By The Gypsy Nurse

June 20, 2020

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Traveling Light: Without the Burnout Suitcase

The Following is a Guest Post by Cheryl J Reynolds.

Burnout prevention is always the best medicine, but for some of us, even with our best intentions….prevention doesn’t happen. Are you one of those nurses who went through burnout, thought it was over, and then realized you are back on the stress and burnout road again?

Road through burnout

I know how you feel as I drove down that road through burnout…more than once. So, I know how disheartening you feel when those symptoms start coming back again. Burnout is a long winding road, but hopefully, this article will help you pack properly for this long drive.

If you are a nurse who has suffered from work stress, compassion fatigue, or burnout and worked through it, you may feel great one minute, then realize all of a sudden that you’re dragging a heavy suitcase. Our unresolved burnout symptoms seem to come pre-packed in an overstuffed suitcase that you may be carrying with you from job to job. The 3 dimensions of burnout (exhaustion, low personal accomplishment, and depersonalization) have this interesting way of layering upon each other, which is why it is a long process that seems to come and go. Over time, burnout weighs you down emotionally, which adds to your already tired mind and body, increasing your exhaustion.

Exhaustion is one of the dimensions that tend to affect the travel nurse. You have longer hours, occasionally heavy assignments, and for some, the stress of being isolated and away from our home and family can be an exhausting burden to the heart. Being tired and frustrated with the situation can decrease motivation which brings a feeling of being dissatisfied. This directly affects your self-esteem and sense of self, therefore adding to the dimension of low personal accomplishment. This can spiral into questioning your ability and purpose as a nurse. This short analogy shows the layering effect of burnout, even without adding the dimension of depersonalization.

Burnout is a process

The bottom line, burnout is a process, and with any process, there will be baggage.

The burnout suitcase you are carrying is being carried internally …within. This is your “inner burnout suitcase,” the subconscious mind space that holds all of your memories, perceptions, and beliefs. When you start to move beyond burnout, you begin to challenge and change your way of coping and thinking. So it is not uncommon for your ego (that protective side of you) to rattle the burnout suitcase again.

You need to be gentle with yourself as you move forward. A few steps backward is not the end. If anything, it is a confirmation that your mind recognizes the shift in awareness and acknowledges the changes you have made. Even if all seems lost, moving gently forward and working through it properly is a huge step you’re taking into your future as a nurse, as a healer.

So, how do you unpack and remove the burden of that inner burnout suitcase?

Just like you do an inventory of your patient’s belongings and take special care of their valuable items, you need to take inventory of your own mind. Begin to treat your heart and Spirit as valuable too. This inner realization lets you look in those hidden compartments to see what presses your buttons, what aspect of burnout has affected you, and where you are now.

Taking a stress/burnout test is another way to determine the extent of your burnout. Regardless of the results, this isn’t the time to be hard on yourself; just be accepting. It can be overwhelming, I know, but you need to be aware to clarify the subtle changes occurring within. The good news is that travel nurses tend to travel light, and they have advantages. For the most part, you are appreciated by the staff members you work with, and you have, to a degree, the ability to control your work destination.

“Don’t let your luggage define your travels, each life unravels differently.

The travel nurse’s qualities that negate burnout are clear-minded, friendly, open to change, and adaptable. So, when you get to your new assignment and the burnout suitcase weighs you down, here a few tips that might help lighten it.

  • Since giving up is not usually a viable option, acceptance of a tough situation is. It is not easy, but surrendering releases control and lets, you flow gently with this process.
  • Go with the flow of the universe, not against it. One of the issues of burnout is that there is usually a feeling of doom, no end in sight, no reprieve. Since you have short-term assignments, there is hope for you; you can see the candle of hope flickering at the end of this assignment tunnel.
  • Be gentle with yourself as this is a process. The lenses of exhaustion can skew your visions and thinking.
  • Meditation helps; passive meditation as breathing, no-mind, sitting, or active meditation like yoga, tai-chi, or mindful walking, is excellent for bringing clarity and peace. Inner awareness comes with gentle stillness, patience, and above all…time.
  • Take advantage of the mind-shift you get from being in a new area. When you see new things and places, the conscious mind automatically slows down and expands to understand its surroundings, which causes you to become more alert and aware. Then it can become a journey of discovery, of an opportunity to expand your awareness and moves you into the present moment.
  • Be creative; find new hobbies, and explore different avenues and cultures. The passion of our own creativity can sing to our heart, open the senses, and brings a gentle focus that shifts us easily into mindfulness.

As you move beyond burnout, think of your victories and the progress that you have made. Breathe into that…constantly. Fill up your suitcase with praises from coworkers, patients, your family, and management. Don’t forget to praise yourself too! Focus on the positive but respect the negative as insight into change. Keep your perspective, be fair, and realize that this is a process.

As you face the challenges of burnout, I want you to consider that there might be grace and purpose for your burnout. Burnout is a forceful reminder that you need to take care of your Spirit. It’s no longer an option not to. Considering that you are still a wounded healer who has scar tissue that needs time to heal and fade. By allowing this process to unfold, you open up to new insights about yourself. Learn a new way of thinking, and perhaps become an even better nurse.

Be gentle, loving, and kind to that inner Spirit of yours, and above all, do this gently. Now, go unpack.

“CJ” is an RN with over 22 years of experience and a spiritual coach. She has over 13 years of teaching and utilizing spiritual concepts to help others. As a previously burned-out nurse herself, she has developed the Gentle Art of Burnout Program, which utilizes a spiritual approach to help nurses and health professionals ride the waves through work burnout, therefore restoring their healing spirit…gently. You can read more from CJ on burnout by visiting her website, Gentle Art of Burnout, or you can connect with her via Facebook.

By Laura Klein

June 6, 2020

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Guest Post: Leaving the Bedside

“You want me to help you turn a patient? Please don’t make me help you. I am so tired of touching strangers.”

I didn’t dare voice this feeling when one of my co-workers approached me—the charge nurse—to help with a simple but potentially life-saving task.  The second after this thought went through my head I was devastated. This beyond burned out. This was the end of an almost thirty-year career at the bedside.  But my fatigue wasn’t just with the patients, it was with the endless worries about patient safety/perception of care;  the ever-widening gulf between futile measures and what is best for the patient; management’s obsession with the Next! New! Shiny! Theory! 

It wasn’t that I didn’t care for my patients. It’s that I cared too much and everything felt so broken around me. It didn’t help my work environment was perhaps the most toxic I’ve been exposed to in my long career.  I felt completely discounted by the driving forces in nursing leadership: my decades of experience were meaningless without a BSN.

It was time. Time to go.

I was “that” nurse. The nurse I never wanted to become. You know the nurse. Let’s call her Barb.

She was once a great nurse: never missed an IV, always had a ready answer for a pathophys question; could recite the correct dosage of any given medication even if she were aroused from a deep sleep.  But over time, Barb losses her mojo: she sleepwalks through her care. She pastes on a therapeutic smile in the room, but a grimace and growl promptly replace it at the nurse’s station. And nothing is ever good enough. No matter how hard you work with her,

It’s not enough. Somehow you’ve failed Barb . . .

I’ve worked with plenty of Barbs and it was my biggest fear—since 1981—that I would be her.

Luckily for my patients and coworkers, I only had hours rather than whole shifts where I felt and acted like Barb.

But it was still hard to admit and face the nurse I was becoming. I had an equally difficult time admitting it was time to leave the bedside.  It felt like a failure. I was trained to work at the bedside, and my calling was to care for patients directly in an acute care setting.  To walk away from the bedside was walking away from my calling.  I was discounting the Universe’s gifts given freely to me if I stepped away from the bedside, spent sleepless nights last winter, and a few tearful days battling hopelessness that came dangerously close to a major depressive episode.   I had walked away from the NICU years before because caring for neonates had become overwhelming. If I couldn’t take care of adults, who could I care for?  Was I ready to completely walk away from nursing?

But this time, it was real

Like most veteran nurses, I had about a billion moments when I threatened to burn my license or work at Wendy’s. “Want fries with that?” is a favorite tagline I use when things are bordering on disaster.  And I was usually over it by the time my next shift rolled around.   But this time, it was real. If the thought of touching a stranger repelled me, it was time to move on. What I couldn’t get around was the emptiness I felt: how could I leave behind a career that allowed me to advocate, troubleshoot, assess, and educate people?   The heart of nursing. These things are what make being a nurse different from being a med tech or even a doctor.  Do they necessarily need to be performed directly in the patient’s room in a facility? No.

I couldn’t move away from my own feelings of grief and loss to see this. I needed help, and sometimes we have to hire people to help us.  But it was more than hiring a career coach.* I trusted my career and my calling to her. It was a profound investment. And I believe it will pay off twenty-fold over the course of the rest of my career. Shari (my career coach) taught me to trust my intuition.

The next place

I would have never allowed myself to see the next place or the best place for my gifts was case management.  I think I hesitated to wish for this at first because many of the case managers I had been exposed to over the years were an assortment of Barb’s: brittle and angry. Or worse, they were dangerous at the bedside, so they were parked behind a desk where they could do the least harm.  Like most of my preconceived notions, this one was just as wrong.  

I love being wrong. Because many of the case managers I’ve worked with are great nurses, they just aren’t posed beside medications and dressings.  Turning my own notions of this role on its ear helped me see what a perfect match my gifts and strengths are.  Shari, my coach, also helped me realize and tease out all the opportunities in healthcare for case management.

Keeping patients safe outside the hospital

In my opinion, when I became a nurse, nursing was largely about keeping patients safe in facilities. Now it’s keeping them safely out of facilities.  I want to be a part of that. I’ve worked in hospitals for years, and despite best practices and perfect intentions, facilities can be dangerous. I want to help people stay home as long and as healthy as possible.

When I realized this, my nurse’s heartfelt lightness and passion hadn’t felt in years.  My professional mission statement had been: “Allow me to guide and care for you through dramatic and complex illness.”    My new mission looks more like this: “I will guide you towards the highest level of wellness you can achieve.”  Just typing that statement makes me a little emotional, so I know it must be true.

This is my end-of-shift report.   I’m just beginning a new phase in my career, and I feel like a twenty-two-year-old new grad: a little scared, a little unsure, but passionate about taking care of people.

I’m also relieved I will never be a Barb.

*Big thanks to Gypsy Nurse for introducing me to my job coach. If you are interested in the process I underwent with Shari Sambursky; please email me at edgyjunecleaver@gmail.com. I will be happy to share with you my experience.

Edited by TheGypsyNurse: You can also reach out to Shari Sambursky via her website Career Esteem.

By Lori Boggan

January 11, 2019

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Gypsy Yoga for First Day Nerves

Are you trying to find a way to relax before your First Day? Check out this sample of Gypsy Yoga to ease your First Day Nerves.

Hi Gypsies!  I’m writing this on a flight from London to Gothenburg.  I am in near panic mode post take off.  I have a bit of  flying anxiety (take off) and rely on my breath (among other things) to keep me calm.  It is a similar feeling to the healthy stress one feels on the first day of a new assignment.  Each time we start a new assignment, we walk into the unknown.  Will it be a good fit?  Will the staff be friendly, helpful?  What will the docs be like?  What will the policies be like?

I was drawn to yoga over 15 years ago while in the trenches of nursing school.  I am by nature a fairly hyper person.  Yoga keeps me grounded.  It has helped me stay balanced and it begins with the breath.  I hope some of you can benefit as well.

The breath has a profound effect on our well being.  Every time we inhale we fill the lungs with oxygen rich air that circulates throughout the body.  With every exhale we rid the body of carbon dioxide.  A deep, even breath washes the autonomic nervous system with calm.  Most of us don’t even use close to our potential long capacity.  Have you ever noticed the changes that occur in your breath when you are stressed versus calm and relaxed?

What is Yoga and Who Can Practice?

Yoga is an ancient Indian philosophical practice of breath and postures dating back to as early as 5000 B.C. to 300 A.D.  In whatever form it is found, yoga has at it’s center the breath as the guide.  Yoga is for everyone.  There are no prerequisites to practice.  It is not a religious practice.  According to BKS Iyengar (Guruji), yoga is “a deliverance from contact with pain and sorrow.”  It’s a moving meditation that’s goal is to relieve the mind of it’s internal chatter and thus suffering.

We will practice one pose in our first ever Gypsy Yoga practice.  It is a pose enjoyed by those new to yoga and those with years of practice under their belt.  It is typically practiced at the end of any traditional hatha yoga class, although I sometimes start and end my classes with it when I teach.  While this pose is safe, if you have any medical condition that you are unsure could be affected by practicing, talk with your physician before practicing.  I will give modifications as we delve deeper into future posts.

What you Need

All you need is a small space to practice.  I have unrolled my mat in many a hotel room.  As you can see from the photos, I practice in my living room 🙂  You will need a yoga mat, beach towel, or blanket, and a small, rolled hand towel.  Wear loose fitting pants and a tshirt.  Pajamas work too.  Dim the lights or use natural light from a window.

One Pose: Savasana (Corpse Pose)

We begin with one simple, but powerful pose.  This pose is sometimes considered even more challenging than  a more advanced pose like standing on one’s head (Sirsasana) because it insists the student be still and relax.  Let’s give it a try.  Lie down on your mat, beach towel, or blanket.  You can place a small rolled hand towel under your neck (optional) to maintain the natural curve in your neck.  If you have any discomfort in your low back, place a rolled blanket or a pillow under your knees.  Draw your shoulder blades in and down your back.  Soften your shoulders down and away from your ears.  Broaden across your collar bones.  Soften your jaw, soften the muscles in your neck.  Stretch your arms out alongside your body, palms facing up.  The upper arms should rotate externally.  Stretch your legs long along your mat and allow your ankles to fall naturally to the side.

Close your eyes.  Begin to bring your awareness to your breath.  Observe your breath.  Is it short and choppy or is it even and smooth?  Smooth, even breath is the goal.  Begin inhaling and exhaling deeply through your nose.  Inhale for a count of four, hold your breath for a count of four, and exhale for a count of four.  Repeat this 10-20 times.  As you focus all your awareness on the breath, allow those first day jitters to just pass you by.  Can you let go of any expectations of your new assignment, let go of any negative reviews you may have read, let go of expectations of yourself?  All will be exactly as it should.  Can you be present in this very moment with only your breath as a guide?  Continue breathing in and out of the nose now, trying to lengthen each inhale and exhale.

Try to stay at least 2-3 minutes in this pose, ideally longer.  Practice just before heading out the door on your first day.  It is a simple pose, but when done with commitment and intention can have a profound effect on your day.  This pose can relieve headache, insomnia, depression, and helps lower the blood pressure.

From Savasana, draw your knees into your chest, rolling to your right side in a fetal position.  Take a few more deep breaths  From here, press yourself slowly up to a comfortable seat.  Bring your hands together to your forehead in honor of right thoughts, to your lips in honor of right speech, and to your heart in honor of right intention.

Stay tuned for future Gypsy Yoga posts!  Best of luck on your first day!!!  Namaste!!