Nurse Wellbeing Mission

Livaware is an innovative nurse-led team that fills the gaps in people's healthcare. They combine clinical excellence, coordination, and empathy to provide an unrivaled experience led by Hemmen Jutla, RN.

In this episode, Nathan Illman talks with Hemmen as he talks about his inspiring journey of breaking away from his traditional nurse role to starting up his own company and becoming an entrepreneur.

Listen and learn in this episode.

KEY TAKEAWAYS FROM THIS EPISODE

Helping people with personal care and helping people who can not do certain things was incredibly humbling for Hemmen.

Understanding that people have their own lives within that: seeing patients as people, but seeing nurses as people as well, and who have their kind of problems going on and trying to manage that.

It is compelling when a leader says they do not have all the answers and directs us to people where to get the answers or solve the problem together.

Entrepreneurship is not just a business; it is a mindset.

It is where people can come to get ideas and help ideas. Just planting the seed, people will come out with great things.

Listening to your team, understanding their needs, and being aware of them having burnout is what Hemmen does as a leader to ensure their well-being is enhanced. 

Having many more nurses taking responsibility for their practice helps people individualize their healthcare, but also individualized profession.

It would be nice to bring an opportunity where people can work privately and use their skills.

Hemmen see stress as something within us for a reason. 

Accepting that it will never be perfect and that it is an ongoing process that you will learn next time is important to ground yourself in that with the whole thing's journey.

Today's Guest:

Hemmen Jutla is the founding clinician of Livaware. He graduated as a nurse in 2013, has become a qualified health coach, and has worked in one of the most prestigious hospitals across London. He aims to provide the best care in the best environment for individuals, enhancing their experience on the road to recovery. 

Connect with Hemmen Jutla here:

https://uk.linkedin.com/in/hemmen-jutla-45489029 

https://www.instagram.com/hjutla/ 

Want to start your journey to better healthcare? Go to:

https://www.livaware.co.uk/ 

Follow Nathan and Nurse Wellbeing Mission for more practical preventative mental health tools for nurses and midwives:

Website: www.nursewellbeingmission.com 

Instagram: @_nursewellbeingmission 

Twitter: @NurseWellbeing 

Join our free Facebook group: https://www.facebook.com/groups/nursewellbeingmission 

Liam Caswell Coaching created a nurse career and life coaching service where they helped nurses navigate the life and career struggles that they face day to day and help them see that they have so many options. 

In this episode, Nathan Illman sits down with Liam Caswell as he shares his own experiences of adversity and challenges he has overcome that influenced his career and desires to help other nurses as well.

Listen and learn in this episode.

KEY TAKEAWAYS FROM THIS EPISODE

There is such a gap in the support, guidance, mentorship, and coaching for nurses globally that it is preventable.

PNA program: Professional Nurse Advocate program is all about therapeutic clinical supervision. Nurses in leadership positions are being trained to provide care to other nurses; that is a space for reflection.

The gap lies for nurses when they are trained to be clinicians and do cardio, CPR, and all of the things but are not trained in humaneness. They are not trained in the human side of health care and how to face adversity, like in constant fight or flight.

Shame is an emotion we all experience, which shows up with things like imposter syndrome and comparing ourselves to others when we do not feel like we are doing a good enough job.

Many people think that as a leader, educator, and senior, being emotionally vulnerable will trip you up, or people will assume that you are not strong, which is the opposite of being true.

The biggest challenge that people see now is that nursing is not a long-term career because of how it is set up.

It is the individual's experience, their belief about themselves, and their perceived fear or worries about what will happen that Liam and his team try to tackle in their program and help them see that they have all the options and all the choices.

Today's Guest:

Liam Caswell is a senior healthcare leader who seeks to draw upon his international nursing and healthcare experience to guide nurses to achieve work/life balance while maintaining their values and integrity. They help nurses and midwives across their careers land their next role with ease, support, and confidence!

Connect with Liam Caswell here:

https://www.linkedin.com/in/liam-grant-caswell/

https://www.facebook.com/highperformancenursing/ 

https://www.instagram.com/highperformancenursing/

https://www.youtube.com/@highperformancenursing/ 

Want to start with Liam Caswell Coaching? Go to:

https://www.liamcaswell.com/ 

Follow Nathan and Nurse Wellbeing Mission for more practical preventative mental health tools for nurses and midwives:

Website: www.nursewellbeingmission.com 

Instagram: @_nursewellbeingmission 

Twitter: @NurseWellbeing 

Join our free Facebook group: https://www.facebook.com/groups/nursewellbeingmission 

In this episode, Nathan talks about sleep again: part three of his mini-series about sleep difficulties, problems, and insomnia and how to improve those for nurses and midwives.

In the previous episodes, Nathan provided an overview of effective evidence-based ways to optimize sleep and overcome sleep problems. Today's episode focused on shift work sleep disorder and the issues it creates for nurses and midwives.

Here is a summary of key points from the episode:

• Shift work is when someone works outside of traditional working hours in Western society. As we all know, many nurses and midwives are also required to do this shift work as part of their roles.
• Essentially our circadian rhythm—that biological clock that our bodies follow, and all of the cells in our body, follow this rhythm that is triggered by the rising of the sun and exposure to light through our eyes, and then darkness.
• When you are working a night shift, you are essentially fighting against the body's natural desire to sleep at night.
• Circadian misalignment is when your body gets used to a natural thing on the day shifts. An unnatural something on the night shift, and then keeps switching back and forth.
• One of the other big problems with working the night shift is it disrupts your social life.
• Shift work sleep disorder is characterized by insomnia problems: difficulty falling asleep or staying asleep, difficulties with impaired concentration, and sleepiness when the person is awake.

Nathan shares several strategies and techniques for overcoming these difficulties and helping optimize sleep for people rotating shifts.

1. A helpful place to start is talking about the differences between those who work rotating shifts and people who are on permanent changes and what we know from the research about the differences between those.
2. Start by considering the day of your first night shift; then, it is essential to sleep in as long as possible before that first night shift. Then in the afternoon, it will be excellent if you can take a nap as well.
3. Having the opportunity to take a nap while on a shift is helpful, and then not drinking caffeine later into your shift, indeed not napping later into your shift.
4. When you leave work, avoid light exposure. The light exposure will trigger all of those mechanisms in your brain and body that will keep you awake.
5. Having a dark, quiet, cool room in your home is super important.
6. We know that alcohol is not helpful for sleep. Alcohol, as are caffeine and other stimulants, is something to avoid right before you go to sleep.
7. The strategy to use after the final night shift
8. You want to sleep a little bit, to begin with. Sleep between 90 minutes and a couple of hours, and set yourself an alarm to wake up.
9. In the afternoon, avoid caffeine and anything that will affect your sleep later that night. Try to stay awake as close as possible to what your regular bedtime would be.

People might put a lot of pressure on themselves to sleep and fall asleep during the day. This psychological pressure we put on ourselves can create a lot of stress and lead to that arousal, making sleep very difficult. So remind yourself that getting rest is essential, and if you are struggling with sleeping, seeking help is really important.

Follow Nathan and Nurse Wellbeing Mission for more practical preventative mental health tools for nurses and midwives:

Website: www.nursewellbeingmission.com

Instagram: @_nursewellbeingmission

Twitter: @NurseWellbeing

Join our free Facebook group: https://www.facebook.com/groups/nursewellbeingmission

In this episode, Nathan talks about sleep difficulties, problems, and insomnia and how to improve those for nurses and midwives.

In the previous episode, Nathan talked about some general tips and tools for improving sleep. Today’s episode focused on people struggling with sleep; this episode is part two of a series about sleep tips.

Here is a summary of key points from the episode:

• Insomnia is the most common sleep disorder; it is a problem in initiating sleep in the first place or a problem with waking at night. 
• Insomnia causes functional impairment where your sleeplessness or your perceived sleeplessness bothers you.
• Sleep difficulties likely started from stress and worrying about something.
• The leading cause of insomnia for people is stress in the short term. Irregular sleep-work-wake cycles also lead to insomnia. 
• It is the things that we are doing unintentionally that are maintaining the problem. 
• Sleep is a natural behavior. The problem is that we focus on sleep as something to be controlled, and the unintentional consequence is that it creates more anxiety.

Nathan shares several tips to improve sleep and break the cycle of insomnia.

1. As you notice worries coming into your mind, acknowledge them as worries. Give your fears a name and change your attitude towards the concern. Try and disengage from thinking about how insufficient your sleep was and how it will affect the rest of your day.
2. The other one is questioning the validity of your thoughts. Examining what your mind is saying as you go about the rest of your day is essential.
3. Try and put yourself in the shoes of someone who is a good sleeper and apply that to your thinking.
4. You have to start abandoning what you are doing to try and control sleep.
5.  Try to reduce the extent to which you’re obsessively monitoring yourself internally. People with insomnia tend to focus negatively on their internal sensations.
6. Sleep window- Set your bedtime and waketime and stick to it. Get out of bed when your alarm goes off, even if you feel you have not slept well. 
7. Stimulus Control- Even going to bed creates that sense of worry and anxiety. You have to start retraining that association with the bed as somewhere calming and where you can fall asleep.
8. Have a balance between having healthy sleep habits and what we call sleep hygiene and then using sleep hygiene-type behaviors to try and make ourselves sleep.
9. Managing insomnia is emotions. Allow those sensations and emotions to be present, and open yourself up to them. Focus on breathing- breathing into your nose and out through your mouth.

Sleep has a massive impact on our physical and mental health. Share this episode with your colleagues and have more conversations about sleep. This way, we can help more people get adequate rest and improve their well-being.

Follow Nathan and Nurse Wellbeing Mission for more practical preventative mental health tools for nurses and midwives:

Website: www.nursewellbeingmission.com

Instagram: @_nursewellbeingmission

Twitter: @NurseWellbeing

Join our free Facebook group: https://www.facebook.com/groups/nursewellbeingmission

In this episode, Nathan talks about the importance of sleep for wellbeing and shares some insights into some of his favourite tips to get better sleep.

This episode is part of a series that will cover general sleep tips (today’s episode); ways to tackle insomnia; and how to improve sleep for night shift workers.

Here is a summary of key points from the episode:

>Sleep has been shown to be a significant predictor of both mental and physical health problems.

>People who regularly sleep less than 7 hours per night are at risk of health conditions. If you sleep less than 6 hours per night this risk increases dramatically.

>Sleep is an evolutionary behaviour that developed over millions of years. In brief, it helps restore the body/mind and repair cells.

>Sleep is controlled largely by light from the sun - light and dark cycles trigger processes in the brain that lead to the feelings of sleepiness we experience and our need to sleep/when we sleep.

>The two key things needed for sleep are: sleep pressure (tiredness) and low arousal (i.e. not feeling stressed or on ‘high alert’)

>Nathan shares several sleep tips for people working regular schedules (i.e. not night shifts):

1. Get morning sunlight for around 10-15 mins per day by going for a walk. This helps stop the release of melatonin in the morning and helps with its production later in the day.
2. Get daily exercise. Cardio and resistance training both help improve sleep quality. Ideally, combine exercise with outdoor light exposure to get a double whammy effect.
3. Bedtime routine - try to go to bed at the same time/wake same time each day. This creates a natural rhythm for your brain to get used to and makes sleep come easier and more efficient.
4. Don’t withhold on sleep during the week and think that you can “make up for it” at weekend. Whilst weekend lie ins provide short-term relief, they don’t undo the damage done during the week from mild sleep deprivation. The negative effects will show in the medium to long term.
5. Limit screen and phone use before bed and try to avoid having a phone in the bedroom for 30 minutes before bed. Use an alarm clock to wake you and leave your phone outside the bedroom. 
6. Avoid alcohol before bed. It is a myth that alcohol helps you sleep. Whilst it helps you fall asleep, it becomes a stimulant and wakes you up more in the night, leading to poorer quality sleep, even if you don’t feel like it’s having a negative effect.
7. Avoid sugar in the evening, especially right before bed. Sugar interrupts sleep rhythms. Try eating something less sweet or try fruit-based alternatives to the usual candy or chocolate you might have.

There are tons more ways we can improve sleep but these tips are a great starting point for anyone, so pick one and give it a go!

Follow Nathan and Nurse Wellbeing Mission for more practical preventative mental health tools for nurses and midwives:

Website: www.nursewellbeingmission.com

Instagram: @_nursewellbeingmission

Twitter: @NurseWellbeing

Join our free Facebook group: https://www.facebook.com/groups/nursewellbeingmission

Fatigue is a common problem in the workplace. It’s even more common and well-documented in people who work night shifts because of the lack of sleep they experience. It can cause different problems in our body systems that can, later on, affect the quality of our lives.

It’s a good thing that in some workplaces fatigue is monitored among their employees and interventions are being implemented. However, in healthcare, this type of monitoring is not present and there is a lack of training available.

In this episode, Nathan Illman talks to Despina Artenie, a psychologist who has conducted some research looking at ways to improve fatigue in night shift workers. She shares the interventions they implemented in her study, the results, and some useful recommendations for night shift workers.

Listen and learn in this episode.

KEY TAKEAWAYS FROM THIS EPISODE

Working night shifts can lead to sleep problems, and digestive and metabolic problems, and can affect our overall health.

Our normal circadian rhythm or biological clock is heavily influenced by daylight. This is due to the way we evolved with the Earth's continuous shift in light/dark cycles across 24 hours.

This leads to alertness during the day and sleepiness at night. This is why, as humans, we work during the day and rest and regenerate at night.

During a night shift, the body clock flips. The continuous shifts of schedules cause a circadian misalignment. All the jumping back and forth makes it hard to get good quality sleep.

The most potent way to adapt to the shifts is to control light exposure. This taps into the evolutionary mechanisms in our brains.

The issues with controlling light exposure of shift workers are the fact that the conditions at work are out of their hands and that light exposure is quite time-sensitive.

Below we explain Despina's research study and how she and her colleagues provided artificial evening light to nurses:

Interventions given to nurses in the study:

1. Using a lightbox to get 40 minutes of bright light exposure using the lightbox as late as possible before going to work 
2. Avoiding light in the morning after a shift by wearing sunglasses 
3. Sleeping in the morning in a dark environment or using an eye mask

Interventions on the active control group:

1. Eating a meal before going to work
2. Eating low-protein meals when eating at night 

Results: The study found that the light exposure intervention did indeed reduce subjectively reported fatigue in the experimental group.

Conclusion: 40 mins of evening light exposure is a safe, acceptable, and effective means of reducing fatigue in shift workers. It can be done at home for a low cost.

Quick recommendations that can help with fatigue or sleep problems: 

1. Nap in the afternoon between 2 pm to 6 pm.
2. Try to get a proper dinner before the shift.
3. Have a healthy snack if you’re hungry.
4. Have a low-protein breakfast.
5. Drink water proactively.
6. Try to socialize with your work colleagues to keep yourself alert.
7. Try not to drink caffeinated drinks 3 hours before sleeping.
8. Mind your sleeping hygiene by blocking external noise and not using your phone before sleeping or with 100% brightness.

Lightbox recommendation: 10,000 lux of wide spectrum light and has a UV filter, use at arm’s length.

Website: https://www.nursewellbeingmission.com

Facebook Group: https://www.facebook.com/groups/nursewellbeingmission 

E-mail Address: [email protected] 

Schwartz Rounds provide a safe space for healthcare staff to share many aspects of their work with others. This results in reflections and realisations that enable staff to be more compassionate towards themselves and others.

In this episode, Nathan Illman sits down with Jill Maben to discuss Schwartz Rounds and her evidence-based research about the effect of these rounds on nurses’ well-being. 

Listen and learn in this episode.

KEY TAKEAWAYS FROM THIS EPISODE

• Making a difference and helping families during their most difficult times is immensely rewarding but it’s not always easy.

• The term Schwartz Rounds was named after a young American lawyer, Kenneth Schwartz who had incurable lung cancer in 1995.

• When medicine can't provide any answers, or has kind of failed, what matters most for patients and families is compassion and empathy.

• Schwartz Rounds help develop more personal knowledge of your emotions and the interpersonal side of the work that you're doing, rather than just the empirical scientific, technical, knowledge that perhaps a nurse might need to have to deliver care.

• What’s unique about nursing work is they are asked to bring and deliver their full selves, emotions, empathy, and compassion all day, every day to every patient.

• Schwartz Rounds are developed to provide a safety net or support mechanism to help people process those emotional, social, and ethical challenges at work.

• The four stages of Schwartz Rounds: Finding the storytellers, preparation of the storytellers, the rounds, and the after-effects.

• It takes time to change culture, but there's a fertile area for conversations to grow and for us to be more compassionate to each other, but also ourselves.

• The Schwartz Rounds touch on many aspects of life and the reflections that happen during these rounds encourage nurses to be more compassionate towards themselves and others.

• Vulnerability builds the bridge to genuine connections.

• In rounds, you allow feelings to come in, and processing them enables different things to grow.

• The more rounds you attend, the more protective it becomes.

• Someone who deeply understands the power of rounds can help spread the word and encourage people to attend them.

• Evidence shows that rounds have more impact on regular attendance.

Today’s Guest:

Jill Maben is a nurse by background and is now a professor of Health Services Research and Nursing at the University of Surrey. She leads a workforce organisation and well-being team. They have several research projects related to nurses’ well-being or healthcare staff’s well-being.

Connect with Jill Maben here:

https://www.surrey.ac.uk/people/jill-maben

https://twitter.com/nursingpolicy

Want to start with Schwartz Rounds? Go to:

https://www.pointofcarefoundation.org.uk/

Website: https://www.nursewellbeingmission.co.uk

Facebook Group: https://www.facebook.com/groups/nursewellbeingmission 

Being in a healthcare team is a tough job and even more when you stand as the leader. You have to be someone your team members can rely on especially during the most difficult times.

It’s not enough to have the courage and strength of a leader. It is most important to keep the compassion that you had since the moment you entered this line of work to keep an open and honest culture for everyone’s well-being. 

In this episode, Nathan Illman has a conversation with Jackie Dominick, the head of nursing for a hospital in the UK. They talk about many different topics about leadership. Jackie shares the principles and philosophy that have guided her leadership for years.

Listen and learn in this episode.

KEY TAKEAWAYS FROM THIS EPISODE

• Leaders need to try to have a different persona at work and check on themselves first to be able to do their work well.
• You must not lose the compassion that you have along the way. 
• You can’t lead on the phone. You have to be with people. You have to be visible.
• You have to be strong as a leader and you have to say no to unimportant tasks or demands.
• Your gut instinct takes you a long way. If you can articulate your gut feeling, they will respect your opinion and they will think that you know what you’re talking about.
• Always have an honest relationship with your team members.
• If a team member makes a mistake, take it slow but get them to talk about what led up to that incident, understand it, and make a conclusion.
• If you want an open and honest culture, in healthcare, you have to create an environment where people feel safe to tell you their mistakes.
• Coaching means letting people come to a solution for themselves, say very little, reflect back with them, and come up with a conclusion together.
• If you always tell people what to do, they won’t learn and you are not developing future leaders.
• If you have a team that pulled together and solves problems together, that’s a great team.
• You spend a lot of time at work, enjoy it.
• As long as you’d say it in the right way, you’re compassionate and caring, you can say anything to anybody. Don’t be frightened to tell someone when you’re not happy with what they’re doing.

Today’s Guest:

Jackie Dominick has been a nurse for 30 years and is now the head of nursing for a hospital in the UK. 

Website: https://www.nursewellbeingmission.co.uk

Facebook Group: https://www.facebook.com/groups/nursewellbeingmission 

In today’s episode, I talk to Jasna Schwind, professor of nursing at the Daphne Cockwell School of Nursing in Toronto about self-compassion in nurse education. Jasna is an RN and nurse educator who is interested in the humanness of care and ways to enhance nurse student learning via mindfulness and compassion.

If you’re interested in self-compassion, this episode is for you! Nathan even leads a short self-compassion exercise at the end of the episode so keep listening!

In this conversation we cover the following topics:

-Jasna’s background and when she started incorporating mindfulness into her teaching with nursing students.

-Why it’s important to address the psychological needs of nursing students so that they can effectively absorb and use the knowledge they are gaining through formal study.

-What self-compassion is, and how it can be developed.

-How self-compassion can help motivate students, soften and reduce perfectionism, and help them be effective leaders.

-The importance of compassionate care in nursing, and how one’s ability to be self-compassionate affects compassion toward patients.

-Jasna’s take on how and why self-compassion should be integrated into both nursing curricula and also permeated throughout nurse educator leadership.

-A self-compassion exercise led by Nathan that will help listeners get a feel for what it’s like to experience this important method of emotional regulation.

If you’d like to find further self-compassion tools then visit the Nurse Wellbeing Mission youtube channel here: https://www.youtube.com/channel/UC80H5IU9un8mX_pLgf2VEWw

You can also join our free Facebook community where you’ll get access to other nurses interested in self-care and self-compassion, and receive great, free resources from us. Join us here: https://www.facebook.com/groups/nursewellbeingmission

To find out more about Jasna’s work then visit her academic profile here: https://www.torontomu.ca/nursing/about/people/faculty/jasna-schwind/

Or her website here: https://theartofexperience.ca/

PTSD can reduce the quality of life for a long time but it is a treatable condition. The earlier it is detected, the better it will be for the person being crippled by it. Furthermore, in a workplace that has a high risk of facing traumatic experiences, taking the steps to prevent PTSD should be a prime concern. 

In this episode, Dr. Jennifer Wild tackles the important aspects of Post-traumatic Stress Disorder or PTSD. She shares the work that she’s been doing around the prevention of PTSD and some recommendations to help prevent PTSD and what to do after nurses experience something traumatic and stressful in the workplace.

Listen and learn in this episode.

KEY TAKEAWAYS FROM THIS EPISODE

Post Traumatic Stress Disorder (PTSD) is a crippling stress reaction and it consists of several symptoms. The core symptoms that drive all of the other clusters are the re-experiencing symptoms.

Re-experiencing symptoms are the repetitive, unwanted, intrusive memories of the worst moments of somebody's trauma.

The Avoidant Cluster refers to people trying hard not to think about what happened and avoiding reminders and places that remind them of what happened.

Negative Alterations in Cognition and Mood Cluster refers to the changes in the way we think about ourselves and the world. 

Memory symptoms also have a direct impact on the body.

The natural response is a resilience response that can include some of the symptoms of PTSD. A small proportion of people go on to develop persistent PTSD.

The Risk Factors of PTSD:

1. Fixed Risk Factors: Being a woman and having a history of mental health problems 
2. Modifiable Risk Factor: Dwelling on the past 

Once you can recognize that you are dwelling, the best thing to do is to get out of your head and shift your attention from your thinking to the outside world. 

When the feeling of guilt lingers, one should shift the focus from what they didn't do to what they did do that was helpful.

Sleep is very important for emotional memory consolidation and in enabling us to access parts of our memories that can help dampen down the trauma response.

In the immediate aftermath of trauma, kindness goes a long way.

Social support is one of the predictors of recovery.

Early detection and intervention can play a very important role in improving the quality of life of people with PTSD. 

Today’s Guest:

Dr. Jennifer Wild is an Associate Professor at the University of Oxford and a Professor of Military Mental Health at the University of Melbourne. She has a program of research that focuses on preventing PTSD for high-risk occupations.

Nurse Wellbeing Mission run online and in-person workshops for nurses and midwives where we train people in four key skill sets of self-forgiveness. This helps to overcome mistakes, setbacks, and moral distress. Drop us an email to find out more: [email protected] 

Visit our website at: https://www.nursewellbeingmission.com

Join our free Facebook group here:

https://www.facebook.com/groups/nursewellbeingmission