Lila Garnett COPY EDITOR F earless. the many different ways people tend to spend their downtime. “I could relate most to Melissa Brandzel the nurses who find relaxation in movement,” says Eller, a health and lifestyle writer RESEARCH EDITOR Tajinder Rehal whose work has appeared in More, Parents and Health. CONTRIBUTORS Theresa Brown, RN; Daryn Eller “For me, it’s swimming, doing yoga or simply taking a Scrubs, WEB SENIOR EDITOR walk.” A contributing editor to Eller says, “Every- Miriam Bookey one I know has a story about how a nurse helped him or WEB EDITOR Paris Lia her. For my husband and me, it was when we adopted our USER EXPERIENCE EDITOR daughter. We had no warning—we just got a call that a Halie Rosenberg WEB ASSOCIATE EDITORS mother was about to give birth—so we went to the hospital Jennifer Fink, RN Marijke Vroomen-Durning, RN totally unprepared. The nurses gave us a room to sleep in so we could spend the first night with our daughter, and NATIONAL SALES DIRECTOR Karen Rogala 917-692-6658 they held our hands until we took her home the next day.” [email protected] NATIONAL ADVERTISING MANAGER It was no surprise to Harry Zernike that he had much Fern Kershon RECRUITMENT & to talk about with the three nurses that he photographed EDUCATION SALES MANAGER for “Nursing a Marriage” on page 12. “There are a lot of Michelle Haskell nurses in our lives,” he says, explaining that his wife is DIRECTOR OF MANUFACTURING Johanna Leovey an ob-gyn and that her mother, who became a registered CREATIVE SERVICES/DESIGN nurse while raising three children, now works with her Rose Masterpol CIRCULATION CONSULTANT husband, also an ob-gyn. Zernike shoots for The Wall Lauren Coniglio PUBLIC RELATIONS Street Journal as well as his own magazine, 9W, a journal Dayna Macy 510-219-0819 of cycling photography and stories named for route 9W, [email protected] the well-known cyclist’s escape route from New York City. MIND OVER MEDIA, LLC 702 16th Street Santa Monica, CA 90402 Vivienne Flesher, the immensely gifted illustrator whose www.mindovermedia.net PARTNERS clients include The New York Times and Random House, Susan Gates Amy Rappeport created the artwork for “Keeping My Faith” on page 30. STRATEGIC MEDIA GROUP “It’s about extreme loss and the loneliness one feels in 9800 De Soto Avenue devastating sorrow,” she says. “Some of us might wish Chatsworth, CA 91311 818-671-2100 there were a reason for things, but in fact, our fate is ran- PUBLISHER dom.” She’s been especially appreciative of nurses since Michael Singer EXECUTIVE VP, MARKETING her grandson was hurt in a playground accident. “We all Marty Morawski VP COMMUNICATIONS & rushed to the hospital—mother, father, grandparents. It INDUSTRY RELATIONS was difficult to hold it together, watching such a small Wendell Mobley MANAGER OF DISTRIBUTION and helpless child in pain and fear. I don’t know how nurses manage to do so much Nicole Madden Scrubs magazine is published for Strategic Media Group by good in such trying circumstances, but I’m certainly grateful they do,” says Flesher. Mind Over Media, LLC, copyright ©2011 Strategic Media Group. All rights reserved. Scrubs magazine is a trademark of Strategic Media Group. Printed in the USA. All correspondence should be directed to Mind Over Media, LLC, 702 16th Street, Santa Monica, CA 90402. Copies of the magazine are available for $2.95 per copy plus shipping/handling, or in boxes of 75 copies for $1 per copy Catherine Ettlinger plus shipping/handling, at scrubsmagazine.com/magazine. Editor-in-Chief BPA Worldwide Consumer Magazine Membership applied for April 2010. babyphatscrubs.com 2 scrubsmag.com•WINTER 2011 The clinically tested premium formula in Free Move joint health. to support the Arthritis Foundation’s theArthritis tohelp efforts to support people take controlofarthritis. 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CORBIS NEWS FOR NURSES ON LIFE, STYLE AND WORK YOU’VE HEARDIT BEFORE: Strike aPose:YogaforNurses Breast Cancer.Oncologynurses,takenote. book, published latelastyear,isYoga and by thehealingpossibilities ofyoga.Hernewest poses in—whereelse?—ahospital setting. includes pictures ofnursesdemonstrating basic room toboostyourmood and yourenergy.The book with anemergencyorrelyonaquicktwistinthebreak stretch yourspine,practicedeep breathingwhen faced a simple forward bend withyourhands againstadesk to no revealing outfitsrequired! Forinstance,youmight do that canbedoneonanas-needed basisatworkorhome— wrote YogaforNurses.The bookillustratessimpleyogaposes research howyogacould help hercoworkers,and eventually pain resultingfromlonghoursonthejob,Kollakwentto of mydaily life,”saysKollak.“Getup, do yoga,have breakfast.” pain, sheresolved totakecontrolofherbody. “Yogabecameapart Sciences inBerlin,Germany,slipped adisk atage40.Inexcruciating nursing managementprograms atAliceSalomonUniversityofApplied knows thiswell.TheRN,PhD,researcherandprofessorinthehealth but youhave tofind outwhichstylesuitsyou,”saysIngrid Kollak.She ferent styles,manyofthemquitegentle.“Yogaissuitableforeverybody, physical postures and breathingexercisesareespecially goodfornurses. Kollak, for her part, continues to be intrigued Kollak, forherpart, continuestobeintrigued Realizing thatyogahelps torelievebothmentalstressand muscle Although yogaisoftenpresented asacrobatic,thereareseveral dif- Yoga offers benefits for everyone. But the Yoga offersbenefitsforeveryone. Butthe vital signs WINTER 2011 • scrubsmag.com 5 [vital signs] DO NURSES GIVE BIRTH TO BETTER KIDS? One Nurse, HELPING NURSES WITH DISABILITIES What’s on Nurses’ Nightstands? It should come as no surprise that One Hospital, MARIANNE HAUGH WAS BORN with spina bifida and uses a wheelchair, SELLING THE INVISIBLE the list of accomplished people and Kelsey Trapp was born without a left arm. Most days you’ll find them by Harry Beckwith whose mothers were nurses is long. 50 Years and in a hospital—but not as patients. Haugh, a nurse at Shriners Hospital in This book will assist you with In addition to the celebrities pic- Counting… how to sell your knowledge tured here, there are also Top Chef Chicago, and Trapp, a nurse at the Medical College of Georgia, are two of and skills. A “gold standard” host Padma Lakshmi,  lmmaker “WHEN I FIRST BECAME A NURSE, we had the growing number of healthcare workers with disabilities. “Nurses with book for the novice and the Quentin Tarantino, author James to stand up any time a doctor entered the disabilities have knowledge, experience and skills to share,” says Donna expert entrepreneur. Ellroy, boxer Sugar Ray Leonard Debbie Cragen, RN, certi ed and Glee star Lea Michele. nurses’ station,” says Norma Salahshour. Maheady, EdD, ARNP, who created the nonprofit site ExceptionalNurse.com legal nurse consultant, Cragen “It was a sign of respect.” to provide resources, employment information, mentors, social and Associates, St. Louis, Mo. Times have changed, and perhaps networking and other forms of support to disabled nurses. “They have no one knows that better than Salah- walked the walk and gained insights that enhance patient care.” GRACEFUL EXITS by Sushila Blackman There’s exceptional diversity, including nurses with epilepsy, miss- shour, who is celebrating her 50th year Great reading for someone as a nurse at The Methodist Hospital in ing limbs, bipolar disorder, multiple sclerosis and kidney disease. “The like me, a teacher and Houston. At 70, she’s not the oldest nurse profession should be even more accepting and accommodating of nurses hospice and palliative care nurse, my specialty in the profession, although she may be with disabilities,” says Maheady. “Many of our hospitals are some of the for the last 12 years. one of the few—if not the only—nurses to most accessible facilities in our society.” As it turns out, that accessibility Melissa Jones, RN, assistant have worked at the same hospital for half is necessary for more than just patients. professor of nursing, Lin eld College, Portland, Ore. a century. Nurses Kelsey Salahshour, now nursing director of Trapp, left, and Marianne Haugh, DEFINING THE WIND Clockwise from above, famous the oncology and hematology unit at right, don’t let by Scott Huler kids with their nurse moms: former Methodist, began her career in 1961. their physical The author set out to president Jimmy Carter; actress disabilities get in She worked the 3 p.m. to 11 p.m. shift the way of their investigate the creator of a Maria Bello; and Supreme Court work. poetically written scale used and was paid $2.10 an hour, which she Justice Sonia Sotomayor. to describe wind velocity at describes as “good money at the time. It sea. I love it when literature, was enough to let me save up for a used history, poetry and love of car.” There was no plastic—everything learning are intertwined. Wendie A. Howland, RN, life from syringes to IV tubing was made of care planning consultant, glass—and there were no computers, Boston, Mass. either. Nurses also had no automated way to determine IV drips. “We had to count LET THE GREAT WORLD SPIN the drops to regulate our IV clamps,” says by Colum McCann Salahshour. Etiquette Q & A This novel tells the stories of 10 New Yorkers and their lives Clockwise from above left: actress How has Salahshour avoided burnout OF COURSE YOU MIND YOUR MANNERS, we know that. Still, every once in a in 1974, using the tightrope Jada Pinkett Smith; The View host/ all these years? “Every day is a challenge, while a sticky situation crops up and your question about how to best handle walk across the World Trade actress Whoopi Goldberg; actress so you have to have a sense of humor,” it goes unanswered. Here’s an all-too-familiar scenario along with some Towers as a touchstone. Laura Linney; and former president she says. “I look forward to coming to expert advice from Lisa Gaché, founder of Beverly Hills Manners. Megan Sikorski, NP, pediatric Bill Clinton, whose mom was also nurse practitioner, Children’s the child of a nurse. work each day, interacting with the staff What do you do when a patient doesn’t want to see members of her fam- Hospital at Monte ore, Bronx, and meeting new patients. It’s never Q N.Y. ily, and they’re all out in the waiting room pressuring you to let them come in? gotten boring for me.” A This is where tact and diplomacy become your best friends. First and THE PRAIRIE PET foremost, honor the request of your patient. In your most gracious tone, explain by Stacey Lloyd A charming story about the need for your patient to rest and recuperate. Communicate honestly, oŒ er You’ll Know You’re a Nurse When… You reach over to a young girl’s stay in the words of support and understanding, and answer any questions they may have hospital and how it turned touch your husband’s hand tenderly in the middle of the about their loved one. This should put them at ease and hopefully alleviate—or into a magical place at least not aggravate—any tension that may be going on behind the scenes. with magic markers and night and find yourself feeling for a vein.Amy Zavesky, RN, BSN, Lansing, Ill. imagination. What are the most perplexing etiquette questions you encounter on the job? Julie LaFata, LVN, pediatrics YOU’LL KNOW YOU’RE A NURSE WHEN…INSPIRATIONS, REFLECTIONS AND EPIPHANIES FROM NURSES LIKE YOU FROM BY SIGMA THETA TAU INTERNATIONAL GETTY IMAGES PHOTOS: OTHER ALL CORBIS; PHOTO: CARTER JIMMY PAGE, THIS Please send them to us at scrubsmag.com/etiquette. nurse, Moorpark, Calif.

6 WINTER 2011 •scrubsmag.com 7 [finds] Introducing Fun and Games THE SCRUBS TEAM WENT SHOPPING...FOR YOU!

▲ All in a Day’s Play The Thinking Nurse is a board game that’s become a hit among nursing students as well as nurses and faculty at hospitals nationwide. Choose among six specialties: maternity, mental health, pediatric, infant, medical and surgical. ▲ Each comes with 150 Training Game patient scenario questions. Nursing is serious, but The shape, May the best nurse win. learning the ins and outs $50 at dupagepress.com/ of the job can be fun. nursing. Johnson & Johnson has a training program/video movement game called “Your Future in Nursing,” which replicates situations that require verbal and comfort responses. “It’s not so much about what to do when a patient crashes as being able to say, ‘Help, I’m in over my of Flexibles head,’” says Barb Tofani, RN, administrative director at the Hunterdon Regional Cancer in dress code- Center, Flemington, N.J., and one of the program’s Terrific Timing ▲ creators. Download it free at discovernursing.com. How many times a day friendly solid do you check your watch? That’s what we thought. It follows, then, that you colors. should have something nice to look at, such as this Nurse Watch. You’ve gotta love that tiny vial of aspirin! $45 at whimsicalwatches.com. ▲ Banding Together Judging by little arms in every schoolyard, few kids are without the latest craze ▲ Daily Dose of Humor in wrist-wear: animal-shaped Who said nursing is no rubber bands. But not laughing matter? The Nurses: everyone on the block has Jokes, Quotes and Anecdotes these Goofy Bands Medical day-to-day calendar proves bracelets—your child can otherwise. Put it on your be the › rst. (It’s okay, we desk as a reminder that even know you’re going to want when things get tough, to wear them, too.) $4.95 there’s a lighter side to life. at wackyshapes.com. $14 at amazon.com.

8 scrubsmag.com•WINTER 2011 For more finds, go to scrubsmag.com/finds. CherokeeUniforms.com &DOO)RU1RPLQDWLRQV [scrubs chic] Clothes with a Conscience cherokee DRESS TO EXPRESS YOUR SENSE OF STYLE AS WELL AS YOUR SENSIBILITIES. INSPIRED COMFORT AWARD Do-Good Designs T H E “EVERY MOMENT OF LIFE is a gift,” says COTTON David Culiner, a musician who has TALE turned Love This Life, his band’s DON’T BE SHOCKED name, into a brand everyone seems when you start to to love—no pun intended. The logo see the prices of your has taken off on T-shirts, jewelry scrubs rise. The cost of and now scrubs. The new tops all have cotton went through the “Love This Life” embedded in the design roof last year, setting of hand-drawn prints, and are available with record highs for this pants in complementary solid colors. Scrubs functional fabric—the seem to be a natural evolution of the line. value of this hot com- “‘Love This Life’ is not a message, it’s what peo- modity leapt more than ple feel,” explains Culiner, who thinks nobody is 80 percent from last better suited to wearing the name than nurses. summer through the Surprise a friend or co-worker. “They are living the feeling at its very best end of 2010, according For their exceptional service, sacrifice or innovation, every day as they selflessly care for others. to The New York Times. The cause is a classic nominate them for the 2011 Cherokee Inspired Comfort Award. ‘Love This Life’ celebrates nurses.”Patients Love This Life are responding, too. “They see ‘Love This tops, $23, case of supply and Fantastic prizes are also available for the nominators! are now Life’ as a humble acknowledgement of the available in demand. Bad weather four prints, fragility and vulnerability of the human in cotton-producing Deadline: May 31, 2011 clockwise form,” says Culiner. “It’s their story, too.” from left: regions of India, China Water Blossoms, Your Magnificence, Your and Pakistan accounted Garden of Groovy and for poor harvests. At the Freddy the Frog. NOMINATION CATEGORIES: same time that supplies 1. 2. 3. RNs Advanced Practice Nurses LVNs/LPNs The Fabrics of Our Lives were diminishing (and 4. Students in Nursing School 5. Other Healthcare Professionals EXOTIC TEXTILES MADE FROM ECO-FRIENDLY BAMBOO and eucalyptus the dollar was being Prizes in each category include: are finally making their way into the scrubs market. These all- devalued), demand ‡ Caribbean cruise for two with roundtrip airfare natural fibers are not only sustainably grown, but are specifically was increasing from ‡ All-expense-paid trip to any clinical conference in the continental U.S. nurse-friendly, too: They’re super comfortable, thanks to their innate China and the United ‡ Paid membership to any clinical association softness, breathability and absorbency. Natural Elements scrubs States, thanks to the ‡ Cherokee Uniforms/Cherokee Footwear $1,000 wardrobe from Dickies are fashioned from Tencel, which comes from the pulp beginnings of our own ‡ Subscription to Scrubs – the lifestyle magazine for nurses of eucalyptus trees. Similar to rayon, the fabric drapes beautifully to economic recovery. Un- flatter your figure. Iguana Med’s Green line is made from bamboo, fortunately, the experts Enter online at: InspiredComfort.com which is completely hypoallergenic, biodegradable and antimicrobial. don’t expect cotton Or pick up a nomination form from your Cherokee Uniforms retailer. It also grows like a weed—up to 18 inches a day!—which means it’s production to catch up For timely updates & tips, follow us on Twitter @inspiredcomfort easily replenishable. This, in turn, means good news for nurses: to consumption for at

BOTTOM PHOTO: GETTY IMAGES PHOTO: BOTTOM You’re not going to run out of these great new scrubs anytime soon. least a couple of years. cherokee WINTER 2011 •scrubsmag.com 11 INSPIRED COMFORT [all about you] Nursing a Marriage Does work wrangle with your love life? Three RNs untangle the tensions they face— and reveal lessons learned, lines drawn, even how to have great sex.

Photographs By HARRY ZERNIKE

MY HUSBAND, ARTHUR, FELL the Sunday before Christ- NURSE mas. He was walking the dog and slipped on a patch of black ice about a block from our house. Luckily, some- one with a cell phone walked by and called our home. Our 13-year-old son took the call and then told me, OR in an oddly emotionless voice, “Dad fell and we need to go get him.” And so it began. I jumped in our van and started driving. It was dark, but Arthur’s orange WIFE? Gore-Tex parka stood out where he lay on the side- walk. “Oh, oh, oh,” I said. Man down. The first thing he said was “I think I broke my shinbone,” and my imme- WHEN YOUR SPOUSE LANDS diate reaction was “No, you did not.” I didn’t want to IN THE ER, IT’S HARD TO KNOW think about him being hurt, and I really didn’t want to WHETHER TO STEP UP AS think that a fall on ice could so easily break a healthy A MEDICAL PROFESSIONAL bone. We want the people we love to be invulnerable, and we want to be invulnerable ourselves. OR STEP BACK AND SIMPLY Turns out he broke two bones—the tibia in two STROKE HIS HEAD. places, the fibula in one—and tore loose the membrane that holds the tibia and fibula together at the ankle. It By THERESA BROWN, RN would take more than three hours of surgery to fix him, Oncology nurse Theresa Brown and but we knew none of that at the time, only that he was her husband, physics in pain and cold and couldn’t stand up. professor Arthur Kosowsky, at home in The stranger with the cell phone called an ➺ Pittsburgh, Pa.

FROM THE NEW YORK TIMES , © JANUARY 20, 2010, THE NEW YORK TIMES. ALL RIGHTS RESERVED. USED BY PERMISSION AND PROTECTED BY THE COPYRIGHT LAWS OF THE UNITED STATES. 13 [all about you]

ambulance, and our son took the dog back home. All conscientious guy, or maybe that was his own denial, three children went to a neighbor’s house where we his wanting to imagine that his injury wouldn’t really were expected for dinner anyway, and I followed the slow him down. ambulance to the hospital. His job as a physics professor ended up matter- MARRIED The emergency medical technicians had placed him ing in a way I never expected: The doctors all treated on a board and fitted him with a cervical collar just in him like a rock star. They respectfully called him case he had a spinal cord injury. They unlaced the boot “Professor,” shyly admitted to struggling in physics TO THE on his left leg (which hurt) and then stabilized the leg and guardedly said they would treat him as long as he with an inflatable splint. All I wanted to do as I drove didn’t ask them any physics questions. to the emergency room was cry, but I told myself, Who knew? I thought our ace in the hole would be DOCTOR “Don’t cry—it won’t help right now,” so I put my game that I’m a nurse in the same hospital system, but my face on instead. husband’s profession trumped any cred I could have “Who was I now?” I wondered. Nurse or wife? “I’m brought to bear. And the truth is, that was kind of a WORKING WITH YOUR HUSBAND a nurse,” I told the nurse in the emergency room, “but relief. Because that night, I realized, I didn’t want to be IS A DELICATE DANCE, I’ll try not to be annoying.” She laughed, and then the there in the emergency department as a nurse. I just MORE BOOGIE THAN BALLET. medical resident said, “I’ll try not to be annoying, too.” wanted to be a wife. By PATRICIA HARMAN, RN Then they got to work and cut the boot off his left We always say that if you go to the hospital, you foot, took his vital signs and gave him some intravenous should take someone with you who understands how narcotics. They also cut off his jeans, which were dirty modern healthcare and modern hospitals work. In gen- and wet, and carefully got him into a hospital gown. eral it’s good advice. But the staff in that emergency During all of this, we were treated to the gallows hu- department knew their jobs—they didn’t need me or mor of the place, and it actually made me feel at home. any other nurse scrutinizing everything they did. When the X-rays came back, the doctors decided to “reduce” Arthur’s That night I didn’t want to be there fracture, meaning that the orthopedist in the emergency room as a nurse. would realign his leg while he was se- dated. The resident, the same one who WHEN I TELL MY FELLOW NURSES that I’m I just wanted to be a wife. The staff had said he would try not to be an- married to a doctor, and that for the noying, gave me the oxygen to put on past 10 years he and I have been part- knew their jobs—they didn’t need me Arthur. “People feel better when they ners in a women’s health practice, their scrutinizing everything they did. can help,” he said. I agreed with him, reactions are split. Half imagine it must but then had a devil of a time getting be wonderful to work with one’s soul the tubing to fit the right way. mate, shoulder to shoulder all day long, The admission nurse asked if Arthur had any alcohol I was too distracted and scared to be good for much looking into each other’s eyes, meeting before he fell. “Well, no more than his usual fifth of in the way of nursing. But maybe because I am a nurse, for romantic lunches. The other half scotch,” I answered. She laughed and then said, “You’d I could see how competent they all were and could cringe. Spending 24/7 with your mate... be surprised.” relax just a little. while he’s acting like your boss! Then she asked him if he felt safe at home, if I’d Waiting for the surgery, I stood at the head of Ar- The truth? They’re both right. Yes, ever threatened him or hurt him. These are standard thur’s bed and absentmindedly ran my fingers through our eyes do meet with affection— questions intended to screen for spousal abuse. “No, his hair. “That’s the best thing you can do right now, sometimes. I get to spend every day nothing like that,” Arthur started to say before she stroke his head,” the resident said. Then he added, with someone I love, doing work that interrupted him with “Well, come on, we know she did “And you’re the only one who can do it.” I love. And since Tom and I are aware this to you.” My husband got the joke. “Oh, except for of each other’s needs, we are able to this,” he said, playing along. THERESA BROWN is the author of Critical Care: A help each other. If my stack of charts Meanwhile, he was worrying about when he would New Nurse Faces Death, Life and Everything in gets too high, he’ll sign off on my labs Patricia and Tom finish final grades for the premed physics class he had Between and a regular contributor to the New York Harman, MD, partners or bring me a salad from the cafeteria in marriage for 30 years just finished teaching at the nearby university. He is a Times blog “Well.” and in business for 10 so I can finish my paperwork. If ➺ years, at their clinic, Women’s Health Care, in 14 scrubsmag.com•WINTER 2011 Morgantown, W. Va. 15 [all about you] he’s running behind, I’ll see one of his patients. And call my husband “Dr. Harman.” And I normally preface him be rather than asking all the time, “What’s wrong?” any marriage is. The lessons are the same, including if something bad happens, a surgical complication or my questions with “May I consult with you” rather than I try to respect his need for space and allow him to the one you always hear: Leave time for romance. I’ll a miscarriage of an infertility patient, we can support “Hey, what do you think?” Likewise, he has to remind withdraw until he returns to his usual mellow self. admit that I don’t always follow this advice. Fortunately, each other. himself to treat me as considerately as he does the rest Because we work together, Tom and I tend to talk Tom is better than I am. At night when we sit on our porch with a cup of ten- of the nurses. about our profession too much. I try to leave work at “Did I tell you about the 17-year-old I saw today sion reliever tea, we can discuss interesting cases, new Here’s an example that happened one morning. work, but thoughts still creep in. “Do you think we can with chlamydia?” I prattle on as I put my bare feet up things we’ve learned or the latest research. It’s not as “May I consult with you, Dr. Harman?” I notice he give bonuses this winter?” I might ask as we’re getting on the porch rail and stare into the dark across our boring as it might be with other couples because we’re has frosting on his fingers and I frown. He’s supposed ready for bed. We’ve learned that we have to call a two acres of freshly cut lawn and surrounding woods. in it together. Like anglers on a mountain stream, we to be on a diet, but I resist my urge to comment. halt to that and schedule a meeting for those kinds of “She cried. I felt so bad. Her mother committed suicide compare notes, tell fish stories and empathize with “Sure. What’s up?” conversations. Planning ahead has helped and, in fact, when she was eight and she has a history of sexual each other’s successes and failures. I flip open Lilac Morgan’s yellow chart and run now we do the same thing with domestic concerns. I abuse. On the other hand, she was having unprotected This is the good part of organize a sit-down, give warning of the topic, put a sex. I just hope she learned something….” working together, but it has When the lines between colleague time limit on the discussion and include food—sushi, “Give it up, Pats.” That’s Tom. Fireflies flicker in the taken time to evolve. We’ve hot dogs or Kentucky Fried. Tom’s easy to please. forsythia bushes. “Let’s think about the way the grass operated as a team our en- and spouse blur, distractions occur. When all else fails, I remind myself what a compe- smells and how the tree frogs sing down by the lake.” tire married life—30 years I’ve learned not to interrupt my husband tent, kind person I have for a partner—and I tell him. He puts his hand tenderly on the back of my neck. I and counting. We met during “Tom,” I might say, “You are the best backup physician still get goose bumps…. our commune days, built log with domestic concerns. He reminds a midwife ever had.” cabins together, planted fruit He smiles because he’s heard this from me a hun- PATRICIA HARMAN is an RN and a nurse-midwife in trees, started food co-ops and himself to treat me as considerately dred times, but I think he still likes it. West Virginia. She is the author of The Blue Cotton marched in peace demonstra- as he does the rest of the nurses. Working with your husband is a delicate dance, Gown: A Midwife’s Memoir and Arms Wide Open: A tions against the war in Viet- more boogie than ballet. But then when you think of it, Midwife’s Journey, due out in April. nam. Eventually, we took turns going back to school. One of us worked while the other through her history. “This is a 57-year-old patient, studied, back and forth. He became an EMT, then I overweight, hypertensive, having severe hot flashes. WORKING IN THE ICU HAS BEEN good for my love life. became an LPN. He became a paramedic, then I became She smokes a pack of cigarettes a day and wants Sex and nursing? Yes, it’s true. Years ago, as a an RN. He worked as a medical assistant in an oncol- hormone replacement.” I’m ready for him to say, “No, SEX AND newbie nurse, I had a patient, a woman exactly my ogy unit while I studied midwifery. He went to medical she’s too high-risk.” age—24—who was critically ill after a freak scuba- school and did his residency while I taught maternal “Get blood work on her and if the results are okay, diving accident. Her fiancé stayed by her side around nursing and did deliveries in a university nurse-mid- you can start her on something.” THE ICU the clock until she arrested and died. Recently mar- wifery practice. During this time, we had three kids Would he answer a clinical question from another ried, I was shocked by this tragedy that felt way too and managed to pull off the usual things parents do: nurse or a nurse practitioner in the same casual close for comfort. Her death shook me to my core and SEXUAL INTIMACY IS THE feed them, do their laundry, make it to PTA meetings. manner? I don’t think so. He would sit down, listen filled me with doubt about whether I had the emotional When we started our private practice, the real chal- attentively and then discuss the critical issues. I give BEST WAY TO PHYSICALLY UNWIND, fortitude to be a nurse. I stumbled out of the hospital, lenges began. I was the administrator, but he was the an inward growl, then toss my irritation aside. It’s SPIRITUALLY REGENERATE AND dazed and distraught, trying to process it all. My hus- medical director. I was in charge of the staff, but he not worth the hassle to go around mad. Progress, not RECONNECT WITH YOUR HUSBAND band, Ivan, met me in the parking lot. was in charge of the nurses—and me! We had to be perfection—isn’t that what they say? There’s another AFTER A DRAINING AND ACTION “How was work?” he asked as I got into the car. careful of each other’s feelings. No offhand remarks. thing. I know my husband so well, I’m always aware of PACKED SHIFT. I was unable to speak. The work was too intense. Patients’ lives were at stake. his moods, even when he’s 40 feet down the hall. I can “Are you hungry? Tired?” When the lines between colleague and spouse blur, tell by the way he walks what kind of day he’s having. By TILDA SHALOF, RN Yes, I nodded. But I didn’t crave food or sleep. distractions occur. I’ve learned to constantly remind Jolly means he’ll stroll around the clinic, joking with When we got home, I was seized with desire. That myself not to interrupt my husband with domestic the staff. Bored and he shuffles back to the kitchen to night our lovemaking was wild and intense as I fled to concerns. “Hey Tom, did you remember to go to the look for baked goodies. Hassled, he whips back and safety in a place beyond words. bank this morning?” I’m tempted to ask as I pass his forth from exam room to exam room without a smile. I stayed in the ICU and learned to meet its chal- desk. I also show respect and don’t seek his advice on Frustrated, he might snap my head off. Like the nurse I lenges, conquer my fears, even thrive as a nurse in a a patient as casually as I’d ask him to stop for a jug am, I want to make him feel better when he’s having a place where, minute by minute, patients’ lives hang in of milk on his way home. In front of patients, I always bad day, but I’ve come to understand that I have to let the balance. But I have to admit, at the end of each ➺

16 WINTER 2011 •scrubsmag.com 17 [all about you]

shift, I have always thrilled to a secret relief: to be able ICU has given my life added urgency and deeper mean- to leave it all behind and retreat to my happy home ing—it challenges me to choose life and love, again and the steadfast comfort of Ivan’s embrace. and again. I’m still in the ICU 25 years later, still working every My marriage continues to be a source of great com- other weekend and night shifts, too, and still loving fort and support. I often wonder if I would have been this work. What has changed is that I now realize a able to stay in this demanding, stressful work without serendipitous benefit of critical care nursing. Spend- this soft place to fall. The loving partnership I have ing as much time as I do with patients who are fighting with Ivan and the happy home we’ve created make mighty battles and hovering between life and death it possible for me to do this work and stay healthy is a constant and harsh reminder of all we stand to and sane. When I get home, Ivan still asks, “How was lose. It’s also an inspiration to appreciate what we have in this moment, now. For me, it turns I often wonder if I would have lovemaking with my partner been able to stay in this demanding, into a necessary and life-affirm- ing practice. Sexual intimacy stressful work without the loving is the best way to physically unwind, spiritually regenerate partnership I have with Ivan. After and reconnect with my husband work, I feel like I have so little left to give, after a draining and action- packed shift on Planet ICU. but much more after a little loving. I wish I could report that our love life has stayed as hot and heavy as it was in those early days. As happens to work?” All I say is “Fine.” I need to leave it behind me. so many couples, the stresses of everyday life—bills, (I have nurse friends for when I do want to talk about babies, occasional bickering—cooled the flames, to be it.) Yes, I’m still hungry and tired after a shift. Ivan sure, but the main culprit was shift work. For years, I always has a nice meal ready for me and then urges me was chronically jet-lagged and out of sync with family to rest. What’s different now is that I’ve finally figured and friends, often working an opposite schedule to out that at these times, it is not food or sleep I crave, Ivan’s as an insurance broker so one of us could be but intimacy and connection. After work, I often feel home with the kids. After each shift, I came home hun- like I have so little left to give, but much more after a gry and tired, and too often used chocolate and wine little loving. for “nourishment,” and mindless TV on the couch for When I reach for Ivan, I’m home. “rest.” Intimacy was pushed to the back burner—hey, • it wasn’t cooking at all for a few years there. (I bet you TILDA SHALOF is the author of A Nurse’s Story and, thought I was going to say “weeks.”) coming this spring, Opening My Heart—A Journey from Our marriage suffered for it—big time. For a while, Nurse to Patient and Back Again. we became roommates, passing in the day or night, sharing responsibilities, but not a lot else. It’s only been in the last few years that our sexual relationship has begun to flourish again. The kids are growing up and don’t need us as much, so we have more time and head space to focus on “us.” There’s something else, too. I recently underwent major surgery. Having been close to death, I am even more awed by the magnifi- Tilda Shalof, an ICU nurse for 25 years, cence of life and more understanding of the courage and the man she loves to come home to, required to cope with illness. Returning to work in the husband Ivan Lewis, an insurance broker, in Toronto, Canada. WINTER 2011 •scrubsmag.com 19 [easy does it] OME PEOPLE WILL GO to the ends of you do it for five minutes or five the earth for a quiet moment, and days. “Nurses know that too much Jamie Fletcher is one of them. Last contact with patients without a pe- year, the ICU nurse left behind the riod of withdrawal makes for scat- daily grind at St. Joseph’s Health tered attention, mistakes, anxiety, Centre in Toronto and headed for depression and loss of interest,” base camp at Mt. Everest. As she says Steven Hendlin, PhD, a clinical trekked for nine days through psychologist in private practice in Tibetan villages, stream-filled hills, Newport Beach, Calif., and a Fellow and valleys and forests of rhododen- of the American Psychological As- dron, the stress and pressures of her sociation. “For people like nurses, nursing life melted like snow. who are always dealing with other She made it to 17,500 feet, a spot people’s pain and suffering, not where she not only found peace and having outside stress reducers may quiet (save for a brief run-in with a lead to depression and early burn- yak), but had an up-close-and-per- out.” Everyone needs a breather, sonal view of the tallest mountain but no one more than a nurse. in the world. “It made the chal- lenges in my life seem like a walk in Searching for Serenity the park,” says Fletcher. “Afterward, There are no rules about what con- I felt as though I could handle any- stitutes the ideal interlude, and it thing that came my way.” doesn’t even have to be quiet. Maybe Do you have to truly get away you seek solace at a rock concert from it all to have an exquisitely or by cheering on your favorite quiet moment? A survey of nurses sports team. Yvonne Sannes, a home in various locales suggests not. health nurse in Lancaster, Calif., What is, however, nonnegotiable rides motorcycles with her husband is regularly taking the time to when she’s not tending to mothers recharge your batteries—whether through Nurse-Family Partnership

Nobody needs to tune out chaos and key into calm more than a nurse. Here, many different—and delightful—de-stressors to bring you peace of mind and body.

By DARYN ELLER

Some nurses seek solace in the middle of nowhere on Mt. Everest, as far from their pressured lives as possible, this page. Others GETTY IMAGES RIGHT: GLASSMIRE; WENDY LEFT: are able to chill just by stealing a quiet moment mid-shift, 21 opposite page. [easy does it]

a public health program. The fact that Many nurses have more than one or go to a salon (definitely spring for “But some of those days, I am able to Togetherness or they’re both nearly 70 doesn’t stop way they take refuge from the pres- the $5 foot massage!)—can lift you into coax myself into my bike clothes and go Alone Time? the couple from riding almost every sures of the job. Fletcher, for instance, another realm. To Ali Frisius, a pre-op for a ride. The first five miles are hard, The French philosopher Jean-Paul Sartre weekend. Kim Bahnsen, who works as a doesn’t get to travel to exotic spots nurse at Post Street Surgery Center in but then I find myself feeling lighter famously wrote “hell is other people.” supervisor for NFP in Port Matilda, Pa., like Everest every day (or every year, San Francisco, closing her bathroom and wanting to go faster and further. Considering that nurses usually believe also revs up on the weekend, though for that matter), but she takes a mo- door and easing into a hot bath with The next morning, I am eager to get the opposite—heaven is other people— her vehicle of choice is the ATV she ment for herself daily by switching on candles flickering nearby and a novel back to work again.” it’s not surprising that some nurses’ rides with her husband and son. classical music after work. “I don’t use in her hand is pure pleasure. The heat On any given weekend you might most peaceful moments are spent with On the other hand, it could be that the television to escape anymore,” says of the water instantly dissipates the find Jane Henson-Inda powering a raft loved ones. Linda Mutzig, lead nurse you use this time simply to take in the Fletcher. Instead of watching life, she nervous energy she has built up during through whitewater rapids or push- at Oklahoma Children First in El Reno, beauty of the world—visiting a botani- now makes an effort to experience it. the day. Other nurses find that just ing off on her cross-country skis. The Okla., loves to camp with her family at cal garden or even a favorite flower A daily dose of Native American using their 15 minutes in the break NFP supervisor with the San Juan Basin a local lake or make plum jelly with her shop on your way home from work; sit- flute helps Paul Phelps wind down. A room for a calming and repetitive Health Department in Durango, Colo., eight-year-old granddaughter. Her col- ting on a cliff watching the fog roll in; nurse who works half the year in the activity like knitting or doing a cross- derives the most calm from doing league, Melissa Heibel, also cooks with ICU at a Greeley, Colo., hospital and word puzzle can be soothing. So can a something active (including her thrice- her family and finds that playing board Physical exertion half the year in Florida (where he cares brief meditation. “Simply closing your weekly bouts of yoga). But Henson-Inda games and cards with her husband may not be tranquil for the for his aging parents, too), he also eyes for 10 minutes, sitting still, with also tosses off the worries of working Getting lost in a body, but it can raucous crowd be quieting to likes to bury himself in a book, taking a straight back and feet on the floor— with clients who have limited resources There are no at a concert or the mind. care to choose one that has nothing to and doing this away from noise—can by coming home and puttering around sporting event rules about what is the relaxation do with nursing. You might call it his help you slow down and feel able to her flower garden or hanging out mode of choice constitutes the among some regular upkeep. In addition, he culti- return to interacting with patients,” with her pets. “I have an older golden nurses. vates his fishing habit as often as he says psychologist Hendlin. retriever and tabby cat who give me ideal interlude, and can in nearby creeks and lakes. “I tell comfort and help me unwind after it doesn’t even put you at a remove from the clamor my coworkers I only work to fish,” he Retreats: Physical work,” she says. and chaos that goes with a 12-hour says. The grandeur of the surrounding and Cerebral When Debbie Cartmell, a home have to be quiet. shift, sending you to a place where mountains, the trickle of cold streams, Like Fletcher, many nurses find peace- health nurse in Everett, Wash., is feel- you can see (or imagine) beauty, feel the occasional whir of a fishing reel fulness as they push their bodies to ing wound up about issues at work, she and two boys soothes her soul. For sensual or be creative or introspective. and the meditative wait for a catch all the limits. Physical exertion, if far from goes outside and “takes it out” on her Deb Bushover, a home health nurse at And even if your literal or figurative add to the serenity of those moments. tranquil for the body, can be mysteri- lawn. Nature is a natural calmer, and Family First Health in York, Pa., noth- getaway is momentarily interrupted, “After 35 years of working in health- ously quieting to the mind. Nancy Beck, many nurses experience their loveli- ing is more perfect than sitting on the it’s still going to do you good. care, I have come to understand the a nurse at Boone Hospital Center in est intermissions outdoors. Urbanite deck with a glass of wine, watching the That, at least, was Fletcher’s experi- necessity of relaxing while away from Columbia, Mo., finds that her 40-minute Meredith Cagen, a New York City RN, sunset with her husband. ence. She was just 30 minutes away work,” says Phelps. brisk walks each day in a local park prefers indoors to out: She takes pen Yet sometimes solitude is the best from base camp when one of her fellow To be meaningful, a time-out needn’t allow her mind to wander. “It’s during to paper (well, fingers to keyboard) and antidote. Karon White Gibson’s trekkers fell. “He suffered a serious be the stuff of dreams. On days when this time that I gain insight into my writes. It’s her way of managing stress favorite quiet moments are those she head injury, and as a nurse, it was up you lose a patient or are short-handed thoughts and sort through them,” from a big-city hospital, and she has a spends floating on her back in a pool. to me to help,” she recalls. “I cared for at work, something as elementary as says Beck. “I see it as a time for self- novel—Size Eight in a Size Zero World— Suspended in aquamarine, the Illinois- him as the porters carried him down sitting down with a cup of tea can feel reflection and personal growth.” and a website (sizezeroworld.com) to based nurse, a first-aid consultant on on their backs so that he could be like a little slice of heaven. To Donna Monica Koenig, a home health show for it. movie sets and host of a healthcare air-lifted off the mountain.” The man or taking a car ride to the nearest river, R. Pauling, a home health nurse in nurse in Sacramento, Calif., refills her Many nurses also keep journals. “It’s cable program, feels weightless—and recovered well, but Fletcher never did lake or ocean. Or it may be a time you Bloomsburg, Pa., the perfect time-out is “energy bucket” by participating in a a way to get my thoughts down and unweighted—as she allows herself to make it to base camp. “Still,” she says, go inside yourself and block out the quilting for Quilts for Kids, an organi- vigorous boot camp exercise program. out of my head,” says Cartmell. Brenda drift. When no pool is handy, Gibson “it was the most rewarding thing I ever rest of the world by daydreaming or zation that distributes comforters to Barbara Bronson, a nurse manager at Grunza, a home health nurse in Lacka- visualizes herself on a beach. It’s a get- did in my life.” reciting affirmations. As long as your seriously ill children. St. Anthony Central Hospital in Denver, wanna County, Pa., gets out of her head away she can take anytime. • escape gives you a chance to remem- A little pampering can also go a long Colo., cycles. “There are days when I am by using her eye—she takes photo- Because isn’t getting away, even if DARYN ELLER is a writer based in Venice, ber—and be—exactly who you are, you way. Simply keeping up with a regular emotionally drained and all I want to do graphs as a way to relax (when she’s not it’s only your mind that’s doing the Calif., who has written for Parents,

know you’re doing it right. pedicure—whether you do your own is lie on the couch after work,” she says. GETTYIMAGES home assembling jigsaw puzzles). traveling, the point? Quiet moments Prevention and Ladies Home Journal.

22 scrubsmag.com•WINTER 2011 Learn more ways to unwind from work and share your strategies at scrubsmag.com/quietmoments. 23 [on duty]

WENT TO WORK EVERY DAY FOR 20 YEARS knowing all As The Nurse Coach, I give my clients simple assignments too well the meaning of “nurse stress.” It wasn’t too long geared to help them discover what parts of their lives are out ago that I was working 10-hour shifts in a G.I. lab assisting of whack. (You’d be amazed at how many nurses don’t even with colonoscopies and upper endoscopies in a windowless know they’re on the path to burnout!) We work on aligning their Iroom. I had one doctor, a sedated patient and a continuously strengths with their careers and finding ways to take better beeping heart monitor to keep me company. care of themselves. This rarely means leaving nursing (we can’t Eventually I sought out a life coach to help me make sense afford to lose even one of us!). of my situation. With her support, I realized that my position What needs changing in your life? Take the quiz below to get didn’t suit my natural knack for listening to people and solving an idea of where you stand on the overload-o-meter—at work their problems. I got up the courage to become a life coach my- and at home. Then take a look at the six assignments on the self, helping other nurses in the Denver area de-stress and find pages that follow: your call to action. Each is designed to put balance in their lives, just as someone else had done for me. you on the road to a happier, more fulfilled life.

ARE YOUON WHAT YOUR SCORE MEANS TAKE THIS STRESS TEST 12–20 Thankfully, you seem to have little job-related Rate each of the 12 statements according to the stress. This is a good position to be in, although you following scale: can always stand to make your life a little calmer. Use OVERLOAD? 1 = never any of the assignments on these pages to tweak the 2 = rarely areas of your life that need improvement. 3 = sometimes 4 = often 21–37 You’re under a moderate amount of stress 5 = always and have a fair chance of becoming overwhelmed if things continue without change. You may want to pay _____I am responsible for so many different tasks particular attention to Assignment #1 to see which at work and at home. aspects of your life are out of balance, as it’s best to _____I feel less competent or effective than in the past. catch and address signs of overload early, before the _____I frequently feel overwhelmed. problem gets away from you. _____I’m achy—head, stomach, muscles. 38–47 You express a potentially sleep-disrupting _____I have trouble sleeping and feel tired even amount of stress and may be close to overload—or at when I get enough rest. least exhaustion. Any of the assignments that follow _____I often wish I could play hooky. will be useful. You may wish to start with #2, as people _____I tend to see the glass as half empty. approaching burnout often sabotage themselves with _____I find myself watching the clock during my shift. negative self-talk without even realizing it. _____I get angry and irritated easily. 48 & up You’re stressed to the max! Use any—if not _____I stick to myself and avoid conversations with all—of the assignments to help you determine where coworkers. you need to make changes. And consider asking others NO NEED TO LET STRESS OVERTAKE YOUR LIFE. _____I’m often tempted to calm myself with alcohol, to help you for a change. There are many places to turn WITH THIS WORKBOOK, YOU CAN ENSURE THAT DOING WHAT drugs or food. for guidance. You can contact your hospital’s employee YOU LOVE STILL MEANS LOVING WHAT YOU DO. _____I rarely take breaks or even vacations. assistance program, find a mentor in someone whose ability to maintain balance inspires you or seek out a By DEB ROFFE _____Your Score therapist or life coach. Illustrations by DAN PAGE

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to banish the saboteur. And it’s with a relationship at work, FIND MORE as easy as A-B-C: have a frank conversation with ASSIGNMENT BALANCE IN that person. Knowing what she YOUR LIFE A. Confront your saboteur. honestly thinks—and not what When you think about what’s you think she thinks—will 2 making you unhappy—your quiet the saboteur and will DON’T BE The circle below is divided into eight job, a relationship, money mat- probably help repair the con- sections, one for each of the most signifi- YOUR OWN ters—listen to what you’re say- nection. cant aspects of your life. Imagine that the WORST ENEMY ing to yourself. If the phrases outer edge of the circle is equal to complete “I can’t,” “I need to” or “I don’t C. Replace the negative fulfillment and that the center, where all the When Stephanie, a young deserve” are part of your inner with the positive. Find a lines meet, equates to utter disappointment. nurse working nights on a dialogue, you know you have a new mantra. For Stephanie, Mary, the CNO of a hospital, was Using a pencil or crayon, shade in each sec- telemetry unit in a hospital, saboteur. Other signs that you who believed she couldn’t exhausted. Her life revolved around her tion of the wheel to represent your satisfac- came to me, she was flounder- are sabotaging yourself: hav- deal with the day shift, it was job. She woke up every day at 4 a.m., tion with that part of your life. For example, ing. She was stressed and had ing difficulty making up your I know enough, I am enough, I worked weekends and was often on call. I if you consider yourself to be at about 30 gained a lot of weight. It came mind and frequently feeling can handle anything. After say- asked Mary to draw what’s known as the percent in your dedication to personal to light that although Stepha- anxious, depressed or angry. ing it over and over to herself, “Wheel of Life,” a tool for assessing which growth, shade only the inner third of that nie worked the night shift, she she eventually switched to areas of your life need attention and, quite wedge. Now look at your circle. What areas was not a night person—her B. Search for the truth. days and she’s doing well. Your often, serious changes. She began by set- of your life could stand some improvement? job went against her internal Seek out someone who can mantra might be I can stand up ting boundaries at work, including saying Use this diagram as a road map to ascertain clock. Whenever she thought help you determine whether to people who are disrespect- no to overtime. Ultimately, she realized what needs your attention. Revisit this as- about switching jobs, a voice your saboteur’s ideas are real. ful to me or I can learn a new her hospital didn’t honor its employees’ signment periodically, drawing a new circle would stop her—and the If, for instance, you actually skill or I don’t have to say yes. need for a personal life. She’s now happily on a piece of paper each time, to chart your voice was her own. Workloads schedule and won’t be able to do it and it keeps you from think you can’t handle a dif- Think about what the naysayer working at a different hospital. progress toward balance. are easier at night; you can’t get the time off you want. moving in the direction of your ferent type of nursing job, talk in your head has been telling handle the days, the voice Negative self-talk, mind dreams. Before you can make to someone in that job. (You you and take the opposite tack. YOUR CIRCLE OF LIFE would say. There won’t be chatter, the inner critic— changes in your life, you have might also try working as a When you pay attention to Physical good people around to mentor they’re one and the same. I call to believe in yourself—which PRN, or “as needed” nurse, to the confident voice in your Surroundings Career you during the day. You’ll lose this inner voice “the saboteur.” is hard to do if someone (you!) get a taste of different posi- head, you’ll begin to believe control of creating the unit’s It’s a force that says you can’t is cutting you down. You need tions.) If you’re having trouble what you’re hearing.

Fun Money When you take a moment to remember the things you’re grateful for, all the things that you’re not grateful ASSIGNMENT GIVE THANKS for slide away and you get the psychological boost you need to start initiating change. Here, two things you Joyce, a 56-year-old nurse working with a company that can do to pump up your gratitude: handles workers’ compensation claims, found herself in tears almost daily. Her days were overwhelming and 1. Before getting out of bed, write down 10 things Personal Health Growth she had several extended family members, including you’re thankful for. a small child, living with her. She had no space of her 2. Stop to savor one thing every day—start small. own at work or at home. One thing that helped her start Stay in the shower for a few extra seconds or take a turning things around was focusing on what she was moment to appreciate the aroma of your morning thankful for: her beautiful house and her good health. coffee before your first sip. Romance Friends & Family

26 scrubsmag.com•WINTER 2011 27 [on duty]

though there are plenty of with a flat-out “no,” you can SEEK SUPPORT other snacks in the house) or offer a couple of words of ex- COMMIT ASSIGNMENT hosting a school fundraiser. planation, but not an apology. ASSIGNMENT TO MAKING The final count could be a real CHANGES eye-opener. STEP 3: Say no five times One summer while hiking with my4 family, we reached a raging river. There was a log across the this week. If something comes middle, submerged in the thigh-deep, freezing water. When it was my turn to cross, I stopped STEP 2: Practice saying no. up and you can’t get the actual halfway. With my 50-pound backpack and the strong current throwing me off balance, I froze This might sound silly, but word “no” out, say, “Let me get in fear. After a few moments, I realized I could ask for help—and I did. In an instant my husband many of my clients find it hard back to you on that,” then go and son picked me up off of the log and carried me to safety. All I had to do was ask! to say that one word. Prac- into the bathroom and practice That realization empowered me to change my own life and become a life coach. Asking tice it. You may want to ask saying no again until you’re friends, family, colleagues, professional coaches or others for the assistance and support you need is a critical part of making life changes—not to mention just making it through the day. a friend or family member to ready to give your answer. Get out a piece of paper or turn on your computer; you have some writing to do! play the role of someone mak- Seeing that the world doesn’t Keep in mind that change happens one step at a time, not LEARN TO ing a request. “Can you take fall apart when you say no will overnight. By making a commitment to alter a few things Write down two instances when you asked for help at work or at home and it was beneficial. on another patient?” “No.” help you realize that you’re SAY NO at a time, you’ll place yourself on the path to happiness. Make the word actually come doing the right thing and will Those changes could be anything done differently, whether As a nurse, you’re a care- out of your mouth. If you’re make it easier to say no the exercising a little more, spending more time with your giver by nature and are not comfortable responding next time. 1. husband or standing up to the nurse supervisor on your floor. prone to saying yes, even And remember, to do more of one thing, you usually have to when doing so can overex- do less of something else. To exercise more, you may have to tend you dangerously. Say- watch less TV or commit to spending less money on eating 2. ing no will not only give you out in order to spend more on a gym membership. To stand the time you need to care for Write down two instances when you didn’t ask for help and realized later that it would have up to your supervisor, you may have to say yes less often. And yourself, but will also help been beneficial. so on. What’s most important is that you have a clear idea of you control your life. [For what your goals are. Think about what all this means to you, other ways to nurture your- and then sign a contract with yourself. Fill in the blanks below, self, see “Quiet, Please!” on being as specific as you can, and you’ll be on your way to a 1. page 20.] Joyce, the workers’ less stressful, more blissful life. comp claims nurse, began by saying no to working extra I am committed to doing more 2. hours. That helped her find her voice. Not long after, she Name a situation you will ask for help with, professionally or personally. also began saying no to the people living with her. in my life. When you’re not used to I am committed to doing less saying no, it can take some practice. Here’s how to Write a letter asking for the help you need. It may be to your husband and children asking them master the fine art of (polite) to pitch in around the house. Maybe it’s to a mentor seeking advice. Let them know that you’d like refusal: in my life. to check in with them on your progress. You don’t have to actually send it (although you can). Just I am committed to doing be sure to follow through on the request somehow so you don’t get stuck in the river. STEP 1: For one week, keep track of everything Who makes up your support system? Draw a circle in the center of a piece of paper—that’s you say yes to—whether you. Then draw circles around you, one for each family member, friend and colleague who’s it’s taking an extra shift, differently in my life. cheering you on. Store this image somewhere in your mind or come back to the page when driving your mother some- • you’re frustrated, tired or discouraged. Knowing you’re not alone lifts a tremendous weight. where, picking up your DEB ROFFE, RN, BSN, CPCC, is a certified Life Coach and kids’ favorite snacks (even founder of The Nurse Coach, LLC and thenursecoach.com.

28 scrubsmag.com•WINTER 2011 29 [belief]

WHEN ONE FAMILY’S TRAGEDY BECOMES ANOTHER’S MIRACLE, A LONGTIME WORSHIPPER QUESTIONS THE MEANING OF GODAND IS SURPRISED BY HER SPIRITUAL AWAKENING.

I HAVE A SNAPSHOT TAPED ABOVE my It wasn’t until I started working at desk at home that some people think a hospital in Los Angeles that tensions is grotesque. arose between my notion of a just God It’s a photo of two human hearts and the reality of what I witnessed. lying on what looks like a blue table- As frontline staff, I was assaulted on cloth. The heart on the left is pink and a daily basis with evidence that sug- robust. The one on the right is brown handed out based on the whims of my gested suffering is random and terribly and shriveled. The picture is from the mother’s unstable brain chemistry, so unjust. I witnessed not only pain, but transfer point of a heart transplant. the notion that an all-powerful, sane, pain compounded by family dysfunc- Each time I see it, I imagine two pa- grandfatherly fellow was in charge of tion, poverty, mental illness, abuse, tients, chests cracked open and empty, my well-being enabled me to toler- addiction and lack of access to care. Keeping whose lives are forever changed and ate life under my family’s roof until I Many times children were at the center connected by this moment. could get out. of this suffering. I found the photo years ago, lying After leaving home, my personal During my workday, I couldn’t af- on the floor of a basement hallway in experience was not incompatible with ford to stop and feel my confusion too the vast Los Angeles hospital where I this notion of God. I was generally acutely or ponder this growing conflict My worked for nearly a decade. I keep it rewarded for kindness and integrity, too deeply. There were other people’s because it reminds me of the begin- faced consequences for misdeeds and emotions to absorb or de-escalate or ning of my career and how much time I stupidity, and encountered no pro- otherwise manage and a thousand spent looking for God in that image. found losses or traumas. So although logistical challenges to attend to. It Before going into my line of work, I I became increasingly aware of man- was only after 5 p.m.—during the long Faith would have described myself as believ- made injustice during college and stretch of evening when I’d try to settle ing in God by default. Although I come graduate school, individual suffering into my own insignificant life—that all from a family of casual atheists, I grew remained distant enough that I didn’t the pain and sadness would simultane- up with a consistent belief in God. In give much thought to questioning my ously sink in and rise up to dismantle The young boy’s heart By CHEYENNE HAVEN was failing fast, and it my house, praise and punishment were long-held assumptions about God. my cozy paradigm of God. was unbearably painful Illustrations by VIVIENNE FLESHER to see his parents smiling and talking to •scrubsmag.com him and kissing him. WINTER 2011 31 [belief] Grieving and Believing Here’s what a chaplain, rabbi, pastor and others say to those who One Friday, early in my first year at that I bring the aunt to my office to a girl who had died in some sort of grandfatherly God of my childhood. question the meaning of God when tragedy strikes. the hospital, I stood in the Cardiac ICU, facilitate a phone call with the pastor accident. The boy’s mother was This realization is a relief. But it is just outside a glass-enclosed patient of the mother’s church. The family unspeakably sad for the other child’s also terrifying because it means those “I assure them that questioning is part of the normal human response room, watching a mother and father wanted him to be at the hospital when family, yet overjoyed for hers. “It is I love are just as vulnerable to tragedy to loss and su ering. I also remind them that Jesus himself felt abandoned by God and asked, spend what would likely be the last she woke up from surgery to tell her a miracle,” she said. as my patients. With a husband, a son ‘Why have You abandoned me?’ God’s response? Silence. This does not mean He has turned his few days with their 7-year-old son. The what had happened. When I look at the photo of those and another child on the way—whose back. God often speaks indirectly, maybe through family and friends or in the strength that keeps boy had been hospitalized for a month, On my drive home, I wondered what two hearts—taken at the moment when perfect or imperfect heart is forming you going from day to day. Or maybe He appears in some deeper expression that is not waiting for a heart transplant. His heart this pastor, this representative of God, one human’s tragedy became another’s as I write these words—this is infi- black or white, but gray and ambiguous. Maybe the God who used to be meaningful no longer is. was just days away from failing, so as would say to the mother: something Starting over in your understanding of God might be in order—and that’s okay.” a last resort, his parents had agreed about God having a plan or a reason The girl—unconscious, —Jim Manzardo of the National Association of Catholic Chaplains and lead chaplain at to put him on ECMO, a machine that for everything or that He doesn’t give intubated, a Barbie wedged into the crook Children’s Memorial Hospital, Chicago bypasses a failed heart and oxygenates anyone more than she can handle. I of her arm—had and circulates blood artificially. The crawled into bed at 7 p.m., my head been in a car accident that already killed “I explain that God never promised life would be fair. He only promised that patient is put under so deeply that he and heart aching with how inadequate her three sisters. Her own death would we don’t have to go it alone because He will be with us and He will give us the strength to cope no longer respirates, and the odds and unfair my God was. make way for a miracle. with what we are dealt. That’s the purpose of prayer: to put us in the presence of God. of finding a donor in the few weeks The next night, I found myself at an I suggest people do not give up on the notion of God just because they’ve given up on the machine can support life are so after party for the MTV Movie Awards. one notion of God. When your understanding of God doesn’t help you heal, when it leaves you small that the family is instructed to If the suffering I had witnessed on angry, I encourage you to † nd another way of looking at God.” say goodbye. Friday had me considering atheism, the —Rabbi Harold S. Kushner, author of When Bad Things Happen to Good People and Conquering Fear I watched them through the glass soulless, diamond-encrusted frivolity crouching over his bed, their faces that surrounded me on Saturday was “Often people will ask, ‘Why is this happening to me?’ or ‘Why does there have inches away from his, as if they might pushing me to the verge of nihilism. to be so much su ering?’ When people are in a crisis, they want answers. I try to lead them back to soak him up. They were smiling and Free from the burden of a God who a time when they felt alone and I ask them speci† c questions about what was helpful talking to him and kissing him. At rewards innocence and punishes cor- then—a relationship, perhaps, or something they read—and try to bring them back to that one point, his father straightened and ruption, I had a fantastic night of reck- moment, almost like a guided meditation. I try to help them explore their feelings so they can † nd turned away so his son wouldn’t see lessly indulgent behavior. the inner strength, healing power and wholeness in themselves.” the grimace of absolute agony that But come Sunday morning, my spiri- —Koshin Paley Ellison, cofounder of the New York Zen Center for Contemplative Care, consumed his face. It was an impos- tual discomfort returned and I spent which has instituted certiƒ ed Buddhist chaplaincy programs at Beth Israel Medical Center sibly private and painful moment to the day smoldering with guilt and a and NewYork-Presbyterian Hospital in Manhattan witness, and I was happy to retreat and deep spiritual unrest. begin my weekend. On Monday, I ran into my colleague miracle—I no longer look for God. I nitely more daunting than when I was “In my relationship with families who have lost a loved one and are struggling Just then, I was paged by a social who was handling the car accident. The believe that physics and biology and without these ties. with their faith and understanding of God, I remind them that in the Book of Genesis, worker who needed a favor. A mother only surviving daughter had died Sat- human nature and random chance are Finally seeing that photo for what it God is seen as a creator and that they are part of His creative process. I assure them that He will had rear-ended a stalled rig on the urday night (probably, I thought, while responsible for that moment, not God. is—and isn’t—has granted me a clarity, help them † nd a way to put their world back together and † gure out how they’re highway. Three of her four daughters I was passed out on my bathroom floor As tempting as it is to imagine a an authenticity regarding sorrow over going to live the rest of their lives in light of this tragedy, even if that means, at the beginning, were pronounced dead at the scene, in a puddle of sour apple martinis). benevolent deity who’s invested in loss and gratitude for good fortune just moving from one moment to the next.” while she and her remaining daugh- The girl’s mother would likely re- my personal safety, I simply can’t that I would not give up. It has also —Chaplain Terry Wilson of the Cooperative Baptist Fellowship and manager ter were in critical condition. I found cover from her injuries. “But for what?” any longer. I just can’t believe that enabled me to continue the work I’ve of Pastoral Care at Medical University of South Carolina my colleague in the ICU standing at my friend wondered. “It is a tragedy.” God would create us and the infinite grown to love, on good days helping to the daughter’s bedside as the nurse I went to check on the heart trans- natural laws to sustain us and the alleviate some suffering and, on really “A number of studies indicate that people who believe there is meaning explained the various machines and plant family and I ran into the boy’s intellectual power to thrive or destroy good days, allowing me to witness the behind a tragic event—something bigger than what just happened—are better o than tubes to the girl’s father and aunt. mother outside the ICU. She told me ourselves only to then micromanage occasional miracle. those who don’t. We help families from di erent faith backgrounds as they ask ‘Why?’ I would never The girl’s head was wrapped from that a donor match had been found every moment of our existence. This • say, ‘You need to † nd meaning in this.’ But if you ask people years after a tragedy, brain surgery. She was unconscious Saturday night while she slept in the is not to say that I am an atheist. I CHEYENNE HAVEN spent nearly a decade ‘Were you able to † nd any kind of meaning in this?’ they will say, ‘I am a more compassionate, and intubated, and had a Barbie chair next to her son’s bed. He received remain in awe of the intricacies of the as a medical social worker at a large caring person’ or ‘I deepened my value of life.’ This is not to say they’re glad it happened. wedged into the crook of her motion- his new heart early Sunday morning. universe and I absolutely acknowledge teaching hospital in Los Angeles. She’s But it’s that transformation of pain into meaning that is most important.” less, IV-filled arm. My colleague asked She’d been told only that it came from divinity in it. But I have let go of the currently a full-time mom. —Donna Schuurman, director of The Dougy Center in Portland, Ore., which provides support to grieving children and families Find more stories about believing and learn prayers for nurses at scrubsmag.com/spirituality. 33 [body] TOP 10 REASONS NURSES GET f a t

The word “nursing,” derived from the Latin nutrire, means “to nourish.” Unfortunately, as you nourish your patients, you might actually overnourish yourself, consuming too many calories and packing on pounds. Here’s how to outsmart the nurse-speci c challenges that stand between you and your thinner self.

By GARY SCHOLAR Photographs by TIA MAGALLON

COMFORT EATING any one of the many things that may be stressing you out 1 With all the pressures of the job, it’s no wonder at home. Knowing your foibles and—this is the tricky part— nurses often turn to food for comfort. What makes you—or choosing to say no to them is more than half the battle of any of us—fall so hard for comfort food is its perilously steering clear of temptation. addictive nature. When you eat refined sugars, serotonin, a neurotransmitter that improves mood, is released into your CHRONIC STRESS brain and you feel good. Your brain has a terrific memory, so 2 Physically and emotionally demanding work plus dif- if you indulge in the morning, it’s going to remember and ask ficult schedules cause stress, which stimulates the release of for sugar again that afternoon and night. the hormone cortisol. An article in the February 2008 issue of It doesn’t help that comfort food is ever present at work: Prevention magazine titled “Outsmart Your Cravings” by Sally the nurses’ station, break room, vending machines and Kuzemchak, RD, quoted experts as stating, “Comfort foods cafeteria. Plus, when you’re completely exhausted after your loaded with sugar and fat basically blunt this hormone. The shift, and the last thing you feel like doing is cooking, how food gets coded in your memory center as a solution to an often do you stop at a fast-food drive-through or open your unpleasant experience or emotion.” Essentially, the release refrigerator and grab something that’s less than healthy? of cortisol becomes associated with craving high-calorie fatty To ease yourself out of the comfort-food trap, it helps to and sugary foods, whether at your nurses’ station or at home. identify the emotional triggers that cause you to seek out Explains a lot, doesn’t it? these bad-for-you treats. These include too many hours, too One of the best stress relievers is regular exercise, which many patients, conflicts with doctors, endless paperwork or raises your endorphin levels and calms your mind. [See “No

USED WITH PERMISSION. EXCERPTED FROM FIT NURSE: YOUR TOTAL PLAN FOR GETTING FIT AND LIVING WELL, PUBLISHED 2010, © THE HONOR SOCIETY OF NURSING, SIGMA THETA TAU INTERNATIONAL. 35 [body]

ER (Exercising Regularly),” below.] But exercise alone can’t exercising keeps you feeling overwhelmed and exhausted. SECOND SHIFT SYNDROME change everything. If, like many nurses, you multitask so Two important strategies can help inject fitness into your 7 Your nursing responsibilities probably don’t stop at much that it drastically raises your stress level, force your- life: 1) Be sure to engage in a physical activity you enjoy, and the door when you get home. Awaiting are dinner, house- self to define healthy boundaries, both on and off duty. [And 2) place it into a schedule that works for you. Here, some work, homework and emotional support for everyone in the check out “Are You on Overload?” on page 24.] ideas to inspire you to get up and get going…. family. It’s the beginning of your “second shift,” making it extremely challenging to integrate self-care, healthy eating NURSE GLYCEMIA “I went on vacation and rode a bicycle for the first and exercise into your life on any regular basis. 3 If every nurse contributed a dime every time he or time in 40 years. When I got back home, I borrowed my she skipped a meal, we could create a fund that would pay daughter-in-law’s bike and started riding the streets. “For 22 years, I worked as a staff nurse on mostly for stressed-out nurses to vacation in Maui at a five-star spa I rode four days a week, 10 to 12 miles a day.” 12-hour shifts. By the time I got home, I was exhausted, for a month every year. — KAREN, NURSE EXECUTIVE starved, thirsty and stressed out. I still had to raise my two beautiful children and take them to ballet lessons, soccer, “I go from my clinic to the hospital at noon and do my “As a new mom, I’ve purchased a jogging stroller, guitar lessons, church activities, basketball, tennis and patient rounds, so most of the time I miss my lunch, which I hope will motivate me to start jogging. I always softball. Who has the time or energy to think about taking and then at 3:30 p.m. I’m starving! So I grab a bag of find jogging to be invigorating and hope it will help care of yourself?” —GINGER, CLINICAL EDUCATOR pretzels, chocolate chip cookies or a handful of M&Ms.” with my energy level with the new baby.” —CARMEN, CLINICAL AND HOSPITAL NURSE —JENNIFER, HOSPITAL NURSE I knew a nurse who was suffering from Second Shift Syndrome. After 12 hours at the hospital, she never had Skipping meals, or waiting too long between them, slows “I try to go to the gym on my way home from work. time to decelerate before plunging into her family’s needs. A your metabolism. Your blood sugar level plummets and you This just happens to be the best time for me because my Does your second neighbor who happened to be a wellness coach advised her shift begin the feel fatigued, maybe even irritable. Unable to work efficient- husband is at work, so it doesn’t take away from our time minute you get to wear a red scarf when she got home every day as a signal home with cooking, ly, you need an energy boost and reach for the nearest together in the evenings. After working out, I feel much housework, to her family to give her time and space to wind down. Once sugary treat. Return to your patients and another meal or better about myself and find that I sleep better during homework and she took off the scarf, she would be available. When the caring for everyone snack falls by the wayside. The cycle begins again. This blood the day!” —JENNIFER, NIGHT-SHIFT NURSE in the family? neighbor checked in a few weeks later, she told him, “It re- sugar roller coaster can cause dysfunctional metabolism, hor- ally works. So my husband went out and bought a red tie!” monal imbalances, weight gain, headaches, migraines and se- COMPASSION FATIGUE and are about to reach for a sweet treat, ask yourself these You may not have a red scarf, but do set boundaries at vere PMS and menopause symptoms. It triggers your body to 5 Most nurses have a Type E personality, in which they questions: Why do I feel drained? What do I really need right home (and at work) so you don’t get too run-down. say, “I have no idea when I’m going to eat again, so I’d better do Everything for Everybody but themselves. The result is now? Where can I create healthier boundaries in my life? store lots of fat. And the next time I do eat, compassion fatigue, or over-care Awareness is the first step to overcoming both compassion THE PERILS OF THE I’m going to overeat because I’m starved.” to the point of burnout. Is it any fatigue and turning to food for comfort. 8 HOSPITAL CAFETERIA A big help is healthy snacking—see “Mobile Mobile Munchies surprise that when nurses feel de- Here’s a quick tour of a hospital cafeteria I recently visited. Keep these healthy snacks on Munchies,” right. prived, they turn to comfort eating NOWHERE NEAR ENOUGH Hours of operation: The cafeteria was open from 7 a.m. to hand, eat every three or four 6 hours and you’ll be able to keep as a way to cope? SLEEP 6:30 p.m.—not a good fit for night-shift nurses. 4 NO ER your blood sugar—and your In The Art of Extreme Self-Care, Too little shut-eye can easily begin a cycle of eating un- Caffeine: Next to the six different high-sugar, caffeinated EXERCISING metabolism—from plummeting. Cheryl Richardson wrote, “I’ve healthy foods that ends in weight gain. In The Harvard Medi- soft drinks were the caffeinated coffee drinks that pick you REGULARLY • Rice crackers with almond butter or come to learn that overgiving is cal School Guide to a Good Night’s Sleep, authors Lawrence J. up, then slam you down—not to mention the negative impact Understandably, adding a regular workout natural peanut butter often a sign of deprivation—a Epstein and Steven Mardon explain, “Curtailing sleep to four this can have on your sleep patterns. routine to an already hectic schedule can be • Whole-grain (6-inch) tortilla with /
signal that a need isn’t being met, hours a night for several nights results in changes in me- Breakfast choices: Ten high-sugar cereals (averaging a difficult. All that walking on your shift, cou- cup fat-free refried beans an emotion isn’t being expressed or tabolism that raise levels of hormones linked with overeating whopping 19 grams of sugar per serving), sweet rolls, pled with the stress of the job, is exhaust- • No-sugar-added, nonfat yogurt with a void isn’t getting filled. Becom- and weight gain.” To avoid that trap, remember to reduce donuts, bagels, fruit juices and sugar-laden yogurts. The only ing—who wants to work out after work? a piece of fruit or handful of raw nuts ing aware of how and why you feel or eliminate caffeine, alcohol and high-sugar foods; avoid a healthful option was a popular whole-grain organic cereal. Think about this, though: For every minute • String cheese or cubes of your favorite deprived can be key to recognizing heavy or high-fat meal shortly before you go to bed (difficult Desserts: A wide assortment of crispy rice cereal treats, you exercise, you decrease your cortisol cheese (could be “light”) what needs to shift emotionally and to digest!); and do relaxing exercises to ease muscle tension pies, cakes and yogurt parfaits. secretion, reduce muscle tension, increase • Canned “light” (and preferably “low- physically to achieve extreme self- from your shift, which then signals your body to prepare for Grill: Hot dogs, Polish sausage, French fries, cheese fries and production of your feel-good endorphins sodium”) soups care.” We often turn to food to fill sleep. (Tai chi or gentle yoga poses are fine just before you the saturated-fat king of the sandwiches: the Reuben! and boost your metabolism. In effect, ex- • Whole-grain cereal (6 grams or less of the void in ourselves. turn in, although anything that makes you sweat should be Pizza and chips: Cheese-and-sausage pizza and potato ercising empowers and energizes you; not sugar per serving) and /
cup of raw nuts When you feel overwhelmed, completed an hour or more before your normal bedtime.) chips with more than 200 milligrams of sodium per serving. • Raw seeds and nuts 36 • Cut-up vegetables and fruit WINTER 2011 •scrubsmag.com 37 THE NURSE’S ONLINE GUIDE TO GOOD LIVING [body]

Salad bar: This may seem like a saving grace, but where’s GRIEFRELATED STRESS the balsamic vinegar when you need it? The choice of dress- 10 Coping with the death of a patient is never easy, ings included Caesar, blue cheese and ranch. whether you’re a new nurse or have been in the profession Impulse buy: The space right before the register was ice for 30 years. Not only do you offer comfort in the patient’s cream. Time yourself; the longer you stand in line, the less last moments, but you also have the burden of comforting likely you are to resist the temptation. his or her loved ones. This can create grief-related stress. Every nurse copes with patient deaths differently, CALL TO ACTION: I want two things from cafeterias— although many attempt to alleviate their emotional response healthier options and a schedule that includes 1 a.m. to through overeating. Here, some suggestions for how to 3 a.m. for night nurses. Is this asking too much? deal with your grief: Are you Your cafeteria won’t change if you don’t ask it to change. • Be in touch with your feelings. Try to be aware Start with the manager, asking for healthier (low-sugar, low- of your emotional response to death and dying. wearing the fat) foods, more healthfully prepared vegetable options and • Voice your feelings. Ask for, and allow yourself to re- hours of operation for the night-shift nurses. If that goes ceive, support from coworkers and friends. right scrubs nowhere, consider a petition—get as many employees as • Turn to your faith and prayer. for your possible to sign it. Suggest that your nurse managers take • Request grief preparation programs for your staff THE NURSING up the cause. You can seek inspiration from Health Care or coworkers. Or help create them, even if it’s simply an BODY TYPE? SALARY GUIDE Without Harm (noharm.org), which has made significant informal practice of asking senior nurses to mentor younger Everyone wants to know what strides in healthcare-based activism and has excellent nurses about the grieving process. the next nurse is earning. resources for hospitals attempting to convert to healthier Seek additional help, if needed. The Hospice Founda- So are you being paid fairly? • Take a peek inside our 2011 foods in their cafeterias. tion of America (hospicefoundation.org) provides valuable earnings projections. links, articles and resources for dealing with loss. u scrubsmag.com/salaries THE NIGHTMARE OF THE 9 NIGHT SHIFT “In my hospital experience, there was never time to There aren’t a lot of healthy food choices available for deal with the feelings of a patient’s death. I was always TOP 25 PRAYERS BY night-shift nurses. Many eat out of vend- moving on to the next patient or the AND FOR NURSES ing machines because the cafeteria isn’t next task. Now, in hospice, we do a lot From Native American wisdom open. Compound this with a chronic lack Perfect Timing of verbal processing with one another, to the Bible, nurses are beating Working the 7 p.m. to 7 a.m. of sleep that lowers resting metabolic and we have the support of the social their stress by reciting these shift? Try these eating plans: rates, and you have a perfect recipe for workers. We also talk a lot about prayers on commutes or taping them up in their break rooms. putting on pounds. SCHEDULE #1 boundaries and how not to get overly Dinner at home around 6 p.m. u scrubsmag.com/prayers involved emotionally with our patients,

Snack at midnight only online “Working night shifts has negatively though at times it’s difficult to do. Lunch between 2 a.m. impacted my eating habits. I have and 3:30 a.m. Many times the nurses will attend the gotten up at 2 a.m. on a night when I’m Snack sometime before you funeral for closure, or they may take an Go to our website and try our new Scrubs Style not working to eat. On most units there head home extra day off or need a lighter caseload DOs and DON’Ts Tool before your next shopping trip! is always food around, typically junk Breakfast between 7:30 a.m. after a patient’s death. Every week, and 8:30 a.m. Go now u scrubsmag.com/style food. We just eat and eat.” —LAUREN, we hold a memorial service to remember Gentle exercise, such as tai chi TRAVELING PEDIATRIC ICU NURSE those who have died. We honor that or yoga, and/or relax for about one hour before going to sleep person, and if it was difficult, there So what can you do if you’re a is more sharing.” night-shift nurse, besides having healthy SCHEDULE #2 —BONNIE, HOSPICE NURSE food flown in from Canyon Ranch Spa? Breakfast in the afternoon when • you wake up Visit us online today to complete our Plan your meals and snacks carefully...and GARY SCHOLAR, MED, is a health and Dinner at 9 p.m. FREE stick to the schedule! Check out the wellness expert, teacher, researcher and brief reader survey and enter to u Go to scrubsmag.com and Lunch at 1 a.m. WIN ALL OF THE SCRUBS Scrubs two eating plans in the “Perfect Timing” Snack at 4 a.m. contributor to Voice of Nursing Leadership Giveaway click on the survey link box at right. This allows you three to four hours and American Nurse Today. ADVERTISED IN THIS ISSUE to digest before you go to sleep.

38 scrubsmag.com•WINTER 2011 [beauty and health]

YOU’RE RUNNING LATE FOR YOUR SHIFT. word—be sure to set an alarm so you don’t fall into a deep slum- ber, which could wreak havoc with your regular sleep schedule.) If you’re more mentally fatigued than physically exhausted, says Bracko, reach for your workout clothes. Exercise can help invigorate your mind as well as your body. But rather than attending the same Decisions, Decisions
tness class you know by heart, consider interval training, which Sleep or work out? Exfoliants or antioxidants? Glossy lips or matte? alternates bursts of intense activity with periods of lighter activity. Take turns jogging for one minute with walking for half a minute. Who has time to suss out the answers to these daily dilemmas Or briskly walk up and down a hill or a — ight of stairs. Studies show when patients are calling, doctors are bellowing and you haven’t had this helps burn fat faster and increases endurance more than work- ing out at a steady pace. Just 20 to 30 minutes will do the trick. enough shut-eye in weeks? We did, so settle in and read on. Choose a workout that works for you—no gym required! By LESLEY ALDERMAN Should you grab an Or wait until you can eat energy bar on your way something less sugary YOUR SKIN IS DRY AND BLOTCHY, out the door? and more healthy? NO DOUBT DUE TO THE RELENTLESS HEAT AND/OR AIRCONDITIONING AT WORK. Go for the bar if it’s your only option. “A little food
rst thing helps you think clearly,” says Wendy Bazilian, DrPH, RD, head of nutrition at the Golden Door Spa in Escondido, Calif. Your body’s been fasting while you’ve been sleeping, so it needs to refuel (caf- feine doesn’t count!) before it can get going. A better—but still quick—bet would be an apple or a banana, low-fat yogurt or nuts and dried fruit that you grab as you race to work. Bonus: Research shows that eating in the a.m. not only increases your metabolism, but may reduce the total calories you take in throughout the day.

YOU JUST GOT OFF WORK AND YOU’RE COMPLETELY EXHAUSTED. Do you need an exfoliant? Or an antioxidant?

Both. An exfoliant rejuvenates; an antioxidant protects. “When your skin cells spend all their energy defending against dry indoor air, the sun, free radicals, even your own internal stress hormones, they cannot do things like make new collagen, retain moisture and repair damaged proteins,” says Linda K. Franks, MD, of Gramercy Park Dermatology in New York City. No wonder hospital skin can look dry, lackluster and blotchy. Time to repair and regenerate! Rx #1: Exfoliate. “An exfoliant will help expose a fresher, younger, more hydrated layer of cells,” says Franks. “I like retinol- based lotions and creams in particular, because in addition to ex- foliating, they stimulate collagen production, which will increase Do you drag yourself Or just take it easy? both support and hydration to the skin.” Her recommendation: to the gym? RoC Retinol Correxion Deep Wrinkle Night Cream ($23). It all depends on how tired you are and why, says Michael Bracko, Rx #2: Counteract the effects of the elements. Try a an exercise physiologist and fellow of the American College of light serum, such as La Roche-Posay Active C Anti-Wrinkle Derma- Sports Medicine. “If you’ve been working long hours and skimping tological Treatment for Dry Skin ($46 for 1 ounce), under a moistur- on sleep, listen to your body and rest,” says Bracko, who suggests izer with a broad-spectrum sunscreen, like Olay SPF 30 Complete

GETTYIMAGES a power nap under these circumstances. (“Nap” is the operative Defense Daily UV Moisturizer ($12).

WINTER 2011 •scrubsmag.com 41 [beauty and health] [scrubs resource connect]

YOUR FEET ACHE AT THE END OF YOUR SHIFT. thing you’re eating, cautions Bazilian, chances are you’re going to eat too much. She suggests you slice a modest portion of cheese and put the rest away, right away. Then add some grapes, an apple or a pear, a few walnuts, some hummus or sliced vegetables to Online Program in make your plate more interesting as well as more satisfying. “Think Applied Health Informatics of your meal as a Mediterranean-style appetizer,” she says. Studies have shown that a glass of wine may have some protective benefi ts for the heart, provided you stick with a single glass. Apply Now As for that salad, it may make you feel virtuous, although its ac- tual virtues can vary dramatically. If you’re in a hurry and just pour for Fall 2011 entry! bottled dressing on a plate full of lettuce, you’re sitting down to Do you massage Or elevate them? a nutritional nightmare. “A commercial dressing with poor-quality Applications for federal tuition and soak them? ingredients can add a burger’s worth of calories to a salad,” says support due February 15. Non-federal Bazilian. Salad is only the better choice if you take the time to wash tuition support applications due June 1. Either one. Each gets the blood circulating, thereby easing the ten- and chop lots of fresh vegetables and make a vinaigrette (try three sion, swelling and fatigue that comes from being on your feet for parts olive oil to one part vinegar). extended periods of time, says Christopher Ferguson, a podiatrist at St. Luke’s-Roosevelt Hospital in New York City. “The more circula- YOUR MAKEUP INEVITABLY FADES BY MIDDAY. tion, the better your feet will feel,” says Ferguson. You can’t go wrong, so the best fi x is whichever one works with your routine. (If time permits, indulge in both!) If you can only spare a minute, give your soles a quick massage right after you kick off your shoes, using your thumbs to fi rmly stroke from your heels toward your toes. If you can spare 10 minutes, soak your feet in warm water with a drop or two of your favorite essential oil. To soothe your nerves as well as your aching feet, simply sit on the fl oor with one hip next to the wall. Then gently swing your legs up the wall as you slowly let your back and head recline on the Why Make Infusion Your Specialty? fl oor. Now just rest as you reverse the eff ects of gravity. Are you better off Or rethinking your retouching during the day? entire makeup routine? Crescent Healthcare YOU’RE STARVING AFTER YOUR SHIFT. provides Rethink your routine. Who has time to run to the ladies’ room to remove mussed mascara or reapply lipstick? A better strategy for Challenge | Variety | Gratification | Independence busy nurses, says Jacqueline Haupt, a New York City makeup artist, An opportunity to advance a critical need is to pare your makeup down to the bare essentials—which is per- in the healthcare field fectly appropriate for a professional look—and stick to products formulated to last longer. Join a Recognized Leader in Infusion Therapy! For your skin: Foundation can come off too easily, whether from perspiration or an accidental brush of the arm (yours or For more information on career opportunities in California, a patient’s). Instead, rely on a tinted moisturizer with SPF, which contact clinical recruiting: saves you time and money with three bangs for your buck: mois- Email [email protected] | Direct 714.520.6511 ture, color and protection from the sun. “I love Smashbox Sheer Toll Free 800.722.8085, ext. 6511 | Fax 714.533.1319 Should you Or can you simply break Focus Tinted Moisturizer SPF 15 ($30). It’s lightweight, sheer and muster the energy out the cheese and crackers www.crescenthealthcare.com luminous,” says Haupt. to fi x a salad? and pour a glass of wine? For your eyes: Skip shadow (which can streak) and liner (which Go ahead and have the cheese and crackers, says Bazilian, as long can smudge) and focus on your lashes. Choose a waterproof mas- as it’s an occasional indulgence. After all, cheese is a decent source cara like Maybelline New York Lash Stiletto Voluptuous ($7) and

of protein and calcium. But if cheese and crackers are the only you’ll fi nd it’s likely to stay in place for an entire shift. Or consider GETTYIMAGES

42 scrubsmag.com•WINTER 2011 continued on page 46 > [scrubs resource connect] [scrubs resource connect]

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getting your lashes professionally tinted. It takes less than an hour, YOUR HAIR HAS SUFFERED A LOT DURING THE costs around $30 and lasts up to a month. DAYAND IT SHOWS. For your lips: Swap smearable lipstick and lip liner for a com- bination lip stain and moisturizing gloss, like Revlon’s Just Bitten Lipstain + Balm ($9), recommends Haupt. The stain adds color that Wear a uniform stays put while the gloss soothes, smoothes and prevents cracking. you can be proud of. A DOCTOR SNAPS AT YOU IN FRONT OF A PATIENT. We care for our patients and our employees.

Interim HealthCare® provides the fl exible assignments you need to fi t your life – and your priorities. As America’s largest provider of healthcare staffi ng and home healthcare services, chances are we have the right assignment to fi t your needs – as

Should you try a Or try an entirely well as the resources and opportunities to help you grow and thrive. And since new styling product? new style? every Interim HealthCare offi ce is locally owned, you’ll be more than just an employee – you’ll be a partner in patient care. Start with a new product, suggests Julie Dickson, owner of Fox and Boy hair salon in New York City. Visit www.careersbyweb.com today to apply for a great job, and sign up If your hair is straight and € ne and tends to look limp and greasy for our free e-newsletter, Health Care Professional Digest! after a long day, spray or sprinkle some dry shampoo on your roots and work it through with your € ngers. Your hair will magi- Should you Or speak up? cally appear thicker and cleaner (and not oily at all!). Dickson likes silently seethe? Rene Furterer’s Naturia, which has small particles of oil-absorbing ©2010 Interim HealthCare Inc. Each offi ce is independently owned and operated. Interim is an equal opportunity employer. Speak up…but not right away, says Mark Goulston, MD, a psy- clay and a light scent. The 1.6-ounce travel size ($12) is a perfect Just Listen: Discover the chiatrist in Los Angeles and the author of purse size. (In a pinch, the old trick of using baby powder on your Secret to Getting Through to Absolutely Anyone . “Give the doctor a roots will also work.) look that telegraphs your displeasure, but don’t let it interrupt your If your hair is curly and unruly by quitting time, spritz it with work,” he suggests. Later, after you’ve taken care of your patient, water and add a small amount of a curl product, such as Dickson’s pull the doctor aside and ask, “When could I have a few minutes to favorite, Re-Coil Curl Activator by AG ($15 for 6 ounces). It keeps talk about how we can work together better in the future?” When frizz at bay and won’t ” ake when you shake your hair out. Or try the time comes to have that conversation, focus on your and the this: Create large, easy curls by applying the product, wrapping doctor’s shared purpose—acting professionally while taking care generous sections of hair around your € ngers to shape, then allow- of people who are sick—rather than your emotional response to ing your hair to dry untouched. “Curly hair is best left alone while what the doctor said. Be € rm but tactful. For example, you may drying—so hands o™ ,” she says. wish to gently ask, “Is there a di™ erent way you could communicate Hair still not cooperating? Try pulling it back. A simple low your frustration?” ponytail (they’re in again this year!) always looks sleek and neat. It may not be easy to say something, but it’s important to stand Wrap a strand of hair around the elastic and secure with a bobby up for yourself. Keeping quiet all but ensures that your frustrations pin, or upgrade to a classic tortoiseshell clip. Consider a chignon, over the doctor’s rude behavior will percolate, and you might end too, because it will further conceal the day’s ravages on your hair. up taking it out on yourself. “Many of my patients tell me they go o™ If these looks feel a little too severe (especially if you don’t have their diets or exercise regimes after they’ve had a bad encounter at bangs), a pretty headband can soften the look and add height. Try work,” says Dr. Goulston. “They say to themselves, ‘Oh, the hell with them in di™ erent widths and with or without a tidy self-knot or it, I’m just going to ______.’” (Fill in the blank with some tem- bow. Another option: Pull your hair back, twist it and fasten it with porarily comforting but ultimately self-sabotaging behavior, such a clip; let a few strands loose around your face. as drinking or eating too much.) Pent-up anger can have serious • long-term health consequences, as well as some not-so-nice short- LESLEY ALDERMAN, a former editor at Money and Real Simple, term repercussions if you end up taking it out on those around you, currently writes about health and wellness for various magazines and

whether your patients, colleagues, partner or kids. is a columnist for The New York Times. GETTYIMAGES

46 scrubsmag.com•WINTER 2011

[expressions] The Healing Power of Painting A NURSE HELPS PATIENTS AND HERSELF FIND FULFILLMENT THROUGH ART.

“I’ve always been interested in healing, creativity and self-expression,” says Catherine Fraser, a public health nurse on Vancouver Island in Canada, who found a way to com- bine all three in art therapy. For the past 20 years, Fraser has spent some of her off-duty time helping others understand their emotions through creative expression. She asks clients to draw or paint their feelings—literally! It works for Fraser, too, who makes paint- ing a priority in her life. “When I’m not doing the creative work, I feel out of balance.”

Clockwise, from above: Catherine Fraser, RN; “The Dove Leaving the Forest,” acrylic and watercolor, in memory of the artist’s father; “The Estuary Patterns,” acrylic, showing the deep sense of calm in nature; “Nurse Walking Down a Hallway,” watercolor, a tribute to healthcare workers everywhere.

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48 See more of Fraser’s artwork, and share your own, at scrubsmag.com/art.