Gillian Gordon BSc(Hons), CertVN ECC, RVN, explores what this state of mental or emotional strain is, how it can be healthy and a way of managing it in a mindful manner
Starting a new year, I was faced with one of the most challenging and hardest decisions of my career – to quit a job I loved to prevent both my physical and mental health from deteriorating. Working in an emergency and critical care (ECC) hospital pushed me to my limits, and without the proper help and support I required, I walked away from a job that I was not only good at, but also had a huge passion for – to protect my health. As we all know, being a VN can be extremely rewarding; however, at times, it can be massively challenging and tremendously stressful. Veterinary nurses are at a huge risk of developing mental health problems at some point in their careers due to the stressful nature of the job. I believe that, as an industry, this stress is not being managed to the same standards as other industries, which offer counselling, coping strategy sessions, cognitive behaviour therapy sessions, crisis helplines, fully trained mental health first aiders, mindfulness via the NHS, and relaxation periods such as massages monthly to their staff members (City Building, 2019; personal communication). I also believe veterinary managers need to take more action in this “taboo” subject by offering more support for veterinary nurses who may be suffering from stress and mental health difficulties within the workplace. Considering this lack of management and support to those suffering from mental health issues within the veterinary industry, I have questioned whether this is one of the main reasons that lead many of us to leave the profession completely. It is heartening that the RCVS is promoting research in mental health with the Mind Matters Initiative. Here, it is raising an awareness of mental health within the profession, together with encouraging people to seek help if required. The RCVS is setting a great standard for other practices and has signed the “Time to Change” employer pledge. This demonstrates its commitment to supporting mental wellness in the workplace – striving to improve mental health and well-being. More information can be found at www.vetmindmatters.org Vetlife is another great step to supporting our sector (www.vetlife.org.uk); however, there is always room to do more – especially more independent practices offering help and support to their staff. This article will explore what stress is, how it can be healthy, and how we can manage it with mindfulness when it all gets a bit too much.
What is stress?
Stress is how the body reacts to external pressures that we perceive to be uncomfortable and occurs when these apparent pressures exceed our ability to cope (NHS Inform, 2020). Things that cause stress are called stressors. When we perceive an event as stressful physiological changes occur and these changes are controlled by the autonomic nervous system. This is divided into two parts:
The sympathetic nervous system: this is aroused when we feel threatened or challenged. It is an essential survival mechanism where large amounts of energy are accessed for short-term use. Adrenaline is released for either fighting or running away – the “fight or flight” response.
The parasympathetic nervous system: this restores the body to a state of rest or calm when the stress subsides. It is healing and regenerating. Energy is directed and resourced in a long-term way to enable performance of self-nurturing activities (Ziegler, 2004).
The two systems behave like a see-saw; one side is in predominance, while the other is quiet. In life, we are aiming to have the appropriate system active at any time. The aim, therefore, is to identify ways of gaining control of the see-saw and access the parasympathetic nervous system. With practice, relaxation techniques are a powerful way of achieving this. The effects of stress can build up over time and symptoms can become more intense.
Further hormones are released that raise blood sugar levels and blood pressure, and the immune system is affected. If this continues over a prolonged period of time, symptoms such as fatigue, poor concentration, irritability, lethargy and ill health become present (Every Mind Matters, 2020). It is important, however, to understand that stress isn’t all bad. A healthy level can actually be a great motivator, but this “healthy” level is different for every individual. Too much stress can lead to anxiety, while too little stress (when too few demands are made on us) can result in boredom, feeling undervalued and understimulated.
This is where mindfulness comes in. No one way to “cure” stress exists, but learning to manage it can keep you in that healthy balance. The most effective way of managing stress is to manage it every day – not only on the days that you feel you have lost control and have difficulty coping. Many mindful ways to manage stress exist, and it is good to find ways that work for you.
What is mindfulness?
With its origins in Buddhist meditation beliefs, mindfulness is a technique that involves making yourself aware of your mind, body and surroundings. Mindfulness can help you:
Every day is a chance to train your mind for a happier, healthier life. Mindfulness isn’t just about taking time for you, but taking time for others, too. Mindfulness isn’t for everyone, and isn’t an instant cure, but trying these techniques could help you manage stress, your brain and your emotions – and understand these emotions. When stress builds up, you need to distract yourself and give yourself a break from worrying. Everyone has their own way of clearing their head of the things that are bothering them. You know what makes you happy and relaxed – or maybe you could try something new?
What do you enjoy?
Think about what you enjoy. It could be:
Helping others – this can make us feel better about ourselves, so why not try volunteering? It’s also a chance to make friends outside your usual circle and learn new things. l Try doing a task with the other hand – does it make you more aware of things?
Mindfulness techniques Learn to relax.
If you can take time out every day to relax, it can stop stress building up and help you cope. Relaxation deeply calms the mind and body; restores energy, ready for the next activity; and counteracts the stress response. It also:
During your working day, take a break – make sure you don’t overdo it. Being a veterinary nurse means you are multitasking – usually to your maximum capability – but try to take a break in-between your day to keep a good balance between work and time for yourself. Take a walk and get some fresh air – being in green spaces can help lift your mood (Welldoing.org, 2017). Relaxation is necessary – particularly after ECC trauma, for example. The following are some techniques you can use at work, at home (or in a quiet place) to help manage stress.
Mindful breathing is a basic technique you can apply to the rest of the tips here. Slow down your breathing, focusing on a slow, but stable, rhythm. This can help lower your heart rate and instil a sense of calm. Try breathing in for four seconds, holding it for seven seconds, then breathing out for eight seconds. Repeat this at least three times. Mindful breathing can ease tension, calm you down and boost your concentration. You can do this just about anywhere – no one will notice. Focus on your breath. How does your next exhalation feel?
Mindful meditation Sit back and relax
This could involve you sitting quietly on your own, focusing on your breathing, your thoughts, and the sensations and things you can hear and feel around you. Focus on your breathing when your mind begins to wander. Meditation takes practice; however, it can make you feel calm and confident while enhancing your emotional well-being, building your confidence, developing your social skills and reducing your anxiety. Close your eyes and imagine a peaceful place. Choose your special place, then for a few moments imagine you’re really there. Meditation helps see your everyday world through a new set of eyes. Meditation and life are not separate – meditation simply helps us see and understand life more clearly. It’s tempting to live as though life will go on forever, so we forget to appreciate each and every moment. The heart of meditation is taking ourselves a little less serious. Have you taken a moment to pause today? To listen? To be present? Try it in this moment now. When we pause to let our minds rest, we feel better. No big mystery. The mystery is why we don’t give ourselves this gift more often.
It’s a myth that drugs, alcohol and smoking relieve stress and help you relax. You might get a temporary boost, but they damage your physical and mental health, and can actually increase stress levels. Fun exercise is a great way to reduce your stress levels. Try going for a walk instead (your local park is great for this) and pay close attention to your surroundings. Focus on your footsteps, the breeze, sights, smells, sounds and textures. This can connect you with nature, and importantly, yourself. Keeping fit also keeps you focused while boosting your coordination. Yoga and pilates are an excellent way to mindful exercise – why not give it a go at home or research your local class? If you are not a gym lover then a simple walk each day, dancing or gentle exercise can actually make you feel happier.
Exercise releases endorphins in the brain, stimulating a better mood. Try doing each of these (or as many as you can manage) three times before moving on to the next one:
Try picking up a pencil (or pen) and beginning to draw or colour in, paying attention to the sensations of the pencil, the colours and the shapes. You don’t need to draw anything in particular, but instead focus on the act of creating. Below is a dog pattern to colour in – why not give it a try? Another proven method of enhancing mental health and recovery is to write things down. Write to Recovery is a very useful website from the Scottish Recovery Network that supports people to share their personal stories – because everyone has a story. Writing things down can help you in many different ways and Write to Recovery is for anyone who has ever experienced some sort of distress, emotional difficulty or mental ill health. It invites you to write your stories and experiences – and gives you tools to inspire you. Visit www.writetorecovery.net
Intuitive eating is trying to understand the way you eat. Your eating habits can change when you’re stressed – and not eating properly can make you feel worse, and affect your concentration and energy levels. Therefore, what you eat can affect your mental well-being. Try to have three meals per day with a couple of healthy snacks in between (try to eat at least five portions of fruit and vegetables each day) and try to drink six to eight glasses of water every day. Water is life. When eating (or drinking), focus on the flavour and texture. Eat good food – eating healthy prevents you feeling sluggish and tired; it increases your concentration and can give you the energy to get through a busy shift. Try switching your fifth cup of coffee of the day to a herbal tea and have a cuppa on me.
Sleeping and veterinary nursing don’t always seem to go together, but you should aim for seven to eight hours every night. Regular poor sleep is associated with a number of health conditions, including diabetes and heart disease, and may lead to mood disorders such as depression and anxiety. Try to have a routine of going to bed and getting up at the same time each day, and avoid caffeine in the evenings. Stress can stop you getting enough sleep – and that can make you feel even worse. Why not try the following?
Write your thoughts down just before you go to bed. It can help clear your head.
Keep a pen and paper handy. Make a note of things that wake you up during the night.
Try breathing exercises to reduce tension and worries that keep you awake.
Some relaxation apps to help you sleep are: l Calm l Sleep Easily l Breathe l Buddhify l Headspace l RelaxMelodies l Pzizz l Insight Timer.
Have you ever considered the impact social media can have on your mental health? We can all be impacted negatively by social media in many ways, including high anxiety levels, depression, bullying, loneliness and constantly comparing yourself to others. A simple detox for social media on how to break the addiction may include:
What would it be like if you turned your notifications off on your mobile phone today? Try to socialise without alcohol. Although you may think alcohol will help you forget your worries, it can actually do the opposite. Alcohol can negatively impact on your mood and should not be used as an escape from worries or mental health concerns. Socialising, meeting new people and exploring can be great fun, and doesn’t always have to involve alcohol.
Time spent laughing always improves your mood, and spending time with friends and family can make you feel good about yourself and life in general. Ever considered volunteering? Make the most of your spare time and try something fun. Volunteering isn’t just good for your CV – it’s a great way to make new friends, learn new skills and do something for others. I am one of the team leads for Glasgow StreetVet and get great satisfaction in helping others.
For more information, email firstname.lastname@example.org or visit www.streetvet.co.uk
How to get the most from mindfulness
To get the most from mindfulness:
It can be helpful to set yourself a “worry period” where you would set a specific time of day (for example) to address your worries or concerns, so if your mind does wander during relaxation time, you know you will come back to these worries at a later time. l Be kind to yourself: become aware of the emotions you are feeling, and approach them with curiosity and without judgement.
It is so important to look after your mind and body. Self-care is a priority and you need to take time for yourself. You wouldn’t let your mobile phone run out of battery, so don’t let this happen to you either. Know your health baseline and prioritise self-care. What I have learned is it’s hard to cope on your own and bottling up your worries adds to your stress, but talking about how you feel can put you back in control. The tough bit can be getting that conversation started. If you feel your workplace is not willing to listen then please talk to someone else who is willing to listen. Some people don’t like asking for help, either. You may not want to burden other people with your troubles, or you may be worried about how they’ll react.
It’s important to find the right person to talk to and to plan what to say. For me, this was externally to my previous job; however, help is always out there. Initiatives such as Mental Health Awareness Week are a good time for everyone to notice how we really feel, slow down a little and reach out for help if we know we are struggling or touch base with those you feel may need help. Don’t let things build up; make it the foundation of your routine. As a veterinary nurse, I have felt pretty awful some days, having low self-esteem, being full of self-doubt and feeling trapped in negative thoughts. Speaking up about it to a colleague, it is amazing the instant relief you feel, and knowing that tomorrow is a new day and a new chance to re-evaluate what you are grateful for, so don’t be frightened to speak about how you feel. We are all different. It’s much healthier to accept that you’re unique than to wish you were more like someone else. Feel good about yourself and grow your own confidence.
Paradoxically, the best way to make ourselves happier is by focusing on the happiness of others. Is there someone close to you that you could genuinely compliment? Kindness is always here, just waiting for us to find it. It is so important to know where to go for support and have a support network in place. Whether you just want to talk to someone, or need help with a specific issue, someone is always there to offer support and advice. Friends and family are often your first contact. Try to be honest with them about what is going on, and share your problems with each other. If you feel you may need extra support, plenty of organisations out there can help, including Vetlife – which is not just for vets.
Help is out there I hope this article gives at least one person the courage to speak out about his or her mental health and always remember that help is out there – you just have to ask for it.
References and further reading