Are Nurses Fueling the Opioid Crisis?

In nursing school we are taught that pain is the fifth vital sign, next to temperature, respirations, heart rate, blood pressure, and oxygen saturation levels. We are also taught that pain is what the patient says it is, leading us to constantly ask patients to rate their pain on a scale of 1 to 10. We are asked to re-evaluate their pain after our interventions, leading us to often tell the physician that a patient’s pain isn’t well-controlled. On top of this, our hospitals are reimbursed by Medicare and Medicaid based on patient’s pain control through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. With all this focus on pain, combined with the monetary incentives to control pain, is it any wonder that so many people are addicted to pain medications?

Our intense focus of alleviating a patient’s pain in all ways possible has lead to many patients becoming addicted within the hospital system. When they can no longer get opioid prescription medication, they turn to illegal drugs like heroin. Many of my patients come in with abscesses from heroin injections. According to the American Nurses Association:

  • 78 Americans die every day from an opioid overdose
  • At least half of all opioid overdoses involved a prescribed medicine
  • Sales of prescription opioids in the U.S. nearly quadrupled from 1999 to 2014, but the overall amount of pain Americans report has not changed
  • Heroin-related overdose deaths have more than tripled since 2010

As nurses, we should advocate for more drug-free ways to relieve pain. After all, pain is a part of life, but so many people are afraid to feel it. There are alternative pain treatments out there, such as meditation, acupuncture, guided imagery, hypnosis, exercise, and so many more. Hospital treatments are almost solely focused on medication, and it’s time for that to change if we want to rid ourselves of the opioid epidemic in this country.



Start the Day with Positive Thoughts

One of the things I’m guilty of is checking all my notifications on my phone when I wake up. I’ll check my news feed and maybe look at Twitter or YouTube notifications first thing in the morning, exposing myself to possible negative news and glaring images. Since most of us keep our smartphones on the nightstand, we have an urge to reach for them when we first wake up. “I’ll just check the time,” I think. But then I keep checking more and more apps and notifications, and before I know it my thoughts are running in different and negative directions.

More than ever before, we are being bombarded with negative messages in the media and in our news feeds first thing in the morning, leading to an increase in depression, stress, and a feeling of being overwhelmed early in the day. This can lead to headaches and anxiety, and make us more likely to say we had a bad day at the end of it.

Instead of starting the day like this, do something you enjoy, such as meditation, exercising, or just relaxing with a cup of coffee. This can help to start your day on a more positive note. It protects you from the gloom-and-doom news of the world, and gives you more space to switch into a positive place in the morning. Get an “old-timey” regular alarm clock that doesn’t come with a bunch of distractions and put that smartphone in another room if you have to.

One of the main reasons for stress in our lives is the feeling of powerlessness we get when faced with things outside of our control. Instead of feeling this way, put yourself in control of the situation by doing something to problem solve. For example, if you see bad news on Facebook about something, think about what you could do about it. You could donate money to an organization that supports a cause you care about instead of feeling helpless against it.

These are a few ideas about how to start you day on a positive note, and how to take control of those stress feelings. Let me know if you have any luck with these in the comments!

Fitness Trend: Water Workouts

Water provides great resistance for a workout, and the newest fitness trends involving water are increasing that resistance even more through spin bikes, kettle bells, and stand-up paddle (SUP) boards. You can even add hand paddles to your workout to increase the resistance of your reps.

Water is a great training tool, and studies show that exercisers who trained in water improved their ab strength more than those who used resistance up on land (European Journal of Applied Physiology). One of my favorite water exercises is stand-up paddle boarding. The newest SUP trend involves resistance bands tethering together boards in a pool, while users do planks and squats, shifting their weight to work out those rarely-used muscles.

For those who hate cycling because of the stress on their joints, why not try it underwater? Aqua cycling is a submerged version of a spin class, where bikes are in waist-high water. You can get all that cardio without the soreness later, and you get a natural massage from the water while you pedal.

There are even new devices to track your water workout, such as the Misfit Shine 2 Swimmer’s Edition tracker band. It can monitor your laps, distance, and time in the pool. And it’s important to have the right shoes to keep your feet in the aqua bikes, such as BodyGlove’s Dynamo Rapid water shoes. Search for water-based classes near you, and let me know in the comments if you like these kinds of workouts.

Balance, Letting Go, and Non-Striving

Balance means different things to everyone. Some people are content where they are in life, and don’t want to achieve anything more. Some people are constantly striving, but don’t seem to get anywhere. When I was studying for my Bachelors in nursing, one professor started off every class with a meditation. Each week we would focus on a different aspect of mindfulness. One of them was “Letting Go.” It’s important to let go of worry, anxiety, fears, and to just be present in the moment. This is one of the ways I’m working to bring balance to my life. Once you realize that all worry is futile, and is nothing but a waste of time, more balance and happiness will come into your life.

There are many videos on YouTube that are all about letting go of worries, fears, and past relationships. I like the guided meditations that can help calm and relax me after a stressful shift. Another aspect of mindfulness that goes along with Letting Go, is Non-Striving. The meditation that we would listen to in class was by Jon Kabat-Zinn, and his non-striving explanation can be found here. There are nine aspects of mindfulness and Jon Kabat-Zinn provides excellent resources.

If you are looking to add balance to your life, I highly recommend some form of meditation.

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Health Trend: Activated Charcoal


Activated charcoal is the latest craze in face masks and for teeth whitening, and it’s being used in juice cleanses for overall detoxification. It is generally used in emergency rooms for patients who have ingested a poison, or maybe for your pet who has eaten something that they shouldn’t. It’s used in water filters to rid the water of toxins, so it should be great for detoxing your body, too, right?

Many people don’t know that there are risks involved in taking activated charcoal and side effects. Activated charcoal can reduce the absorption of certain drugs such as acetaminophen, digoxin, theophylline, and tricyclic antidepressants. Side effects include black stools, black tongue, vomiting and diarrhea, and constipation. It shouldn’t be combined with other drugs that are used for constipation such as sorbitol and magnesium citrate, as this can lead to electrolyte imbalances.

Since most of the newest products are topical such as face masks, there shouldn’t be many side effects to worry about. Those who use it orally on a long-term basis have to be careful. The capsules are sold in most grocery stores and it’s recommended to take two before and two after a meal to prevent gas and bloating. It can even be used rectally. Just make sure to tell your doctor about any other supplements you are taking, because it isn’t regulated by the FDA. If you have any success stories using activated charcoal, tell me in the comments!

The Power of Attitude

We have all come in contact with those people who have a million excuses: they’re negative, complaining, and toxic. They have a poor attitude. They say “Woe is me, my life is so hard.” Sometimes it’s our friends, family, or co-workers. Sometimes it’s us!! After a while they drag you down to their level. This has happened to me numerous times, and maybe I’ve done it to others.

Attitude is everything and affects every setback and obstacle we face. Situations, obstacles, and problems are just situations, problems, or obstacles. They aren’t good or bad, they just are. It’s how we cope with such situations that turns them either good or bad. We can turn every negative into a positive with the right attitude, positive vibe, or flow.

I’m working on my positive attitude right now, and not letting my subconscious mind drag me down. I’m managing my thoughts and turning any negative thought into a positive one. Don’t watch the sad news and be dragged down by the negativity. Face everyday with enthusiasm, passion, motivation, and determination to have a positive attitude. When faced with anything or anyone that’s negative, turn it around with a positive attitude. Think big and loud. Feel content and satisfied, and you’ll be surprised at how fast your life will change!

The Stress Response

Last week at work I was dealing with a difficult situation. A patient wanted to make a complaint about me, personally, and even though there was nothing to it, I still felt an enormous amount of stress. I remember going into the bathroom and watching the hives break out on my neck and creep up my face. This happened one other time in nursing school, so badly that I had to leave clinical early and go to the doctors, afraid I was having an allergic reaction.

Now I know that when I break out in hives it really is my body telling me that I’m under stress. It’s kind of embarrassing that anyone who notices can point it out and say, “What’s that? Did you use some kind of new lotion or laundry detergent?…” Anyway, I tried to hide it underneath my shirt, pulling it up as far as it would go, but it was still pretty noticeable. I took a deep breath and left the bathroom to go face the patient and the rest of my shift. I still had about 3 to 4 hours left of an already bad day.

As a nurse, I think it’s important to realize the stress reaction is happening before it gets too out of hand. This is the point when you can say or do something you regret, because of the pressure. I discovered that there is now a tracker you can wear, like a FitBit, called Spire. It measures respirations and tells you if you are feeling tense. It can tell you when you need to take a break or meditate. I feel like this would be a good reminder for me, as I am always going about 100mph at work. Health professionals recommend Spire for their clients, but what about for us? If you’ve tried Spire or something like this let me know in the comments!

Change One Daily Habit, Change Your Life

Daily routines can be good, as I’ve pointed out before. Routines can give you a purpose and create meaning in your life. But what is that one habit that might be holding you back from being your best version of yourself? This is something you might do every day that gives you comfort but isn’t healthy for you in the long run. Maybe you are really good about eating breakfast, but it is not the best choice (like a muffin, bagel, or anything that resembles dessert).

For me, it was taking a nap in the afternoon when I didn’t have to work. Recently, I stopped taking an afternoon nap and I feel like I have more energy. I can get more done, and I also fall asleep easier at night. I’ve started working out instead of taking a nap, and breaking this one habit has helped me lose some pounds and feel healthier. One thing often leads to another to create a lifelong change. Sustaining that change is hard when you want to slip back into those old habits. Work to create healthy habits that make you feel so good that you won’t want to ever go back to the way you were! Take before and after pictures to help you stay motivated. Meditate when stress is getting to you (if you are able) to fight the urge to give in to cravings. Find out what your daily habit is that is holding you back, and figure out how to change it!

The Problem with “Body Positivity”

The new “body positive” movement, and “healthy at any size” mantras may make people feel good about themselves, but it won’t help them live any longer. The people who are angling for fat acceptance may not realize what kind of health problems they will face down the road. As a nurse, a lot of my patients are in their 30s and 40s, overweight, and have all the co-morbidities that go along with it. I don’t think they will make it to 70 or 80, and if they do, it won’t be an easy road.

The healthcare system is already burdened with those morbidly obese patients who drain the precious resources of the staff who must care for them. I remember a remark one of my techs made about an obese patient, stating that “she is literally killing us.” Every time this patient had to be repositioned, or put on the bedpan, or have a dressing changed for her bedsores, it took 4 staff people off the floor. That was time taken away from other patients who may be more critical. Not only that, but imagine how the patient felt that she was totally dependent on others for all of her care.

Most of the adult patients I see in the hospital suffer from chronic diseases that could have been easily prevented with a few lifestyle changes. Among the obvious: don’t drink or eat to excess, don’t smoke, and exercise on a regular basis to maintain a healthy body weight. By all means stay active as long as you can, into your 60s and 70s if possible. A healthy body weight will take stress off of your joints and go a long way toward improving your overall health!


Your Beliefs Create Your Reality

The past few weeks have been very stressful for me at work. I haven’t written anything in a while, being in the process of moving and taking a short vacation. I’m happy to announce that I will be trained for a charge nurse position at work, but unfortunately with this new role and position has come a lot of animosity from fellow co-workers who believe that the promotion should be theirs. This had made it hard to even face these people at work without a sense of anxiety. I feel like a “clique” is forming and I’m being ostracized.

Remember that whatever happens to you in life happens for a reason, good or bad. If you believe that you are worthy and your thoughts reflect that, good things will happen. If you believe that you are not worthy, or think, “I can’t do that,” then you won’t be able to do that which you don’t believe. Whether you think you can or think you can’t, you’re right.¬†Believe that you can, and you will.

I will make myself stronger, and go to work without fear. If I have fear of these people, they will control me. I won’t get sucked in by these toxic co-workers, I will rise above.