Today is National Nurses Day, so Bernadette Melnyk, PhD, the chief wellness officer and dean of the College of Nursing at Ohio State University, joined Contemporary Clinic to discuss the results of a recent study she was the lead author on which shone some light on the extent to which alarmingly high levels of stress, depressive symptoms, and anxiety have been affecting critical care nurses nationwide, even before the COVID-19 pandemic began.

So, Dr. Melnyk, what were some of the findings from the study you recently published, and why might critical care nurses be experiencing such high levels of stress, depressive symptoms, and anxiety?

 Our study findings showed very high rates of depressive symptoms affecting 40% of the sample, and this was a random sample of critical care nurses throughout the United States. So, we can generalize those findings to all critical care nurses in the American Association of Critical Care Nurses.

We also found a little over 50% of these nurses met the cutoff for clinical anxiety on the valid and reliable screen that we used. But very importantly, we found that the poorer the physical and mental health of these nurses, the more medical errors they made over the last 5 years, and that's very sad.

I don't want that to put a poor light on critical care nurses because they're fabulous, but it gets back to the issue of: If we don't support our clinicians’ health and well-being, it is going to affect health care quality and safety. 

Absolutely, yeah. How are these mental health concerns affecting nurses ability to also provide patient care, as well as other medical services?

 Well, I think any time any person experiences stress, depression, or anxiety to the point that it's going to interfere with concentration, judgment, or functioning, it will affect the quality and safety of care.

These are wonderful, caring, well-meaning nurses, but the level of burnout, depression, even suicide, in nurses is higher than the general population. So, health care systems really need to invest in fixing system problems that we know are the root cause of burnout, depression, and anxiety, as well as offer great screening programs and wellness evidence-based programs to protect oneself against these mental health issues.

It's just so critical. We know what works, we just got to translate it much quicker into the real world.

Right, right. How have these mental health concerns specifically impacted critical care nurses during the COVID-19 pandemic?

 They definitely have skyrocketed even further. Think about being a critical care nurse taking care of very, very sick people whose family members could not come in and be with them.

So those nurses had to be the primary support for dying people. That adds to the already stressed-out situation that they're functioning in. I think we're going to see an aftermath of skyrocketing rates of post-traumatic stress disorder and chronic grief reactions as we pull out of this.

Yeah. What are some ways nurses can approach an awareness of their experience of these mental health concerns?

 I think for one we've got to just become self-aware and honest with ourselves, and if any clinician is experiencing burnout, depression, or anxiety to the point where it's interfering with their concentration or functioning, they've got to get help.

It is not selfish to take good self-care. It's truly necessary to be able to take great care of others.

Yeah, and what has been the impact of programs like the Stress, Trauma and Resilience (STAR) Program or the Buckeye Paws program for critical care nurses?

 At Ohio State, we have such a fabulous menu of options to help all of our clinicians, faculty, staff, and students. Buckeye Paws is our pet therapy program, and honestly you should see the faces and the stress melt off of clinicians when those trained dogs step up on the unit.

We also have this other STAR programming for both patients as well as our own clinicians who are experiencing issues with stress and trauma. We offer evidence-based mindfulness programs and cognitive behavior skills building programs that we now work to decrease depression, anxiety, and stress.

Yeah, that is excellent, that is excellent. Why is it important for all medical health professionals or medical professionals to focus on continuing to care for themselves while caring for their patients?

 As clinicians, we cannot pour from empty cups. When we get on an airplane and the oxygen mass drop, we're told to put them on ourselves first before we can be effective in helping others.

Again, oftentimes clinicians want to help everybody else, but they often don't focus on their self-care. Self-care is not a nicety, it's a necessity. We have got to take a little bit of time—I call them micro-recovery breaks—during the day to focus on effective strategies that'll decrease our stress and improve our mood.

Yeah absolutely. What is the value of nurses in health care today?

 Nurses are at the bedside of patients 24/7. They are there to make observations, to pick up early complications, and to nurture the emotions and spirit of patients who are often seriously ill. They are such a valuable piece of our workforce.

Absolutely, absolutely. Is there anything you would like nurses to know on this National Nurses Day?

 I'm going to give all of our nurses a dose of vitamin G for gratitude. People honestly underestimate the power of practicing daily gratitude. If we get up every morning and just think about a few things and people we're grateful for and then do it again when we go to bed at night, it will so decrease our stress, decrease blood pressure, improve our mood.

So, I’m going to give all nurses out there a dose of vitamin G today, and just thank you, thank you so much for everything you do every day to transform health and improve lives. You are greatly appreciated.

Thank you so much for taking the time to speak with me today, Dr. Melnyk, and for sharing these important words on this National Nurses Day.

Videos

Today is National Nurses Day, so Bernadette Melnyk, PhD, the chief wellness officer and dean of the College of Nursing at Ohio State University, joined Contemporary Clinic to discuss the high levels of stress, depression, and anxiety affecting critical care nurses nationwide. 

Expert: This National Nurses Day, ‘Self-care Is Not a Nicety, It's a Necessity’ for Nurses

Contemporary Clinic spoke with Patricia Ryan Krause, MS, RN, MSN, PNP-BC, from the National Association of Pediatric Nurse Practitioners (NAPNAP) about Global Health Awareness Month 2021, which takes place in May.

Krause discussed what Global Health Awareness month is, its importance for health care providers, and how to overcome the barriers of treating migrant or refugees properly.

The Importance of Global Health Awareness Month 2021 

Contemporary Clinic spoke with Dr. Kelly Clark, president of Addiction Crisis Solutions and DisposeRx board member, about the impact of the pandemic on opioid use and the importance of proper disposal.

Clark also highlighted how health care providers can counsel their patients on safely dispose of their unused medications, National Clean Out Your Medicine Cabinet Day, and the future of opioid use with the ongoing COVID-19 pandemic.

The Impact of the COVID-19 Pandemic on Opioid Use and Proper Disposal Tips

interviewed Donald Wood, PhD, the recently elected president and CEO of the Muscular Dystrophy Association, on muscular dystrophy research and care during the COVID-19 pandemic and beyond.

During the discussion, Wood addressed how care for patients with muscular dystrophy has evolved over time. Specifically, Wood noted that care for patients has not just changed, but has been revolutionized over the past several decades.

“When I first started my research, there was basically no treatments whatsoever for any of the 40 neuromuscular diseases. Today, I couldn’t even begin to tell you how many treatments there are,” Wood said. “We trained physicians who had never treated neuromuscular disease before.”

Wood explained that the ability to train physicians was made possible due to the development of treatments for neuromuscular disease, which, for many of these physicians during their time in medical school, was not something they were taught could be done.

“There was a time, not so long ago, maybe 40 to 50 years ago, when the medical community was taught in medical school that you weren’t going to be able to treat a patient with a genetic disease. Why? Because there were no treatments,” Wood said.

Researchers in the field were able to eventually identify drug treatments that would make life for patients with neuromuscular disease a bit easier. Overtime, as more and more medical professionals were trained, more treatments and diagnostic tests were identified in order to help patients get both diagnosed and treated as early as possible.

“The earlier you identify where problems are, the more opportunity you have to treat those problems and make life better for patients. And that has occurred over time,” Wood said. “Now we have patients who are living into adulthood, and that’s because of not just the science and research, but because we have trained medical professionals and attracted superior physicians into this field.”

Contemporary Clinic ® interviewed Donald Wood, PhD, the recently elected president and CEO of the Muscular Dystrophy Association, on how care for patients with muscular dystrophy has evolved over the past several decades.

Care for Patients With Muscular Dystrophy Has “Been Revolutionized”

Contemporary Clinic spoke with pediatric nurse practitioner Tina Rickenback, APRN, from NAPNAP about the latest updates on the COVID-19 vaccines and education around this topic.

Rickenback also discussed any myths or rumors surrounding the uncertainty of the vaccine and different ways that health care professionals can spread awareness and properly counsel patients on this topic. 

Latest Updates on the COVID-19 Vaccine and Education On Immunizations

Contemporary Clinic spoke with Laura Kelly, PhD, about Columbia Nursing's newest program and first-ever certificate in Professional Achievement in Transgender/Gender Non-Binary Health Care for Nurse Practitioners beginning this September.

Kelly also discussed why programs like this are important in today's health care world and what NPs can do to continue closing the gaps in treating transgender/gender non-binary patients. 

Professional Achievement in Transgender/Gender Non-Binary Health Care Certificate for Nurse Practitioners 

interviewed Lea Davis, PhD, an associate professor of medicine in the Department of Medicine at Vanderbilt University Medical Center and an investigator in the Vanderbilt Genetics Institute, on a recent study she co-authored that was published in 

 on the epidemiology of functional seizures among adults treated at a university hospital.

Are functional seizures experienced throughout patients’ lives, or is its occurrence associated with the exacerbation of these other comorbid symptoms, such as the psychiatric conditions?

 Actually, both. So, they are experienced throughout the lifetime for many people, and they can be exacerbated. So, for example, if somebody has [post-traumatic stress disorder (PTSD)] and experiences a PTSD flashback, that can also trigger a seizure event. But the range of seizure events is pretty broad for functional seizure patients. There can be some who maybe only occasionally experience seizures and others who experience dozens of seizures a day, and it is extremely impairing.

Lea Davis, PhD, of the Vanderbilt University Medical Center and Vanderbilt Genetics Institute, discussed the frequency with which patients may experience functional seizures.

Expert: Functional Seizures Can Be ‘Extremely Impairing’ for Patients

Contemporary Clinic spoke with Kellie Bryant, DNP, about vaccination training for nursing students and vaccine distribution in her community.

Bryant discussed how the COVID-19 pandemic changed the nursing students', the experience of providing COVID-19 vaccinations to the public, and her hopes for the students' future in the field with their hands-on experience.

The Importance of Vaccination Training for Nursing Students

interviewed Donald Wood, PhD, the recently elected president and CEO of the Muscular Dystrophy Association, on how the COVID-19 pandemic has impacted the muscular dystrophy field.

What are your hopes and plans for the future in terms of research and care for patients with muscular dystrophy?

 Well, let me tell you the same thing I tell my kids, my family: I'm here. [I’m here] to continue to move forward on treatments and advances.

We have seen so much growth and progress in the last few years. We're in the clinical trials now for gene therapy. When we first discovered the gene, I remember getting asked by reporters at the New York Times and all the rest of it, “So when do we get a genetics cure?” And I would say, “Well it’ll probably take 25 years,” because we didn't know enough.

But guess what folks, we are now at the point of being able to take the genetic makeup of a single individual, identify the specific genetic defect, and start to develop treatments that would repair that defect. We have people with spinal muscular atrophy—in the history of the world with spinal muscular atrophy—no patient ever walked who had the childhood form of it. Now, we got kids that are walking.

I have a friend with spinal muscular atrophy, and he's in his 30s, and I was talking to him the other day, and he's in one of the clinical trials. It brought tears to my eyes. He says, “I'm feeling better, Don. I'm feeling stronger. I'm for the first time feeling better.”

Folks, you have no idea—this is a frontier unlike any other. To be able to talk to a patient with a genetic disease in gene therapy treatment who says, “I am feeling better,” and he's an adult? Oh my gosh, well that's where we are. We're in a miracle place; we're in a magic place. We're in a place that I always wanted to get to.

What am I looking at 2021? I'm looking at medical history; I'm looking at scientific history. We are making history. I expect to continue that progress as long as I'm allowed to lead this wonderful organization.

Donald Wood, PhD, the recently elected president and CEO of the Muscular Dystrophy Association, discusses the future of research and care for patients with muscular dystrophy.

Expert Says Muscular Dystrophy Research Today ‘Is a Frontier Unlike Any Other’

Contemporary Clinic spoke with Tomika S Harris, DNP, CPNP-PC; Traci Gonzales, APRN, CPNP; and Cheryl L. Grave, RN, CPNP-PC about Cerebral Palsy Awareness Month, how HCPs can help pediatric patients spread awareness of CP, and recommended programs to bring awareness to this topic.

These experts are leaders of the Children and Youth with Special Health Care Needs Special Interest Group at the National Association of Pediatric Nurse Practitioners.

Tomika S Harris, DNP, CPNP-PC; Traci Gonzales, APRN, CPNP; and Cheryl L. Grave, RN, CPNP-PC are leaders of the Children and Youth with Special Health Care Needs Special Interest Group at the National Association of Pediatric Nurse Practitioners.