It’s no secret that hospitals and healthcare are undergoing tremendous changes. Medical and nursing associations are struggling to maintain quality patient care and hospitals are focused on the bottom line in order to stay alive.

While much attention has been focused on the turmoil, we have been hard-pressed to focus on the emotional toll it has taken on us, the nurses. It seems that no one is caring for the caregiver, and we must as a group take care of ourselves. In light of that I propose the following rules.

Rule #1: Everybody knows something.

Rule #2: No one knows everything.

Rule #3: In light of rules #1 and #2, create a colleague-supportiving environment. Offer information. Share what you know. Constantly teach one another. Be nonjudgmental and accepting. Answer questions. Ask questions. There is no such thing as a stupid question, but we’ve all asked it! Give senior staff a break. Don’t expect them to know everything and be disappointed and critical when they don’t. Give new staff a break.

Rule #4: Work as a team. Consistently offer to help with the physical demands of the work. You are responsible for your own patients, but you are responsible to each other as professional nurses and human beings.

Rule #5: One nurse shouldn’t have a horrible, terrible, awful day unless all nurses are having a horrible, terrible, awful day.

Rule #6: One nurse shouldn’t have a breeze of a day unless all nurses are having a breeze of a day.

Rule #7: Recognize the turmoil that change brings. Healthcare is changing. Nursing is changing. The environment is unpredictable, tentative, and stressful.

Rule #8: Recognize the losses. Allow yourself to grieve the way things used to be. New staff grieve the loss of seniority, familiarity, and the comfort zone of their old areas. Senior staff grieve the aburpt loss of many colleagues who were role models, leaders, and consultants in care. New grads grieve the protection and security of a school environment.

Rule #9: Attempt to survive. Determine that as a cohesive staff you will “circle the wagons” to defend and protect yourselves. Do small but important things for each other. Leave the patient care area neat and clean, tie up loose ends, label tubing and multiple drips, restock important items. You don’t have to be everyone’s friend, but you need to have a professional working relationship with all staff. Collectively communicate concerns as well as anything positive about each other and the hospital to the charge nurse and nurse manager. Explore your options. Are you suffering from burnout? Can you take a break of some duration to regroup? Are you too burned out to recover? Be realistic. Some things will get better, some will not. If you decide you really need a change … go for it! There’s a nursing shortage and the world is your oyster.

Rule #10: Carpe Diem! Remember that we are all part of a noble profession, that despite tremendous obstacles and frustrations, we are able on a daily basis to assume responsibility for the life, comfort, well-being of other human beings. Seize the day.

Source: Nursing Spectrum / Patricia Agostino, RN, CEN, CCRN, is a critical care nurse at Stamford Hospital, Stamford, CT.