DOGMA

“It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.” Charles Darwin

How are you coping so far? Have you made strides in taking up this crisis in a positive outlook? I have or rather to be more genuine, I am intentionally striving to take it positively with each dawn. It is no easy task but as long as I am alive and healthy I choose to celebrate my small wins. It has been a while since my previous blog post but I had taken more time to reflect on two things. Firstly, the value placed on us health professionals and secondly,  the value we place upon ourselves. What do you think is the answer to this?

Worldwide I am noticing that the health workers' narrative is being controlled. Often it is by the same people declaring to be supporting the workforce. It is time we constructively critic this for it may be the only way to get back our power and to receive our worth. Effective change is uncomfortable but it is necessary. Bill Clinton once said that “The price of doing the same old thing is far higher than the price of change.”

Have you been keen to listen and to watch things closely? I have been and this is what I have noticed. PS. This is my personal opinion

1.  There is a specific choice of words

Have you asked yourselves on the genesis of the use of the following terms; healthcare heroes, going to war, going to the frontline while referring to going to work?  I had casually adopted it and put it down on a message but something always felt off. As health professionals we are obliged to prevent illness and promote wellness irrespective of the scale so why are we adopting military terms. I began to look into it I was not getting enough information on the same till I came across an article that briefly explained it. The use of military terms in past experiences has been noted to be more effective in generating emotions among people and directly this also affects our psychological response. I have attached a link to an article that seeks to explain this better than I do. I encourage you to read it and continue reading more on this then draw a conclusion for self https://rcni.com/nursing-standard/opinion/comment/covid-19-why-we-need-to-ditch-military-terms-160071.

2. Use of different antics that act as indirect gag orders

Most countries are facing a shortage of personal protective gear and with that more and more health workers are being infected in the workplace. However, as you may have noticed those on the ground are not allowed to openly discuss it on their platforms further still some are not allowed to seek assistance externally. This is mostly to save face. Often it is achieved through a subliminal manner and it may go unnoticed to some people. For example, some sublime antics would be you raise a concern on inadequate PPEs then get told off through statements like "you have to provide care being that its what you are employed to do. Otherwise, go home and lose your job."

3. The moralization of poor practice

Evolution in healthcare has shown that every couple of years a crisis strikes. It can be either man-made or naturally occurring and this always creates a disaster that may, unfortunately, end in many fatalities such as we are experiencing now. With this same evolution, we have seen how the provision of care has become very commercialized resulting in hospital bills racking up to millions. Currently, in our country, most insurance companies declined to pay for CoVID-19 patients due to their being high-risk. As health workers what have we done to shed light on this?  Are we not supposed to be the patients' advocates? Why have we allowed ourselves to keep quiet on this issue? Is it because we have something to gain in terms of retaining favor with the same companies and therefore not lose the client/patient base? I have attached  an article that explains the moralization of different practices and the legal implication of the same in healthcare please review https://www.annualreviews.org/doi/abs/10.1146/annurev-lawsocsci-101518-042853.


4. Our benefits are predetermined

 With increasing physical and psychological demands upon the healthcare workers, there isn't any vast evidence of intentional inquiry upon what we actually need. The great assumption implies that what we need is just recognition for still doing our job which is disease prevention and health promotion. However, if we were to be asked then it would be identified that what we actually need is improved pay, better work conditions, better health policies, and all those things we have all been discussing in our different forums. I am not saying that being applauded at and having a helicopter fly-by declaring a positive message is not appreciated but with the powers, our leaders have this is just a PR stunt to seem like something is being done yet nothing is actually been done.


How then can we as team players be involved in changing the narrative;

1. Seek to get actively involved with the stakeholders

I applaud the different organizations eg NNAK, KMPDU, the different hospital management offering a listening ear to our needs, and anyone playing their part well. However, it is upon all of us to seek to communicate our needs and grievances to facilitate inter collaboration. We still have a long way to go and it for us to try to formulate solutions for the problems we are currently facing. This is the best way we can control the narrative. I had highlighted this in the following blog post titled yes we can https://lilylovelong.blogspot.com/2020/01/yes-we-can.html.

2. Actively use the networks you have created

We often interact with people working in different organizations meaning we have a great pool of ideas and we should discuss and borrow best practices from each other. Helen Keller said, "Alone we can do so little; together we can do so much."

3. Be more open-minded
We should try to always challenge the status quo for change to happen. It should be approached in a smart way for it to be effective. Tina Seelig in her book titled What I wish I knew when I was 20 she recommends that: one should not dismiss an idea no matter how wild it is. They may appear silly on the surface but with the right frame of mind, you can get something valuable out of everything.

As I conclude, as we keep striving to get ourselves out of Coronaville it is important to always remember this  quote “The art of life lies in a constant readjustment to our surroundings.” Kakuzō Okakura, The Book of Tea

CORONAVILLE

"Life's challenges are not supposed to paralyze you, they're supposed to help you discover who you are." Bernice Johnson Reagon



Does your mind often go into overdrive? Mine does quite often. I have often been told that I tend to overthink which I have come to learn it is both a blessing and a curse. Today I'm sticking to that being a blessing and by the end of this, you will realize why. I have been having quite a hard time with work lately and so have many of my friends and colleagues because of the uncertainty at this time. Whenever we in healthcare go in for a shift you really don't know how it will end for you. Will you go in and end up in isolation or quarantine due to exposure? Will there be adequate protective gear? Did I promote stigma? Is it safe enough to go home? What if I infect my loved ones? What if I have been safe all day then board a public service vehicle or take a cab and get infected there? Now do you get why I said I overthink? Maybe it is an inate trait to help with self-preservation and  I am sure I am not alone in this.


After my daily shifts, I have decided to be walking home from work. Of course, in a mask and all. By doing so It has helped me put these thoughts into perspective. It has aided in giving me clarity and I have decided to embrace this pandemic instead of allowing it to take total control over my whole life. The more I do so the more I am at ease. Let me elucidate.

1. It has retaught me the art of mindfulness.

According to the Oxford dictionary (2019), mindfulness refers to "​a mental state achieved by concentrating on the present moment, while calmly accepting the feelings and thoughts that come to you." Different studies have shown the pros and cons of this practice. Benefits from it are wholly dependent on what and how one plans to apply it. Mindfulness has made me reexamine the care I'm providing both to self in the form of self-care and the affected patients/friends and colleagues. A study done in England examining mindfulness and compassionate care showed that when properly applied it improves one's wellbeing while decreasing stress and burnout levels. The study further states that for those who applied it, it gave feelings of peace, calmness which then translated to reduced chances of feeling overwhelmed and increased their ability to engage effectively with patients while being fully present. Below are articles that provide more light into mindfulness
https://www.cambridge.org/core/journals/behaviour-change/article/effects-of-a-focused-breathing-mindfulness-exercise-on-attention-memory-and-mood-the-importance-of-task-characteristics/43CA1245B506F4B96BF5B9B0EF157067
https://link.springer.com/article/10.1007/s12671-017-0740-z
https://onlinelibrary.wiley.com/doi/abs/10.1111/jocn.14987
https://pdfs.semanticscholar.org/328c/225c0a1492615d86c4254ac8f298828441a0.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5741000/


 Reflect on this:
a).If you got unwell or are currently unwell from COVID -19 how does it feel being nursed by a faceless individual in an unfamiliar environment that is limited in terms of space, human contact and you are unsure of the outcome? In addition to that, being referred to as the COVID-19 patient?

b) Are you in touch or out of touch with your patients?
 Do not compromise on personal safety just use the resources around you to humanize the care delivered. For instance,

 Do not just look at it, study this image.











2. I am learning to be grateful for the little things

I had not realized the magnitude of the things I often take for granted. They had become so quotidian and with that, I tended to complain more instead of being appreciative.  For instance, those random trips to see a friends/family, hugs, quickly dashing outdoors for an errand, the sun on your skin, taking a walk on the beach when I felt like it, visiting the animal shelter, having a job, being able to afford amenities, etc. I am learning to stop complaining and rather to appreciate the little I have. As much as I am having days lately where I'm questioning my profession. I am glad I still have an opportunity to help someone at their worst while still being in protective gear. I am learning to appreciate those uplifting calls and messages from people checking up on me. I am grateful that currently I still have a source of income. I am grateful  I still have a roof over my head.I'm actually glad this season has reminded me of what is important.

3. It has taught me to always do your best irrespective of the task at hand.

Honestly, Its a very stressful time to be alive but again I want to get out of it a better individual. As I had stated in a previous blog post titled Noble Truths follow the link to read it https://lilylovelong.blogspot.com/2019/12/noble-truths.html I want to die having identified my purpose and or while working towards it. Those things about self that we tend to make excuses for, this is the time to actually work on them. Get out of this season with better relationships, better your skills with online resources if you can, better fitness levels using the resources around you. That dream job or business you wish to start,  make a point of studying on how to achieve that. If nothing this pandemic has reinforced the fact that tomorrow is never guaranteed so give your best version today, put forth positive energy only and enjoy the small moments do not postpone them.

4.Lessons for my future roles, lessons in the selection of leaders


The gaps identified in this time are the tools I choose to use in applying for or in creating future roles within my profession. This pandemic has also taught me what leaders should do for us while in power. I am learning about the type of leadership we actually need and how much value comes from embracing the roles given to us. It has also given me a better appreciation for the tough decisions those in power have to make. Be honest with yourself with the knowledge you had before all this would you have performed any better if you were in their position?

Finally, as we continue trying to make the best out of this enigmatic season  let us never forget that “It is only in our darkest hours that we may discover the true strength of the brilliant light within ourselves that can never, ever, be dimmed.”
 Doe Zantamata

Wie fühlst du dich heute?

"Everything can be taken from us but one thing: the freedom to choose our attitude in any given set of circumstances." Viktor Frankl


How are you feeling today? Has anyone taken the time to ask you that? For me, my emotions are all over the place. One minute I feel fine the next am almost having a panic attack. The reason is this COVID-19 pandemic. It seems to keep on evolving despite the measures put in place. In the past week, this was worsened by several discussions with different groups of people, visualizing relentless despondent news and consistent assessment, and reassessment of our healthcare policies and systems. These aspects have been creating a very melancholic atmosphere. It makes one almost wish to curse out but then again life has to move on. So how are you coping? Would you wish to share? If yes email me or comment below.

There has never been such a crucial time to maintain our mental wellness in this century such as now. Studies have consistently displayed a direct relationship between our mental health as healthcare professionals and our ability to provide care to patients. As it is now we have already started noticing an increase in numbers of sickly patients whom soon as a continent we shall be aggressively competing for the limited resources.  Within healthcare, researchers have already started noticing an exponential increase in burnout levels among healthcare professionals and increased anxiety levels among patients. To read more on this https://www.ncbi.nlm.nih.gov/books/NBK540859/ and https://www.medrxiv.org/content/medrxiv/early/2020/02/23/2020.02.20.20025338.full.pdf.

For healthcare professionals, this has been attributed to;

• Longer working hours 
• Ethical dilemmas
• Insufficient protective gear
• Increased mortality rates
• Increased infection rates among themselves
• Poor organizational planning etc

Occupational health specialists are already establishing that health care organizations will soon have to deal with greater numbers of employees dealing with anxiety disorders, depressive symptoms, post-traumatic stress disorders, insomnia, suicide, and burnout The COVID-19 (Coronavirus) pandemic: consequences for occupational health.


With all this happening we therefore need to actively play a role in maintaining our own mental wellness. This is at a personal level and collaboratively at an organizational level. Upon discussions with several colleagues, acquaintances, and friends its sad to notice that most organizations have not yet put up additional measures to aid in the promotion and maintenance of mental wellness. Personel, therefore, have to formulate their own mechanisms. This is, however, proving to be insufficient for a large group of health professionals.

Organizations that are investing in their health professionals mental wellness are doing so by ;

1. Constantly relaying messages that reiterate the importance of health workers their value and that pandemic management together is the goal.
2. Clear communication of current practice.
3. Managing expectations.
4. Clarifying work hours.
5. Providing sufficient resources and adequate PPEs.
6. Regularly monitoring their wellness.
7. Proactively addressing concerns related to staff safety and that of their families.
8. Encouraging open discussions on vulnerability and importance to protect one's  mental strength
9. Provision of information on effective stress management.
10. Distributing messages of gratitude.
11. Providing basic provisions on the long shifts eg healthy snacks, water, toiletries.
12. Offering environments that foster spiritual resilience.
13. Offering online tele-counseling etc.

To read more on ways organizations can do this continue reading the articles below
http://www.annals.edu.sg/pdf/special/COM20043_HoCSH_2.pdf
https://annals.org/aim/fullarticle/2763592

On a personal level, I am actively utilizing a few minutes each day on self-care. Some of the activities am doing include;

1. Intentionally connecting with friends/colleagues

Social distancing should not limit our human interactions. I am using my daily resources to maintain the needed human contact. Despite using features such as Zoom, Google Duo and Skype for meetings.I am finding such forums useful for holding online discussions on how one is coping. By propagating positive messages it provides some kind of mental relief. Also, these same forums are also proving to be very useful for catharsis.

2. Regularly going through websites that promote mental wellness

From my previous blog posts, I have indicated that I regularly follow the action to happiness website. They aim at always providing activities that help one maintain a positive outlook. For this month of April their activity calender is titled active coping If you wish to access it plus other more great resources click the following link.https://www.actionforhappiness.org.

3. Indulging in indoors activities I love

I have been listening to a lot of music hence dancing more which generates a lot of endorphins providing much-needed relief. I am also trying to re-learn how to play online games such as Blur am staying away from the violent ones. It had been so long since, that I seem to have become quite rusty at it but am gradually improving. I am also cooking more and finding it to be quite therapeutic.

4. Praying more

My belief in a higher power is providing an avenue to direct my concerns. I have found it very calming especially anytime I have experienced a highly stressful situation that I cant phanthom initiating a discussion on.

5. Reading more

As usual, I am reading as many books as I can. They are providing practical solutions to so many mental blocks I have been encountering. The most recent read that I recommend is Joyce Meyer's book titled Living beyond your feelings: controlling emotions so that they don't control you.


In conclusion, as we continue giving our best to try fight this pandemic let us always remember  that