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Walter Reed National Military Medical Center (WRNMMC) celebrated its nurses last week during National Nurses Week.

The celebration at WRNMMC included a candlelight ceremony with the blessing of the hands that heal; a DAISY award ceremony honoring the medical center’s extraordinary nurses; a Nursing Grand Rounds focused on compassion fatigue; pizza night; a social on Building 10’s rooftop garden; and a nurse call.

This year’s National Nurses Week theme, “Nurses Leading the Way,” highlights the evolving roles of the caregivers while they are embracing new technology and resolving emerging issues. This was also the focus of the presentation by guest speaker Dr. Marguerite Littleton-Kearney during the DAISY award ceremony on May 7.

While Littleton-Kearney discussed some of nursing pioneers, including Florence Nightingale, Linda Richards (the first professionally trained American nurse), Mary Eliza Mahoney (the first African American professionally trained nurse in the United States), and Dr. Luther Christman (an American nurse, professor, university administrator and advocate for gender and racial diversity in nursing), she also focused on the future of the profession.

A retired captain from the Navy Nurse Corps, Littleton-Kearney is professor and associate dean for research in the Daniel K. Inouye Graduate School of Nursing at the Uniformed Services University (USU), and the university’s director of the Faye G. Abdelluh Research Center.

“In order to move patient care and health care forward, we have to be more educated,” Littleton-Kearney said. She added advanced practice registered nurses (APRNs) and nurse practitioners (NPs) have moved the profession forward, and “are making a difference in patient care.”

Another movement in the nursing profession came about five years ago, when the American Nurses Association (ANA) called for more clinical doctoral education for nursing, Littleton-Kearney said.

She added that as prevention and wellness increasingly become the focus of health care, more APRNs will be in demand, which may exacerbate the nursing shortage. The shortage may be intensified as “baby boomers” age and the need for health care grows, she continued.

The demand for nurses may create more entrepreneurial opportunities within the profession, Littleton-Kearney continued. “Nurses may be involved in non-traditional roles, such as with policy development, in health care related businesses and with insurance companies. It’s limitless. I think we’re also going to see an explosion of nurse-run clinics, especially in underserved areas where health care is at a premium,” Littleton-Kearney concluded.

Following Littleton-Kearney’s presentation, WRNMMC leadership staff presented the DAISY award to Army Spc. Jia Jenkins, a practical nurse in the Mother Infant and Child Care Center. Nominated by a “grateful patient” who wished to remain anonymous, Jenkins was described by the patient as a patient advocate and a star.

“She was my nurse after a very scary C-section,” patient stated. “Within minutes, she was advocating for me, getting me to laugh, answering any and all questions, [and] I felt like family. She was instrumental in building my confidence. No request was too huge or too small. She’s a stand-out nursing star. Her commitment to me as a patient will never be forgotten.”

Following the DAISY ceremony, Army 1st Lt. Christopher Reyes, a pediatric nurse, hosted the Nursing Grand Rounds, discussing compassion fatigue. According to the ANA, compassion fatigue is “a combination of physical, emotional and spiritual depletion associated with caring for patients in significant emotional pain and physical distress.”

Reyes added not everyone who works in health will develop compassion fatigue. He explained compassion fatigue is a term first coined about two decades ago to describe the loss of a nurse’s ability to nurture, most often seen in those caring for the ill, wounded, traumatized and vulnerable patients in their charge. He said some of the symptoms of compassion fatigue may be headaches, digestive problems, sleep disturbances (too much or the inability to sleep), muscle tension, cardiac symptoms, mood swings, restlessness, irritability, oversensitivity, depression, anger and resentment, loss of objectivity, memory issues, and poor concentration, focus and judgment. He said people with compassion fatigue may also exhibit work avoidance, lack of joyfulness, reduced ability to feel compassion towards patients or families, and frequent use of sick days.

“Most of us spend our time developing care plans for others, but we tend to forget about ourselves, and when we neglect ourselves we have the potential for compassion fatigue and/or burnout,” Reyes said.

The pediatric nurse explained the difference between compassion fatigue and burnout, stating compassion fatigue’s onset is sudden, whereas burnout occurs gradually and overtime. Compassion fatigue is relational, resulting from caring for those who are suffering, whereas burnout is reactional in response to work or environmental stressors such as staffing, workload, managerial decision-making, etc. In addition, compassion fatigue’s possible negative outcomes includes imbalance of empathy and objectivity, while burnout’s potential outcome includes decreased empathetic responses. “The longer you stay in a situation in which you feel burned out, you will eventually just give up,” Reyes said.

He added it’s important for caregivers to develop coping strategies, such as “not going it alone” by maintaining close professional relationships and rapport, which provides an outlet versus enduring the fatigue. “Have a mentor and a peer you can go to who understands your profession,” he continued.

“Know your limitation,” said the lieutenant. “Learn your triggers, take leave as necessary, develop rituals for dealing with loss, grieving or death, and use self-care strategies such as meditation.” He added a self-care plan, similar to WRNMMC Director Brig. Gen. Jeffrey B. Clark’s Prosperity Plan, should include physical, spiritual, emotional, psychological and professional components.

“Sleep, eat and exercise well,” Reyes said. “Pray, meditate and fellowship. Cry and laugh. Self-reflect, learn to say no, smile, take breaks, set limits, seek peer support, and use vacation time,” he concluded.

According to the 2014 Congressional Resolution (H. Res. 540), nurses represent the largest single component of the health care profession with an estimated population of 3,100,000 registered nurses in the United States. In addition, nurses have again topped the Gallup’s annual Honesty and Ethics survey of professions. Nurses have topped the list every year since 1999, the first year Gallup asked Americans to rate professionals based on their honesty and ethical standards, except for in 2001 when firefighters were included on a one-time basis, given their prominent role in the 9/11 rescue efforts.

National Nurses Week is celebrated during the week that coincides with Florence Nightingale’s birthday (May 12), considered the founder of modern nursing. She came to prominence while serving as a nurse during the Crimean War, where she cared for wounded soldiers. The first National Nurses Week in 1954 was observed during the 100th anniversary of Nightingale’s mission to Crimea.