Tag: COVID-19

Trivia and teabags

On 15 August 2022

Did you know that teabags were an accidental invention? That’s right: they were never intended to be dipped into that piping hot cup of water you are holding in your hand. In fact, in 1908 American tea merchant Thomas Sullivan used silk bags to send samples of tea to his customers, who mistakenly thought the bags were meant to replace traditional metal infusers and dunked them into their teapots.

Did you also know that teabags have been given out to exhausted and overworked NHS healthcare workers to thank them for their efforts during the COVID-19 pandemic and encourage them to take a break? The token gesture has received scathing criticism on social media and in news articles across the UK. The NHS trust that gave them out says that the gesture has been taken out of context and was just one part of a range of measures being used to thank healthcare workers for their hard work.

‘Nice trivia’, I hear you say. But what’s the point?

In the last few weeks, random trivia emails have been popping in to my inbox. These are being sent on a regular basis by the higher echelon, I presume in an attempt to raise morale and build a sense of community. Of course I could be wrong about the motive behind them, since no explanation for their sudden appearance has been communicated. With approximately 15 questions each email, they’ve obviously taken some time to compile. Then there’s even more time for someone to receive and read the responses and send out the results the following day.

I wish I could say they have been fun, a bit of light hearted activity to fill in during a tea or lunch break. Instead I am finding that with each new email I am feeling more and more resentful. If ever there has been a sign that management are reading the room wrong, this is it.

The emails arrive with a ‘ding’ and land in the depths of the inbox amongst what seems to be a never-ending mountain of referrals and requests to review patients. Rather than welcoming them, I am becoming more and more angry with each one. I can’t hit the delete key quickly enough. Who on earth has time for this?

Many healthcare workers around the world have received expressions of appreciation for their efforts during the pandemic and in an effort to boost morale. There have been claps for carers, music from balconies. badges of thanks, donations of meals, and signs in windows. A myriad of ways for the public, and employers, to show their appreciation. While all of these gestures and the teabags and trivia are well-meant, there are so many more practical ways to show healthcare workers that they are valued and appreciated.

What we want is respect. For managers to provide us with opportunities to raise concerns and give constructive feedback, and for them to act on it. We want enough staff and resources to meet the ever-increasing workloads. We’d like adherence to ratios, enough desks, working computers and phones. We want streamlined recruitment processes so that positions are not left vacant for two years. We need backfill into our positions when we are on leave so we can return refreshed to a manageable workload instead of having to exhaust ourselves trying to catch up. We’d also appreciate better pay, perhaps a retention bonus for slogging it out during a pandemic and still turning up every day. What about access to a free workplace gym and to a cafeteria or even just a mobile coffee van? I could go on and on, but I just don’t have the energy.

So there you have it. I’ve managed to link teabags to trivia, and had a rant.

Time for a cuppa.

Hitting the wall

By Unravelled

On 15 May 2022

In Reflections

You’re not prepared for it. You’ve seen it in others, recognised the signs, and hoped it would never happen to you.
And then, WHAM!

Lethargy. Insomnia. Anxiety. Physical illness. Complete mental, physical and emotional exhaustion.

I should have seen it coming. I didn’t.

Some of the signs had been there for months. Feeling disillusioned about my job, and finding it hard to concentrate. Little snippets of irritability and impatience poking through during the day. A sense of never being able to get on top of the workload, and not being able to see the good outcomes – never feeling like the job is done properly and of being completely overloaded and overwhelmed. Frustration and anger with management. An overall lack of job satisfaction.

Burnout in nursing is not a new concept, and it is not just having a bad day. It is continuous work related stress that can have a cumulative, unwanted effect. Workforce studies have identified burnout as a nursing ‘outome’; with high workload, low staffing levels, long shifts and low control all associated factors.¹ Nursing stands out as one of the most at risk professions, due to the different circumstances in professional practice causing physcial and emotional exhaustion.²

Other risk factors for burnout include a lack of control or an inability to influence decisions that affect your job, a lack of resources needed to do your work, and extremes of activity (read: chaos). Some personality traits can make you more vulnerable and increase the risk of burnout – perfectionism, over commitment, idealism and self-criticism.

Many blame the pandemic for the increase in health workforce burnout, but if we are honest, the truth is that many of us were at risk prior to the start of the pandemic.

Health services have been stretched to capacity for decades. Unfilled shifts and roster shortfalls. Nurses working long hours and unpaid overtime. Phone calls to staff on days off, begging them to do extra shifts. Bed block and caring for patients on trolleys in corridors. And in aged care, no staff:resident ratios, and an ever increasing workload and patient complexity.

In my own palliative care service, the workload has increased three-fold in the last two years. We are averaging 15-20 referrals and 5-10 deaths each week. In January, February and March, we had more than one death each day. The emotional burden of this work really takes it’s toll.

For the last two years I’ve pushed through – working in COVID outbreaks in aged care facilities, using telehealth much of the time to increase efficiency, and attending an unbelievable amount of meetings. I’ve tried to support the people working with me, at times to my own detriment. Palliative care by telehealth is not my idea of clinical excellence. My job satisfaction has suffered. My health has suffered.

In a week when multiple members of the team were diagnosed with COVID19, I trudged on. It was good to get out of the office and do face to face consults, but by the end of that week I was at the end of my tether.

I hit the wall.

Something had to give, and I realised that if I wasn’t careful, it would mean long term damage. It took a strong lecture from one of my team mates to really bring the message home. It was time to stop, recover and take stock.

After a visit to my GP and some reflection on how I was feeling, I set out to get myself back on track. Daily exercise, eating well and plenty of rest. Lots of reading, some meditation, listening to podcasts, and crochet. I bought storage boxes and sorted some cupboards – regaining a sense of control over my personal space at home. I completed some administrative tasks that have been piling up for months.

After two weeks I feel rested, but not fully recovered. I’m ready to go back to work, but I’ve made some decisions. It’s time to be very clear that our team cannot continue to work without adequate staff and resources. It’s time to step back from some of the committees and meetings. It’s time to put some boundaries in place to protect myself from real burnout which may lead to walking away from a job that I really do love.

Burnout CAN be managed, and you can learn strategies to prevent it from happening. Paying attention and taking control over your own health is just the first step. Information about preventing and managing burnout can be found at https://www.nmsupport.org.au/. Please don’t wait until it’s too late.

References

Dall’Ora, C., Ball, J., Reinius, M. et al. Burnout in nursing: a theoretical review. Hum Resour Health 18, 41 (2020). https://doi.org/10.1186/s12960-020-00469-9
de Oliveira, S. M., de Alcantara Sousa, L. V., Vieira Gadelha, M., & do Nascimento, V. B. (2019). Prevention Actions of Burnout Syndrome in Nurses: An Integrating Literature Review. Clinical practice and epidemiology in mental health : CP & EMH, 15, 64–73. https://doi.org/10.2174/1745017901915010064
https://www.nmsupport.org.au

Bone tired

By Unravelled

On 30 July 2021

In Reflections

I’ve never really thought of myself as being on the frontline during the pandemic.

I haven’t been exposed to COVID-19, or cared for anyone with it.

Sure, the PPE requirements have been a nuisance working in aged care facilities, and wearing a mask all day feels like hard work. But it’s nothing compared to what I imagine my colleagues interstate and overseas have endured working in hospital COVID wards and care homes where there are outbreaks.

I’ve worked alongside nurses who are run ragged caring for the elderly, watching them patiently explaining to angry relatives the reasons for visiting restrictions, while at home in their own countries their family and friends have been dying of COVID. I have listed to their grief as they tell me about not being able to say goodbye to mothers, fathers, siblings and cousins.

I have used telehealth to connect families overseas and interstate with their dying loved ones, giving them that last chance to say goodbye, because travel restrictions mean they cannot come to sit at the bedside and hold the hand of those they love. I’ve lost count of the letters I have written to Chief Health Officers on behalf of these people to support their applications to travel to attend a funeral.

I’m tired. Everyone at work is tired. Not just because we work long hours, or because we are understaffed while the workload increases, but because the permanent state of vigilance is exhausting. Every radio station, television channel, newspaper and social media forum is filled with COVID news – we can’t escape it. We have not been able to have holidays – those precious days and weeks each year in which we can take ourselves off to explore other places, turn our faces to the sun, unwind and relax to recharge our body, mind and spirit.

Caring for the dying is difficult at the best of times, but during a pandemic there are layers upon layers of complexity that we peel back one at a time, only to reveal more layers underneath. We bear witness to grief, we hold space for others, it is accumulative and eventually catches up with us.

I have cried more in the last six months than in all my years of nursing. Advertisements on tv can bring me to tears, they randomly run down my cheeks when I’m listening to a song, watching a movie, or reading a book. The sadness comes out of the blue, overwhelms me, then disappears. I’m not burnt out – I still want to go to work, I love my job. But I’m tired – ‘bone tired’, as my grandmother used to say.

Just today, I read an article about the grief that nurses are experiencing during the pandemic, and the potential impact of this on the nursing workforce in the years to come. I know many who have left their jobs, moved to different areas, or decided it’s finally time to retire. It’s difficult to imagine the pandemic coming to an end, and that we will ever return to what we once knew as ‘normal’ life and work.

To my nursing, medical and allied healthcare colleagues on the front line in COVID hotspots, hang in there. Take a mental health day, or two. Stay safe.

The year of change

By Unravelled

On 1 January 2021

In Reflections

It ended as it began, with a sense of uncertainty, a feeling of danger just around the corner, and an urgent desire to step into self-protect mode.

2020 was the International Year of the Nurse and Midwife, but will no doubt be written into the history books as a year that everyone wished they could forget. It was the year of disaster – unpleasant surprises, unwanted lifestyle changes, the year of grief and loss, and of one bad news story after another.

In our family, it started with the bushfire season which was one of Australia’s worst ever. RFS firefighting deployments began in late August, and it was a long, hot summer of pager calls, long days and nights, and waiting for the next assignment. I spent a night in December waiting for the dreaded knock on my door after receiving a text from my husband with a photo of the Nerriga firestorm, and a message saying his crew were preparing for a burnover. For hours on end I waited for some news, truly believing that this time he wasn’t coming home. His phone was either out of range, or no longer useable. I was so relieved when he returned the next day, covered in soot, ash and that unmistakeable smell of bushfire smoke. We had no idea that things would get much worse before they would get better.

New Year’s Eve was a warm summer evening that developed into a thick, choking smoky night. My parents were in danger on the south coast, and my husband was out on fire duty, while I tried hard to remain calm and checked my phone for news every five minutes. The firefighting continued for many weeks, I put on my RFS uniform and helped with shifts of community liaison and supporting our crews at the shed. We watched the country burn, and listened to stories of family and friends that lost properties and livestock. The rain finally came in late February, and finally we thought there was a chance to rest and recover.

In March COVID-19 reared it’s ugly head, and the downhill slide into 2020 continued. At work our team rapidly pivoted, adopted telehealth, packed kits of PPE and changed from everyday workwear into scrubs. We worked from home when we could, but there was no doubt our clinical work was going to increase rather than slow down. We planned how to decontaminate after each shift to protect our homes and those we loved. In addition to my clinical workload, there were now multiple COVID-19 committees with meeting after meeting on WebEX, Zoom, Teams. We knew we were in for the long haul. I was exhausted before we began.

July and August were bleak. It was cold, dark and miserable. We shed tears for two very special people in our lives. Uncle was in his late 90’s, and was tired. We were sad, but not surprised when he decided it was time to stop taking the medicines that kept him alive but were failing to improve the quality of each day. Rhonda’s death came as a total shock, and we grieved this very sudden loss hard. She was my second mother, my lifeline when the children were small and I was navigating new marriage and motherhood, and one of my best friends as I grew into adulthood. She was the person who was always there to help out, the reliable person in a crisis, the one you thought would always be there to make a cup of tea and have a chat. She was at every birthday, every special occassion, every Christmas. Life goes on, but we are changed irrevocably.

Both my parents had bilateral knee replacements in 2020, Mum in February and Dad in November. Both had complications with blood clots, and delayed recovery. Usually active, busy and energetic, they have been forced to slow down and are struggling a little. It comes as a shock when you realise your parents are entering old age and you are reminded that they won’t be here forever.

During the year I sat with so many people who were facing loss and grief. I held the hands of the dying and listened to their stories. Every day there was something new to learn, a different challenge to face. While the world seemed to come to a standstill with lockdowns, COVID-19 and a sense of continuously waiting for the next outbreak, care of the dying continued and was made much more difficult by having to navigate border and travel exemptions and visiting restrictions.

I sought comfort in my family, my home, Molly the Wonderdog, and Wonkykitty. My grandchildren reminded me that new life and new energy are always just around the corner when you think things are at their worst. I learned to bake sourdough. I relearned crochet, and used it to relax at night and to keep me awake while watching Netflix. It gave me a sense of purpose, as each item I made was being gifted to someone I loved. It forced me to slow down, to sit, to temporarily lose myself in colour, texture, patterns. It grounded me.

2020 ended with a whooshing in my ears and dangerously high blood pressure that involved an emergency visit to a doctor, tests and medicine. This time I was frightened for myself. It was a wake up call that I need to focus on self-care. My resolution for 2021 is to excercise, eat well and slow down enough to take time to spend with family and friends, to smell the roses, to bake more sourdough, and keep crocheting. It’s time to enjoy the simple things in life.