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Nursing 2009 Journal articles

Written by LeAnn Thieman, CSP, July 6th, 2009

The Best Medicine

Written by LeAnn Thieman, CSP, October 7th, 2008

The overwhelming demands of caregiving frequently exhaust the caregiver physically, mentally, and spiritually. Often, you get so caught up in ministering to another, you forget to eat, sleep, exercise – and laugh. Yes, laugh!

“How can I laugh at a time like this?” many ask. “Is it okay?”

Not only is it okay, it’s imperative.

Laughing is one of the most effective, yet forgotten, coping skills. Medical studies prove laughter lowers blood pressure, increases lung and heart performances, decreases stress, exercises abdominal and facial muscles, boosts immune systems and even increases the production of tumor and virus-killing cells. Besides all that, it’s free, has no side effects, and feels good!

Laughter, like other rhythmic actions, releases endorphins– are our bodies’ “feel good medicines”–in our brains. Think about the last time you enjoyed a hearty belly laugh. Remember, when you finally caught your breath, how good you felt? How much lighter your chest was? How there seemed to be, literally, a weight lifted from your shoulders?

I’ve been privileged to read thousands of true stories from caregivers. Time and time again they shared how laughter helped them through their toughest times.

A loving daughter sat for months at the bedside of her ailing father who was confused and rarely spoke. Still, she chatted away, trying to communicate with him. One day she ran out of things to say, so began singing. Unfortunately, she couldn’t carry a tune in a bucket, but crooned, “I love you. You love me. We’re a great big family.”

Her daddy opened his eyes and spoke for the first time in days. “I love you too, honey,” he said. “But you don’t have to sing about it.”

Laughter, she wrote, helped her reclaim some joy in what seemed to be a hopeless situation.

Obviously, we should never laugh at another person, yet laughing with them can be a blessing to both. Many infirmed people insist that just hearing laughter boosts their spirits and happy heart rate. When we laugh at someone else’s silly antics, they often laugh along with us, offering them, too, all the healthy benefits mentioned above.

Sometimes, though, it’s hard to find the humor in a situation. Yet to endure the daily challenges, that’s exactly what caregivers must seek.

Terry, a grown granddaughter, went home to help her mother care for Grandma. Heartbroken by her mental deterioration, she attempted to add some joy to Grandma’s life by taking her to a buffet restaurant. There, the only food Grandma recognized and selected was red Jello. Even so, the two were enjoying a pleasant lunch when suddenly Grandma jerked Terry under the table yelling, “Indians! We’ve gotta get out of here!” Heading for “cover,” Grandma crawled on her hands and knees across the restaurant floor with her purse and skirt – and granddaughter on all fours – trailing behind her. When they arrived at the front door the manager looked down and asked in disbelief, “Is everything all right ladies?” Grandma stood, brushed herself off and said, “Yes, now that you’re here Marshall Dillon.” By now her granddaughter was laughing so hard she couldn’t stand up! Grandma tugged her to her feet, brushed her off and pulled her toward the door saying, “Come on, Terry, we’ve got to get out of here – you’re embarrassing me!”

Instead of being sad and mortified, Terry embraced the moment and laughed–then Grandma laughed–and their joy connected them.

If there are too few laughing occasions during your days, create them. (Not necessarily by crawling on all fours in public!) As you care for someone, think back to what used to make them laugh. And what used to make you laugh? Recall the favorite “I Love Lucy” episodes, knock-knock jokes, or funny family escapades and reintroduce them into your lives.

Remember, laughter soothes the soul and weary mind. It is, indeed, the best medicine.

Caring at Work: Tips for employees

Written by LeAnn Thieman, CSP, October 7th, 2008

Are you one of the 54 million Americans who care for a family member? One of the 20-50% of employees who tend to a loved one before going to work, then return to care again after a long hard day on the job? Feeling torn between both “jobs” and trying to perform well at each, causes so much stress that working caregivers are often plagued with more mistakes, conflicts, and stress-related illnesses. These simple tips will help ease that stress:

Talk to Your Employer Honestly: Tell your supervisor about your caregiving demands at home. Make an appointment to discuss this at a time when you are better rested and feeling your strongest so you can state the situation in a professional, emotionally-controlled manner. Don’t offer excuses, but instead reasons for changes he or she may note in your attendance, work schedule, or attitude. Explain why you may need to decline additional hours, a promotion, or transfer. Reassure him or her that you are committed to the company and its peak performance and will remain accountable to your duties.

Ask For What You Need:
Once you’ve reinforced the above commitment, your employers will be more receptive to ideas to make the workplace and schedule more manageable for you. Come prepared with suggestions that will help– for example, coming to work early, staying late, working from home, or taking longer lunch hours to check on your loved one, make personal phone calls, (or take a nap!) Brainstorm with him or her about other workable options. Often employers allow flexibility in the use of comp time, sick days and vacations. In many organizations fellow employees are allowed to donate accrued time off to help a caregiver during a crisis period.

Take Care of Yourself: Caregivers have higher than normal incidents of illness–those taking care of someone with a chronic illness have a 63% chance of dying early; another 63% say depression is their most common emotion. Caregivers often become so depleted they cannot maintain the stamina to continue caring for another. Therefore, you must take time daily to nurture yourself physically, mentally and spiritually. Physically: Eat well-balanced meals on a regular schedule. Take a daily multivitamin. Exercise regularly, even if it’s simply taking a walk. As difficult as it may be, strive for a minimum of seven to eight hours of sleep a night and nap when possible. Get regular medical checkups and treatments of aches and pains before they turn into something more serious. Mentally: Pay attention to your own feelings and emotions and seek counseling if needed. While it’s impossible to always leave the stress and heartache in the parking lot, try to keep emotions in check at work. Vent feelings to trusted family members or friends, not coworkers. Schedule time for yourself. Use relaxation or stress management techniques, such as meditation, visualization, biofeedback and yoga. Stay actively involved with friends and hobbies. Create a support network and/or join a support group. Spiritually: Take time, even as little as 15 minutes per day, for prayer or meditation. Read or subscribe to inspirational magazines or books to uplift your spirits. Seek the counsel of a minister or religious leader you trust and respect.

Seek Support: Ask for help. Friends, family, and church groups are often eager to assist and are only waiting to be asked and directed. Find respite care so you can regularly take time out for yourself. There are countless community, state and national resources to support you not only at work, but at home. Most cities have programs to offer assistance to the caregiver. The National Family Caregiver’s Association, www.nfcacares.org, is an excellent start in accessing this information. Another great resource is the Area Agency on Aging, www.loaa.org. With the passage of the National Family Caregiver Support Program in 2000, all AAAs have a mandate to address the needs of family caregivers. Finally, if needed, you may be able to utilize The Family Medical Leave Act (FMLA), a national policy that guarantees covered employees 12 weeks of unpaid leave each year to care for a newborn baby, a newly adopted child, a seriously ill family member, or to recover from their own serious health condition while ensuring their job security. Each state has different regulations. To learn about yours, call your state legislator.

Following these tips will help you better tend to your job, your loved one, and yes, yourself.

Caring at Work: Tips for employers

Written by LeAnn Thieman, CSP, October 7th, 2008

John, a dedicated employee, doesn’t linger at the coffee pot, but grabs a cup, black, and hustles to his first assignment of the day. For two hours he toils, efficiently, cheerfully, even though he didn’t get much sleep last night. Then he begins his next task, working faster now because another still awaits him. That job done, finally, he grabs another cup of coffee and heads out the door.

To work.

John is one of the more than 54 million Americans who is a caregiver for a family member.

Why is the working caregiver an issue for businesses today?

This problem, of near-crisis proportion, escapes no business. Nearly one-half of all caregivers work outside the home. At any given time, 20-50% of the workplace is dealing with a caregiving situation.

How does it impact the workplace?

A recent study showed 82% of working caregivers came into work late or left early as a result of caregiving and 55% modified their work schedules. Many take unpaid leaves of absence or use personal or sick days to provide care. They make long and frequent phone calls on the job, have more mistakes, accidents, conflicts, poor morale and health problems. Caregivers have more stress-related illnesses, utilizing the companies healthcare plan and adding costs to the employer. 11-12 % of caregivers quit their jobs early, increasing the turn over rate. Caregiver-employees often turn down promotions, overtime and assignments or take early retirement.

What is a “typical” employed caregiver?

The average age of the employed caregiver is late 40s and early 50s. Some are the primary caregivers for a sick or handicapped child. Others are taking care of a terminally ill spouse. Many more are tending an older adult, most often a parent or an in-law, while raising their own children. This group, the “sandwich generation” is a growing segment of our population. Over 40% of families who provide care for an elder have children at home under the age of eighteen. Many employees are caring for a parent or family member out of town.

How can caring for a family member “long distance” impact the working caregiver?

Long distance caregiving can be equally challenging. Phone time and days off are regularly consumed by efforts to obtain care for their loved one in another community. Many workers take weekends and days off to travel, helping siblings care for a parent in another state, then they return to work, exhausted.

What can employers do to help their caregiver-employees?

Employers can make a tremendous difference in the professional and personal live of their caregiver-employees, as support from coworkers and supervisors is their greatest need. Extending compassion and empathy is your first step. Encouraging the caregiver to care for themselves is vitally important. Remind them to get regular checkups, to eat properly, exercise, and get adequate sleep. Suggest the use of relaxation or stress management techniques, such as meditation, visualization, biofeedback and yoga, and to take time out for themselves. Advise them to pay attention to their own feelings and emotions, and to seek counseling and support groups if needed.

Caregiving depletes a person not only physically, but also emotionally and spiritually. Subscribing the employee to a supportive informational periodicals and magazines, or gifting them with spiritual, inspirational encouraging books for caregivers goes a long way to show them you care not only about their productivity, but about them personally.

What adjustments can be made in the workplace to support caregivers?

One of their greatest workplace needs is flexible hours and time off. This benefit helps all workers, regardless of their age or family situation. Other program considerations should include providing information about support services available, such as eldercare services, adult daycare, respite care, or home health assistance. These resources can be provided on-site in lending libraries with in-depth information about resources in a format that minimizes the time required to access them, such as web-based, printed, or video materials.

What support resources can businesses offer?

The National Family Caregiver’s Association, www.nfcacares.org, is an excellent start in accessing this information. Another great resource is the Area Agency on Aging, www.loaa.org. With the passage of the National Family Caregiver Support Program in 2000, all AAAs have a mandate to address the needs of family caregivers. Working with employers is an excellent and efficient way to reach out to them. Whether it involves a contract to provide services or merely provides information to area employers to pass on to their employees as an outreach effort, working in partnership with AAA is good practice. Trained volunteers are skilled in advising consumers about insurance matters and professional providers can give employees online forms and resource information as well as workshops to address specific needs of workers.

Caregiving employees are the ones most worthy of retention, as their determination and commitment apply to both their home and work lives. Supporting them is a win/win/win proposition. The family member gets care from someone who loves them, the employee keeps their commitments to both priorities in their lives, and the employer retains a dedicated, cheerful, efficient employee.

Taking Care

Written by LeAnn Thieman, CSP, October 7th, 2008

Terry stacks the breakfast dishes into the sink, hands the freshly-packed lunchboxes to her son and daughter, then hustles them to the school bus. With a smile and a wave she promises, “I’ll pick you up after school for Girl Scouts and baseball practice.” She scurries back into the house to spoon-feed one more before leaving for her part-time job. After wiping his hands and face, she kisses his nose, helps him into the car, buckles him in, and drives him to daycare. Hugging him, she promises, “I’ll pick you up at lunchtime, Dad.” With a vacant look in his eyes he asks, “But what about breakfast?”

Terry is one of the 54 million Americans caring for a family member. Over 40% of families who provide care for an elder have children at home under the age of eighteen. Seventy-five percent of caregivers are women. Part of the “sandwich generation,” many will spend more years caring for a parent than they will raising a child. Not only are they ministering to their parents and children, many are caring for their children’s children. From 1990-2000, the number of kids living with grandparents increased 30%. Alarmingly, women who care for grandchildren have a 55% greater risk of heart disease. Caregivers of someone with a chronic illness have a 63% chance of dying early. It’s no wonder caregivers often experience troublesome feelings such as depression, resentment, worry, helplessness, exhaustion, guilt, anger, and sadness with reversal of parent-child roles. But when caregivers care for themselves, these statistics and severe emotions can be drastically reduced.

Caregiving depletes a person not only physically, but also emotionally and spiritually. Because 25% of the world population is caring for someone, we all know a person in a caregiving role. Here are 12 easy tips for you to help care for that caregiver:

  1. Extend compassion and empathy first.
  2. Encourage them to care for themselves as attentively as they do another. Remind them to get regular checkups, to eat properly, exercise, and get adequate sleep.
  3. Suggest they take time out for themselves and use relaxation or stress management techniques such as meditation, visualization, biofeedback and yoga.
  4. Advise them to pay attention to their own feelings and emotions and to seek counseling and support groups if needed.
  5. Listen.
  6. Help them to stay actively involved with friends and hobbies.
  7. Assist them in finding respite care so they can regularly take time for themselves.
  8. Subscribe them to supportive caregiving periodicals and magazines and gift them with spiritual, inspirational, encouraging books.
  9. Help them tap into community-based and national resources for support. The National Family Caregiver’s Association, www.nfcacares.org and the Area Agency on Aging, www.loaa.org. are great places to start.
  10. Deliver a heat-and-eat meal.
  11. Offer to sit with their loved one, even for 30 minutes, so they can take a bubble bath or a walk.
  12. Tell them how much you admire them for all they are doing.

These small efforts to care for the caregiver create a win/win/win situation. Your relationship with the caregiver will flourish; the family member will receive care from a happier, healthier caregiver; and that caregiver will feel cared for, too – a much needed and overdue reward.

Caring for the Caregiver

Written by LeAnn Thieman, CSP, October 7th, 2008

by LeAnn Thieman

Often we are so busy taking care of the patient, we scarcely have time to notice, let alone nurture, the friend or family caregiver at the bedside. Yet it only takes a few minutes and doing so benefits everyone involved. These 10 tips will help you care for the caregiver and the patient:

  1. Take their hand in yours, look them in the eye and verbally acknowledge their pain. Too often our comments to them are understandably made in haste while we making rounds or doing treatments. This small gesture of touch shows them you sincerely care about them too.
  2. Tell them you realize that they have entrusted you with their most valuable asset – their loved one, and assure them you will provide your absolute best possible care.
  3. Cultivate reciprocal feelings of trust – you for them, and they for you. Show them you’re on their side.
  4. Honor their knowledge of the patient and his or her condition. Let them know you realize they know them best. They will be much more receptive of your input when you have honored theirs. Make them feel part of the caregiving team.
  5. Alleviate their guilt. The family member frequently harbors unspoken feelings of blame about their loved one ending up in your facility. Just a few words on your part can ease their burden of remorse.
  6. Tell them the truth, gently and honestly. Feeling fooled or ill-informed is one of their greatest worries.
  7. Remind them to care for themselves physically, mentally, and spiritually. Encourage them to eat regularly, visit the chapel or walk in the garden. Have your facility subscribe to caregiving magazines for them to read, which offer knowledge and tools for coping. Provide uplifting, inspirational books to give them hope and healing. Give them permission to take time for themselves. Remind them that they cannot care for their loved one if they are weak and sick – often they’ll care for themselves not for their own well-being, but for that of their loved one.
  8. Be patient with their impatience. They are often guilt-ridden, exhausted, and worried beyond their ability to cope.
  9. Connect them with your facility or community’s social services departments. Most have resources for caregivers, offering support and much-needed assistance.
  10. Smile. Their facial expression will mirror yours. When you smile, they will – maybe for the first time that day.

These 10 tips will benefit you, the patient and the caregiver. You will save time, as difficult family members can impede patient care. Your heart (and feet!) will ache less. The patient will notice your compassionate understanding and treatment of their caregiver, which contributes to his or her healing and peace. And the caregiver will feel cared for–a much needed and long overdue reward.

Women in the Military

Written by LeAnn Thieman, CSP, October 7th, 2008

This Veterans Day is an important time to remember the nearly 1 1/2 million women veterans in America. Chicken Soup for the Nurse’s Soul offers this story to honor those who serve our profession and our country so gallantly. For their service then, now, and forever, we thank all those who sustain and defend our freedom.

LeAnn Thieman, co-author, Chicken Soup for the Nurse’s Soul

The first military women to arrive in Vietnam were nurses, in 1956. As the American presence in Southeast Asia grew, so too did the number of young women who served. In all, nearly eight thousand military women were there, along with thousands more who served in the civilian sector.

Eighty-three percent of us were nurses, the rest held positions in special services, supply, air traffic control, cartography, the USO, American Red Cross, and many other jobs in support of our combat troops. We were all fairly young when we volunteered to serve our country. And many of us were woefully naive in believing our recruiters’ promises; mainly that we could be stationed anywhere in the world that we wanted, and that Vietnam was “strictly voluntary.”

Still, when our orders arrived sending us to war, most of us believed in our hearts that we were needed, that what we were doing was important, and that it was our duty to go. We did our jobs, facing the perils of enemy fire, horrific heat and humidity, disease, insects, isolation, long work hours and sleepless nights. Then we managed to pull ourselves together, dab some perfume behind our ears, and do it all again the next day.

We learned a lot about ourselves. We discovered our strengths, and tried to survive our weaknesses. We were ordinary young women trying to function in the most extraordinary of circumstances; dealing in life and death and seeking not just to survive, but to understand.

We did the best we could with who we were and what we had. And daily we collected our memories, and stored them away someplace safe, out of our conscious minds where we thought, “I’ll deal with this later.”

And after a year, we came home, back to “The World.” In one plane ride we went from war to peace. In one year we had gone from childhood to irrevocable adulthood. We knew we had changed, that our lives would never be the same, and that we could never explain any of it to the folks back home. We couldn’t, and we didn’t. For as unacceptable as it was for the guys to talk about the war when they came home, no one wanted to acknowledge that young women had been there. Even as the Women’s Movement was making its voice heard, the underlying message was clear: “nice girls wouldn’t have gone to war.”

So we came home quietly, went back to our homes, our families, our jobs and never spoke about the war to anybody. Many of us quit nursing, and never knew why. Some of us had recurring nightmares, flashbacks, unexplained illnesses, depression, or abused drugs or alcohol. Many women applied themselves with a fury to school, attaining one degree after another, to work, rising to the top leadership positions in their companies, to their church, their social organizations, their families–anything to avoid the memories they had stored away “to think about later.” The memories had created a deep impenetrable wound that needed to be healed.

In 1982 the initial healing ground was laid, in the form of the Vietnam Veterans Memorial-The Wall. The women, just like men who had served, were drawn to it. The healing power of that sacred place is evident to all who have been there. We could go to The Wall, and mourn, and cry, and reach out for comfort if we chose, and yet it was so easy to be invisible there.

Women simply weren’t recognized as veterans.

Then, on Veterans Day 1993 the Vietnam Women’s Memorial is dedicated in Washington D.C. Thousands of women vets attend and we are overwhelmed. We lead the parade; the nurses, Red Cross workers, entertainers, women who worked in administration, logistics, and intelligence. The streets are lined with people applauding and crying. A vet sits high up in a tree yelling “Thank You! Thank You!” A man in a flight suit stands for over two hours at attention, saluting as the women pass by. People hand us flowers and hug us. One GI has a picture of his nurse taken “July 1964.” He is trying to find her.

We find each other. We know, at last, that we are not alone; that we are not crazy or paranoid, but that we have a lot of work to do in order to heal. We talk to each other and find comfort as well as pain in our words and our tears. Words and tears, that now, finally we share. Now, after so many years, the process has finally begun, and we hold each other close, and say “Welcome Home!”

Janis Nark, Lt. Col., U.S.A.R. (Ret.)

Finding Your Easter Sunrise

Written by LeAnn Thieman, CSP, October 7th, 2008

Nurse’s give, not only with their hands, but also with their hearts and souls and spirits. Chicken Soup for the Nurse’s Soul offers this story to remind nurses the importance of acknowledging and nurturing their spiritual lives. As this nurse so poignantly points out, we must refill our “spiritual wells,” and each “find our Easter sunrise.”

There is a stopping point in the North Carolina mountains called Pretty Place. Pull off the main road and follow a dirt one to a clearing and there stands an open-air chapel on the side of the mountain. Simple concrete benches encompass a stone pulpit. The area is open on all sides so you can see the breath-taking beauty of the scenery. There is a feeling of reverence about the place. People talk quietly, as though in church, in this wonderful place of solitary reflection.

At Easter time about twenty years ago, a group of friends and I decided to attend the sunrise service at Pretty Place. I had always wanted to go but never managed. I was an Emergency Room nurse and had to work on this particular Easter Sunday too, but worked it out to go to the service, and then go to work my shift. We got up about 2:00 a.m. to make the drive to Pretty Place. We arrived in the dark, parked, and proceeded toward the chapel. A huge gathering of people collected in and around the chapel. In darkness, a simple nondenominational church service was held including a hymn, a prayer and a short message.

I was content just to sit and enjoy the tranquility, the smell of earth and pine, and feel the coolness of the morning air on my skin. I heard the birds and the sounds of the woods around us and enjoyed the pleasure of being with my friends. The sky lightened as the day broke and a glowing orange ball began to appear as if it was rising out of the earth. One minute there was a gray canvas and the next, a glowing sphere of orange, yellow, pink rose filling the sky. Then, more quickly than they had come, the crowd took their leave to return to the real world. I headed for work.

I arrived feeling peaceful and ready for the day. The ER was quiet too. Since there were no patients, I began cleaning and restocking.

I heard the familiar announcement, “patient in the hall” and then the sound of a man’s voice calling for help in desperation and panic. I entered the hallway to see a man carrying a small, limp, breathless child. Traces of blood and discoloration smeared one side of her pale face. No other wounds were visible. The man handed me the little girl, dressed in a frilly dress, lace-trimmed socks, patent leather shoes, and a crushed Easter bonnet. His words spilled out. He couldn’t see her when he backed the family van out of the driveway. She was dressed and ready for church. She saw her daddy leaving. She ran behind him. She only wanted to go with her daddy.

I rushed her into critical care leaving the father in the hallway. Someone would come shortly to get him to fill out the paper work and show him to the family waiting room–not the usual waiting room, but the small, softly-lit, private waiting room where families and friends await bad news and pray desperate prayers for the lives of their loved ones.

As the call of Code Blue went out over the hospital loudspeaker, a team gathered to do all that was possible to save this child. Her Easter clothes were cut away and she was intubated. We began CPR, started an IV, and gave her drugs to attempt to restart her heart and lungs. It soon became obvious her neck was broken. We continued to resuscitate her, doing everything within the power of man and medicine. We couldn’t give up the life of this small child. There is a knowing, an intellectual process that says there is nothing to do, but the heart often pushes us beyond this knowledge to try anyway. So try we did.

After the hopeless resuscitation ceased, I slowly removed the tubes with tears in my eyes, a huge lump in my throat, and heaviness in my chest. We took care of the details of preparing her body for death and for her family to see her. The Emergency Room doctor went to the family room. His words to the father would start with, “Your little girl is dead. There really was nothing we could do, but we tried.” He would talk, trying to explain what had happened. He would listen for a little while to give the father a chance to begin to verbalize how he was feeling.

The cry we heard coming from this man as he was given the news still touches me at the core of my very being. Some of us have experienced the misfortunes in life that enable us to understand the pain and loss this man must have felt.

It’s been twenty years since that Easter Sunday. I am married now and have four children of my own. I traded in the job of being a nurse for that of being a full time mother and homemaker. Not an Easter has passed since that I do not remember that little girl in the arms of her father on that Easter Sunday. I can always recall the pain and agony of that father’s cry at the news of the death of his daughter. Now, as a parent, I understand that cry in a way that I couldn’t at that time.

Medical personnel must learn to deal with the pain and suffering of others in order to do their job. We witness human misery, loss of limb and life, loss of family, and at times, the horrible unspeakable things that people do to each other. My saving grace is always that when I remember that little girl dying I also remember the profound experience of being at the Easter sunrise service. I’m glad that on that morning I made the effort to go. I remember the magnificence of that sunrise there on the side of a mountain and the awe I felt taking it all in.

I experienced two opposite ends of the spectrum of human emotion that day – -wonder and despair, life and death, joy and suffering, breath-taking beauty and profound sadness. I wrap the beautiful memory of the sunrise service around me to protect me from the hurt I felt at the death of that little girl. That memory of the sunrise was the armor I carried into battle that day as I went to do my duty in the ER.

As a nurse or a doctor or anyone who deals with pain and suffering, we must care for ourselves in order to be of service to others. We cannot give water to others from an empty well. We must take time to refill the well–to find our Easter sunrise.

Cindy Bollinger

Nurturing the Nurse

Written by LeAnn Thieman, CSP, October 7th, 2008

My work as PM charge nurse in a small convalescent hospital brought many frustrations, but the biggest was the lack of qualified help. Still, everyone working there had a genuine love for the patients, and we all did our best to care for them.

Alice, a tiny, alert elderly lady with bright blue, twinkling eyes was everyone’s favorite. Her only living relative was her son Jack, a large, tough man in faded filthy jeans. A scraggly beard grew haphazardly on his chin and tattoos covered his arms and chest. No matter how cold the weather was, Jack always wore a tank top so the dragon and snakes could be admired by all. His loud and gruff manner terrified most of the staff.

But this monstrous man loved his tiny mother. Everyday he roared up to the hospital entrance on his old motorcycle, flung open the front door, and tromped down the hall to her room, his clacking boot heels loudly announcing his arrival. He visited at unpredictable hours so he could surprise anyone he suspected of not taking proper care of his mother. Yet, his gentleness with her amazed us.

One particularly bad evening, three aides called in sick, the food carts were late and cold, and one of the patients fell and broke his hip- – and Jack came in at suppertime, as usual, to help his mother with her meal. He stood gawking at me in the nurses’ station as I busily tried to do the work of three nurses. Overwhelmed, and near tears, I avoided his stare.

At the end of the shift, after the patients were finally fed, bathed, and put to bed, I sat at the desk and put my head down on my arms, exhausted. Then the door burst open. Startled, I thought, “Oh no! Here comes Jack, checking up on us again!” As he stomped to the desk, I looked up to see his burly hand gripping a pickle jar with a bit of colored yarn tied in a bow around the neck. And in the jar was the loveliest, long stemmed red rose I’d ever seen. Jack handed it to me and said, “I noticed what a bad time you were having tonight. This is for you, from me and my mother.”

With that, he turned around, marched back out the door, and with a roar from his motorcycle, rode out into the darkness.

Of all the many gifts I’ve received from the many grateful patients over all the years, nothing has touched me more than the red rose in the pickle jar so many years ago.

Kathryn Kimzey Judkins, R.N.

We could use a lot more pickle jars and roses in our lives as nurses today, couldn’t we? Being a nurse is stressful, working longer hours with shorter staff. As we leave work with achy feet and, often, achy hearts, it’s important to remember, though, that not all stress is bad. There is a positive stress called eustress. It’s the kind of stress found in every biological life form on earth – it’s what helps them cope, to be creative and productive, to make changes that help preserve themselves. So some stress is good, but a little goes a long way! Nurses are crying, “Enough already!”

The U.S. surgeon general says eighty percent of people who die from non-traumatic causes die from stress-related illnesses. Nurses see that in their patients and sometimes feel it in themselves. Many claim they are beyond eustress and stress and are in distress.

To cope with all our stressors today, we must have our lives in balance physically, mentally, and spiritually. We must take time daily to balance our lives in these three ways. But usually we’re so busy taking care of other people, we forget to take good care of ourselves.

Everyday we teach patients how to care for themselves physically, but often don’t apply those lessons personally. We educate them about the 4 Basic Food groups, the dietary pyramid of good nutrition, and the importance of drinking six glasses of water a day, yet regularly forget to consume it ourselves. We remind them of the importance of sleep yet frequently deprive ourselves of it. We encourage them to get exercise every day, yet are too busy to get it ourselves.

How are you going to take time everyday to eat, sleep, and exercise – to nurture yourself physically – to care for yourselves as lovingly as you care for others?

LeAnn Thieman, co-author, Chicken Soup for the Nurse’s Soul

Kathryn Kimzey Judkins, R.N. has lived in California since 1962. Since retiring in 1998, she spends much of her time writing poetry and short stories. Married fifty-five years, she has three children, six grandchildren, and two great-grandchildren.

Caregiver Crisis Fact Sheet

Written by LeAnn Thieman, CSP, October 7th, 2008

by LeAnn Thieman

“There are only four kinds of people in the world – those who have been caregivers, those who currently are caregivers, those who will be caregivers, and those who will need caregivers… The stories in Chicken Soup for the Caregiver’s Soul soothe and nourish family members and professionals devoting themselves to the care of those who are ill or disabled.” – Rosalynn Carter

Over 54 million Americans help care for ailing family members or friends. Millions more selflessly minister to people in daycare, emergency, and community services. While often rewarding, this benevolent care-giving requires tremendous emotional, physical, and spiritual strength.

Facts:

  • Nearly one out of every four US households (23% or 22.4 million households) is involved in caregiving to persons aged 50 and over.
  • One-quarter of the adult population worldwide help care for family members or friends.
  • Nearly 7 million Americans provide long distance care to an elderly loved one.
  • The typical family caregiver is a 46 year old woman who is employed and also spends about 18 hours a week caring for her mother who lives nearby.
  • 75% of caregivers are women
  • The average family caregiver provides 18 hours of care per week; 20% provide “constant care” or 40 hours a week
  • One in three family caregivers cares for 2 or more persons
  • The average age of the caregiver is 46; the average age of the person being cared for is 77.
  • The average out-of-pocket expenses for a family caregiver is $171 per month. Total un-reimbursed monthly expenses for family caregivers is $1.5 billion.
  • The number of children living with grandparents increased 30% from 1990-2000.
  • Women who care for grandchildren have a 55% greater risk of heart disease.
  • Caregivers of someone with a chronic illness have a 63% chance of dying early.
  • 63% of caregivers say depression is their most common emotion.
  • Forty-one percent of caregivers have children, too. Part of the “sandwich generation,” many women will spend more years caring for a parent than they do raising a child.
  • Around 4 million Americans are diagnosed with Alzheimer’s disease. Approximately 70% of them are cared for at home.
  • Approximately 64% of caregivers of the elderly are employed. They spend an average of 18 to 40 hours per month caregiving.
  • Ninety-two percent of elders are related to their working caregivers. Two-thirds of caregivers work full or part time. Over half make adjustments in their work schedules, i.e. coming in late, taking time off, dropping back to part time or quitting.
  • Of the 7% of workers who care for an elderly parent, grandparent, in-law, relative, friend, or spouse, 56% are women and 44% are men.
  • Nineteen percent of elders live with their working caregivers, 46% live 20 minutes or less from the working caregiver, and 18% live over an hour away.
  • Caregivers who quit or drastically reduced their hours have the highest level of stress, and relatives with the most severe behavioral problems. Leaving the workplace causes an annual income loss of about $20,400 per employee.
  • Family caregivers account for and estimated $257 billion annually in services, if they were paid.
  • The average cost of nursing home care is over $51,000 a year, yet funding is not available to help family members keep their loved one at home.
  • This crisis is of national proportion. Last year congress allocated $125 million to develop new programs for family caregivers.

Problems:

American businesses lose between $11 and $29 billion a year in productivity costs due to caregiving-related work interruptions.

Caregivers often experience troublesome feelings such as:

  • Resentment about demands, real and imagined
  • Worries, especially about the financial impacts of diseases
  • Frustration with health care providers and the patient
  • Exhaustion from balancing caregiving with the competing demands of daily living
  • Depression as life changes drastically
  • Helplessness as the reality and enormity of managing caregiver responsibilities impacts your life
  • Guilt over negative feelings aboout the patient
  • Discomfort with reversal of parent-child roles
  • Anger is common among caregivers and comes from the emotional stress of caring for another.

Caregivers Must Take Care of Themselves

As a result of caregiving and the ongoing stress it incurs, many caregivers develop health problems. There is a powerful and well-documented connection between the body and the mind. Sometimes strong feelings and emotions such as anger, grief, and overwhelming frustration show up as:

  • High blood pressure
  • Stomach aches
  • Dizziness
  • Acid reflux
  • Blurred vision
  • Headaches
  • Generalized muscle soreness
  • Sleeplessness
  • Exhaustion
  • Depression

“Why should I care?”

See the Rosalyn Carter quote at the beginning of this fact sheet. This problem escapes no one.

Solutions: (So glad you asked!)

Caregivers can significantly reduce stress by:

  • Paying attention to their own feelings and emotions, and seeking counseling if needed
  • Getting regular checkup and treatments of aches and pains before they turn into something more serious
  • Eating properly, exercising, and getting enough sleep
  • Creating a support network that may include joining an AD support group
  • Easing standards for things such as cleanliness
  • Learning and using relaxation or stress management techniques; such as meditation, visualization, biofeedback and yoga
  • Staying actively involved with friends and hobbies
  • Finding respite care and regularly taking time out for themselves
  • Tapping into community-based resources for support, as well as national resources

Increased funding to support caregivers is a must through nationally funded and community-based programs.

So what’s this have to do with Chicken Soup for the Caregiver’s Soul?

Whether they’ve chosen caregiving as a profession or caregiving has chosen them, the caregiver’s daily commitment and sacrifice are true testaments to the human spirit. Currently, the few caregiving books on the market offer “How-to” solutions to ease caregiver burnout, but no other books offer inspirational stories of real-life experiences that will replace possible guilt, resentment and frustration with hope, courage, and strength. The need to be understood is said to be the greatest human need – this book offers that understanding. Chicken Soup for the Caregiver’s Soul offers a respite from their responsibilities, bringing uplifting and comforting insights to fill caregivers with renewed hope, courage, and strength.