Energy Crisis
Faced daily with the demands of an emotionally and physically draining job, nurses need to take time out to recharge the batteries

By Linda Childers
March 18, 2004

It was a typical frenzied night on the med/surg unit and Kathy Sommese, RN, was frantically attempting to care for 10 critically ill patients. At the end of her shift, she felt emotionally drained, knowing that once again she would barely have enough energy to drive home and crawl into bed.

In Los Gatos, Calif., Lisa Kelly, RN, also was fatigued after completing her shift at Community Hospital of Los Gatos. An operating room charge nurse, Kelly routinely juggles patient care duties with myriad management responsibilities.

Sommese and Kelly are among the many nurses who have experienced a personal energy crisis. Dealing with death and illness daily, in jobs that are both physically and emotionally demanding, can leave nurses feeling as if they are running on empty.

While many will resolve to better care for their bodies in the coming year, few will take steps to address their emotional well-being, assuming that stress and fatigue are a non-negotiable part of their jobs.

“Emotional fatigue is a part of our frenetic modern-day lives, but there are proven strategies nurses can use to regain their energy levels,” said Mira Kirschenbaum, a Boston-based psychotherapist and author of The Emotional Energy Factor.

Kirschenbaum said that it’s a misconception that the energy we require is primarily physical rather than emotional. Her studies of endocrinologists, nutritionists and sports medicine staff show that 70 percent of our total energy is emotional—the kind that manifests itself as hope, resilience, enthusiasm and fun.

“In order to refuel, nurses need to incorporate pleasure, freedom and self-care into their lives,” Kirschenbaum said. “Every nurse needs to ask, ‘How am I giving myself pleasure?’ ‘What am I doing as an act of freedom?’ ‘What are the ways in which I’m genuinely taking care of myself?’ ”

In her book, Kirschenbaum illustrates the secrets that high-energy people use to beat emotional fatigue. She said that people who are least likely to suffer from emotional meltdowns are those who make it a priority to protect and replenish their emotional energy.

“Nurses need to learn to recognize the factors that drain their energy such as overcommitting, holding on to losses or trying to live up to others’ expectations,” Kirschenbaum said. “Once they have identified these triggers, they can take steps to avoid or minimize them.”

Kirschenbaum’s book includes a list of “Eight Energy Drains and How You Can Fix Them.” She encourages nurses to address their drains, and then identify areas that give them energy, such as prayer, fun and pleasure, and determine how to incorporate these pleasures into their daily lives.

“When a crash victim is brought into the emergency room, staff immediately start an IV,” Kirshenbaum said. “When nurses find their energy crashing, they need to treat themselves to something that is beautiful or uplifting such as flowers or a soothing CD of music. This can serve as an emotional IV for those days you feel completely drained.”

Emotional toll

Sommese realized the emotional toll her job was taking. She felt she was being pulled in too many directions to provide the level of care that each of her patients deserved, and she hated the way her job often made her feel physically.

“At the time I was working in acute care, I was also going through a painful divorce,” Sommese said. “I knew something had to give and I considered leaving the nursing field.”

Sommese began investigating other job opportunities and soon found a job with Rossmoor Home Health in Walnut Creek, Calif., that offered her flexibility and a more manageable patient load.

Her new job gave Sommese more time with her two young sons, the chance to resume regular gym workouts and to rediscover her spiritual side.

She also has found a tremendous resource in her nursing colleagues who are committed to maintaining candid conversations at their weekly staff meetings and planning regular outings to talk and relax outside of work.

Kelly is also aware that she internalizes her work-related stress, but hopes that the recent changes she has incorporated into her life will help restore her emotional energy.

A devout Christian, Kelly finds solace in the power of prayer. She uses her 30-minute commute as a way to unwind and reflect on the day. At home, she finds pleasure in playing with her 4-year-old and in taking walks with her family.

“I work with a very close-knit group of nurses in a small community hospital and we strive to support each other in our jobs,” Kelly said. “I think it helps to talk about your stresses with colleagues who face the same challenges and can offer valuable insight.”

Jane Neubauer, MS, RN, is a firm believer in nurses providing support to their peers. Six years ago, she founded The Creative Leadership Retreat in Vashon Island, Wash., to help colleagues revive their emotional energy in a supportive environment.

“Nurses see so much pain, suffering and stress on a daily basis, yet they typically don’t receive enough support from their employer or supervisors to help them deal with their experiences,” Neubauer said. “Nurses can learn more about themselves and avoid stress if they make the time to work through their emotions.”

In her retreats, Neubauer shows nurses and other health professionals how to effectively deal with their emotions, and encourages them to use creativity such as art and music to express their feelings.

The retreats usually begin with yoga, stretching and breathing exercises and then move on to writing and art with an emphasis on listening to each other’s stories.

“Until nurses effectively address their feelings and emotions, they continue to carry the pain and stress inside, which can lead to migraines, stomach and joint problems, anxiety and other stress-related conditions,”
Neubauer said.

Her workshops have been well-received among members of the health care community. Group Health Cooperative and the Veterans Administration in Seattle have both held retreats for staff members and are incorporating team building and reflective practice time into their work environments.

Neubauer uses a structured reflective practice process to train managers in how they can better support their nurses and what changes can be made in their workplace to increase job satisfaction among staff.

“I’ve seen many nurses who are emotionally worn out and think their only solution is to pursue a new career,” Neubauer said. “In fact, what they really need is a new way to work with their life experiences.”

Solace in sharing

Terri Lindeman, MS, PNP, RN, has spent a large portion of her career caring for children who are gravely ill.

“It is always a horrible experience when you lose a pediatric patient,” said Lindeman, a mother of two who lives in Hercules, Calif.

While working at Children’s Hospital Boston, Lindeman learned to channel her grief through hospital-sponsored “grief rounds.” A week after the death of a pediatric patient, family members and the hospital care team were invited to gather to share memories of the patient and talk about their feelings. A bereavement counselor facilitated their meetings.

“These meetings provided staff with an opportunity to address their emotions and to grieve,” Lindeman said. “We found solace in sharing with each other and realizing we weren’t alone in our feelings.”

After moving to California, Lindeman took a job in the outpatient oncology department at Lucile Packard Children’s Hospital in Palo Alto, Calif., and found another support system among her nursing colleagues.

“Dealing with critically ill children day after day can be emotionally challenging,” Lindeman said. “Some days, there aren’t any happy endings.”

Realizing they needed a time to recharge, nurses from the oncology department made a pact to get together several times a year outside of work. Plans included going to dinner, meeting at a colleague’s home or indulging at a spa.

“These regular outings provided us with a chance to be together outside of the workplace,” Lindeman said. “And even more importantly, to reconnect with the reasons we decided to originally become nurses.”

Contact Linda Childers at eastbaypr@aol.com.