By Sandra Howlett, Ed. D
As a nurse, you are the front line caregiver and as such, often bear the brunt of the angst, frustration, worry and fear from patients and their families. You carry tremendous responsibility. In addition to being clinically current, you also serve as an interpreter between physicians and patients as well as their confidant for 2AM bouts of sleeplessness and loneliness. A continuing key contribution you offer is one of assurance and calm in the face of what may be a clinical storm. You are the work horse and shock absorber for much of the medical system.
You deal with grief and loss on a daily basis. Loss has many forms – loss of health, independence, ability to work, unfulfilled dreams, loss of future, financial changes, loss of expectations and perhaps the saddest of all, a loss of hope.
Loss brings grief. Simply stated, grief is the body’s physical, emotional and mental response to loss. Grief is a form of stress which can present itself in many manifestations.
· Physical symptoms include: changes in appetite or weight, sleep disturbances, lower immune response, exhaustion, changes in hair / skin, accelerated aging, muscle / joint pain, breathing difficulties, chest pain, clumsiness, and self-destructive behavior.
· Mental symptoms include: forgetfulness, difficulty concentrating, increased errors and accidents, self doubt, getting lost and misplacing things, disproportionate worry and fear. · Emotional symptoms include: short patience, shut downs and outbursts, mood swings, desire to withdraw or run away, excess crying, numbness, anxiety, argumentative, extreme criticism of self / others, hopelessness.
· Mental symptoms include: forgetfulness, difficulty concentrating, increased errors and accidents, self doubt, getting lost and misplacing things, disproportionate worry and fear.
· Emotional symptoms include: short patience, shut downs and outbursts, mood swings, desire to withdraw or run away, excess crying, numbness, anxiety, argumentative, extreme criticism of self / others, hopelessness.
You may have been taught to put the needs of others first. Day after day, year after year, all that caregiving and selflessness takes a toll. It is impossible to serve others without being affected in both affirming and hurtful ways. It is easier to see signs of stress and grief in others than in ourselves, yet it is often there. Who takes care of you? What do you do with your own grief after your patients move on? You cannot give what you don’t have.
To be nurse, a healer for the long term, takes commitment. One commitment must be to yourself. Like the wise advice of flight attendants, "In the event of a rapid decompression, place the oxygen mask on YOURSELF before assisting children and those traveling with you". This is a life saving directive. Rather than being selfish, it is self responsibility
Where is your oxygen mask? When was the last time you used it? Don’t stow for an emergency -- the need is now! What do you do for yourself that affirms life in the face of grief and loss? How do you care for yourself as you care for others?
The self care mask has many faces with endless options. A few include: spend time in nature, exercise, create a quiet sacred space in your home, do something new, do nothing for an hour, let yourself cry the tears you’ve been holding inside, call someone you have drifted away from, practice saying "no", watch a silly movie, read something unrelated to work, hold hands, take a nap, change your expectations, get a massage, grab a pool noodle and hit the wall to release the big feelings you are holding in, write a letter that you will never send to address old hurts, take a vacation with no destination obligations, start a gratitude journal, clarify your own needs and start making requests, take a bubble bath, buy bubbles to blow, get out the crayons and draw, put on dance music and go wild. The options are endless. The decision is yours and it is one that needs to be made on an ongoing basis. Grief is a natural response to loss; it does not have to be a way of life. Acknowledge grief. Affirm life.
Imagine giving yourself the quality of care that you give and insist upon for your patients. Imagine taking that first breath from the mask knowing that as you care for yourself, you will be able to care for others. What will you commit to do in the next 24 hours that says, "I am responsibly attending my own needs today?" Breath it in – enjoy!
Dr. Sandra Howlett, bereavement specialist, master facilitator, speaker, teacher, and writer. She has two decades of inspiring, encouraging and educating her audiences with her unique blend of compassion, humor, reality and possibilities in life. In addition to keynotes and retreats, she is a key presenter for the American Hospice Foundation's Grief at Work programs in Arizona and facilitates grief support groups and retreats.
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