6 Easy Ways To Stay Organized and Productive as a Caregiver A Guest Post by Maggie Drag

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Being a caregiver is arguably one of the most noble professions out there – but it can also take a serious toll on your personal life. Here are 6 work-life balance tips to help you reduce stress, and ultimately make you the best caregiver for not only your clients, but for yourself, too!

1.) Plan Ahead

If you have multiple clients, or work as a live-in caregiver, keeping track of their favorite foods, interests, and medications may seem like a job in itself. Keeping a daily planner can help! If you’re constantly on your phone, try downloading an app like Fantastical, ReQall and Evernote. They are super easy to use and will allow you to set up alerts and various notifications in case you’d like to be reminded of their doctor appointments, and even your own appointments with your caregiving agency, for example. At the end of the day, keeping on top of your clients’ needs and preferences will save you a lot of stress and in the future.

2.) De-Clutter

From old receipts and grocery lists, you may have trouble remembering which documents belongs to who! Here are some easy ways to help both yourself and your client, and try doing it together and make it fun while you’re at it! First, organize your bills and clients’ bills in a binder for safe-keeping. Next, divide up your coupons into a handy coupon organizer for easy access. Finally, keep track of your own caregiving documents, from contracts, care plans and emergency contacts in a folder. Try organizing each folder by client if you have multiple, and keep a small notepad to jot down any other helpful information.

3.) Think Ahead

As a caregiver, you know that life as you know it may change in a second, whether it be your client’s health, a sudden re-assignment, and not to mention changes in your personal life. First, make sure you have a list of emergency contacts (including your agency) prepared in case you are unable to help your client or need to be relieved at any point. Next, be sure you have a plan set up for a medical emergency based on your client’s health history. Keeping track of their food allergies for one is a simple but critical step to preventing emergencies in the future.

4.) Reconnect with Loved Ones

If you’ve lost touch with a close friend, since you started another assignment, remember this: Caring about your job is one thing, but caring about your relationships is far more important in the long run. Call your distant relative via Facetime – you could even plan a day where you help your client Facetime their grandchildren after you connect with your own family!

You carry a great responsibility as a caregiver, and while your friends and family should understand that you are often very busy, don’t forget to show them some appreciation and keep in touch!

5.) “Me” Time

Being a caregiver takes a lot of work, but it is incredibly rewarding and allows you to build meaningful relationships and touch so many lives. However, as much as you may love your job, don’t forget to carve out some time for yourself each day– even if for only an hour, to do some gardening, watch some old movies, surf the internet, and even go out for a relaxing day at the spa. If you are a live-in caregiver, ask your client if they’d like to join in on the fun! This will help you stay productive and engaged in your assignment in a much more meaningful way.

6.) Take Care of Yourself

As much as you care about your job as a caregiver, don’t forget that the first step to being an amazing caregiver is taking good care of yourself. Keep up with exercise, eat a balanced diet but make sure you’re getting the necessary rest between assignments first and foremost- especially if you work overnight. Sleep allows your body and brain to replenish, not to mention stay alert on important assignments and throughout the day if your client needs extra supervision when taking medications, for example. Losing sleep can ultimately take a serious toll on your health in the long run, so don’t be afraid to ask your agency about rescheduling your assignments or for tips on how to manage your sleep schedule to help you be your best for your clients.

About the author:

Maggie Drag is the owner and founder of a homecare agency located in central Connecticut. With over 27 years of experience in the industry, Maggie shares her knowledge and tips about care at home.  Visit homecare4u.com  to learn more about Maggie Drag.

A Geriatric Psychologist’s Perspective on Aging Parents: Guest Post by Dr. Melissa Henston

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5 STEPS TO TAKE DURING A VISIT

Spending quality time with loved ones is usually something you look forward to. But when you have aging parents or loved ones, going home to see them can sometimes signify a rather different, and at times, stressful experience.

You may already have an inkling that Mom, Dad or a favorite aunt or uncle is having trouble with everyday life, but sometimes seeing changes in family members after months – or maybe years – of not seeing them can be disquieting. People change in their later years, and sometimes they can decline in health and spirit faster than you expect.

A Place for Mom expert and geriatric psychologist Dr. Melissa Henston provides some guidance on how to not only spot common problems, but tips on how to deal with any issues to get your elderly loved one the help they need.

1. NOTICE WHEN SOMETHING IS “OFF”

You can spot problems the minute you drive up to your loved one’s house, Henston says.

“There are a whole bunch of warning signs that are easy to spot. For example, the exterior of the house has peeling paint, or the driveway isn’t shoveled or the walkway isn’t treated. Once you enter the home, newspapers are still in plastic wrap and mail is piled up. Maybe the house isn’t as clean as normal or has an odor. You can usually tell when something is ‘off’.”

Having a grandmother who suffered from Alzheimer’s in tandem with working in the nursing home practice in her ‘previous life’ (during college), Dr. Henston has a personal connection to the elderly. She decided from a young age that her primary focus in psychology would be issues in aging, and she has devoted her practice to improving the lives of the elderly, informing families about the signs that their loved ones need help, and helping find the right care options for each unique situation.

Since a health crisis in the elderly can escalate quickly and catch everyone involved off guard, it’s important to not ignore signs that something may be wrong. Ideally, families will have conversations with their children or loved ones about getting their affairs in order and end of life care well in advance of having any issues, but here are some signs to be cognizant of when visiting aging loved ones:

  • House and yard need care / maintenance
  • Disheveled clothing
  • Broken appliances
  • Spoiled / expired groceries
  • Poor personal hygiene
  • Cluttered / disorganized house
  • Depressed or low energy temperament

Henston emphasizes the importance to noting anything out of character or outside of normal behavior. She remembers personally having the discussion of green eggs and ham with her own father. “I told my dad, ‘Dad, you can’t eat this stuff. Ham isn’t supposed to be green.'”

If health or happiness seems to be compromised, it’s time to have a conversation and address problems.

2. APPROACH THE “TOUGH CONVERSATION” WITH CARE

Tread delicately when it comes to discussing retirement plans or end-of-life care. Henston comments, “Typically you need to look for the opening and opportunity, rather than just jumping in. Don’t try to take control. Try to get a natural conversation going.”

Remember that parents still consider you their child. You need to respect this relationship. Here are a few tips for setting the right ambiance for a positive and effective talk:

    • Sit in a comfortable location, such as over coffee.
    • Start with a normal, conversational tone.
    • Ask open-ended questions, such as “How is it around the house?” or “How is driving going?” or “What have you and Dad been doing for fun lately?” to get the conversation flowing.

3. DON’T FEEL GUILTY

Henston relays that guilt is one of the biggest problems for family members. Many families make promises to their loved ones that they will care for them, but sometimes this just isn’t feasible. Senior living is often the best option for expert care, socializing and good quality of life. She notes:

“Mom, Dad, aunts and uncles — even spouses — feel a tremendous amount of guilt about putting their loved ones in senior living. But the most important thing is to overcome the guilt and assess the situation. Look at the logistics and whether caring for your loved one is accommodating to everyone’s life. If there is a single parent, finances may be a problem. But the biggest problem is often that caring for them can be a huge disruption to your life and their life. In reality it doesn’t work out well.”

It’s important to also remember that the role of caregiver may fall solely on the elderly partner — who may have physical limitations. In many cases, caregiving is passed to family members who may or may not have the time, finances or necessary skills to provide the best care for their aging loved one. Families need to re-evaluate their initial promise and determine what is truly the best choice for their loved one.

So much goes into the decision of caring for an older relative. Here are some questions Henston notes are important to consider:

      • Can I take time off from work?
      • Can I afford to stop work for an extended period of time?
      • Can my children and older relative co-exist in harmony?
      • Will my children be able to tolerate not always coming first?
      • How will this impact my relationship?
      • How will this impact my relationship with my older relative?
      • How will my siblings and I manage this as a team?
      • How will any of this be paid for?

This line of questioning is totally realistic and an important part of the process of making informed decisions. It’s important to consider these questions before having the ‘tough conversation’ with your loved one. Henston comments,

“The ‘promise’ is often made during an emotional time in which we do not feel we have many options. There are common emotional roadblocks when making difficult choices about caregiving, and families might want to consider seeking practical guidance to help all parties feel more confident during the transition.”

4. HAVE AN HONEST CONVERSATION

Elderly loved ones usually appreciate an honest conversation. If you discuss that it’s important to communicate their wishes for retirement and end-of-life care, you’ll go farther than if you are condescending or dishonest.

Include them in the decision-making as it helps them feel as though they’re not being “put out to pasture.” Talk to them about their options; whether they include staying in their family home and what that entails, or if they want to explore and tour senior living and retirement communities to see if any seem to be the right ‘fit.’ Many people still have a stereotypical image of what assisted living and nursing homes look like. Today communities offer anything from comfortable and intimate settings to large, almost resort-like communities that offer social activities and amenities. Does your loved one like fancy, intimate, or down-home and cozy? If they help you find one that is appealing, they may be able to get over the stigma and stereotypical view.

5. CONSIDER THE RISKS

Henston discusses that it’s important to think of the risks involved if seniors live alone if they’re no longer capable. “There are many risks to consider if someone is truly living alone and shouldn’t be,” she relays. “For example, if there’s a physical issue where the senior has trouble getting around and they fall or get hurt it can be very scary. There was an elderly lady sitting on her bathroom floor who had fallen and couldn’t get up for 18 hours. Finally a neighbor noticed she hadn’t picked up the paper and checked on her to discover the problem.”

Here are some other issues to consider:

      • Elder Fraud
      • Isolation
      • Physical Constraints
      • Mental Constraints

If your loved one suffers from any of the above, there could be many consequences. From economical problems to depression and health problems; there are many things to think about. “If an elderly person can’t drive and get out easily, they can become depressed – it can become a situation of being imprisoned,” Henston candidly notes.

Above all else, approach the conversation as though it is a gift. You are concerned about their well-being and welfare. Henston reminds us, “Treat your aging loved one with love, respect, kindness and compassion. Consider what is truly the best decision for everyone involved.”

About Dr. Melissa Henston, Geriatric Psychologist

Dr. Melissa Henston is a geriatric psychologist in private practice with Colorado NeuroBehavioral Health, where she helps seniors and caregivers understand and navigate physical, cognitive and mental health changes. Additionally, Dr. Henston is a professor at the University at Denver, Graduate School of Psychology, where she teaches “Aging and Geriatric Psychology” to doctoral students.

Dr. Henston’s philosophy is that getting older is a unique process that requires self-acceptance and awareness to life values in order to achieve successful aging. She has worked with the Alzheimer’s Association, presented at conferences on aging, and lectured at the University of Colorado Health Sciences Center. She diligently works with families who are facing problems that may develop as parents transition into needing more care and performs neuropsychological evaluations on older clients to help them understand cognitive issues that can arise with aging.

http://www.aplaceformom.com/senior-care-

Answers Your Top Medicare Coverage Questions A Guest by GoHealth

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Whether you’re a first-time Medicare buyer or a long-time enrollee, finding the right Medicare coverage can be confusing.

In an effort to help you find the right combination of plans, we’re answering the top consumer Medicare questions, including what your first step should be, your prescription drug coverage options, and much more.

Top 10 Medicare Coverage Questions

1. If I have Part A, how do I add Part B?

In order to complete your Original Medicare coverage and enroll in Part B, you must contact the Social Security office and actively enroll. Once you have both Parts A & B, you can complete your Medicare coverage with additional options.

2. What is a Medicare guaranteed issue right, and do I have it?

A Medicare guaranteed issue right is your right in certain situations to be granted a Medicare Supplement plan – or Medigap policy – regardless of certain other details concerning your health. In these specific situations, insurance companies must sell you a Medicare Supplement plan, cover all your pre-existing conditions, and not charge you more for a policy because of any health problems. Most commonly, you may have a guaranteed issue right if you lose coverage or your current health coverage changes.

3. If I only have Part A, what other types of Medicare can I get?

If you only have Part A, you are eligible to also get Part B. You cannot move forward with exploring other types of Medicare coverage until you have both Parts A & B.

4. Can I enroll in Part D without having Part B?

Unfortunately, you cannot. In order to move forward with additional Medicare options (including Part D), you must first have both Parts A & B.

5. What are my coverage options when it comes to prescription drugs?

If you need prescription drug coverage, you have a few different options. Once you get Parts A & B, you can choose to switch to Medicare Advantage, which sometimes offers prescription drug coverage. You can also choose to enroll in a Prescription Drug plan – or Part D – which offers different coverage options depending on which drugs you take.

6. How do I find my Medicare claim number?

You can call Social Security, and a representative there can help you locate your Medicare claim number.

7. How do I enroll in Medicaid?

You should call your state’s Medicaid department if you’re interested in Medicaid health insurance coverage.

8. What is the difference between Medicare Supplement and Medicare Advantage plans?

Medicare Supplement – or Medigap – plans help you complete your coverage. They can help you pay for health care costs that may not be covered by Original Medicare, such as copayments, coinsurance, and deductibles. Medicare Advantage is a private health insurance option that is required to cover all the same benefits as Parts A & B, plus additional benefits, such as prescription drug coverage. You cannot have a Medicare Supplement plan and Medicare Advantage at the same time.

9. Why would I enroll in Medicare Advantage instead of Original Medicare? Aren’t they the same thing?

While they are similar, there are also differences between Medicare Advantage and Original Medicare. By law, Medicare Advantage plans are required to cover all the same benefits as Original Medicare, or Parts A & B.

However, there may be some differences in how you pay your out-of-pocket costs with a Medicare Advantage plan, or you may have a smaller or larger deductible. There also may be some differences in the coverage itself. For example, while Original Medicare does not cover prescription drugs, some Medicare Advantage plans do offer that coverage.

10. How do I avoid gaps in my Medicare coverage?

There are many different types of Medicare coverage available to help you avoid any gaps in your coverage. It’s important to explore all of your options and coverage combinations with a licensed agent.

Call 1-877-568-1851 – TTY 711 to speak with one of our licensed sales agents. To enroll in Original Medicare, please contact your local Social Security office.

Medicare has neither reviewed nor endorsed this information.

Related Articles:

GoHealth Answers Your Top Medicare Coverage Questions posted by GoHealth

America’s Family Caregivers Can’t Wait: Tell Congress to Pass the RAISE Act Now Guest Post by Nancy A. LeaMond

Originally Posted http://www.blogAARP.org on 08/22/2016

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After Labor Day, when Congress returns from its summer recess, there will only be 33 working days left for the U.S. House of Representatives before the end of the year. That’s not a lot of time to address some of our nation’s biggest challenges. One item awaiting action that should be an immediate priority is the RAISE (Recognize, Assist, Include, Support and Engage) Family Caregivers Act.  This bipartisan, commonsense step to aid America’s greatest support system — family caregivers — is long overdue.

Passed unanimously by the U.S. Senate, the RAISE Act would develop a national strategy to support family caregivers, bringing together stakeholders from the public and private sectors — including state and local officials, health care and long-term services and support providers, employers, federal agencies, older adults, persons with disabilities and family caregivers themselves — to identify specific actions communities, providers, government, employers and others can take, including with respect to: promoting person- and family-centered care in a range of settings; assessment and service planning involving both care recipients and family caregivers; information, education, referral and care coordination; and respite options so caregivers can reset and recharge.
Today, more than 40 million family caregivers care for veterans, parents, spouses, children and adults with disabilities and other loved ones so they can continue to live at home. The unpaid care family caregivers provide — valued at about $470 billion annually — helps delay or prevent more costly care and unnecessary hospitalizations, saving taxpayer dollars.

I know from firsthand experience that caring for a loved one is a tremendous responsibility. While I have much in common with my fellow caregivers, my experience is unique in many ways. Indeed, each of our caregiving experiences is individual, seen through our own personal family lens. Everyday duties can include bathing and dressing; preparing and feeding meals; transportation; handling financial, health care and legal matters; and often complex medical tasks like wound care. Many family caregivers are working full time and raising families. They are often on call 24/7.

That’s why AARP, together with a number of other organizations and family caregivers themselves, is calling for the U.S. House to pass the RAISE Act now.   

One such organization, the Elizabeth Dole Foundation, works with military and veteran caregivers. In a recent radio news story, former senator Dole said:

“Five and a half million military and veteran caregivers are caring for loved ones with devastating wounds, illnesses and disabling injuries — visible and invisible. By passing the RAISE Act, we can create an important path forward so military family caregivers, all family caregivers, get the support they need.”

Another group pressing the U.S. House to pass the RAISE Act is Autism Speaks. Executive Vice President of Programs and Services Lisa Goring says:

“Millions of family members are forced to step in as full-time caregivers to keep their loved ones with autism and other developmental disabilities safe and supported. Now is the time for a national strategy to support all family caregivers to ensure their loved ones a better future.”

For me, it’s the stories and experiences of family caregivers that really underscore why the RAISE Act must pass now. Britnee Fergins cares for her father. She says:

“My 91-year-old father, who’s a World War II veteran, requires a lot of attention. I also have a very energetic 3-year-old son — and work 12-hour shifts as a chemist. It’s a constant juggling act, and some days, I’m afraid I’m going to drop the ball.”

Family caregiving is a unique and deeply personal issue that affects just about all of us, wherever we are on the political and ideological spectrum. We are either family caregivers now, were in the past, will be in the future — or will need care ourselves one day.

The RAISE Act would implement the bipartisan recommendation of the federal Commission on Long-Term Care, requiring the development of a national strategy to support family caregivers, similar in scope to the national strategy developed to address Alzheimer’s disease. The need is urgent and time this year is running out.

AARP urges the U.S. House to pass the RAISE Family Caregivers Act now. And I urge you to contact your representative about the RAISE Act today.  Call 844-259-9351 or click here.

The following U.S. representatives are cosponsors of the bipartisan RAISE Act as of Aug. 22:

Lead Sponsors
Reps. Gregg Harper (R-Miss.) and Kathy Castor (D-Fla.)

Cosponsors

Rep. Lujan Grisham (D-N.M.)

Rep. Black (R-Tenn.)

Rep. Pascrell (D-N.J.)

Rep. Emmer (R-Minn.)

Rep. Pocan (D-Wis.)

Rep. Deutch (D-Fla.)

Rep. Katko (R-N.Y.)

Rep. Pompeo (R-Kan.)

Rep. O’Rourke (D-Texas)

Rep. Amodei (R-Nev.)

Rep. Duckworth (D-Ill.)

Rep. Chu (D-Calif.)

Rep. Schakowsky (D-Ill.)

Rep. Fortenberry (R-Neb.)

Rep. Gibson (R-N.Y.)

Rep. Pingree (D-Maine)

Rep. Bonamici (D-Ore.)

Rep. Napolitano (D-Calif.)

Rep. Lujan (D-N.M.)

Rep. Hastings (D-Fla.)

Rep. Kirkpatrick (D-Ariz.)

Rep. Kuster (D-N.H.)

Rep. Blumenauer (D-Ore.)

Rep. Lofgren (D-Calif.)

Rep. Freylinghuysen (R-N.J.)

Rep. Murphy (R-Pa.)

Rep. Frankel (D-Fla.)

Rep. Dingell (D-Mich.)

Rep. Lee (D-Calif.)

Rep. Brady (D-Pa.)

Rep. Rice (D-N.Y.)

Rep. DesJarlais (R-Tenn.)

Rep. Beatty (D-Ohio)

Rep. Davis (D-Calif.)

Rep. Beyer (D-Va.)

Rep. Roe (R-Tenn.)

Rep. Stefanik (R-N.Y.)

Rep. Courtney (D-Conn.)

Rep. Langevin (D-R.I.)

Rep. Meehan (R-Pa.)

Rep. Kilmer (D-Wash.)

Rep. Takano (D-Calif.)

Rep. Payne (D-N.J.)

Rep. Allen (R-Ga.)

Rep. Ashford (D-Neb.)

Rep. Peters (D-Calif.)

Rep. Matsui (D-Calif.)

Rep. Larson (D-Conn.)

Rep. Denham (R-Calif.)

Rep. Bishop (R-Mich.)

Rep. Hunter (R-Calif.)

Rep. Smith (D-Wash.)

Rep. Meng (D-N.Y.)

Rep. Cramer (R-N.D.)

Rep. Clark (D-Mass.)

Rep. Boyle (D-Pa.)

Rep. Esty (D-Conn.)

Rep. Dold (R-Ill.)

Rep. Thompson (R-Pa.)

Rep. Lipinski (D-Ill.)

Rep. Messer (R-Ind.)

Rep. Jenkins (R-Kan.)

Rep. Moore (D-Wis.)

Rep. Smith (R-N.J.)

Rep. Clarke (D-N.Y.)

Rep. Watson Coleman (D-N.J.)

Rep. Carolyn Maloney (D-N.Y.)

Rep. MacArthur (R-N.J.)

Rep. Curbelo (R-Fla.)

Rep. Wasserman Schultz (D-Fla.)

Rep. Grayson (D-Fla.)

Rep. Corrine Brown (D-Fla.)

Rep. Takai (D-Hawaii)

Rep. Joe Heck (R-Nev.)

Rep. Cicilline (D-R.I.)

Rep. Joe Wilson (R-S.C.)

Rep. Frederica Wilson (D-Fla.)

Rep. Bennie Thompson (D-Miss.)

Rep. Peter King (R-N.Y.)

Rep. Sessions (R-Texas)

Rep. McKinley (R-W.Va.)

Rep. Slaughter (D-N.Y.)

Rep. Simpson (R-Idaho)

Rep. Kelly (D-Ill.)

Rep. Nolan (D-Minn.)

Rep. Holmes Norton (D-D.C.)

Rep. Capps (D-Calif.)

Rep. Zeldin (R-N.Y.)

Rep. Guinta (R-N.H.)

Rep. Miller (R-Mich.)

Rep. Walberg (R-Mich.)

Rep. LoBiondo (R-N.J.)

Rep. Tonko (D-N.Y.)

Rep. LaHood (R-Ill.)

Rep. Lance (R-N.J.)

Rep. Sean P. Maloney (D-N.Y.)


Nancy LeaMond, chief advocacy and engagement officer and executive vice president of AARP for community, state and national affairs, leads government relations, advocacy and public education for AARP’s social change agenda. LeaMond also has responsibility for AARP’s state operation, which includes offices in all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands.

You can follow her on Twitter @NancyLeaMond.

INCIVILITY VS. BULLYING: KNOW THE DIFFERENCE: AN INTERVIEW WITH PHYLLIS

INCIVILITY VS. BULLYING: KNOW THE DIFFERENCE

Originally published in the AORN Periop Insider Weekly Newsletter  July 28, 2016.      Authored by Carina Stanton

The term “bully” is often used incorrectly to classify both bullies and those expressing incivility. Understanding the distinction between the two can help to put structure around communication and action in attempts to weed out bad behavior in perioperative nursing care, according to nursing Career Coach Phyllis Quinlan, PhD, RN-BC.

“The 10% of nurses who are true bullies have a personality defect,” Quinlan says. “Knowing the distinction is key to protecting your staff and deciding whether to develop a plan of remediation or to get rid of a toxic staff member.”

Understanding Incivility vs. Bullying

Quinlan describes bullying as a threatening behavior based in intimidation that stems from the bully’s issue with personal power. “For a bully, their personal power is far more important than the other person’s needs—if the other person needs to feel supported, a bully says ‘tough.’”

A person who indulges in bullying is very egocentric and has far more limited opportunity for personal growth, introspection and a commitment to change.

In the practice setting, a bully will intimate to someone that “you are on your own, if you don’t do what I want I have the power to isolate you,” Quinlan explains. She says bullying is not distinct to one professional level because this bad behavior knows no direction. It can be top down (leadership to staff), down up (staff to leadership) or lateral (peer to peer).

Although incivility is also bad behavior, it stems more from not being fully respectful of the other person’s perspective. Incivility is commonly seen by Quinlan during patient hand-offs or when a patient is transferred to a different area of care, such as from the OR to PACU. “As the nurse is explaining the patient’s state and previous care, an uncivil reaction by the nurse listening is to act as though they are being inconvenienced or worse to provide negative judgment about the previous care, making the nurse handing off the patient feel as though they must justify themselves and their actions.

With 80% of communication being non-verbal, much uncivil behavior is expressed with a less-than-polite facial expression or a toe-tapping type of stance indicating the nurse talking should speed it up and finish what they are saying.

Seeing Bad Behavior as Neurotic Need

One common thread between incivility and bullying is denial of wrongdoing. “If you ask an uncivil or bullying nurse to assess their behavior, they will report they were unaware of wrong doing and may say the nurse who reported their behavior was ‘too sensitive’ or ‘took it the wrong way.’”

Yet research indicates that both uncivil and bullying nurses essentially know exactly what they are doing because it fills a neurotic need.

Quinlan recalls the words of Abraham Lincoln, in which he suggested you can see the character of a person when you give them power. “Someone with good character will take a role in power and be collegial, find common ground and be generous enough to give praise for a job well done. On the flip side, someone with problematic character will use a power role to offer criticism and make remarks that are self-serving.”

Catching It Early

For new employees, Quinlan recommends a set time frame for a probationary period in which the hire is observed for both clinical and behavioral performance. Quinlan says nurses who are good clinically but lacking in collegial behavior are often kept on staff to work on the behavior piece, what she hears nurses refer to as the “soft stuff.”

“Nonsense, behavior is the tough stuff and should be viewed as equally important to clinical skills,” Quinlan stresses. She advises a strong collaboration between nursing, hospital administration and human resources to establish strict behavioral boundaries that are reviewed wisely through the probationary period to measure knowledge, skills and behavioral benchmarks that are demonstrative of culture.

“Make sure everyone is on same sheet of music with clear descriptives of bullying and incivility weaved into your code of conduct and stand behind a zero-tolerance approach to toxic behavior,” she suggests. “If a true bully is identified, cut your losses quickly, otherwise you will lose good staff members.”

For Managers

Register now to attend “Bringing Shadow Behavior into the Light of Day: Understanding and Addressing Incivility and Bullying Behavior,” AORN’s Nurse Executive Leadership Seminar with Phyllis Quinlan, and get the skills to build your own zero-tolerance policies and practices against bullying and incivility.

6 Ways to Restore Your Nursing Resilience: An Interview with Phyllis

Image of a tired nurse

Publish Date: July 20, 2016 in Periop Insider by AORN written by Carina Stanton

Nursing in the twenty-first century requires a new set of tools to go the distance, according to nursing Career Coach Phyllis Quinlan, PhD, RN-BC. “To have the vitality and resilience to practice nursing today, we need to pay attention so our insides match our outsides.”

Quinlan says nurses need to realize that technical skills and knowledge are not enough to truly meet the needs of patients without their well of nursing compassion running dry. “We have done an excellent job of getting technical certifications, championing evidence-based practices and collaborating under shared governance, but this is all outside of the individual nurse.”

Looking Inward

Quinlan says it’s time for nurses to do more introspective soul searching so they can build skills such as emotional intelligence to strengthen positive interactions with patients and positive relationships with coworkers. This emotional intelligence can also be a powerful tool to keep workplace incivility in check.

“Ask yourself how well you are developing relationships with colleagues—are you trying to do everything yourself or are you holding your colleagues accountable to do their fair share?” she asks. “We need to work on our ability to be patient enough to hold our ground and fight the temptation to be an enabler. In the name of good patient care, safety and time management, we tend to dip our toe into enabling behaviors that can sabotage collegial relationships and build our own frustration and resentment toward others we work with.”

Assessing Physical and Emotional Health

Quinlan describes nurses as professional doers for whom caring is deeply intertwined into their energetic makeup. “When you are constantly in a caring or doing mode, it can be depleting, yet nurses may not take the time to realize that their well of compassion gets a little bit lower if they don’t take time to renew themselves,” Quinlan suggests. “Before you know it, you find yourself giving from fumes of a compassionate nature as opposed to giving from a full heart.”

Nurses don’t always honor the fact that we are not made up of a renewable energy source, that we need to check in with ourselves even if we would rather put time into caring for others, she adds. Part of this self-care is recognizing habitual behaviors nurses have developed to endure when they are depleted and acknowledging how these behaviors can harm instead of help.

“Pay more attention in your downtime for more personally renewing activities,” Quinlan advises. “Resist the urge to give too much free time to friends, neighbors or family members if a little ‘me-time’ is needed.”

Building Resilience

Learning how to say “no” to others and “yes” to yourself can be a challenge for nurses who have spent a lifetime putting others first. That’s why Quinlan recommends nurses build personal time into their daily life and monthly calendar of appointments to renew mind, body and spirit in order to maintain a resilient attitude in professional and personal life. Here are her top five “me-time” activities to put on the schedule.

1. Sleep

Caregivers need more sleep than others to process the emotional strains of their day and give their bodies time to physically renew from expended energy. Make a commitment to get a set amount of sleep every day and shift activities that could jeopardize this rest and recovery.

2. Massage

This is as important as getting your flu vaccine and it should be something you make time for monthly. If you get your nails done, pay a little extra to get a 10-minute massage, even just a few minutes of massage is powerfully renewing for the body.

3. Nutrition

Make the healthy food choices you advocate for your patients to make. Look carefully at the way you nourish your body and look for ways to up the nutritional value to keep you from feeling run down, especially with sugars and carbohydrates that can leave you crashing when you need to be at your best for your patients.

4. Attire

Think about how you “tool-up” for the day. Make sure you are mindful of supporting your physical well-being for the demands of your job. If you are on your feet for long periods of time, find supportive stockings for circulation and footwear to support posture. Consider wearing a supportive belt to reduce the risk of secondary injury if you lift or position patients on a regular basis. Think about ergonomics and proper lifting techniques, but also be proactive about reducing the risk of injury before there is a chance for it to occur.

5. Attitude

Recognize the power of a positive attitude in which you are aware of the good things to be grateful for on a daily basis because this can help keep you renewed and maintain an even perspective. Maybe it’s sunny outside and you take a few minutes to soak it up; maybe your favorite co-worker is on your shift today; maybe you got a great parking spot. Positivity can be hard to maintain when you are tired and powering through in endurance mode. When this happens you are not in a state of resilience and you can feel like the world is coming down on you.

6. Emotional Intelligence

Take time to build your knowledge and skills for areas within nursing practice such as emotional intelligence that also support you in your individual growth and well-being. Reading up on strategies and tools for emotional intelligence should be part of developing professional nursing practice, as it’s beneficial in nursing interactions with patients, families, and co-workers.

Start Small

“You can start small with making time in the day for yourself—perhaps you take 10 minutes to read a book or listen to soothing music through your headphones while on break,” Quinlan suggests. “Make a plan at the beginning of each day to schedule at least one activity that is only for you.”

She says nurses may be resistant to make time for themselves. “It can begin with one simple change in thinking, in recognizing a habitual behavior that no longer serves you, in being disciplined to complete one renewing activity per day for only you—the self satisfaction and joy you will feel on the other side is immeasurable.

4 Tips to Ensure That You Fuel Your Caring Nature From a Full Heart and Not Fumes

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Dearest Caregiver

  1. Acknowledge and Respect Your Compassion Nature

Most people have the capacity to feel empathy for another person when there is a tragedy such as a plane crash or mass shooting. Some people have the capacity to rise to the occasion and offer a helping hand to someone in need. However, very few people have the ability to mobilize their compassion into the action we call caregiving.

The uncommon ability to be a caregiver is the highest form of generosity. It is a gift and it needs to be honored for the gift that it is. This means that you must respect your caring nature by taking really good care of yourself as well. All too often, caregivers put their own needs last. Granted, this extra effort may be needed on occasion.

Putting yourself last time after time can mutate your awakened heart in a toxic sense of self-sacrifice. Remember, putting your caregiver-self first is an act of selflessness and it is healthy. It allows you to keep your compassionate heart full and ready to serve.

  1. Ask and Accept Help

The responsibilities that accompany your role as caregiver can be daunting. There always seems to be a relentless list of things to do, appointments to coordinate, and care to be rendered. You are gifted with a highly evolved sense of the duty, responsibility and loyalty. However, these qualities can channel you into a life of isolation if you resist asking for help.

Asking for help is not a sacrilege. It’s honest. No one, no matter how dedicated or organized, can manage alone. Many folks like yourself resist asking for help because they feel that they do not want to impose on benevolent friends of family. The irony is that these same folks are often trying to find a way to lend a hand without sending the unintended message that you are not doing a good job.

No everyone can do hands-on care but most everyone can do something. I encourage you to investigate support networks such as Share the Care. This non-profit organization trains groups such as family, friend, neighbors, and church members to create Care Circles. The goal is to surround the person in need of care and their primary caregiver with a sense of community and support.

A calendar and task list is set up so that everyone can weave their part of the caring into their daily life. Who does the food shopping? Who transports to the doctor’s appointment and when? Who mows the lawn, etc. I ask you to please consider this option so that you can pace yourself. Remember, caregiving is not a sprint. It is a marathon and it takes a team to keep you in the race.

Resources:

http://sharethecare.org/

http://caringforthecaregiver.org/caring-healing-circle-meetings/

http://project-compassion.org/nc-initiatives/circles-of-care

http://caringcircle.ca/support-organizations/

http://www.circleofcareproject.org/ways-to-help/

  1. Stay Connected with Friends

It is often said that laughter is the best medicine. Without a doubt, this is true.  However, the demands and realities of constantly caring for others can often leave you struggling to find a reason to smile let alone laugh. Fatigue is your worst enemy. It can leave wanting to “crash” and be alone during any down time. Please resist this temptation. Yes, the extra effort to get ready for some social time with friends may seem daunting but the payoff is priceless.

Caregiving is what you do not who you are and it is your friend who will keep you connected to the outside world. Friend will often listen and just let you vent without judgement. Friend can show you the exit sign out of your head and your relentless thoughts centered on caregiving and reintroduce you to the rest of your life. Friend can help you keep a perspective on your situation so that the frustrations of caregiving don’t fester into pain and resentment.

Friend can make you laugh until your side ache and you find yourself hoping you don’t wet your pants. In short, they are often your lifeline. So please don’t let go. Socializing may need to me modified. Lunches and matinees may replace dinner and a movie. You may not be able to leave your home, so the party may have to come to you but however you arrange it, stay connected.

  1. Don’t Confuse Endurance with Resilience

So often we torment ourselves with the notion that as soon as you get past this latest hurtle in life, all will be easier. In reality nothing gets easier. No sooner do you exhale from meeting one demand than the next burning issue presents itself. So we hunker down and call upon our endurance to meet the next challenge.Here is where the danger lies, in a caregiver’s endless ability to endure.

You see, we mistake endurance for resilience. Endurance is a coping skill intended to be called upon when things become exceedingly challenging and stressful. Endurance is the ability to deal with unusual pain or suffering and continuing to function. Our ability to endure is intended to be maintained for only a fixed amount of time until a situation is resolved. It was never intended to be used as an everlasting source of fuel for life.

Resilience, however, is the ability to withstand the stress and challenges of life while remaining centered and fresh. Resilience is a healthy reserve of personal fuel that can be accessed to maintain a state of equilibrium, not only to rise up to overcome the crisis of the moment. Resilience is like dropping the engine of your life into second gear so you can maintain speed as you go uphill.

Developing a resilient mindset means understanding you can only thrive in a lifestyle of perpetual generosity, such as a caregiving, when you give from the excess of your energetic fuel tank and not from the fumes. It means that regardless of the demands of a situation, you are addressing that situation from a place of fullness.

The true lesson here is to embrace the fact that choosing a mindset of endurance is choosing only to survive. Choosing a temperament of resilience is embracing living life fully each day. So explore what it takes to develop a resilient nature that is ready, willing and very much able to serve, regardless of the circumstances surrounding that call to care.

Blessings, Phyllis

 

 

 

When Being the Caregiver Is Not an Option

Self-Empathy Word Cloud
Self-Empathy word cloud on a white background.

 

According to The National Alliance for Caregiving and AARP, there are 66 million unpaid adult family caregivers (29% of the adult population in the US) providing care to someone who is ill, disabled or aged. While the number of male caregivers is steadily growing, female caregivers still outnumber their male counterparts two to one.

As the age of the population in the US increases, so is the mean age of caregivers.  In 2012, female family caregivers, on average, were 48 years old and lived alone. They rendered approximately 25 hours of care per week. This is the equivalent to the hours of a part time job. Caregiving is rarely a sprint. It is most often a marathon of planning, adjusting, attending, and doing. Not everyone is capable of staying in the race.

What happens when being a caregiver is not an option? What do you do when your own health, personal and career commitments, or relationship with the person in need of care leave little room for you to take on the added responsibility that comes with the role? Many struggle with this relentless internal conflict and the onslaught of negative emotions that often result in a profound sense of isolation. The comments and judgment from outsiders add your confusion and perhaps toxic sense of self.

What is called for at this crossroad is Self-Compassion. Surprised? You thought that I was going to suggest that you listen to your harsh self-criticism and dig down deep to find a way to be available and accommodating. Actually, I want you to honor your sense of personal limits and not make a commitment when committing to just one more thing could invite undue hardship or risk your health and wellbeing.

Just what is self-compassion? It is responding to yourself (and your situation) with kindness rather than criticism. It is stopping the loop of derogatory self-talk that often takes on the tone we imagine we would hear from some authority figure in our life. Rather, it is the extension of kindness, care, warmth, and understanding toward oneself when we are faced with the reality of our human shortcomings, inadequacies, or perceived failures.

Self-compassion is not self-pity and does not perpetuating a sense of being a victim. It offers you the sense of objectivity and control earned by being an adult. Self-compassion is giving yourself the time and space to make a choice that honors your needs as well as the needs of others. Individuals who are self-compassionate are more likely to learn and grow from the challenges in their lives.

Self-compassion provides the foundation for developing personal resilience. It helps us to maintain a healthy prospective when we are bombarded by those on the periphery of the decision. Those who are all too often unwilling to lend a hand but all too free with judgments and rhetoric designed to manipulating you into thinking that you’re the best or only person who can do the caring when others cannot.

So my recommendation is to stay strong.  Honor your understanding of what is best. Do not make a noble sacrifice by ignoring what you intuitively know is right, wrong, healthy or destructive. Respond to the challenge of caregiving with critical thinking rather than judgement clouded by emotion. Put your own oxygen on first.

 

Resources:

  • Share the Care Organization: sharethecare.org
    • A not-for-profit organization that trains groups to create care circles for an individual.
  • Veterans Benefits Administration: http://www.benefits.va.gov/benefits/
    • This site contains organizational information that can connect the Vet to benefits and services.
  • HOMETEAM: http://join.hometeamcare.com/
    • Find highly rated In-Home care providers
  • Nursing Home Compare: medicare.gov
    • Site designed to help individuals and family shop for the best long-term services in your area.
  • Care Navigators: https://www.healthcare.gov/glossary/navigator/
    • Individual/organization trained to help consumers look for health coverage options through the Marketplace, including completing eligibility and enrollment forms. These individuals and organizations are required to be unbiased. Their services are free to consumers.

 

Incivility & Bullying Within the Profession of Nursing: Is Peace In Our Time Possible?

wooden numbers forming the number 2016 and a heart-shaped chalkb
wooden numbers forming the number 2016 and a heart-shaped chalkboard with some wishes for the new year, such as peace, love and happiness, on a rustic wooden surface

 

I find it frustrating to acknowledge that despite all the work of recent years to implement initiatives aimed at creating healthy and safe workplace environments, that lateral and horizontal hostility still remains within the nursing profession. I think we all hoped that when the idea of Zero Tolerance bloomed into an actual Human Resource policy the darkest days were behind us. Disappointingly, this is not what I hear from my private coaching clients and other professional caregivers across the country. The elephant remains in the room and the reluctance to talk openly about it continues as well.

I do not feel the need to define bullying behavior or outline the toll such shadow behavior takes on individuals. You are all too familiar with it most likely because you have been on the receiving end of it. What I want to shed some light on is the nature and makeup of someone who engages in bullying tactics. Having insight into the mindset of the enemy goes a long way to taking the power away from them and empowering yourself.

First I want to point out that we often use the term Bully to describe a coworker or leader that exhibits uncivil conduct but is not a true bully. Unfortunately, we live in a time where uncivil behavior is celebrated. Just consider some of the popular reality TV programs currently enjoying high ratings let alone the antics demonstrated along the campaign trail of 2016. Engaging in uncivil behavior is the consequence of a low emotional intelligence and an unrefined ability to manage one’s emotions under stress in the workplace. Keep in mind that we are all capable of giving into the needier side of our neurotic selves under pressure.

People who are, at times, uncivil usually have the ability to step outside themselves and reflect on a disagreeable interpersonal exchange and take ownership of their behavior when they cool off or are held responsible and accountable by others. They are also capable of expressing genuine remorse and of taking steps to improve in the future. Bullies do not have that capacity.

Consider the following characteristics of an individual with the neurotic personality disorder known as narcissism. They include but are not limited to:

  • Authoritarian
  • Having a strong need for control
  • A desire to dominate people and situations
  • Perceiving themselves as a special, elite individuals that are deserving of VIP treatment
  • Lacking in empathy toward others
  • Having a tendency to be exploitative of others

 

Now think of someone you work with that is knowingly intimidating and/or cruel; someone who has no desire to consider how their words or behaviors affect others. That’s right! Bullies are narcissists. Investing time and efforts into trying to appeal to their higher nature and grow from coaching sessions or disciplinary actions will prove very frustrating. An individual must first be capable of acknowledging that there is an issue before they can buy into their responsibility to remedy the issue. Narcissists lack the ability to grow from insight and introspection.

Addressing both uncivil and bullying behavior requires a true collaboration between administration, the human resources department and in organizations with collective bargaining agreements, labor. All stakeholders must agree on a unified definition of bullying behavior and a unified approach to bullying conduct. The finish line for tolerating this type of misconduct must be fixed and unaffected by the manipulating skills of the bully.

Managing someone who is given to uncivil behavior is very different than addressing someone with a true bullying mentality. The person given to regular demonstrations of low emotional intelligence must understand that we are now in a time in the industry of healthcare and the profession of nursing when skills and knowledge are not enough to secure your professional future.

The literature demonstrates that the level of one’s emotional intelligence directly correlates with that person’s ability to demonstrate a consistent caring behavior to patients and families as well as own their responsibility to maintain a healthy work environment (McQueen 2004). If these individuals are not willing to grow from in-the-moment feedback, coaching and in-depth discussions during the performance evaluation process then; the conversation must move onto asking if they are in the right working environment.

Unfortunately, the personality of a narcissist does not make them amenable to demonstrating sustained improvement with conventional managerial interventions. In these instances, clear performance improvement plans must be crafted and immediate and sustained improvement demonstrated. The push-back will be relentless but there are very few options.

So my question becomes, if we are not willing to put an end to abusive conduct in the workplace now, when will we be willing? Let us resist getting caught up in finger pointing and complaining about how our inter-professional colleagues may mistreat us. Let us decisively address the issues in our own house first. We must commit now, not later, to peace in our time.

Resources:

  • Bakr M, Safaan S (2012) Emotional intelligence: a key for nurses’ performance. Journal of American Science. 8, 11, 385-393.
  • Benson G, Martin L, Ploeg J et al (2012) Longitudinal study of emotional intelligence, leadership, and caring in undergraduate nursing students. Journal of Nursing Education. 51, 2, 95-101
  • Codier E, Codier D (2015) A model for emotional intelligence and patient safety. Asia Pacific Journal of Oncology Nursing. In Press
  • Codier E, Kooker B, Shoultz J (2008) Measuring the emotional intelligence of clinical staff nurses: an approach for improving the clinical care environment. Nursing Administration Quarterly. 32, 1, 8-14.
  • Holbery N (2015) Emotional intelligence: essential for trauma nursing. International Emergency Nursing. 23, 1, 13-16.
  • McQueen A.C.H. (2004) Emotional intelligence in nursing work: Journal of Advanced Nursing 47(1), 101–108