“This is doing my head in!” by Harriet Oxley

Harriet 1I wonder how often you’ve heard someone say these words. Every day perhaps? Depending on our circumstances the things that provoke each of us are different. As we become more stressed and pressurized it becomes harder to see the way forward clearly. If we go unsupported and problems start to pile up they can start to bring us down.

Staff listening offers one-to-one support that is confidential and non-judgmental. Each person is supported to talk about issues of concern, deepen his or her understanding and rediscover hope. As a result they are enabled to tap into personal strengths and find a way forward if that’s what they need to do. Staff listening is a service offered by the NHS Dumfries and Galloway’s Spiritual Care team.

I recognise that some people are not sure what spiritual care is or what we do. I notice that some people hear the word ‘spiritual’ and imagine everything from ‘religious nut’ to ‘bible basher’. Others wonder why we need spiritual care in the NHS nowadays.

I wonder if it would help to make the distinction between religious and spiritual care. Religious care is given in the context of the shared beliefs, values and rituals of faith communities. Spiritual care, on the other hand, makes no assumption about personal beliefs or lifestyle. In other words, spiritual care is not necessarily religious and many people with no religious beliefs recognise their own need for spiritual care.

Spiritual care recognises that everyone needs to have meaning and purpose in their lives and fostering this promotes resilience and wellbeing. Spiritual care enables people, whether they’re patients, carers, volunteers or staff, to cope with life transitions, such as illness, loss or bereavement, as well as ethical dilemmas and major life decisions.

The Spiritual Care team consists of self-aware and sensitive listeners who have time to be with each individual in their need. Staff listening promotes spiritual wellbeing by offering a safe space for people to explore their concerns and draw strength from their own inner resources and those of supportive people around them. It is available to any member of staff, volunteer or carer within Dumfries and Galloway Health and Social Care. Equality and diversity is important to us and we welcome everyone irrespective of personal beliefs or life circumstances.

Harriet 2So perhaps you’re wondering what happens in staff listening. Firstly I’d like to point out that our role is not to fix problems or give advice. Instead we listen as each person tells his or her story, ask the right questions and offer support and encouragement. For many people telling their story is all they need to do. To have someone listen to the issues they are struggling with is enough to leave them feeling heard and able to carry on.

Sometimes, in talking about the situation, the person hears themselves say what they need to hear and gains insight just from having put their story into words. At other times the person’s story may be very complex, with many different strands. In such situations our role is to help them disentangle some of these strands, to look at them in turn and perhaps identify what some of their options are.

‘I have just realised what I need to do – I have never thought about that before.’

‘I have just heard the answer to my problem in what I have said.’

‘Saying that made me hear and see my own story differently.’

Space to reflect and talk through issues with colleagues has become rare, yet it is often the very thing that makes a difference in how we cope. If something is troubling you or you’re struggling with a particularly difficult situation, maybe it would help to talk in confidence with someone outside your situation. If so, please drop us an email to: dg.stafflistening@nhs.net

Harriet Oxley

Spiritual Care team

Stressed about Stress by Amanda Taka

Stress is one of those words that has become intrinsic in our everyday vocabulary: we’ve all heard ourselves moaning “I’m so stressed!” What is it and how can we manage it?

Stress is defined in different ways by different organisations, but the common thread seems to be that stress is “feeling under pressure”. A small amount of stress is good for us: it keeps us motivated and helps us to do our best. However, when we are living with stress all the time, it can lead to a myriad of unpleasant feelings and physical symptoms can follow.

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Often we are quick to identify stress in others, but would we recognise it in ourselves? Symptoms associated with stress are wide ranging and initially we might not associate the physical symptoms as related to our mental wellbeing. There has been a tradition to separate mental and physical health, but evidence shows the link is greater than we previously may have understood. The jury is still out as to whether stress itself causes disease, but there’s lots of evidence to show that the unhealthy habits we rely on when we’re stressed contribute to many conditions.

Physical symptoms can include:

  • Sleep problems
  • Dizziness
  • Chest pain, palpitations
  • Dry mouth, lump in the throat, shaky hands
  • Lack of appetite, or conversely, comfort eating
  • Repetitive tic
  • Headaches
  • Diarrhoea or constipation
  • Loss of libido
  • Tearfulness/depression/anxiety
  • Worsening symptoms of long term conditions

Additionally:

  • Poor concentration
  • Difficulty making decisions
  • Irritability
  • A feeling that things are hanging over you
  • Excessive intake of caffeine, cigarettes or alcohol
  • Low self esteem/lack of confidence

This list is not exhaustive!

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What causes stress?

Here’s the tricky bit. We’re all different, so we all have different triggers. For example, one nurse would struggle to cope with the incessant physical and emotional demands of working in the Emergency Department, whereas that environment is perfect for a different nurse.

Acknowledged triggers of stress are as follows:

  • Work pressures, job instability, fear of redundancy
  • Parenting, family and relationship difficulties
  • Financial pressures
  • Bullying and discrimination
  • Loneliness and isolation
  • Living with a long term condition
  • Caring responsibilities

And one more for us workaholics:

  • Taking on too much responsibility and feeling you don’t have enough time to do everything!

OK, so it looks like life itself is stressful.

If you’re feeling like stress is starting to impact on the quality of your life then the first thing would be to get it down on paper. Spotting stress in its early stages can help prevent things from getting worse. Things to include in your “stress diary”:

  • Date, time and place of the incident
  • What you were doing, before, during and after
  • Who you were with
  • What were your feelings, before, during and after
  • Any physical sensations
  • Give the event a “stress rating” e.g 0 = no stress, 10 = the most stressed you could possibly feel.

Making a stress diary is helpful because it aids our ability to make connections between the context and the symptoms. Ideally, a stress diary should be continued for at least 2 weeks. This helps us to see things in perspective. Additionally, this is a vital piece of evidence to discuss with your GP if you’re feeling overwhelmed and unable to cope.

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Quick Fix

When I searched ‘wellbeing’ in Amazon at the beginning of the year, I was astounded at the number of different products that claim to enhance one’s wellbeing: necklaces, crystals and orthotic sandals sat alongside the list of ‘new age’ literature that was available. I’m not sure it’s something that can be bought. There’s certainly no single ‘cure all’ solution. Therefore it’s worth trying, or combining, a number of different approaches until you succeed. Most research shows the following are a good place to start:

  • Physical activity – doesn’t need to be a gym membership, incorporating 30 minutes of activity can help boost mood and clear the mind (remember it can be in blocks of 10 minutes)

 

 

  • Relaxation techniques such as mindfulness and breathing exercises are evidence based ways of reducing stress. Courses are available across the region, check the local press or http://www.uws.ac.uk/wellnessandrecoverycollege for details.

Nursing is acknowledged to be a stressful profession. In our profession, we tend to put everyone before ourselves, but who looks after the caring professions? I passionately believe that we need to give ourselves the time and effort to look after our own mental wellbeing, and being aware of our stress levels is intrinsic to this.

Further self help resources to try:

  • Living Life telephone self help service and online programme for people with mild to moderate feelings of anxiety and depression using Cognitive Based Therapy. See http://www.llttf.com/ for more info

 

  • Breathing space – confidential helpline that describes itself as a ‘first stop’ service which aims to listen and provide emotional support. http://breathingspace.scot

 

 

  • Steps to Deal with Stress – you may have noticed the little square booklets floating around NHS D&G, pick one up, they have great common sense tips to help with stress busting. More info at http://www.stepsforstress.org/

A last word

If you or someone you know is struggling and self help techniques haven’t worked, you may need to seek expert help. For some people a combination of medication, talking therapy alongside some of the techniques outlined above are appropriate. Also, it’s worth remembering that the Samaritans have changed their number to 116 123. Further helplines can be found at http://www.nhs.uk/Conditions/stress-anxiety-depression/Pages/mental-health-helplines.aspx

And remember… “taking on too many commitments” may lead to feelings of stress!

Amanda Taka is a Keep Well Nurse at NHS Dumfries and Galloway