Rx for mental health

Resilience is key, RN and CMHA specialist advises

While the pandemic has had many negative effects on nurses’ health and well-being, it’s also paved the way for necessary conversations about mental health  stress management, according to a local mental health professional.

“It has normalized discussions of anxiety and depression and helped health care providers reach out for supports from their employee assistance programs or other community resources to find the help they maybe even needed before the pandemic,” says Margo Cameron, clinical practice specialist at Canadian Mental Health Association (CMHA) Windsor-Essex County Branch. “I think the pandemic has shown us the limits of our physical, mental and emotional capabilities and that it is important to pay attention to what we each need to do to manage adversity.”

Cameron, a registered nurse herself, has worked in hospital and community settings since 1986 in Detroit, Windsor, Edmonton and the GTA. She has been in her current position at CMHA since 2018.

She says the pandemic has nurses running on fumes, with no chance to pause and find restoration or renewal.

“Everyone’s reserves of adrenaline and resilience are tapped out,” she describes.

But even pre-pandemic, nursing has always been an extremely demanding and stressful profession, she notes. It’s a career defined by long hours, heavy workloads in short-staffed environments, fiscal restraints that affect supplies and services for clients, physical and mental exhaustion, vicarious trauma, burnout, moral distress, moral injury, post-traumatic stress and more.

These are realities nurses have always faced that have only been exacerbated during the pandemic, she says.

“Nurses are altruistic and empathetic professionals who will often put the needs of patients and clients before their own, missing breaks and meals to ensure essential care is completed,” Cameron says. “Like many helping professionals, individuals who pursue nursing do so out of a desire to care for others and improve the health and quality of peoples’ lives.”

There are many things that nurses deal with on a regular basis that could affect their mental health, Cameron points out – things like dealing with crises and emergencies, sudden or unexpected death, palliative care and slow deaths.

Clients who do not improve or who cannot return home or go to rehab, or clients who need long-term care but are not ready to accept it, can also be very stressful to deal with, she says.

Nurses also have to often manage family misunderstandings, conflicts within families or conflicts with families and other allied health care providers.

And clients and families who have unrealistic expectations and do not understand how the health care system works is also an issue.

“Nurses can also be exposed to verbal and physical violence, harassment and intimidation with clients and unfortunately sometimes with colleagues,” Cameron adds.

While nursing education does provide some guidance and preparation for nurses to anticipate that their jobs will be stressful, this education is an achievement that requires strength and resilience to complete, according to Cameron.

“This lays the foundation for what’s required to practice the profession, but the competing priorities and challenges with which nurses are confronted may make it difficult to sustain and develop resilience long-term,” she says.

To face adverse situations, stay focused and continue to be optimistic for the future, nurses need education about resilience building, support of colleagues and healthcare leadership and recognition, Cameron states.

“Research shows that investment in nurses’ resilience reaps dividends for both nurses and patients because it enhances client safety, quality of client care and the experience of individuals through the health-care system,” she says.

Nurses are educated health-care providers who seek to serve the public to the best of their ability to consistently ensure safe and evidence-based care, even in environments where work volume is overwhelming, supplies are limited or staffing is short due to fiscal restraints, says Cameron.

“Nursing is a profession that requires lifelong learning to continually recalibrate nursing practice with the latest research, best practice guidance and regulatory expectations,” she adds.

Mental health coping strategies for nurses

Cameron says there are some different strategies for nurses to help deal with the mental challenges the field poses, including:

Self-reflection/self-care

Take a careful inventory. Ask yourself how you’re doing. Do you have time to take a break, exercise, do things you enjoy, engage with friends and hobbies?

Any maladaptive coping emerging to deal with stress? Are you engaged in any binge behaviours, such as eating, drinking, watching, shopping, new or increased substance use, new addictions, or avoidance of people, places and things?

And Cameron says an important thing to consider is: what are the unique things that nurture you, and how can you do more of them?

“It is essential to take care of yourself so you can keep taking care of others, says Cameron, noting the phrase, “You can’t draw water from an empty well”.

Mental health supports/therapy

“If suffering with anxiety, depression or PTSD that is impacting your personal or work life, seek help,” advises Cameron. “See your GP/NP, consult your employee assistance program or find a therapist who can help you navigate how you are dealing with professional and personal stress.”

Exercise/ relaxation strategies/ meditation/ yoga

Cameron says it’s important to find ways to unwind that are healthy and work for you personally.

“Find ways to nurture the mind-body connection and restore physical and emotional balance,” she notes.

Participate in professional organizations

Organizations such as the Registered Nurses Association of Ontario (RNAO) or the Canadian Nursing Association (CNA) are great ways to find like-minded colleagues for encouragement and support. And she says CMHA’s new program called ECHO Coping with COVID is a great example of joining with other multidisciplinary groups dealing with similar issues.

Seek out new resources to counter compassion fatigue and rebuild professional resilience

Canadian Francoise Mathieu founded the TEND Academy, which provides education and consulting to a broad spectrum of workforces encountering stress and intense workloads, notes Cameron. Their training helps professionals to understand and address the natural consequences of working in a high-stress and trauma-exposed workplace.

Mathieu’s TEDX talk, called The Edge of Compassion, is something Cameron also recommends checking out.

And ECHO Coping with COVID is designed for healthcare providers and health professions students responding to the COVID-19 pandemic, which can help nurses dealing with overwhelming stresses they’re currently facing.

Rebecca Wright
National Nursing Week 2022 (Special Insert)
The Windsor Star