Now I need to go do my laundry, including washing the sheets…

Here is Neil Pasricha’s awesome blog.

Here is the full post this nurse wrote for this question, opening up over eight pages of response from other nurses in a very important discussion.

This is a controversial subject that I bring up but … should we – the tax paying public– have to pay for the cost of non-compliant obese patients and all their problems (htn, chf, dm, metabolic syndrome, depression)? Recently we had a 40 something female patient in with a celluliitis and she was totally non compliant with her care, meds and diet. Her ‘boyfriend’ was seen several times bringing large quantities of fast food from the outside. And this gal was younger then me and already chronically ill, and weighed well over 450 lbs. Now I’m not a skinny mini, but you can’t tell me the extra 300 pounds was from hormone problems.

Geeze what the heck is the matter with people????

Yet she expected to be waited on hand and foot and was one of the most obnoxious patients I’ve ever cared for in all my years of nursing.

So why is it she qualifies for all sort of aide – and free insurance — when she has chosen a life of sloth and gluttony?

So my question to you reader is should we pay? Would she have become this aberrancy if we (society) hadn’t supported it in the form of welfare and social security disability? And should we withdrawl her benefits if she remains non-compliant?

My response:

I have just read every response to this very important thread. “Walk a mile in my shoes.” We truly have no idea what has led any person to make the choices they have. It is not our job to judge them. So what would be the best care plan for this “obese” (or insert whatever other so-called non-compliant condition here) patient? Are you a nurse who knows how, and is willing, to listen and communicate with her spirit? Who could access what is at the core of her pain? Because, yes, this patient is in pain of some kind. She cannot just will the weight off of her body. Her body now “needs” the sugar, food fix. Where is the nurse who will assist her in this? Who will nurse her pain (now described as a vital sign, remember) and support her as she changes deeply ingrained patterns, which have invaded her life for whatever reason. Where is the healthcare infrastructure and insurance payment for this kind of follow-up?

Non-compliance is a serious issue in healthcare, but not because of so-called non-compliant patients. It is because of the judgment handed down by caregivers. If someone feels uncomfortable to take a lot of pills, and their gut instinct says it is not for them, then they are judged non-compliant. Who determines what the best healthcare course is? The for-profit drug companies?

Health is about wholeness, not following orders. Nurses have a huge opportunity to support this return to wholeness, which has to come small step by small step.

Perhaps the frustration of the nurse, who asked this important question, is also related to a feeling of helplessness, not really being able to help someone who “appears” not willing or able to help themselves? Being able to be neutral is the key. Judgment can energetically land on someone, even contributing to a need for more adipose padding to deflect that energy hit. Obesity, is more than eating food. And the fact that so many people in this country are over weight, is bigger than just the number of calories in and calories burned.

“I am not a mechanism, an assemblage of various sections.
And it is not because the mechanism is working wrongly, that I am ill.
I am ill because of wounds to the soul, to the deep emotional self
and the wounds to the soul take a long, long time, only time can help
and patience, and a certain difficult repentance,
long, difficult repentance, realization of life’s mistake, and the freeing oneself
from the endless repetition of the mistake
which mankind at large has chosen to sanctify.” D.H. Lawrence

Many aspects of life brought both this patient and this nurse together at this exact time….with an opportunity, a mirror (because we are all mirrors for each other) to help each other face issues in their lives. Sometimes the smallest of gestures, words, compassionate recognition of spirit, can change everything…everything.

Being a nurse is a difficult choice and a serious responsibility. Respond in the best way you can to light the way for patients in your care to find and return to wholeness. Redefine healthcare as you do this. It has become a profit-oriented business and not the care-giving, heart work that it could be. Do the best that you can in this difficult work that you have chosen to do. Heal both nurses and other people, who are called patients, as you step up to the plate.

Gratitude is about eating some humble pie, but not the pie that denigrates or belittles the grateful one. Humble pie reminds you that you are a daily novice in this earth life experiment. Swallowing it with reverence and fearlessness will feed you exactly what you need. Be grateful when you see it on your table.

The motion of gratitude is propelled simply with love.

“Wu Wei” digital mandala (made from one original photograph) © Elsah Cort

Today the concept of “burnout” itself is trying to undergo a makeover, with new terms coming out for it. People are hesitant to use the word burnout at all. This is especially true for the nurse who is burned out, whether in small, subtle ways of job dissatisfaction or more severely as nurses who would quit the profession all together (if they did not have to meet life’s necessary financial obligations.)

The potential for healing nursing burnout is really within the burned out nurse her/himself. This is a challenging notion, I realize. If you are that burned out nurse, how could you possibly accept that you are the one who can transform it? It already takes all your energy reserves to just show up for work!

There are two kinds of burned out nurses. Both are exhausted and at their wit’s end in their work. One talks about the burnout, often in the form of bitching (don’t you just hate this word?) and lashing out at fellow workers and family or friends. The other one is the burned out nurse who has reached a kind of despairing complacency, but still longs for a solution, a better something.

I have been both, and in recent years found myself immersed in a kind of deep grief that I could no longer stay on the job as a nurse. This decision has taken a personal financial toll, but I still feel that I did the right thing to step aside and get a different perspective. Out of this came the birth of a nursing burnout retreat called “Re-Membering the Healer’s Spirit.” When I teach this retreat I wake up happy and joyful about going to work that day. How many times do nurses really wake up happy and excited about going to work?

The burnout retreat has revealed another aspect to nursing burnout that I had not realized. It seems that the nurses who could benefit the most from the retreat are not able to let themselves do it. Part of it is the huge energy depletion in the burned out nurse, that barely allows them to get done what is already on their list. And with family obligations, the household chores and the daily list of things needed to be done, there leaves very little time for getting away or going on “retreat.” Yet, this can be the most potent time to drop everything, and take a very deep breath!

Underpinning all this, is the level of self-worth that is often diminished in the burned out nurse. We are taught as nurses that we have to be exceptional at our work, be strong and able to multi-task where lives are depending on it. If we aren’t measuring up, as our symptoms of burnout are telling us, then we see ourselves as nurse failures. This devaluing of ourselves is the most profound aspect of nursing burnout, that somehow we just aren’t good enough. The cycle deepens here…if we aren’t a good nurse then we can’t do a good job, and if we are exhausted, drained and on the edge, how can we be a good nurse?

There is a sadness coming over me as I write these words, because I know at this very moment in time, there are nurses out there thinking and feeling this way right now. And there are persons (we call them patients) who are in dire need of a nurse who is present, competent, caring and energized to help them.

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An open invitation is sent out to anyone (not just nurses) to gift yourself with a retreat from The Deeper Well.

There are two dates set this fall, one in October and one in November, and both have open slots. You can schedule a retreat for a different timing, if you have three other persons who also want to come. The retreat does offer 24 hours of Continuing Education for California or Nevada nurses. The retreat does offer 24 hours of Continuing Education for California or Nevada nurses.

Read more about them at “burnout retreat” link in the above menu, but know that the fluid, organic nature of the retreat is not so easy to put in words.

“Don’t rock the boat…is a common thread for many nurses and nursing work environments. Management says they want to have input to make the nursing environment better (what they really want is more productivity for less paid hours on the clock.) And nurses don’t want other fellow nurses stirring up the dust too much by sharing their frustrations. Just get through the day, do your job (perfectly) and don’t tell me about what you think needs to be fixed or changed.

I have been researching burnout for years, both from an experiential perspective (40 years as a nurse) and from a holistic “healing” perspective. To realize the complicity between both nurses and the job situations themselves, is a multi-faceted discussion. How do you talk about burnout with anyone–other nurses, family or friends–without it becoming just a gripe session or getting suggestions like this article’s title says to “just relax”?

There is a fundamental core issue that relates to nursing burnout and to our so-called health care crises….that is that we are not becoming healthier or “getting well.” We need to send ourselves, as nurses, an authentic Get Well card. We can change the nursing profession. And I know for sure that there are nurses who realize this, envision this and long for it to happen.

This author is one of these nurses. She offers her insights and tells us that we can change our mindset about how we approach our difficult and sorely needed jobs as nurses. She has discovered a process for transforming nursing burnout, born out her own personal experiences as a nurse who cares.

I have looked at her offerings and found that we share common views on how to help nurses with burnout. It gives me hope to find such a kindred spirit. And I know there are many more of us out there, and I hope some of you will post your perspectives here. Burnout is becoming a cliche, and we are supposed to couch it in different words like compassion fatigue, almost in a kind of denial that it is still happening. Nurses are not supposed to burn out, they have been trained to be professionals who get the job done. And now, with the economic times so unnerving for many people, nurses are feeling even more stuck in jobs that they fear they cannot leave or “rock the boat” in any way.

If you are a burned out nurse reading this, or know of one, or wonder if you will become one…..I invite you to explore it with me in a mountain retreat in California. You can see the details at thedeeperwell.wordpress.com and yes, this could seem like an advertisement, but it truly is a helping, caring hand reaching out. (The retreat does offer 24 CE’s for California and Nevada nurses.) It is a documented fact that burned out, stressed out and overwhelmed nurses contribute to a less than helpful, and sometimes out right dangerous, health care environment for patients. Nursing burnout affects us all, whether we are immersed in it or not.

We need to welcome all the voices talking about it.”

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Read more about burnout from Lori Daniell, author of the article, at her Nurse Your Spirit website.

“In your heart is a mysterious portal that interconnects the infinite ocean of Love to the oceanic consciousness in your body. Ground substance, as the inner ocean of the body, is a liquid connective tissue inside and outside every cell that unites the awareness of 50 trillion cells as one consciousness. So body as microcosm reflects macrocosm: our individual consciousness is an expression of the whole. Paradoxically, by descending inward to heart we contact the outer shimmering, pulsing oceanic heart of mother earth. And since the heart of the Mother is one with the infinite heart, we directly realize ourselves as Love – all that is – expressed as body.”

from Charles Ridley, author of
Stillness: Biodynamic Cranial Practice and the Evolution of Consciousness
a free download called “Relax into Your Natural State”
from his biodynamic craniosacral school

Link to new facebook nursing burnout group.
Please join us and add your two cents.

Image available as greeting card or digital print at 1000markets.com
©2010 Elsah Cort

We all have rushed by the invisible persons that keep our human society functioning. Some of them work right beside us, some are cleaning up after us, and some are even in our families. Some times we feel that we are the invisible person that no one really recognizes or even wants to know.

Martín Prechtel (Native American healer, author and teacher) teaches a beautiful ritual in his moving workshops. He asks that you bring three small gifts. During the workshop you interact with a partner. At the end of the time together, you give one of your gifts to this person. You also give them the other two gifts, with the instructions for them to give one of the gifts to an “invisible” person that they come across in their daily life. You are to also give them the second gift and ask them to notice another invisible person and share the third gift.  It can become a profound paying it forward.

Image is a drawing by Martín Prechtel.
floweringmountain.com

I don’t guarantee this will work, but here is an idea to try:
Take 1-3 deep breaths before some of your tasks, or even all of them.
Stop walking, talking, and moving while you do this. Smiling is definitely okay to do, though. Looking into the eyes of your patient while you do this is also encouraged. Invite your patients to join you.

Then when you return to your mundane, and often critical, tasks after this brief “retreat” notice how your hands move, how your mind feels (not thinks) and how your eyes see.

When you first try this, you may feel entirely ridiculous. You may not even want to give it a try. But don’t let your negative, discouraged, stressed out self force you to continue working mindlessly and even sorrowfully. Do this often each day. The key is the noticing that comes during these intervals. You could write little notes to yourself, but don’t let it become another chore and a something that you should do. Just breathe…

[There's more to try after this small step.....
but for now, this is a first step or two.]

Essential Breathing (art and words from Yoga News)
Oxygen is the most essential nutrient for human life. We can live mere moments without oxygen, while we can go without water for three days and without food for nearly six weeks. Breathing deeply is essential, both for optimum health, but also for continued lung capacity. Some studies have estimated that up to 75% of a person’s lung capacity can be lost unless a person practices deep breathing. Deep breathing stimulates organs in the body, increases circulation, decreases stress and allows us to process our emotions fully. Many people have to actually re-learn how to breathe fully, so start today to reclaim the wonderful effects of filling your lungs to capacity!

My longer response to his article comes below. I had to shorten it to fit with the comment format for his article.

:: Right and wrong, black and white, us and them, red and blue, yes and no, you and me, my science and your non-science, only tell two viewpoints and do not reflect the organic, multi-faceted and abundant lives we live here on this small planet….We listen (sort of) to any argument, and lean toward acceptance of a particular message, based on where we are “standing” at the moment.  I am right and you are wrong. We all want to be right and to have others agree we are right. And most of us would rather die than change our minds.

Wanting to be right starts at a young age for most of us.
(photo source: dreamstime.com)

This conversation about healing, causes of dis-ease, treatments and cures, efficacy and longevity pivots around wanting to be the one who is “right”.  Moreover, many “right” people want to force their views on everyone and also want to make a profit while doing it.

We are emerging out of a group mentality where we have been abdicating our individual power to outside (of our true nature) authorities. It is not comfortable, nor is it meant to be.  What I know (or believe or where I invest my money) is what I know only for now. My knowing is evolving, not fixed, and I am open to admitting I was mislead by a lot of what I have been taught (especially as a registered nurse).

I admire this author’s courage to speak the truth as he knows it and, more importantly, lives it. Prove all things, for yourself. The best advice I have ever given as a nurse to a patient, is to see all doctors, nurses, pharmacists and healthcare professionals as consultants presenting possibilities, not necessarily the final word on what is the right health care path for you. Being personally responsible for your own healthcare is a challenge requiring great courage and wisdom. It is not easy.

We heal from the inside out, and all the bandaids, medications, surgeries, and scientific/homeopathic remedies work only when the body says yes. And the body only says yes, when our consciousness (whatever this really is or is not) is on board. ::