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In hospitals around the world, doctors, nurses, and other healthcare workers are fighting to combat the spread of the novel coronavirus, a highly contagious and little known virus that has infected over 1.5 million US citizens and has killed nearly 87,000 people at the time of this post. 

Nursing staff are on the frontlines and are affected in all settings: within the community, primary and social care, redeployment, clinical placement, hospital wards, and more. Nurses are bravely responding to this crisis without question of their duty.

Historically, professional nurses have brought compassion, ethical and competent care while meeting the medical needs of the communities they serve. However, they are now finding themselves in uncharted territory in response to the enormity of the coronavirus pandemic.

COVID-19 has required an unprecedented, fast-paced response from the nursing community. This response has been challenged by exposure to a highly contagious virus, shortages of personal protective equipment (PPE), work overload, and increased moral stress when required to make high-stake decisions on patient care. 

The Risk Of Burnout 

Nurses play an integral role in promoting health, preventing illness, and ensuring the well-being of their patients throughout their healthcare journey. They are no strangers to stress and tragedy in this profession. However, the coronavirus has upped the ante on anxiety, increased levels of stress, and exhaustion.

Related:
How to Manage Coronavirus Anxiety in this Unprecedented Time

High and increasing rates of burnout amongst healthcare providers have been well-documented. The World Health Organization (WHO) recognizes burnout as an “occupational phenomenon,” citing 63% of hospital nurses reporting burnout before the COVID-19 crisis. The risks for clinician burnout seems particularly high now, with a growing concern for long-term emotional and mental consequences beyond the pandemic. 

Providing care to others during the COVID-19 pandemic can lead to fear, depression, feelings of isolation, and ongoing emotional trauma. Nurses providing care to critical patients are putting themselves at risk with multiple exposures, at times without appropriate PPE. Nurses have the same pandemic-related stressors as the general public, but with additional challenges, as they leave their homes each day to care for gravely ill patients. Nurses’ greatest worries include:

  • the fear and uncertainty of a heightened risk of infection
  • worry that they may carry COVID-19 home and infect loved ones
  • a dwindling or already inadequate supply of PPE needed to minimize the risk of infection
  • increasing demands to work longer hours as their colleagues become sick or are quarantined
  • ever-changing recommendations from local leadership, medical and public health experts, and political leaders
  • the inability to provide the level of care they are used to
  • having to make distressing and difficult ethical decisions about which patients get lifesaving care and which do not 

The hard data has been slow in coming, but we know that the mental health impacts of this pandemic are here now. For some, it will remain long after the threat of infection has been reduced. Researchers examined the mental health outcomes of 1,257 healthcare workers attending to patients with COVID-19 in 34 hospitals in China, the epicenter of the virus. The study showed that a large portion of them report experiencing symptoms of depression (50%), anxiety (45%), insomnia (34%), and psychological distress (75.1%). 

Be Aware and Monitor Your Mental Health

Provision 5 of the American Nursing Association (ANA) Code of Ethics for Nurses states, “The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence and continue personal and professional growth.”

A nurse’s code of ethics and values become compromised when they are overworked and exhausted, when they are asked to work unprotected, when they fear for their own health and safety, and when they cannot practice their trade the way they were trained to. Nurses are natural problem solvers, demonstrating incredible resilience in caring for their patients on a normal day. However, today, they are being tried and tested in ways they have never experienced, and need to recognize that it is normal to feel vulnerable, and that is ok to ask for help when they are feeling excess stress or psychological distress. 

Experiencing or witnessing traumatic events and multiple deaths will impact individuals differently. It is important during the pandemic, and on any given day, to recognize the signs of emotional stress and where to look for support.

Some of the warning signs of excessive stress are:

  • Difficulty problem solving and making decisions
  • Disorientation, confusion or memory issues
  • Misinterpretation of situations and comments
  • Anger, hostility or frustration
  • Difficulty maintaining emotional balance
  • Headaches, tremors, rapid heart rate, palpitations
  • Trouble sleeping, nightmares, flashbacks
  • Conflict with others, reduced ability to support peers or endangerment to others

Managing Stress to Avoid Burnout 

Recognizing the signs and addressing them, is more important now than ever before. Taking care of yourself will ensure the best care for your patients. Some tips for self-care, recommended by the Center for Disease Control (CDC) are below:

  • Remind yourself that everyone is in an unusual situation with limited resources.
  • Increase your sense of control by keeping a consistent routine daily. When possible, get adequate sleep, eat healthy meals, and take breaks during shifts to stretch, rest and check in with supportive colleagues, friends, and family.
  • When away from work, get outdoors for fresh air while staying active or relaxing and spending time with family.
  • Engage in mindfulness techniques such as breathing exercises and meditation.
  • Communicate with co-workers, supervisors, and other nurses about job stress. Talk openly about how the pandemic is affecting your work. Identify factors that cause stress and look for solutions 
  • Recognize that you are performing a crucial role in fighting this pandemic and that you are doing the best you can with the available resources.

There is no one-size-fits-all approach to coping with mental health. If symptoms affect your ability to provide care to your patients or family, or if you are feeling overwhelmed by sadness, anxiety, depression, or hopelessness, seek help from a trained mental health professional.

Related:
Managing Sleep Deprivation During Crisis
Quarantine Pains: Staying Active During Self-Isolation

If you or someone you know needs help in finding mental health or substance abuse support in your area, go to SAMHSA, call the Disaster Distress Hotline (1-800-985-5990), or text TalkWithUs to 66746.

The Future and the Need for Governance: COVID-19 has not only exposed racial, ethnic, and socioeconomic disparities, but it has revealed a health care system that is ill-equipped to care for its citizens and is failing to protect its health care workers. 

Healthcare organizations will need to illustrate a higher level of commitment to support all frontline workers to ensure best practices can be followed in the future. The assurance of adequate levels of PPE to do their jobs safely; eliminating redundant administrative duties; avoiding excessive hours worked; hazard pay and providing anonymous mental health advocacy are just the beginning of a system in need of a tremendous overhaul to protect our valuable healthcare workers.


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November 24, 2019 Caregivers

Long-distance caregiving can be challenging due to the inability to be as “hands-on” as you would like. It is natural to have questions and concerns when filling the role of a caregiver, particularly when dealing with sensitive information and vital medical responsibilities. Here are some ways you can care for your loved one from afar with ease.

These days, we are living in a much more mobile society. Elderly parents may choose to retire to warmer climates, and adult children may move away for job opportunities. We may not think about our parents falling ill or losing their independence until that day is upon us. Caring for an aging parent is a responsibility few people expect or envision. 

There are 34.2 million family (unpaid) caregivers in the United States who take care of a loved one 50 years and older. Of those, 15% are living an hour or more away. Distance plays a vital role in family decision-making in how and who will handle the responsibilities associated with the care of loved ones.

Whether you live a mile away, an hour away, or in another state, caregiving for a close family member presents its challenges. For those living at a distance, logistical and financial responsibilities pose additional difficulties when planning for the right care for mom or dad. 

There is no one right way to be a caregiver; everyone’s situation is unique to them. Despite the challenges involved, long-distance caregiving can be achieved with planning and preparation. Below are some tips to ensure your loved one receives the best possible care when you are unable to be present.

Long-distance Caregiving

If the responsibility of long-distance caregiving has fallen in your lap, it is essential that you be proactive in managing even the finest details early on.

Gather Sensitive Information

The primary care provider will be responsible for several tasks, including but not limited to:

  • Coordinating medical services
  • Handling financial matters
  • Managing at-home care and oversight

Plan a visit with mom or dad to gain a better understanding of how they are dealing with their health and home needs, what their day-to-day expenses are, and how medical costs are being handled.

Financials and Insurance

Discussing finance and insurance matters is never easy. However, you will need access to some sensitive information to help your loved one if they can no longer speak for themselves. Gather medical insurance details such as Medicare or Medicaid coverage as well as policy numbers for auto, home, and life insurance. 

Additionally, you will need to know about and have access to financial records like savings and investments, and be aware of any outstanding debt. Knowledge will help if decisions need to be made regarding a move to assisted living or if hiring private health care can be afforded.   

Medical

It is essential to have all of your parent/s medical history, past and present, documented. All illnesses, conditions, and medications, including the dosage and number of times taken, should be recorded. Also, take note of all doctor’s names (primary and specialists), their contact information, and instructions for medical emergencies. Be sure family members and health care providers can easily access this crucial resource.

Hopefully, your parent(s) can work with you to locate essential documents and communicate end-of-life wishes, which will help you assist in their health care management. Having the authority to make financial and medical decisions on behalf of your loved one in the event of an emergency will require certain documents to be in place.

Legal documents, such as Power of Attorney for Health Care and Durable Power of Attorney for Asset Management, should be prepared before a health condition makes it impossible to do so. Having these documents in order will allow you to access vital medical information, participate in conversations with medical professionals, and make medical decisions when your loved one cannot.

A Team of Family And Friends 

It is natural for long-distance caregivers to feel guilty about delegating specific jobs. Still, you will need others to be your eyes, ears, and hands to help with essential tasks you are unable to do remotely.  

Form a care team of siblings, relatives, and friends who are close by and willing to offer assistance. Have a substantive discussion with participants to coordinate roles and responsibilities so everyone is contributing in a way that is sensible and feels fair. Care can be shared based on skill or geography. A sibling or relative that lives closer may be able to visit more often, while someone who is financially savvy could pay the bills. Sharing responsibilities will relieve the pressure that may be associated with just one caregiver handling all of the tasks.

Get to know your parent’s neighbors, close friends, and clergy members. They are the people who interact with your loved ones and can provide perspective and an immediate account of their well-being. 

Using Technology As An Aid

You may live in one city and your loved one/s in another. However, with advancements in technology, you can easily stay in touch with mom and dad. Email, Skype, text, and FaceTime are excellent communication tools to get some literal “face time” and help your elderly parents from a distance. 

Setting up a home computer or laptop will reassure your loved one that you are only a “few clicks” away while allowing you as the caregiver to quickly access medical updates. Schedule regular conference calls or video meetings with your caregiving team to get updates on your loved one’s well-being and get clarity to any questions you may have. Be sure to provide a tutorial for new users and leave step-by-step written instructions.

If your loved one wishes to live in the comforts of their own home, modifications should be made to the house to ensure safety. Consider outfitting the home with:

  • A medical alert system to bring aid in the event of an emergency or fall
  • Install handrails and grab bars 
  • Ramps to replace stairs if wheelchair use is necessary
  • Install strobe lights to indicate smoke alarms and doorbells
  • Clear clutter and remove area rugs that are trip hazards 

Related:
Aging in Place: Home Safety Tips for Solo Seniors

Meet Medical Care Staff

When visiting, take the opportunity to accompany your loved one to doctor appointments. This way, you can meet primary care providers and stay informed about health and treatment plans. Understanding the care plan and developing a relationship with the medical team will help when you need to check-in from a distance. 

Coordinate Local Assistance

The day will come that your loved one will need more than what you can offer from a distance –  daily care. Conduct some local research online and by phone to learn about in-home care services, day-time services for adults, and respite services for primary caregivers. 

In-home care teams can provide a multitude of services to help the senior in your life live comfortably at home. Skilled nursing staff can provide medical assistance by monitoring their physical condition and administering medications. They can also help with the more personal daily responsibilities, such as grooming, bathing, and tasks around the household.  

The worry that comes from long-distance caretaking can be overwhelming at times. Not having immediate access to an aging parent can be stressful. Wherever you live, you are not alone as a long-distance caregiver. Support networks are available, and talking to others can provide significant emotional support.


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October 3, 2019 Caregivers

Caring for someone else often starts with caring for oneself. Learn how to manage your time, stay organized, and practice self-care to avoid the overwhelm with our tips for caregivers.

One of the most important roles we can play in another’s life is that of a Caregiver. Choosing the path of a professional caregiver is one of the most honorable and selfless professions out there! The goal of an experienced Registered Nurse or Nursing Assistant is to provide the best quality care to patients and their families. 

The responsibilities of a caregiver can be diverse, touching on many aspects of the care journey. This role can include providing support in the stages of chronic disease or terminal illness, to engaging with patients and families in their care plan. Assisting in daily activities such as meal preparation, running errands, exercise, or light housekeeping may also be associated with this role. And a trusted caregiver will undoubtedly provide companionship.

Caring for our elderly population can be rewarding and frustrating at the same time. Aiding in someone’s well-being, helping to keep seniors safe and bringing joy is gratifying, but caring for multiple elderly patients can also bring complexities that can challenge your stamina, patience, and organizational skills.

So, how can you manage the emotional and physical demands involved with caregiving that can strain even the most resilient person? Below are a few caregiving tips and hacks to stay organized and as stress-free as possible.

Time Management Tips for Caregivers

The best way to stay organized is to manage your time in the most efficient and effective way possible. Many caregivers are on the road visiting multiple patients in various locations. Each care receiver will have different needs such as medication schedules, doctor appointments, physical therapy assistance, and more. There will also be scheduled meetings with family members to provide updates on the care provided. 

1. Implement a Calendar

Most providers have typical daily/weekly/monthly routines that are carried out for each patient. Having a map of your day will keep these routines systematic and hopefully help you run like clockwork.

What type of calendar is a personal preference; paper-based calendar notebooks such as Day-At-A-Glance have plenty of space for each patient name, time of visits, doctor appointments, errands, and family meetings. For the technically savvy, there are great online options that can provide email notifications and text alerts, automatic reminders for recurring appointments, tasks, and one-time events. 

Selecting the best type to suit your style is essential in how well you will use this tool. Set a time each week to review your daily schedule, outline how you will manage your to-do list, and check for conflicts. In doing this, you will stay on task.

2. Prioritize Responsibilities

Understanding the true nature of a senior’s needs can sometimes be challenging. The more time you spend with each patient, the more they come to depend on and value the relationship. With extended families in far-flung places, a care provider may be a primary source of companionship.  

Spending the “allotted” amount of time with each individual to attend to primary tasks while providing a social connection is the primary objective. The temptation to overstay on a routine visit is natural when you know a patient may be lonely. If you have a senior you know will need some extra TLC, build this time into your calendar. 

Dividing your time between patients, satisfying all of their needs, and doing so without compromising care or compassion is a skill. Mastering the use of a daily calendar, anticipating changes due to unexpected occurrences and being consistent will prove to be effective. 

3. Remember: Family Members are Part of the Team

Building a relationship with family members of the care receiver is as important as the one you develop with the senior. They will rely on you for communication between physicians, home health administrators, and sometimes the senior themselves.  

Get to know the family members and their “dynamics.” Express an interest in their concerns regarding their loved one’s care. Recognize challenges they may face in being present (full-time jobs, distance, etc.). Doing so will build trust and reassure them you are there to support them as well.

Keeping an open and honest line of communication will reassure family members their loved one is in good hands, particularly for those who live far away. How often you provide updates may be challenging when multiple members expect updates and questions answered. 

Your availability to family members when they are in need will be critical to the nature of the relationship. Minimizing schedule disruptions such as multiple inquiries is also essential in efficient time management. Planning family updates and scheduling them into your master calendar will not only assure family members they will be kept in the loop but will also aid in task management. Designate one family member, if possible, to be the point person, and they can disseminate information to the rest of the family. 

Keep Written Journals 

Most home health care services keep detailed patient care files internally. To maintain written journals for each patient for your reference, as well as for family members and potential substitutes, could prove to be invaluable. Each patient folder should include:

  • Name, address, and social security # of the patient (sometimes needed for doctors’ appointments).
  • Designated family members in the care plan, including phone numbers. 
  • A record of all medications and the schedule for administering. 
  • Any allergies the patient may have.
  • Previous medical issues.
  • Copies of health insurance cards, ie. Medicare and Medicaid.
  • Social and food likes and dislikes.
  • Behaviors and sensitivities.

Trained caregivers are prepared to act accordingly in the event of an emergency; however, to recall all this pertinent information from memory is not only next to impossible but dangerous. Having this file handy is a necessary tool.

There will be times when the primary caregiver is unable to make the visit. Caregivers do succumb to colds and other illnesses from time to time and hopefully will take a vacation now and then. If someone is pinch-hitting, the senior patient may feel out of sorts, but having this valuable information to guide the substitute can help make the visit as comfortable as possible.

Take Care of Yourself

 “There is a reason air travelers are instructed to put on their own oxygen masks before tending to a child’s: you are better able to take care of others when your own physical condition is secure.” – Harvard Women’s Health Watch 

Caregiver strain is a real thing! Most professional caregivers balance the responsibilities of their personal life along with the many demands of their professional life. Incorporating time to exercise, eat healthy meals, and get the proper amount of sleep may seem impossible, but necessary to be your best self.

Recognize your concerns if they are interfering with your performance. Are you fatigued? Having a hard time maintaining your pace and keeping up with your schedule? Feeling out of sorts?

Related:
Stress and Aging: Recognizing & Managing Your Senior’s Symptoms

Don’t be afraid to ask for help! Your fellow caregivers most likely have felt the same pressures and stress you may be experiencing. If you’re feeling stressed, your senior is likely to feel residual stress. Get some advice. Sometimes talking about how you are feeling to someone who understands is half the battle.

  • Take a break once in a while during the day.  
  • Get fresh air by taking a walk between client visits.
  • Practice mindful meditation anywhere you can find a quiet 10 minutes (even in the car).
  • Listen to comedy podcasts while traveling for a new perspective. Laughing has excellent healing powers.

Remember, you are not alone! The work of a caregiver is invaluable to so many. Providing quality care with love, empathy, patience, and compassion, is not only a skill but a precious commodity, and we are glad you are out there! We hope these tips for caregivers help keep you healthy, timely and organized!


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