Skills children need to succeed in life — and getting youngsters started

All parents want their children to be successful in life — and by successful, we mean not just having a good job and a good income, but also being happy. And all parents wonder how they can make that happen.

According to Harvard’s Center on the Developing Child, it’s less about grades and extracurricular activities, and more about a core set of skills that help children navigate life’s challenges as they grow. These skills all fall under what we call executive function skills that we use for self-regulation. Developing strong executive function skills, and finding ways to strengthen those skills, can help people feel successful and happy in life.

What are five important core skills?

  • Planning: being able to make and carry out concrete goals and plans
  • Focus: the ability to concentrate on what’s important at a given time
  • Self-control: controlling how we respond to not just our emotions but stressful situations
  • Awareness: not just noticing the people and situations around us, but also understanding how we fit in
  • Flexibility: the ability to adapt to changing situations.

While these are skills that children (and adults) can and do learn throughout their lifetimes, there are two time periods that are particularly important: early childhood (ages 3 to 5) and adolescence/early adulthood (ages 13 to 26). During these windows of opportunity, learning and using these skills can help set children up for success. In this post, we’ll talk about that first window of early childhood.

The best way to learn any skill is by practicing — and we are all more likely to want to practice something if it is fun and we feel motivated. Here are some ways that parents can help their children learn and strengthen executive function skills.

Planning

It’s natural for parents and caregivers to do the planning for young children, but there are absolutely ways to get them involved, such as:

  • Planning the day’s activities with them, whether it be a school day or a play day. Talk about all the day’s tasks, including meals, dressing, bathing, and other things; help them see it as part of a whole, and something that they can help manage.
  • Cook or bake something together. Put together the shopping list, go shopping, go over the recipe together, and help them understand all the steps.
  • When getting ready for a holiday or a party, include them in thinking about what everyone would like to do and how to do it.

Focus

The explosion of device use has definitely caused all sorts of problems with focus in both children and adults. There is an instant gratification to screens that makes it hard to put them aside and focus on less stimulating tasks. Now, more than ever, it’s important to:

  • Enforce screen-free time, even if they complain (parents need to abide by this too).
  • Have the materials on hand to make or build things. Find projects that will take an hour or two. Do it with them!
  • Read print books out loud together, including chapter books. Having to picture things themselves rather than seeing it on a screen helps children learn to focus.

Self-control

This is one where being mindful of your own reactions to situations is important. How do you react to anger and frustration? Is road rage a problem for you? Remember that children always pay more attention to what we do than what we say. To help your child learn self-control, you can:

  • Talk about feelings, and about strategies for managing strong emotions — like taking a deep breath, stepping away from the situation, screaming into a pillow, etc.
  • Help them understand how their behavior affects others, and why it’s important to be mindful of that (which also teaches awareness).
  • Debrief after tantrums or upsets. What could everyone have done differently?

Awareness

This one can be fun to teach.

  • Go for walks. Visit places together. Listen and watch. Imagine together what people might be doing or thinking.
  • Join community service activities; show children that anyone can make a difference.
  • Have rituals of checking in as a family, like at dinner. Give people a chance to talk about the best and worst parts of their day, and talk about ways you can work better as a family and treat each other well.

Flexibility

We tend to cater to our children and their needs, making our schedules and plans around them. Some of that is pure parenting survival. But ultimately, it’s not always helpful; life has a way of messing up even the most careful plans. Kids need structure, sure, but they also need to be able to adjust to the inevitable curve balls.

  • Don’t always say no to something that might happen during a naptime or mealtime. It’s okay if schedules occasionally vary.
  • Be spontaneous when you can. Go for an unplanned outing, and otherwise make last-minute plans sometimes.
  • When plans change or fall through, be upbeat about it and make the most of it. Be a role model.

In helping your children learn these skills, you might just learn something about yourself — and learn some new skills too.

Follow me on Twitter @drClaire

Sick And Tired: The Case For More Sleep

Less than a third of nurses get 7-9 hours of the recommended sleep time per night. Demanding schedules contribute challenges to achieving a good night’s sleep, but it’s important to recognize why we should make the case for more sleep. Read this blog to understand why.

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Too many Americans are short on sleep, and nurses are no exception. The National Sleep Foundation recommends adults aim for seven to nine hours of quality sleep each night. Yet according to the American Nurses Association’s 2016 Health Risk Appraisal, less than a third of nurses log in that much shuteye.
 
On days they work as well as days off, nurses average approximately 6.5 hours of sleep each night. That’s not just below the recommended quota, it’s also lower than the national average. 
 
Healthcare requires a 24/7 workforce, but that around-the-clock pace presents challenges to achieving a good night’s sleep:

  • Many nurses work evening, night, or rotating shifts, which can interfere with sleep schedules. Those who work the night shift report getting one to four hours less sleep on work days.
  • Sleep quantity isn’t the only concern. Nurses who work the night shift or rotating shifts often get poorer quality sleep than people who maintain a more conventional nightly sleep schedule.
  • More than half of nurses regularly work shifts longer than 10 hours, and 41% work more than 40 hours per week. Sleep is often one of the first things to get short shrift in a too-busy schedule.
  • Resting during working hours is nearly impossible for many nurses; 56% say they have to work through breaks just to complete their assigned workload.

Such a demanding schedule can take a toll on health and overall well-being. Chronic insufficient sleep has been linked to an alarming list of health problems, including:

  • Cancer
  • Obesity
  • Mood disorders
  • Type 2 diabetes
  • Metabolic syndrome
  • Injuries and accidents
  • Cardiovascular disease
  • Gastrointestinal problems
  • Musculoskeletal disorders
  • Adverse reproductive outcomes

Patient Care Suffers
Being tired isn’t just a problem for nurses’ health. It’s also a risk to their patients. One study found that 1 in 5 nurses struggle to stay awake while caring for a patient at least once a month. 
 
Even when they’re not fighting to keep their eyes open, exhaustion can affect the skills and cognitive abilities nurses rely on to do their jobs. Fatigue is associated with a laundry list of performance deficits:

  • Negative mood
  • Reduced vigilance
  • Reduced ability to learn
  • Impaired decision making
  • Poor communication skills
  • Poor information processing
  • Increased risk-taking behavior
  • Reduced innovation and insight
  • Impaired planning and execution
  • Reduced short-term and working memory

In fact, sleep is so critical to human functioning that the American Nurses Association has issued a position statement on the topic. That statement attests that registered nurses and their employers have an ethical responsibility to consider the need for adequate rest when deciding whether to offer or accept work assignments.

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 9877798c1740787d942be39bde6526cf-huge-anHave you joined the Healthy Nurse, Healthy Nation (HNHN) Grand Challenge yet? Join us today! 

Source List:
The American Nurses Association’s Health Risk Appraisal — Exploratory Data Analysis, November 30, 2016
ANA Position Statement: Addressing Nurse Fatigue to Promote Safety and Health:
Joint Responsibilities of Registered Nurses and Employers to Reduce Risks, 2014

Thinking about COVID booster shots? Here’s what to know

Vaccination against the virus that causes COVID-19 is the most important lifesaving tool we have in this pandemic. Fortunately, the vaccines authorized in the US have proven remarkably safe and effective. And we’ve known from the start that the strong protection they provide would likely wane over time.

But has protection declined enough to warrant booster shots? Studies published in the last few months by researchers in the UK, Israel, and the US (reviewed here and here) raised this possibility, and Israel and the UK have already started ambitious booster programs.

First things first: Vaccinate everyone

In the US, the CDC and FDA have reviewed the necessity, safety, and effectiveness of boosters for the Pfizer/BioNTech, Moderna, and Johnson & Johnson vaccines. I’ll discuss these recommendations in a moment.

But first, it’s important not to overlook this fact: vaccinating the unvaccinated should be a much bigger priority than giving booster shots to those who’ve received vaccines. That goes for people in the US who have been unable or unwilling to get the vaccine, and people in places throughout the world with limited access to vaccines.

Broadening the pool of people with initial vaccinations would not only save more lives than promoting boosters, but would also reduce COVID-related healthcare disparities between richer and poorer countries. That’s why the World Health Organization (WHO) called for a moratorium on booster doses. Meanwhile, the Biden administration has announced a promise to donate another half billion vaccines to countries with low vaccination rates, bringing the total US commitment to donate 1.1 billion doses. The administration emphasizes that starting a booster program in the US and helping other countries get their citizens vaccinated are not mutually exclusive.

Is there a difference between a booster dose and a third shot?

It’s not trick wording: not all extra vaccine doses are boosters. In August 2021, the FDA approved a third dose of the Pfizer or Moderna vaccine for people who are immunocompromised. This includes people who have HIV and those receiving treatment for cancer that suppresses the immune system. For them, the extra dose is not a booster; it’s considered part of their initial immunization series.

Getting the timing and dose right on vaccine boosters

Ideally, vaccine boosters are given no sooner than necessary, but well before widespread protective immunity declines. The risks of waiting too long are obvious: as immunity wanes, the rates of infection, serious illness, and death may begin to rise.

But there are downsides to providing boosters too early:

  • Side effects might be more common. While studies published to date suggest that boosters are safe, we don’t yet have long-term data.
  • The benefit may be small. It may be better to wait on boosters if most people are still well-protected by their initial vaccinations.
  • Current boosters may not cover future variants. If new variants of concern emerge in the coming months, boosters may be modified to cover them.
  • Waiting longer before a booster might lead to a stronger immune response. As noted by Dr. Anthony Fauci recently: “If you allow the immune response to mature over a period of a few months, you get much more of a bang out of the shot.”

The recommended dose for the Pfizer/BioNTech booster and Johnson & Johnson booster is the same as the initial dose. For the Moderna booster it’s a half-dose, which may reduce the risk of side effects and increase the number of doses available to others.

Recommendations for vaccine boosters

For the Pfizer/BioNTech and Moderna vaccines, a booster is recommended at least six months after the second dose for those who are

  • 65 or older
  • 18 to 64 and at high risk for severe illness from COVID, such as people with chronic lung disease, cancer, or diabetes
  • living or working in a high-exposure setting, such as residents of long-term care facilities, healthcare workers, teachers and day care staff, grocery workers, and prisoners.

No Pfizer/BioNTech and Moderna boosters are recommended for the general population yet. That’s because the initial doses still appear to be providing good protection against severe illness and death for those at lower risk of severe COVID-related illness.

For the Johnson & Johnson vaccine, a booster is recommended for everyone 18 or older two or more months after the first dose. 

Mixing or matching booster shots

The FDA and the CDC have concluded that mixing or matching vaccines when getting a booster dose is safe and effective. Regardless of the initial vaccine you received, any of the three available vaccines may be given as a booster.

Plenty of unknowns

The release of these new recommendations for vaccine boosters raises a number of questions:

  • How convincing is the safety data? Reports to date suggest boosters are safe, but we need more research and real-world data.
  • Will the boosters be modified to protect against emerging variants of concern?
  • Will additional boosters be needed in the future? If so, how often?

There are important gaps in our knowledge of how well vaccine boosters work. We need larger and longer-term studies involving a broad range of participants representing all races and ethnicities and people with compromised immune systems. Look for further information in coming months.

What’s next?

You can expect the FDA and CDC to expand booster recommendations based on continued review and analysis of ongoing research. In the meantime, we should redouble our efforts to vaccinate people who haven’t yet received vaccines. Boosters can play an important role in protecting individuals. But, as CDC director Dr. Rochelle Wallensky notes, “we will not boost our way out of this pandemic.”

Healthy Tactics To Overcome Emotional Eating

As nurses, too often we are dealing with multiple emotions in a given day. Things at work and at home can be stressful and those high-calorie treats from coworkers or patients are just so readily available, that we hardly notice overindulgence. Before you reach for that feel good confection, try these strategies from other nurses!
 

 
4c67d68abdd0c56366bac522e40b53fe-huge-foBy the time nurses sit down for a meal, we’re often physically hungry and emotionally depleted. This can lead to an overindulgence without even realizing it. We are human and sometimes we eat just to cope with stress, anxiety, frustration, or exhaustion instead of hunger. The fact that high-calorie treats from coworkers or patients are readily available doesn’t always help us make healthy choices. How can we be mindful of this reminder that food is fuel NOT therapy and better curb emotional eating? We asked nurses like you to tell us about how they deal with this. Test out their suggestions and let us know if they helped or if you have any other suggestions in our REMINDER: Food Is Fuel Not Therapy discussion.
 
Express yourself
Many nurses resort to overeating as a way of stuffing back their feelings. Try to let those feelings out in healthy ways. Consider keeping a notebook at your work-station where you can quickly write down what’s stressing you. Find a friend or coworker you can vent to. You may even try calling your own cell phone and leaving a voicemail about what’s bothering you. Saying the words out loud may give you the release you need.
 
Take a moment
Nurses frequently get very limited break time, if we take any at all. Instead of going directly to the break room to scarf down a sandwich, spend a few minutes someplace quiet. Having a moment to yourself can be a stress-reliever and will get you centered before diving into your meal or the next task. Stop by the hospital chapel or head outside to get an energy boost from the fresh air and enjoy a hit of nature.
 
Be prepared
You’re more likely to grab an unhealthy snack or eat treats if they’re readily available and you don’t have a healthy alternative. Bring your own healthy snacks and meals. “I stay away from places that will tempt me to overeat, like the cafeteria, and eat the lunch I packed from home,” says Missy Conover Walker, a nurse practitioner in Hunt Valley, Maryland who has lost over 100 lbs. 
 
Fight stress all day
Make combating stress a priority throughout the day, not just during meal-time. Use these simple strategies to relieve stress on the job to feel calmer and more in control during your shift.
 
Think before you eat
You may tell yourself that you’re truly ravenous and you need that treat in front of you to satisfy your hunger. Before you indulge, ask yourself if you would eat an apple or a plate of steamed broccoli at that moment. If the answer is no, you’re probably not genuinely hungry and are just turning to sweets because they’re convenient. Use The American Diabetes Association’s Hunger Rating Scale to determine if you’re really hunger or eating for other reasons.
 
Show support in non-food ways
“Nurses are their own enemy. We frequently bring the goodies in ourselves,” says PACU nurse Brenda Murdough. Next time you think about bringing in a dozen donuts for the staff as a reward, consider a non-food treat. Buy a bouquet of flowers or a plant for the nurses’ station, buy a healthy kitchen gadget like a blender for the break room so colleagues can make smoothies, or purchase a pretty picture to hang in a common area. Try to show appreciation for your team without unhealthy treats.
 
Think outside the (bakery) box
“It’s great that nurses are being recognized, but we don’t need to be rewarded with cupcakes or cookies. That reinforcement with food is constant. It perpetuates that feeling of I deserve this,” says Heidi Wellnitz-Rye, an RN and certified group fitness instructor. “That instant sugar just gives you a quick hit and makes you feel tired later.” Think about what you do deserve and what would be truly fulfilling for you. Work towards achieving those goals – enough sleep, quality time with loved ones, fulfilling work or time to exercise.
 
Get to the root of the issue
Keep track of the times you turn to food to deal with stress or frustration. You may notice a pattern. If you realize sharing bad news with patients’ families leads you to console yourself with chips from the vending machine or confrontations with coworkers send you trolling for treats, you can recognize that behavior and find healthier outlets for those feelings. “Overcoming emotional eating is about more than going on a meal plan or being consistent with the gym. It’s a holistic process of figuring out the reason for your behavior and coming up with other ways to cope,” says Conover Walker.
 
Forgive yourself
If you’ve experienced a slip up, accept it and move on. Just because you may have mindlessly shoved a cookie into your mouth, doesn’t mean you need to eat the rest of the box. Think of it this way: If you got into a fender bender, you’re not going to crash the whole car afterwards. You repair the damage and continue moving forward.

Have you found other healthy ways to overcome emotional eating?  Join in on our discussion REMINDER: Food Is Fuel Not Therapy. Tell us if these tactics are helpful and share your tips, tricks, and real-life inspiration about living a healthier life. Show us examples of your healthy eating on our Facebook, Twitter, Instagram. Tag a nurse and us #HealthyNurse.

Source list:
Centers for Disease Control. Eating Habits.
American Diabetes Association. Emotions and Eating.
American Diabetes Association. Get In Touch with Your Appetite. The Hunger Rating Scale.

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Have you joined the Healthy Nurse, Healthy Nation (HNHN) Grand Challenge yet? Join us today! 
 

Cancer survivors’ sleep is affected long after treatment

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Once the stress of a cancer diagnosis and its intensive treatments have passed, the hope is that life can return to normal. But we know that this is not true for many people who have had treatments for cancer, and sleep is often impacted for a long time after treatment.

Researchers at the American Cancer Society studied responses from 1,903 cancer survivors from across the US. These survivors were diagnosed with cancers such as breast cancer or prostate cancer about nine years before the study. As part of the research, these cancer survivors were asked questions about their sleep and cancer history, and their overall physical, mental, and social health. Even though these men and women had been diagnosed with cancer almost a decade ago, a staggering 51% reported that their sleep had been disturbed over the prior month!

Why do sleep problems continue after cancer?

Findings suggest that the residual effects of cancer may continue to negatively affect a survivor’s sleep. Not surprisingly, poor sleepers were more likely to report that they had more physical and emotional distress. Perhaps more unexpected were results that showed survivors who were sleeping poorly were also more likely to be having some economic hardship, and expressed worries about money and a fear of cancer recurrence.

These are common burdens for cancer survivors. Financially, cancer survivors not only have to shoulder the medical costs associated with their initial treatments, but also ongoing bills from managing the lasting effects of those treatments. Additionally, survivors may have had to change their work situation, or leave their job entirely, in order to manage their health.

Other research has shown that fear of cancer recurrence is common among survivors. Despite having completed their treatments many years prior, people struggle with chronic distress regarding their health and well-being, often at levels equal to that experienced when they were initially diagnosed with cancer.

What can cancer survivors do to improve their sleep?

It is critical that cancer survivors raise the issue with their medical team. There are a number of different sleep disorders that require thorough evaluation and accurate diagnosis. For example, insomnia disorder and obstructive sleep apnea are common among middle-aged and older men and women. If sleep disorders are left untreated, they can lead to a host of negative health outcomes, including cognitive dysfunction, mood disorders, cardiovascular disease, and more.

Medication is a common treatment to help sleep, but it’s not always the best choice, as there are concerns about medication tolerance (needing a larger dose to get the same effect), dependence, and daytime side effects. In the study previously mentioned, 28% of respondents reported using a sleep medication within the past month. While there is certainly a time and a place for medications designed to help with sleep, long-term use is not advised for cancer survivors, especially if the problem is insomnia disorder.

Rather, cognitive behavioral therapy for insomnia (or CBT-I) is recommended as first-line treatment by both the American Academy of Sleep Medicine and the American College of Physicians. Instead of masking the symptom (poor sleep), CBT-I targets the problematic sleep behaviors and thoughts that continue to cause a person to sleep poorly. For example, a patient receiving radiation therapy may be fatigued during the day and take extended naps. During active treatment, this can be helpful. But they may develop a habit of continuing to take naps, which can affect their ability to fall asleep at night. As part of CBT-I, cancer survivors can expect to track their sleep, develop a sleep period that is better aligned with how much sleep they need, learn to avoid problematic sleep behaviors in the bedroom, and change the thoughts that can make it more difficult to fall asleep or stay asleep.

What are the key takeaway messages?

Sleep difficulties are common among cancer survivors, even if they were successfully treated for their cancer years ago. Sleep disorders should be evaluated by a medical provider trained in sleep medicine. There are a number of excellent treatment options that can improve sleep for cancer survivors, such as CBT-I. With increasing virtual access to medical care, telemedicine and online interventions are exciting possibilities for cancer survivors struggling with their sleep.

Finding balance: 3 simple exercises to steady your steps

A healthy life requires balance — and not just in a metaphorical sense. Being able to maintain physical balance is crucial to performing everyday activities from going up and down the stairs to reaching for an item on a shelf at the supermarket. But while many people squeeze in a daily walk and may even do some strength training exercises a few times a week, exercises to build balance don’t always make the workout list. They should, according to experts.

As you get older, the physical systems inside your body that help you maintain your balance aren’t as responsive as they were when you were younger. Maintaining balance is actually a complex task for your body, requiring coordinated action from not only your muscles, but also your eyes, ears, tendons, bones, and brain.

In addition, health problems that become more common with age, such as inner ear disorders, decreased sensation in feet, or postural hypotension (low blood pressure with standing) may leave you feeling unsteady.

Practicing exercises designed to improve your balance can help keep you upright and prevent a fall that causes injuries.

Building balance three ways

You may wonder, what exactly is a balance exercise?

Standing on one foot? Yes, that qualifies. It falls into a category called static balance exercises. These improve your balance when you’re standing still. But a good balance workout should also include dynamic exercises, which are aimed at building balance when you are moving. Ideally, you should try to incorporate a few of these exercises two or three times a week.

Below are three simple exercises that you can get use to get started. The first is a static balance exercise and the other two are dynamic balance exercises. For additional ideas, read this blog post on the BEEP program.

Tandem standing

Reps: 1
Sets: 1 to 3
Intensity: Light to moderate
Hold: 5 to 30 seconds

Starting position: Stand up straight, feet hip-width apart and weight distributed evenly on both feet. Put your arms at your sides and brace your abdominal muscles.

Movement: Place your left foot directly in front of your right foot, heel to toe, and squeeze your inner thighs together. Lift your arms out to your sides at shoulder level to help you balance. Hold. Return to the starting position, then repeat with your right foot in front. This completes one rep.

Tips and techniques:

  • Pick a spot straight ahead of you to focus on.
  • Tighten your abdominal muscles, buttocks, and inner thighs to assist with balance.
  • Keep your shoulders down and back.

Make it easier: Hold on to the back of a chair or counter with one hand.

Make it harder: Hold the position for 60 seconds; close your eyes.

Braiding



Reps: 10 to each side
Sets: 1 to 3
Intensity: Light to moderate
Tempo: Slow and controlled

Starting position: Stand up straight, feet together and weight evenly distributed on both feet. Put your arms at your sides.

Movement: Step toward the right with your right foot. Cross in front with your left foot, step out again with the right foot, and cross behind with your left foot. Continue this braiding for 10 steps to the right, then bring your feet together. Hold until steady. Now do 10 steps of braiding to the left side of the room. This completes one set.

Tips and techniques:

  • Maintain neutral posture throughout.
  • Look ahead of you instead of down at your feet.
  • Don’t turn your feet out.

Make it easier: Take smaller steps.

Make it harder: Pick up your pace while staying in control of the movement.

Rock step

Reps: 10 on each side
Sets: 1 to 3
Intensity: Moderate to high
Tempo: 2–2–2–2

Starting position: Stand up straight, feet together and weight evenly distributed on both feet. Lift your arms out to each side.

Movement: Step forward with your left foot and lift up your right knee. Hold. Step back with your right foot and lift up your left knee. This completes one rep. Finish all reps with the left foot leading, then repeat by leading with the right foot. This completes one set.

Tips and techniques:

  • Tighten the buttock of the standing leg for stability.
  • Maintain good posture throughout.
  • Breathe comfortably.

Make it easier: Hold on to the back of a chair with one hand for support; lift your knee less.

Make it harder: Hold each knee up for a count of four.


Exercise photos by Michael Carroll

What to do when elective surgery is postponed

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Each time a wave of COVID-19 engulfs a community, overwhelmed hospitals wind up postponing elective surgeries. The schedule changes are needed to make room for COVID patients, allow all hands on deck for crisis care, and shield people in the community from unnecessary COVID exposure. This scenario may grow worse if the flu season isn’t mild this year –– a good reason to get that flu shot!

Postponement of an elective surgery is upsetting, and automatically presents you with two dilemmas:

  • You’ll have to cope with your ailment while you wait for the all-clear.
  • You’ll have to be prepared for your surgery when you get the call that’s it’s back on.

Read on for steps you can take to cope with both situations.

First, what’s considered elective surgery?

All surgical procedures involve cutting skin and tissue using a variety of tools and techniques. But unlike heart surgery done in response to blocked arteries, elective surgery is not an emergency. It’s a procedure that can be safely scheduled in advance. That’s not to say it isn’t important.

An elective surgery could be

  • major, such as a hip or knee replacement, or surgery to repair a prolapsed (fallen) uterus
  • minor, such as surgery to relieve carpal tunnel syndrome (an entrapped nerve in the wrist), or surgery to remove a cataract (cloudy lens) in the eye.

The determination of whether surgery is elective isn’t always clear-cut. Sometimes it depends on your health circumstances. For example, surgery to replace a heart valve might or might not be an emergency, depending on the person’s condition.

Coping while you wait for elective surgery

Waiting for your surgery has potential consequences. Maybe you won’t be able to work, or maybe your condition, pain, or anxiety about the situation — or all three — will get worse.

While you’re in limbo, here are four steps you can take:

  • Keep lines of communication open with your health care providers. That could mean having important phone numbers for your physician on hand, or logging onto your patient portal and emailing your doctor or nurse. Ask your doctor how often you should check in. 
  • Report changes in symptoms. When you scheduled your surgery, your condition wasn’t life-threatening. But things can change. Don’t wait until you experience an emergency; report symptom changes as soon as you notice them.
  • Get prescriptions refilled. You don’t want to be without medications when you need them, especially if you’ll need your doctor to sign off on refills.
  • Arrange for additional help. Perhaps a friend or family member can assist you with grocery shopping, meal preparation, housekeeping, or getting through daily activities. If you can afford it, consider hiring someone to assist you temporarily. Prices average about $25 per hour in the US, with a minimum of several hours per week.

When surgery is back on schedule

Eventually, you’ll get the call that your surgery is a go. That doesn’t mean it will occur soon. Most likely there will be a backlog of postponed surgeries, which may add more time to your wait. Prepare for the possibility that you’ll need to extend the arrangements that have been getting you through your waiting period.

It’s equally wise to prepare for the chance that your surgery will happen with little notice. Alert friends, family members, or your private-duty care agency about this possibility, so they can arrange to jump in to help when you need them.

And make sure you have the answers to these questions ready well in advance:

  • How will you get to and from surgery? (Will you count on a friend, a ride service, or a hired health aide?) 
  • How will you obtain medications prescribed after surgery?
  • Which equipment (if any) will you need after your surgery? For example, if you’re going to have a joint replacement, you’ll need a walker and shower chair afterward. See if you can arrange to get it now, so you’ll have it ready.

It may not be easy dealing with your condition until your surgery takes place, but at least you’ll have both a plan A and a plan B. That preparation may give you a little peace of mind and a feeling of some control over your situation.

What happened to trusting medical experts?

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In all aspects of our lives, we rely on experts, from home repairs to weather forecasting to food safety, and just about everything else that’s part of modern society. There’s just no way to know everything about everything. Yet when it comes to medicine, people seem to be taking their health in their hands in ways they’d never consider if, say, their car brakes needed repairs and they weren’t auto mechanics.

What if your brakes were shot?

Suppose a well-recommended car mechanic tells you your brakes need repair. Hopefully, they explain why this is necessary and review the pros and cons of your options, including no repairs. You certainly could get additional opinions and estimates. But to make a decision, you’d have to accept that a mechanic has specialized knowledge and that their advice is sound. Quite likely, you’d get the brakes fixed rather than risk injury.

Would you berate the mechanic personally because they told you something you didn’t want to hear about your beloved car? Let's hope not. And unless you knew a lot about cars, you probably wouldn’t tinker with the brakes yourself, or take the advice of a neighbor to spray the tires with vegetable oil because a friend of his cousin said it worked for his car. And you wouldn’t take your car to a veterinarian — it just wouldn’t make sense, right?

Yet hundreds of thousands of people in the US are rejecting advice on getting a COVID vaccine from well-respected health authorities like the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration (FDA). Healthcare providers have somehow become the target of taunts, hostility, and even death threats for encouraging people to protect themselves and others.

Fear of the proven and an embrace of the unproven

What’s driving this? It seems to be some combination of distrust ("these so-called experts don’t know what they’re talking about"; "they rushed the vaccines just to help the drug companies") and unfounded suspicion ("they’re trying to control us, experiment on us, inject microchips in us"). Some people see recommendations regarding COVID-19 as attacks on American values ("mask and vaccine mandates infringe on my personal freedom").

At the same time, many who dismiss the advice of true experts are embracing unproven and potentially dangerous remedies, such as ivermectin pills and betadine gargles.

How did we get here?

Some reasons we’ve seen erosion in trust placed in public health experts are

  • Politics. COVID-19 quickly became a political issue in the US. For example, trust in the CDC varies markedly by political affiliation, with Democrats giving much higher marks to the CDC, FDA, and NIH than Republicans.
  • Social media. Misinformation spread through social media is rampant, and much of it has been linked to a small number of people.
  • "Pseudo-experts." Even impressive credentials don’t automatically qualify everyone to be experts in a pandemic disease. Recent examples include radiologists, cardiologists, and chiropractors who have made headlines with their controversial views.
  • Personal gain. Some have profited financially, politically, or otherwise by deliberately spreading health disinformation and denouncing expert advice.

Confusing changes in message

Public health messaging about protecting ourselves from COVID-19 also affects trust. For example, recommendations around wearing masks were inconsistent early on, and have continued to change since then.

While some confusing, seemingly contradictory messages were true missteps, most are simply changes in recommendations based on a change in circumstances, such as spiking virus cases or a more easily spread variant causing severe illness, hospitalizations, and deaths.

Particularly in the early months, no one had all the answers. But as we have accumulated information from research and real-world experience, changes in recommendations should not only be expected but embraced. It’s usually a reflection of the close attention experts are paying to changing circumstances.

Doing your own research?

A wait-and-see policy can be risky — and not just when it comes to fixing your car brakes. The virus that causes COVID-19 was only discovered 18 months ago, and vaccines have been in use for less than a year. Yet already we have an enormous amount of data from research and real-world experience from many millions of people.

So, when someone says they want to "wait and see" or "do their own research" rather than accept the advice of their own doctors or public health experts, what exactly does that mean? Are they waiting to see if something bad will happen to those who were vaccinated? How long is long enough?

Unless you’re a cutting-edge virologist, immunologist, epidemiologist, or public health expert, doing your own research isn’t likely to provide more reliable data than studies published in peer-reviewed medical journals that guide the CDC and FDA. Of course, most people "doing their own research" are relying on others who are also not doing actual research, yet they discount the findings and recommendations of true experts.

It’s important to ask questions. But pose them to your doctor. Rely less on people who tell you what you want to hear, and more on those who trained in science and whose careers have been devoted to improving health.

Can blue light-blocking glasses improve your sleep?

Recently, my brother mentioned he was sleeping better since he got new prescription glasses with a blue-light filter. He wears his glasses mostly for reading screens (both computer and smartphone) during the day while at work. So I was intrigued, but a little skeptical: could daytime use of blue light-filtering glasses make a difference in how well he slept? How, when, and why blue light affects us seemed like good questions to pose to an expert before deciding whether those glasses could help me, too.

What is blue light?

Visible light includes a short segment of wavelengths tucked into the electromagnetic radiation spectrum. Together, the wavelengths of visible light captured by our eyes are translated into white light by our brains.

You may remember looking through a prism to bend the wavelengths that make up white light into a rainbow of colors. At one end of this rainbow, blue light shades toward violet. Sunlight has a lot of light at all visible wavelengths.

Measured in nanometers (nm), visible light wavelengths range from 400 to 700 nm. Blue-light wavelengths lie between about 450 and 495 nm. And different slices of blue-light wavelengths have different effects on our bodies, including on sleep and alertness.

How does light affect our bodies?

In addition to helping us see, light also has nonvisual effects on the body, says Dr. Steven Lockley, a neuroscientist at the Division of Sleep and Circadian Disorders at Harvard-affiliated Brigham and Women’s Hospital.

The 24-hour circadian clock in the brain regulates sleep and wake cycles, hormonal activity, eating and digesting, and other important processes within the body. “Special photoreceptors in the eye detect light to control our circadian rhythms,” he says. These cells contain a nonvisual photopigment called melanopsin, which is most sensitive to 480 nm light at the blue-green end of the visible light spectrum. Other visual photoreceptors called cones allow us to see even shorter wavelengths of blue-violet light at around 450 nm.

How can blue light affect sleep?

During the day blue-enriched light is desirable, because it helps synchronize our circadian clocks to a 24-hour day. So, exposure to a regular light-and-dark cycle is vital to achieve and maintain good sleep.

Stimulation from certain wavelengths of blue light helps us stay alert, whether this comes from a natural source like the sun in daytime hours, or from electronic devices that emit blue light. While the stimulation is helpful during the day, at night it can interfere with sleep. Blue-light exposure in the evening — for example, binging a TV series on your laptop right before bed — will stimulate the melanopsin-containing cells and alert the brain, making it think it is daytime. That can make it harder to fall asleep and may affect the quality of your sleep.

Blue-light filtering: Can it help a tired body and tired eyes?

Although a recent systematic review suggested that blue light-blocking glasses may help people with insomnia, Dr. Lockley says there’s not enough detail about the studies to draw that conclusion. Most commercially available blue light-filtering glasses, and special coatings added to prescription lenses, aren’t standardized. So you have no way of knowing which wavelengths are being blocked, and whether this affects only visual function, or important nonvisual functions such as alertness and the circadian clock. Also, the timing, duration, and nature of the nighttime light exposure in the summary of these studies was not clear.

If you want to block stimulating blue light that could interfere with sleep, avoid screen use as much as possible after dusk — especially within two to three hours of bedtime. You can also try using computer software that reduces the amount of blue light emitted. Examples include Night Shift (available on Apple devices) or f.lux, a free download available for all computers and related devices. You should also try to address other issues that affect your sleep.

To help reduce eye strain, a common concern for people who use screens often, the American Academy of Ophthalmology advises taking regular breaks using the 20-20-20 rule. Every 20 minutes, look away from your screen at an object about 20 feet away for about 20 seconds.

You should also get as much daylight exposure as possible in between screen use to provide a strong circadian and alerting stimulus, particularly if you spend most of your time indoors.

As for my brother, he doesn’t watch much television and tends to prefer reading print books in the evenings. He agreed that he might be experiencing a placebo effect from the blue-light filter on his new glasses — or simply that he is sleeping better now that he has the correct prescription, and therefore less eye strain.

How Employers Can Help Keep Nurses Healthy

When employers provide the right tools, employees can create and foster healthy habits both at work and at home. Whether an on-site fitness center, weight loss plan reimbursement, or free cancer screenings, wellness perks all contribute to the health and longevity of staff members. Take a peek at what hospitals and other employers nationwide are doing to enhance the health of their nurses. 
 

Vegetable gardens
Many hospitals are converting rooftops or unused outdoor space into vegetable or herb gardens for their staff. “Our rooftop vegetable garden has tables, chairs, and umbrellas so we frequently go there for lunch, breaks, or for meetings,” says Deirdre O’Flaherty, MSN, APRN, BC, NE, ONC, and Senior Administrative Director at Lenox Hill Hospital in New York City.
 
At Lenox Hill Hospital, a premier partner of the Healthy Nurse, Healthy Nation™ (HNHN) Grand Challenge, the garden provides opportunities for education and renewal for the staff, such as:

  • “Snipping parties” where everyone brings a zip-close bag and scissors and can take some of the fresh bounty.
  • Cooking classes in which participants learn how to use garden-fresh herbs and vegetables.
  • Special treats for the hospital staff. For example, O’Flaherty says it’s not uncommon for them to make mint tea or mint water and hand it out, when they’re trying to use up excess of the herb.

Off-site meetings
Many nursing leaders have begun to take their teams outside of the hospital for meetings or special occasions. At Lenox Hill, nurses often have potluck celebrations or picnics in nearby Central Park. The trips serve as team-building opportunities and a chance for fresh air.
 
Organizations that don’t have an accessible green space can put up tents in the parking lot and have picnics there. O’Flaherty sometimes takes her staff to a frozen yogurt shop across the street to enjoy the low-calorie treat. Even something that simple can boost mood and morale.
 
Leadership programs
Many organizations are providing leadership seminars to nurse-leaders so they’re better equipped to recognize when staff members are suffering from stress, burnout, or just need a day off. Seminars like these help nursing directors encourage and empower their employees and build safe and healthy teams.
 
Renewal rooms
Many hospitals now provide renewal rooms for nurses. These quiet spaces include myriad forms of self-care such as aromatherapy, music therapy, massage chairs, and journal writing.
 
The rooms proved so successful that the administration at the Cancer Treatment Centers of America® (CTCA) at Midwestern Regional Medical Center (Midwestern) supported the creation of six additional renewal rooms in various locations throughout the hospital. Read our blog The Case for Taking a Break to understand the importance of why rest is so important.
 
Hydration and healthy snack stations
Since nurses frequently cannot carry water bottles around the hospital due to infection control concerns, organizations have started creating “hydration stations.” The lobby at Lenox Hill, is outfitted with water coolers that have fresh fruit and vegetables in them. Also at Lenox Hill, “hydration carts” visit nurses on the floor, giving them an opportunity to pick up a healthy snack or fruit-infused water.
 
Virtual health challenges
Hospitals and organizations have also been encouraging staff members to join virtual challenges, like Healthy Nurse, Healthy Nation’s Make Time for Yourself Challenge or Safety Challenge, that are focused on health and wellness. In these challenges, a new tip is emailed out to participants each day. O’Flaherty and her staff participated in a “Walk Across America” challenge from Northwell Health (the organization that owns Lenox Hill Hospital). Participants even have the opportunity to win prizes for completing the tasks.
 
Wellness programs
Even when employers don’t have special events or sessions for their staff, they still often provide reimbursement or discounts for programs such as:

  • Smoking cessation
  • Weight loss
  • Nutrition counseling
  • Gym membership
  • Group fitness classes

In fact, ANA Massachusetts has been inspired by the Healthy Nurse, Healthy Nation™ (HNHN) Grand Challenge and created the Healthy Nurse, Healthy Massachusetts initiative for their members. Hundreds of Massachusetts nurses have taken advantage of program perks including discounts on heath, wellness, and nutrition programs. “The initiative is about helping nurses to take care of themselves so that they can better take care of their patients,” says Diane Jeffery, Executive Director for ANA Massachusetts.
 
Keeping the night shift in mind
Unfortunately, hospitals and organizations that provide seminars and special events to staff often don’t include night staff.  At Lenox Hill, the administration makes an effort to include activities in the evenings so that night shift nurses can take part as well. The hospital recently held a spa night for the nighttime nurses including aromatherapy and massage sessions.
 
Recognition
Special events and self-care sessions may help nurses put themselves back on the priority list. Perhaps even more important, they serve as evidence that their leaders want them to succeed. O’Flaherty says, “These activities help our staff recognize how much we care about them. Just letting your team know how important they are can make a huge difference.”
 
Talk to your employer about adding these programs at your workplace
If your employer doesn’t offer special services to employees just yet, don’t despair. Try these strategies:

  • Come up with one or two ideas and talk to your supervisor about them. Volunteer to help set up an event for them. Your team leader is likely focused on day-to-day tasks, so they may not be thinking about how programs like these can help in the long-term.
  • Look at the resources that are already available to you. Reach out to other departments within your organization to see what they can offer. A member of the nutrition department may be happy to conduct a seminar or perform a cooking demo for your team. The physical therapy department may be able to give a talk about fitness. Even a local yoga studio, YMCA, or massage therapist may be willing to offer discounts or freebies to nurses, too.
  • Let your employer know about the Healthy Nurse, Healthy Nation™ (HNHN) Grand Challenge focused on improving the health of the nation, starting with nurses. The HNHN Grand Challenge includes a variety of blog posts on topics that affect the health of nurses, wellness challenges, inspiring stories from real nurses, and more.

c987219becfc64baa8a999f8eee281c1-huge-an Have you joined the Healthy Nurse, Healthy Nation (HNHN) Grand Challenge yet? Join us today!