Feeling stressed out as a result of the state of the world? Between social unrest, global health concerns and any personal upsets, that stress is totally normal and you are not alone.
However, just because stress is a normal reaction to troubles doesn’t mean that stress has to take over your whole life.
If you’re starting to feel worried all the time, or developing physical symptoms such as stomach aches or panic attacks, then you need some tools to reduce the intensity of that anxiety and bring it down to more manageable levels.
Here are some tips to get you started, courtesy of Cup of Nurses.
Creating a Positive Space
Before you dive into meditating, ask yourself if you have a space that will foster peace and mindfulness. Meditating in a busy room full of kids, for example, can be a bit of a challenge.
Make sure you have a space that’s quiet, private, and emits soothing energy.
If self-isolating was part of your self-care plan during the pandemic, you might have started to build up some negative associations with your home.
You can release and replace this energy by burning sage, or even simply letting in some fresh air. Releasing negative energy that may have built up in your space is vital for achieving inner peace.
Also, remember that aromatherapy can be an invaluable asset in balancing and unlocking various chakras.
Movement Meditation
If you’re brand-new to meditation or work on mindfulness, movement is usually a good place to start. Trying to plop down in a quiet room and clear your mind right out of the gate isn’t likely to be particularly effective.
When your brain is used to running a million miles a minute, having something physical to focus on can help you develop the focus necessary to meditate effectively.
Yoga is one of the best forms of physical meditation, and you can find a ton of resources online that will help you develop mindfulness this way.
However, you can practice mindfulness while doing any kind of physical activity; swimming lends itself well to meditation. You can enjoy a walk while paying attention to the sensation of your feet against the ground, or the sounds happening around you.
If you already have a favorite form of exercise, the next time you work out, pay close attention to what’s happening in your body. This will help you develop mindfulness, as well as make your workouts safer and more effective.
Guided Meditation
A great way to ease yourself into meditation is to try some guided meditations. For example, Irish Life Health notes you could try a free guided meditation app designed to help you unwind whenever and wherever you are.
There are guided meditations on all sorts of topics, from fostering focus, to parenting, to releasing anger, and more.
Guided meditations give you a chance to practice releasing control over your mind and watching what your mind does instead.
At the start, having a voice prompting you to notice your breath and to observe where your mind goes can keep you from feeling frustrated or overwhelmed by your own straying thoughts.
Eventually, however, you can learn to meditate with or without guidance, opening you up to a world of relaxation and inner peace.
At the end of the day, meditation doesn’t get rid of stress, nor does it magically make you constantly happy. Stress and unhappiness are, after all, a natural part of living.
What it does do is teach you how to sit with those emotions without the urge to push them down or fight them away. When you learn how to sit beside your pain, you will find it becomes far more bearable.
Cup of Nurses is your best source for all the current news in health, as well as other topics related to nursing. If you have any questions, please email marketing@cupofnurses.com.
Being an advocate for your own health is essential, especially as you age. If you feel you’re not receiving the right type of treatment, you may need to address previously overlooked health concerns or simply take a more active role in physical and financial matters involving your health. Advocating for your health and taking full responsibility for your own care can be both empowering and rewarding. So here are some tips from The Cup of Nurses to help you get started!
Maintain Healthier Habits
One crucial way you can advocate for your health is by actively maintaining it. Exercising and eating healthy on a consistent basis will help you to feel better and avoid illnesses and injuries more consistently. Having more physical strength also enables you to continue living independently. Working out often enough can be challenging if you have a busy work schedule but small movements throughout the day. Yoga can be a fun and challenging way to keep fit, as well!
Be Prepared
If you’re unsure what you might be dealing with, pull up some symptoms and express your concerns. To make things a little easier, you can always organize medical records and other important documents on a PDF. This free tool will enable you to edit a PDF online, which you can then save to your iPhone for easy access once you reach the doctor’s office.
Prepare for Insurance Needs
If you’re unsure about a diagnosis, get a second opinion! Whether or not you have Medicare, you need to know how your insurance policy in Virginia works, what it covers, and how often you can use it.
Stand Up for Your Care Needs
If you’re unsure about a diagnosis and want a second opinion, you shouldn’t feel bad about getting one. You’re the last defense against poor medical care and should be adamant about getting opinions you trust and being sure about them. If you don’t feel like the medical professional in Alexandria, you’re currently seeing is providing adequate care, don’t hesitate to explore other options.
Look After Yourself
Taking an active role in maintaining your health is essential. Not only does improving your health have a tremendous impact on your body, but it can also benefit your mind as well. When your body is healthy, you’ll feel less depressed. What’s more, your stress levels may decrease, too.
Be Brave
Dealing with health concerns or chronic conditions is never easy, so you’ll want to get familiar with your insurance plan and financial arrangements, hold your doctor accountable and ask questions. Don’t be afraid to involve a loved one if you need help or emotional support.
The Cup of Nurses is your source for current health news and hot nursing topics. If you have any questions, please contact us at marketing@cupofnurses.com.
6 Tips for Creating a Healthy Workplace Environment
A healthy workplace environment is possible, but it takes cooperation to do that. Our place of work should be something that we love going to. It should be a safe space where employees can communicate openly, discuss issues, and work together to keep the company moving. But sometimes, misunderstandings among coworkers or employers do happen. A toxic workplace can sometimes be unavoidable. It’s part of the work-life, but it doesn’t always have to be like that.
Why a Healthy Workplace Environment is Essential
Keep in mind that the people you work with have different ideologies, points of view, and opinions. One way or another, someone will clash with somebody at work. But wouldn’t it be nice to keep our work environment healthy and happy for everybody?
As nurses, we have our fair share of ups and downs in our workplace. What makes a company a great place to work? It can be perks, locations, and incentives, but creating a healthy work environment will retain employees. And to do that, here are helpful tips that you can apply:
Give your employees a real voice
Employers need to create a space where employees can express their feelings. After all, that’s how you identify pain points. Feedback is one of the most valuable tools you can get, to improve the workplace. There are tools such as annual surveys, but they don’t result in timely action.
Feedback is excellent in real-time; that is why your charge or manager must have excellent leadership skills to honor your voiced opinion. Are there issues with other units or staff, and how are these problems addressed in real time?
There needs to be change implemented post feedback, just like in the surveys. If things continue, this leads to lower engagement, and ultimately your staff will fail to voice future concerns.
Showing appreciation every day
When was the last time you got a shout-out from your manager when you least expected it? Sometimes those little words of affirmation can give you a big boost of confidence, instantly improving your mood. Recognition is essential to let employees know that their hard work is valued.
Meaningful recognition can dramatically improve employee engagement, retention, and satisfaction. What is a simple way to show appreciation? Maybe something small like having a day off on your birthday.
Create an environment of psychological safety and trust
On the opposite spectrum, employees will be scared to speak up if they fear failure, judgment, or disrespect.
Clean and functioning workspace
Nothing makes life more complicated as a nurse than dealing with faulty equipment. Equipment includes things like computers, scanners, glucometers, suppliers, etc. Nothing grinds our gears more than not having the proper equipment to complete our tasks.
In every facility we worked at, this has been a reoccurring problem. It only added stress to the nurse who’s already dealing with patients’ lives. In the current facility we work in, we salute them for having proper lift equipment in every room.
Empowering your team members
This multifactorial approach requires managers, HR, and anyone else in the chain of command. No matter how capable your workforce is, they still need support to be their best selves at work. It is important to establish open feedback to show that your organization listens and encourages the team to keep voicing their wants and needs.
Get to know your employees on a human level. Taking the time to do this will help uncover the best way to empower them and create an environment that makes them feel safe.
Empowering team members should also include building team-building skills. Often, nurses work individually within their role, but employers can encourage teamwork to make a better workspace environment. We all felt that unit where nurses and staff come to ask you if you need help with anything.
Promote wellness through a healthy workplace environment
Wellness can be overlooked in the workplace, but psychological, emotional, and physical are essential to having a healthy workplace environment. Being a frontline health worker requires us to juggle between chill mode and fight-and-flight. The constant release of cortisol in stressful situations can inhibit rational and logical thinking.
A healthy workplace should encourage breaks for shifts and be mindful of workloads. Encouraging employees to rest is overlooked in most healthcare, but it’s crucial to take a break and boost energy to continue a busy shift. Randomly, imagine if a unit invests in apps like Headspace to help mitigate stress?
Do you want a healthy work environment? Follow these tips here 👇
TIMESTAMPS:
00:00 Intro 00:47 Plugs 02:27 Episode Introduction 04:23 Tip 1: Give your employees a real voice 07:20 Does annual surveys work? 08:50 Tip 2: Showing appreciation every day 11:06 Difference between Professional and Genuine Appreciation 12:41 The power of giving and take 16:16 Money as the solution 19:09 Tip 3: Create an environment of psychological safety and trust 21:57 Compromised and abused nurses 23:09 Inadequate Ratio 24:28 Tip 4: Clean and functioning workspace 26:38 Additional protocols for additional profit? 29:06 Nurse’s safety being last on the list 32:29 Tip 5: Empowering your team members 37:32 Being considerate to other practitioners, races, and cultures 42:09 Tip 6: Promote wellness 45:54 Incentive program for nurses
There are five personality traits that we all have in common. Even though every one of us is different, ranging from our personality to our physical appearance, psychologists and psychoanalysts have been trying to predict behaviors and thought processes.
Body Types
Look at the friends around you. Do you share any personality traits with them? When you think about it, we are not entirely nonidentical. Even though drastically different from one another, humans do have many similarities. On the physical level, when it comes to body type, the majority, if not all, fit into three main body types:
Endomorph
Mesomorph
Ectomorph
Each body type has its strengths and weaknesses. In the same way, there are general body types. We all share certain personality traits, for example, agreeableness. We are all agreeable but to a certain point. Some might be very agreeable and are ready to say yes, while others are less agreeable and will need some convincing to take your side.
Background on the Top Five Personality Traits
Initially developed in 1949, the big five personality traits is a theory established by D. W. Fiske and later expanded upon by other researchers, including Norman (1967), Smith (1967), Goldberg (1981), and McCrae & Costa (1987).
It’s suggested that as early as the late 19th century, social psychologists were trying to gain a more scientific understanding of personality. However, it wasn’t until the first official study in the 1930s by Gordon Allport and Henry Odbert that personality had some scientific acknowledgment [1].
They took 18,000 words from Webster’s Dictionary to describe personality traits and found adjectives that described non-physical characteristics creating a 4500-word bank of visual behavior markers.
There was a hiatus from the late 1960s to the 1970s; the changing zeitgeist made publishing personality research difficult. In his 1968 book Personality and Assessment, Walter Mischel asserted that personality instruments could not predict behavior with a correlation of more than 0.3.
Social psychologists like Mischel argued that attitudes and behavior were not stable but varied with the situation. Indication of behavior from personality instruments claimed to be impossible.
The Paradigm of the Five Personality Traits
The paradigm shifted back to accepting the five-factor model in the early 1980s. During a 1980 symposium in Honolulu, four prominent researchers, Lewis Goldberg, Naomi Takemoto-Chock, Andrew Comrey, and John M. Digman, reviewed the available personality instruments of the day. This event was followed by widespread acceptance of the five-factor model among personality researchers during the 1980s.
By 1983, experiments had demonstrated that the predictions of personality models correlated better with real-life behavior under stressful, emotional conditions, as opposed to typical survey administration under neutral emotional conditions.
Emerging methodologies increasingly confirmed personality theories during the 1980s. Though generally failing to predict single instances of behavior. Researchers found that they could predict behavior patterns by aggregating large numbers of observations. As a result, correlations between personality and behavior increased substantially, and it was clear that “personality” did exist.
Personality and social psychologists now generally agree that personal and situational variables are needed to account for human behavior.
In 2007, Colin G. DeYoung, Lena C. Quilty, and Jordan B. Peterson concluded that the ten aspects of the Big Five might have distinct biological substrates.
The FFM-associated (five factors model of personality) test was used by Cambridge Analytica and was part of the “psychographic profiling” controversy during the 2016 US presidential election.
The Big Five Personality Traits
Although a person’s personality and behavior are hard to predict, there are specific tools that we can use that can provide insights into it. These tools help us understand others and ourselves better.
The five personality traits are broad, but they will give us a good general understanding of how people behave [2]. So, what are these traits?
1. Openness
Being open means being able to experience a general appreciation for art, adventure, unusual ideas, imagination, curiosity, emotion, and various experiences. People who are available to new experiences are often intellectually curious, sensitive to beauty, open to feelings, and willing to try new things.
These individuals are known to be creative and aware of their emotions. They are also most likely to have unconventional beliefs. And because they are open to these new things, they are often unpredictable. They also lack the focus they need sometimes and are most likely to engage in behaviors that are against the norms.
The Risk-taker Among Five Personality Traits
Very open people often pursue self-actualization by seeking out euphoric experiences. Conversely, those with low openness seek to gain fulfillment through perseverance and are characterized as pragmatic and data-driven, maybe even close-minded and dogmatic.
*Some disagreement remains about interpreting and contextualizing the openness factor as there is a lack of biological support for this particular trait. Openness has not shown a significant association with any brain regions as opposed to the other four attributes, which did when using brain imaging to detect changes in volume associated with each trait.*
Creativity also plays a big part in the openness trait; this leads to a more significant comfort zone in abstract and lateral thinking.
It includes the ability to “think outside of the box.”
Think of that person who’s always ordering the most exotic things on the menu, going to different places, and having interests you would never have thought of. That is someone who has a high openness trait.
People who are high in this trait tend to be more adventurous and creative. People low in this trait are often more traditional and may struggle with abstract thinking.
High
Very creative
Open to trying new things
Focused on tackling new challenges
Happy to think about abstract concepts
Curious
Imaginative
Unconventional
Low
Dislikes change
Does not enjoy new things
Resists new ideas
Not very imaginative
Dislikes abstract or theoretical concepts
Predictable
Prefer routine
Traditional
2. Conscientiousness
Conscientiousness tends to display self-discipline, act dutifully, and strive for achievement against measures or outside expectations. It is related to how people control, regulate, and direct their impulses.
A person with high conscientiousness is perceived to be stubborn and focused. Those who have high scores on conscientiousness are usually people who do not go without plans. They prefer a reliable method rather than spontaneous behaviors.
The Planner Among Five Personality Traits
The best example of a person with this personality trait is when someone you know likes to plan ahead of time the next time you meet. They also keep in contact and check on your wellbeing. People with this trait often want to organize their dates and events. They are also focused on you when you do meet them in person.
On the other hand, those with low conscientiousness are associated with flexibility and spontaneity but can also appear sloppy and lack reliability.
People low in conscientiousness tend to dislike structure and schedules, procrastinate on essential tasks and fail to complete tasks.
The average level of conscientiousness rises among young adults and then declines among older adults.
High
Spends time preparing
Finishes important tasks right away
Pays attention to detail
Enjoys having a set schedule
Competence
Organized
Dutifulness
Achievement striving
Self-disciplined
Deliberation
Low
Dislikes structure and schedules
Makes messes and doesn’t take care of things
Fails to return things or put them back where they belong
Procrastinates important tasks
Fails to complete necessary or assigned tasks
Incompetent
Disorganized
Careless
Indiscipline
Impulsive
3. Extraversion
Extraversion is a trait that many people will have come across in their own lives. It’s easily identifiable and widely recognizable as “someone who gets energized in the company of others.” The other traits of a person with extraversion include:
Talkativeness
Assertiveness
High levels of emotional expressiveness
All of which made them recognizable in many social interactions or settings. Have you noticed among your family members that there is always someone who is not afraid to express their feelings? They’re often loud and one who laughs the most audible among others. These people are also social butterflies and have the most friends or groups you know.
Extraversion is characterized by breadth of activities (instead of depth), surgency from external activity/situations, and energy creation from the external environment. The trait is marked by pronounced engagement with the outer world.
The Energetic Among Five Personality Traits
Extraverts enjoy interacting with people and are often perceived as full of energy. They tend to be enthusiastic, action-oriented individuals. They possess high group visibility, like talking and asserting themselves. Extraverted people may appear more dominant in social settings than introverted people in this setting.
On the other hand, introverts have lower social engagement and energy levels than extroverts. They tend to seem quiet, low-key, deliberate, and less involved in the social world. However, do not mistake their social involvement as shyness or depression. They are more independent of their social world than extroverts.
Introverts need less stimulation and more time alone than extroverts. But this does not mean that they are unfriendly or antisocial; instead, they are reserved in social situations. Generally, people are a combination of extraversion and introversion.
High
Enjoys being the center of attention
Likes to start conversations
Enjoys meeting new people
Has a wide social circle of friends and acquaintances
Finds it easy to make new friends
Feels energized when around other people
Say things before thinking about them
Sociable
Excitement-seeking
Outgoing
Low
Prefers solitude
Feels exhausted when having to socialize a lot
Finds it difficult to start conversations
Dislikes making small talk
Carefully thinks things through before speaking
Dislikes being the center of attention
Reflective
4. Agreeableness
Being agreeable or agreeableness refers to how people treat their relationships with others. Compared to extraversion, who like to pursue relationships, agreeable people focus on their interaction and orientation with others.
The agreeableness trait also reflects individual differences in general concern for social harmony. Agreeable individuals value getting along with others. They are generally considerate, kind, generous, trusting and trustworthy, helpful, and willing to compromise their interests with others. Agreeable people also have an optimistic view of human nature.
Disagreeable individuals place self-interest above getting along with others. They are generally unconcerned with others’ well-being and are less likely to extend themselves to others.
Sometimes their skepticism about others’ motives causes them to be suspicious, unfriendly, and uncooperative. Low agreeable personalities are often competitive or challenging individuals who can be argumentative or untrustworthy.
Since agreeableness is a social trait, research shows that this positively correlates with the quality of relationships with their team members. Agreeableness also positively predicts transformational leadership skills.
The Strongest Among Five Personality Traits
In a study conducted on 169 participants in leadership positions in various professions. These individuals were asked to take a personality test and have two evaluations completed by directly supervised subordinates. The results showed that leaders with high levels of agreeableness were most likely considered transformational rather than transactional.
Although the relationship was not strong, it was the strongest of the five personality traits. However, the same study showed no predictive power of leadership effectiveness as evaluated by the leader’s direct supervisor.
Conversely, agreeableness is negatively related to transactional leadership in the military. A study of Asian military units showed leaders with high agreeableness are more likely to receive a low rating for transformational leadership skills.
Agreeable people tend to find careers in areas where they can help the most. Charity workers, medicine, mental health, and even those who volunteer in soup kitchens and dedicate time to the third sector (social studies) are high in the agreeableness chart.
High
Has a great deal of interest in other people
Cares about others
Feels empathy and concern for other people
Enjoys helping and contributing to the happiness of other people
Assists others who are in need of help
Trust (forgiving)
Straightforwardness
Altruism (enjoys helping)
Compliance
Modesty
Sympathetic
Low
Takes little interest in others
Doesn’t care about how other people feel
Has little interest in other people’s problems
Insults and belittles others
Manipulates others to get what they want
Skeptical
Demanding
Stubborn
Show-off
Unsympathetic
5. Neuroticism
Neuroticism is characterized by sadness, moodiness, and emotional instability. Often mistaken for anti-social behavior, or worse, a more significant psychological issue, neuroticism is a physical and emotional response to stress and perceived threats in someone’s daily life.
Individuals who exhibit high levels of neuroticism tend to experience mood swings, anxiety, and irritability. Some individuals who share sudden changes in character from a day-to-day perspective could be highly neurotic and respond to high-stress levels in their work and personal lives.
Anxiety, which plays a large part in the makeup of neuroticism, is about an individual’s ability to cope with stress and perceived or actual risk. People who suffer from neuroticism will overthink many situations and find difficulty in relaxing even in their own space.
The Skeptic Among Five Personality Traits
These problems in emotional regulation can diminish the ability of a person scoring high on neuroticism to think, make decisions, and cope effectively with stress. Lacking contentment in one’s life achievements can correlate with high neuroticism scores and increase one’s likelihood of falling into clinical depression.
Individuals with high neuroticism also tend to experience more negative things in life. However, this also changes in response to their positive and negative life experiences.
Of course, those who rank lower on the neurotic level will exhibit a more stable and emotionally resilient attitude to stress and situations. Low neurotic sufferers also rarely feel sad or depressed, taking the time to focus on the present moment and not get involved in mental arithmetic on possible stress-inducing factors.
High
Experiences a lot of stress
Worries about many different things
Gets upset easily
Experiences dramatic shifts in mood
Feels anxious
Struggles to bounce back after stressful events
Angry hostility (irritable)
Self-consciousness (shy)
Vulnerability
Low
Emotionally stable
Deals well with stress
Rarely feels sad or depressed
Don’t worry much
Is very relaxed
Calm
Confident
Resilient
The Five Personalities Traits and Their Influence
From nature and nurture to age and maturation, the big five personality traits have been widely studied where we can see what influences their impact on a person’s behavior and character.
Personality has often been hypothesized as a question of nurture or nature. One particular study looked at 123 identical twins and 127 pairs of fraternal twins. The results suggested that the heritability for each trait is:
53% for extraversion
41% for agreeableness
44% for conscientiousness
41% for neuroticism
61% for openness
It has also been widely recognized that the older we get, the more our behavior traits will change. We become less neurotic, extraverted, and less open to new experiences as we age. However, our agreeableness and conscientiousness grow as we get older.
Five Personality Traits: Men vs women
The consensus is that men and women are more alike than what normative social science would have us believe. But as the title would suggest, there are some exceptions.
Weinsberg and DeYoung 2011 studied the big five traits and, in particular, Gender Differences in Personality across the Ten Aspects of the Big Five. They concluded that women tend to score higher on Extraversion, Agreeableness, and Neuroticism than men.
Other studies have concluded that while the differences may be present, some traits are not extensively separate. Getting older will tend to align behavior traits such as agreeableness and extraversion, where both genders tend to score lower as time moves on.
To know more about Episode 97, click here 👇:
TIMESTAMPS:
00:00 Intro 00:46 Plugs 02:07 Episode Introduction 03:55 Background on the Big Five Personality Traits 10:04 Big Personality Traits: Openness 15:04 Big Personality Traits: Conscientiousness 18:01 Big Personality Traits: Extraversion 21:50 Big Personality Traits: Agreeableness 27:34 Big Personality Traits: Neuroticism 31:18 Big 5 and its Influence 36:19 How the 5 personality traits play role in gender 40:25 Wrapping up the episode
Encephalopathy, delirium, and coma are disorders of consciousness (DOCs) frequently encountered by critical care nurses.
For nurses in the hospital setting being able to have knowledge of encephalopathy, delirium, and coma is important in improving patient outcomes. Furthermore, it is also vital to perform standardized assessments and interventions that are consistent with the cue-response theory.
What is the State of Consciousness?
Plum and Posner’s Diagnosis book define consciousness, that is, being fully aware of the self and the environment, as having 2 aspects, content and arousal.
The content of consciousness is defined as “the sum of all functions mediated at a cerebral cortical level.” The content of consciousness includes cognition, which reflects how well information is processed and stored across the 2 cerebral hemispheres.
Arousal, on the other hand, refers to the level of consciousness or state of being awake. Consciousness and responsiveness are separate phenomena. Some patients may be aware but not able to respond (eg, locked-in syndrome), and patients may respond to stimuli but not be aware of their surroundings.
Based on current research the thalamocortical interactions are crucial for consciousness experience and voluntary action. The thalamocortical system is made up of the Thalamus and Cerebral Cortex.
For Refresher:
Thalamus – the primary function of the thalamus is to relay motor and sensory signals to the cerebral cortex.
Cerebral cortex – many areas of the cerebral cortex process sensory information or coordinate motor output necessary for control of movement.
The Brain
The brain, like other organs, has a limited capacity to withstand injury. The brain reacts to acute stress that can result from:
Toxins
Infections
Inflammations
Metabolic or nutritional derangements
Use of nutrients, glucose, electrolyte level, hydration, or structural damage
A stress response results in multiple cellular-level processes and neurochemical changes that disrupt equilibrium.
This disequilibrium initiates multiple cascades that become a vicious cycle of competition between supply and demand, which are depicted as neuroelectrical changes on an electroencephalogram (EEG).
When the brain can no longer compensate, behavioral symptoms such as altered levels of arousal and disorganized thinking begin to develop.
Progression of Disorders of Consciousness
Delirium
Delirium is a neurocognitive disorder that presents as an acute change in behavior secondary to impairments in consciousness and cognition. There are 3 types of delirium: hyperactive, hypoactive, and mixed.
Regardless of delirium type, individuals are often disoriented to place and time and have impairments in cognitive and visual-motor functions.
Patients with hyperactive delirium tend to have greater disturbances in their circadian rhythm (ie, sleep-wake cycle) and mood lability. Conversely, patients with hypoactive delirium are more likely to be inattentive, have a flat affect, and face challenges with language.
Coma
Like delirium, coma is on the continuum of altered states of consciousness. However, with a coma, there is a loss of both awareness and wakefulness
Minimal consciousness state
Persistent vegetative state
ICU Synposis of Consciousness
When a patient has an altered consciousness, after 2 to 4 weeks, the individual will either progressively recover, die, or transition to a minimally conscious or more persistent vegetative state.
Encephalopathy
The term encephalopathy is derived from 2 ancient Greek words: “enkephalin”, which means “brain,” and pathos, which means “suffering” and is associated with the disease.
Encephalopathy is defined as any diffuse disease of the brain that alters brain function or structure with the “hallmark feature being altered mental status.”
Although the phrases altered level of consciousness and altered mental status are often used interchangeably with encephalopathy, they are not the same. For example, sleep is an altered level of consciousness but is not caused by injury or disease.
Chronic Encephalopathy
Chronic encephalopathy is the result of permanent, usually irreversible, structural changes within the brain. The characteristics of chronic encephalopathy are prolonged alterations in mental status that usually progress slowly.
Examples of these are brain conditions such as Alzheimer’s disease and other dementias or anoxic brain injury. Acute encephalopathy results from the rapid development of abnormalities in cerebral structure and/or function.
Level of Function
Function
Coma
Minimally
conscious
Vegetative state
Self-aware
No
Very limited
No
Motor
Not purposeful
Severely limited
Not purposeful
Respiratory
Variable but depressed
Variable but Depressed
Normal
Sleep-wake cycles
No
Yes
Yes
Feels pain
No
No
Yes
The Mechanism Responsible (DOC’s)
Interruptions in the delivery or use of oxygen
Changes in neuronal excitability
Signaling alterations and changes in brain volume.
Potential Causes
Hypoxia
Ischemia
Toxic and metabolic disturbances
Acute organ failure
Seizures
Drugs and/or alcohol
Infection
Electrolyte imbalances.
Hypothalamic-pituitary-adrenal Axis
Disorders of consciousness and illness severity are linked by the activity of the hypothalamic-pituitary-adrenal axis, which response to stress by impairing glucocorticoid and glucose metabolism.
The severity of the DOC is directly proportional to the levels of glucocorticoids and glucose in the blood that enters the brain (Stress response). In addition to that, the levels of these substances are directly proportional to the strength of the hypothalamic-pituitary-adrenal response, and that response is directly proportional to the severity of the illness.
Early First Signs of Delirium Are Often:
Subtle changes in focus and attention, including distractibility,
Delays in responding to stimuli
Short-term memory deficits
Disorientation
Prevention of Delirium in the Hospital
Nurses should pay particular attention to the following to prevent and resolve delirium:
Resuming home medications
Minimizing the use of chemical and physical restraints,
Providing adequate pain management and high-quality basic nursing care.
Practice habits such as nighttime bathing, promoting uninterrupted sleep as well as day-time activity
Hydration
Nutrition
Early mobility
Nursing Care for Comatose Patients in the ICU
Enteral tube feeding
Promotion of regularity of bowel and bladder functions
Airway management such as suctioning tracheostomy tube
Management of muscle tone (excessive tightness of muscles)
Prevention of infections such as pneumonia and urinary tract infection
Management of other medical concerns such as fever, seizures, etc
If you want to know more about the disorders of consciousness, check out our full episode here 👇
TIME STAMPS:
00:00 Intro 00:44 Plugs 02:31 Episode Introduction 04:35 What exactly is consciousness? 06:37 What happens to the brain? 11:38 Progression of disorders of consciousness 17:24 What is encephalopathy? 19:58 The mechanism responsible for the disorder 20:37 The Potential Causes of Consciousness Disorder 24:57 FUN FACT: How does DOC severity determine? 25:52 What are the early signs of delirium 28:54 How to prevent and resolve delirium 32:23 Nursing care for comatose patients in the ICU 33:55 Area management 35:10 Wrapping up the episode
Reading is a crucial skill that all of us must learn. A person who reads exercises their comprehension abilities and analytical abilities. Imagination and memory recall is stimulated through reading. It also helps in stabilizing your emotions too.
In this episode, we will discuss the three reasons why reading is essential and why we should make it a habit. Towards the end of the discussion, we will dive into a book that we have read in the past year that we enjoyed reading. Be prepared because we are going to dive into life and philosophy on this one.
History of Reading
The National Library Lover’s Month is in February. It’s dedicated to the people who love whole buildings devoted to reading, housing, organizing, categorizing, finding, studying, and otherwise loving books. Join us as we tackle another excellent episode of Cup of Nurses!
Where Did It All Start?
Around 4,000 to 6,000 BCE, Mesopotamia started the first known human civilization. This changed the course of history discovered in these city-states, the earliest known form of writing, cuneiform, and script.
It started with some squiggles on clay to represent a goat and an ox, this form was good to depict the list of goods. But, what exactly do human beings get from reading books? It is just a matter of reading for pleasure, or are there benefits behind the enjoyment of reading?
The 3 Benefits of Reading
Reading transports us to worlds we would never go to, and never see. It introduces us to people we would never meet and instills emotions we might never otherwise feel without reading. Are there other benefits? Reading books benefits both your physical and mental health as well.
1. Reading reduces stress
Put simply, by opening a book, you allow yourself to be invited into an artistic world that distracts you from your daily stressors. On a physical level, reading can even relax your body by lowering your heart rate and easing the tension in your muscles [1].
In a 2009 study from the consultancy Mindlab International at the University of Sussex, tests found that reading reduced stress levels by 68 percent. Thus making it a more effective means of relaxation than taking a walk (by 42%), drinking a cup of tea (54%), or listening to music (61%).
In another study in 2009 as well, a group of researchers measured the effects of yoga, humor, and reading on stress levels of health science program students in the United States.
The study found that 30 minutes of reading lowered blood pressure, heart rate, and feelings of psychological distress just as effectively as yoga and humor did. Lastly, 30 minutes devoted to reading is something that can easily be incorporated into your daily schedule [2].
2. Reading strengthens your brain
A small study in 2013 found that reading a novel increased communication between parts of the brain that control language processing [3].
These changes could be segregated into networks associated with short-term changes originating near the left angular gyrus (Langauge, reading & writing) and long-term changes dispersed bilaterally in the somatosensory cortex (receives and process sensory information across the body).
Reading creates new neural pathways in the brain, this process is known as neurogenesis. Neurogenesis creates neurons that send messages and transmit information to different parts of the brain. How is this possible?
Reading books require thoughts, consideration, and effort to metabolize what’s being described in the book, which leads to the creation of new neurons. The question remains for further research to study how lasting are these effects.
3. Reading percent age-related cognitive decline
Having an active life, mentally, is generally one of the best things you can do to protect yourself from Alzheimer’s. Cognition includes the ability to learn, remember, and make judgments.
A study published in 2020, a 14-year longitudinal study with a representative sample of 1,962 Taiwanese community-dwelling older persons aged 64 and above, followed up in four waves of surveys over 14 years [4].
Results showed that those who read one or more times a week were less likely to have cognitive decline at 6-year and 14-year intervals. After 14 years, older people who read more often had a reduced risk of cognitive decline compared to those who read less often.
Reading is even associated with a lower risk of dementia. In a very large 2018 study in China, 15,582 community-living Chinese individuals aged 65 years or older who were free of dementia were followed up for a median period of 5 years [5].
Daily participation in intellectual activities was associated with a significantly lower risk of dementia several years later independent of other health behaviors, physical health limitations, and sociodemographic factors.
How to Make Reading a Habit
The easiest way to start reading more is to schedule it in your daily life. If you assign it into your planner or schedule, it’ll be harder to miss, having that accountability.
If you are trying to take better care of yourself with activities such as – sleep, nutrition, & exercise, you will want to schedule it into your daily life.
Other tips:
Keep a book with you when traveling or commuting places
Reading books on topics you want to learn more about or are interested in
Reading a book when you wake up or before bed
Be patient – reading, like any skill/habit, takes time to develop
The Books We Like
We are avid readers and among the books that we’ve read, here are three of the best books that made us more conscious of ourselves and life in general.
1. Jordan Peterson – 12 Rules For Life: An Antidote to Chaos
It provides life advice through essays on abstract ethical principles, psychology, mythology, religion, and personal anecdotes. The book pushes the idea that people are born with an instinct for ethics and meaning and should take the responsibility of searching for meaning beyond their own interests.
The critical idea of the book is that suffering is built into being. Being in the material and immaterial existence of a thing. With suffering people have a choice through life to either face it and transcend or withdraw which is almost a suicidal gesture.
He stresses that we live in a world of chaos and order and that everyone has a darkness that can turn them into the monster they are capable of being. However, when that darkness has a focus the impulse can be satisfied in the right situation.
Happiness Should Be a Byproduct
Another key point he brings up is happiness. Happiness should not be a goal of life it should be a byproduct or side effect of your life. Happiness should not be an aim because it’s not something that can stay there, it’s unpredictable and changing.
When you are unhappy does that mean you are a failure or failing? Happiness is based on perception and with perception, you don’t always realize what’s there.
The Gorilla Test does a good job of showing you how your perception changes based on what you are doing. Gorilla test conclusion: results indicate that the relationship between what is in one’s visual field and perception is based much more on attention than was previously thought.
2. 12 Rules for Life Proposed by Jordan B. Peterson
If you like self-help books, this one is a good read. There are plenty of lessons and virtues that you can get from this book. Here’s our take on this book:
“Stand up straight with your shoulders back.”
All animals including humans are governed by an internal hierarchy that is involuntary and biochemical. JBP talks about lobsters in this sense. When 2 lobsters square up for battle a winner is chosen before a fight occurs and many times it does not even lead to a physical battle.
Dominant lobsters have high serotonin to octopamine ratio leading to greater confidence, posture, and strength. That works in the human and nonaquatic world as well. In addition to that, stronger animals get more food, better homes, higher status, better mates, and cooperation from others.
There is a really harsh passage from the bible that goes: (Matthew 25:29) “to those who have everything, more will be given; from those who have nothing, everything will be taken.”
The recommendation JBP gives in this section is to always wake up at a similar time each day. You don’t have to go to bed at the same time each night but waking up is crucial.
Don’t slouch, fix your posture and give eye contact because when both of those are poor it signals weakness.
“Treat yourself like you are someone you are responsible for helping.”
JBP brings up another fundamental t chaos and order, that fundamental is to consciousness. Consciousness is how you bridge the gap between chaos and order and that consciousness allows you to function in whichever manner you choose.
What we should truly be doing for ourselves isn’t what we want and it is also something that doesn’t make us happy. No one understands us better than ourselves and no one can help us more than ourselves.
“Make friends with people who want the best for you.”
The environment around us shapes us. He asks the question if you have friends whose friendship you wouldn’t recommend to others why would you have that friend?
We become the average of the people we spend the most time with.
“Compare yourself to who you were yesterday, not to who someone else is today.”
No matter how competent and accomplished you are there is always someone out there better.
Life is not just a game it’s you playing many games at the same time. If we are always playing the same game and always winning there is no difficulty, there is no growth.
Pay attention, focus on your surroundings notice that something bothers you, concerns you, something that you just want to change.
What is it that is bothering me?
Is that something I can fix?
Will I actually be willing to fix it?
What could I do, that I would do, to make Life a little better?
“Do not let your children do anything that makes you dislike them.”
Children are constant learners trying to figure out where the boundary lies. They are always trying to figure out what the limit is, that is how they learn what they can and can not do.
If you want your children to talk more you need to communicate with them first.
Raising children is having the ability to properly create order in chaos. Giving the child the right amount of adventure while still enforcing good behaviors.
Studies show that if a child does not learn the basics of socialization and discipline it will be a lot harder for them to learn later in life.
Limit the rules
Use the least amount of force possible to enforce those rules
Don’t be a revengeful parent
As a parent, you are the proxy for the real world
“Set your house in perfect order before you criticize the world.”
Many, perhaps even most, of the adults who abuse children were abused themselves as children. However, the majority of people who were abused as children do not abuse their own children.
Ask yourself, have you cleaned up your life?
Start with not doing what you know is wrong
Stop questioning the things you are doing wrong when you know they are wrong.
“Pursue what is meaningful (not what is expedient).”
The successful delay gratification they bargain with the future. The successful sacrifice.
What are your values and do you follow them? Are they in your reality? You may have to sacrifice something you love best for you to become who you might become instead of saying who you are.
The one who wants to bring out the best of all possible futures will always make the greatest sacrifices.
No tree can grow to heaven if its roots don’t reach hell
Realize that thinking about life in a meaningful way is a difficult task for many individuals. Think about it this way CO2 emissions are relevant but are they relevant to someone that is hungry?
Always aim up fix what you can but don’t be willfully blind or arrogant of others and your surroundings.
“Tell the truth — or, at least, don’t lie.”
Nazi Germany was built on small lies.
What should you do when you don’t know what to do? Tell the truth. To accept truth mean to sacrifice.
Don’t lie to yourself. Are your goals really aligned with what you want to be doing or plan on doing?
“Assume that the person you are listening to might know something you don’t.”
Memory isn’t only a tool for the past, it is something that guides your future. However, memory is there to stop you from doing the same thing.
For many listening is too dangerous, they have an impulse to evaluate. It takes courage to listen. But if you listen, people will talk.
“Be precise in your speech.”
The only way you can get your needs out is through speech. Furthermore, speech directs your actions and lets others know your wants and needs.
“Do not bother children when they are skateboarding.”
We are hard-wired to enjoy risk, but it’s the chaos that helps us develop.
People compete to rise to the top. There is no reward without risk.
“Pet a cat when you encounter one on the street.”
Maybe when you are going for a walk and your head is spinning a cat will show up. And if you pay attention to it then you will get a reminder for just fifteen seconds that the wonder of this being might make up for the ineradicable suffering that accompanies it.
3. Meditations by Marcus Aurelius
Meditations is a collection of 12 books written by Roman emperor Marcus Aurelius, who’ll introduce you to Stoic philosophy, the concept of logic, and self-discipline, and give you faith that the course the world runs is good. Aurelius called them “writings to myself.”
4. Book Chapters and Their Summary
Book 1
Marcus Aurelius thanks those to whom he is indebted. His father showed him to be humble, frugal, and calm; his mother for teaching him to be generous and non-materialistic; and his teachers taught him the value of hard work, self-discipline, equanimity, rationality, humor, and tolerance.
Book 2
Aurelius reminds us that each day we will meet some terrible people. He says death, is nothing to fear; it can’t hurt us. But what is most important about us is our minds.
We shouldn’t let them be slaves to selfish passions, argued with fate, or be anxious about the present or afraid of the future.
We can’t guarantee fame or fortune, but we can keep our minds calm and free from injury, a state superior to both pleasure and pain. Freedom is the control of our minds.
Book 3
Aurelius tells us to be mindful of little things like cracks in a loaf of bread and the texture of figs and olives. He says to think and talk about things you would not be ashamed of if they were found out. There is nothing more valuable than a mind pursuing truth, justice, temperance, fortitude, rationality, and the like.
Book 4
Aurelius tells us that we can always find solitude in our own minds. If our minds are serene, we will find peace and happiness. As for how others view us, we have little control over this.
Book 5
Aurelius says to get up each day and do good work. We need to act naturally and contribute to society without expecting payment or gratitude for doing good deeds. Instead, be satisfied with being like a vine that bears good fruit. Virtue is its own reward.
Book 6
Aurelius disavows revenge, not to imitate injury. It is our duty to act righteously and not be disturbed by the rest. Think of good things and control your mind.
Book 7
Aurelius advocates patience and tolerance. Nature works like wax, continually transforming—so be patient. Evil people try our patience and tolerance, but we can remain happy by controlling our response to them.
Book 8
Aurelius argues that being disconnected from humanity is like cutting off one of your own limbs. Instead, live connected to nature and other people. No matter what you encounter, maintain a moderate and controlled mind.
Books 9, 10, 11
Aurelius argues that we should be moderate, sincere, honest, and calm. If someone reports that you are not virtuous, dispel such notions with your integrity, and use humor to disarm the worst people. Kill them with kindness, essentially.
Book 12
Aurelius asks why we love ourselves best but so often value the opinion of others over our own. This is a mistake. Remember too, that the destiny of the greatest and worst of human beings is the same—they all turn to ashes.
One of the last things that Aurelius wrote in his tent, in modern-day Austria, “Life is warfare and a stranger’s sojourn (temporary stay), and after fame, oblivion.”
Learn why reading is important by watching the full episode here 👇👇
TIME STAMPS:
0:00 – Intro 0:46 – Plugs 2:50 – Episode Introduction 7:56 – History of Reading 9:23 – Reading reduces stress 14:20 – Reading strengthens your brain 18:25 – Reading percent age-related cognitive decline 26:50 – How to make reading a habit 29:42 – Peter on “Jordan Peterson – 12 Rules For Life: An Antidote to Chaos” 33:22 – Rule 1: “Stand up straight with your shoulders back.” 36:00 – Rule 2: “Treat yourself like you are someone you are responsible for helping.” 36:53 – Rule 3: “Make friends with people who want the best for you.” 37:58 – Rule 5: “Do not let your children do anything that makes you dislike them.” 39:10 – Rule 6: “Set your house in perfect order before you criticize the world.” 41:07 – Rule 7: “Pursue what is meaningful (not what is expedient).” 42:15 – Rule 8: “Tell the truth — or, at least, don’t lie.” 45:46 – Rule 9: “Assume that the person you are listening to might know something you don’t.” 47:04 – Rule 10: “Be precise in your speech.” 48:43 – Rule 11: “Do not bother children when they are skateboarding.” 49:28 – Rule 12: “Pet a cat when you encounter one on the street.” 51:13 – Matt on “Meditations: by Marcus Aurelius” 51:57 – Meditations: Books 1 to 12
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