If you’re considering working with a Nurse Practitioner, you probably have a lot of questions. Here are some answers!
Your questions answered
Even Keel Health
Nathalie Héloïse Graveline is a nurse practitioner in the Almonte area with deep experience. Nathalie's 25+ years in nursing was mainly spent caring for people with concurrent disorders who struggled with persistent or complex health problems. Learn more from the EvenKeelHealth.ca website.
A different kind of coming out
Disclosing a personal secret is always a daunting experience. So today I want to share some tips with you that might make the process a little bit easier. Whatever the secret, the tips still apply, so read on.
Even Keel Health needs a new home
Sadly, I had to leave Even Keel Health’s first home at the end of June. Many thanks to my colleague in mental health, Julie Clarke of julieclarketherapy.com, who welcomed me with open arms as I got started with my private practice.
Virtual technologies have their benefit but I sure miss face-to-face sessions as many of you do too. I’m not sure when we will get the “go ahead” to resume in-office sessions but I’m hopeful that it will be soon. With that in mind, I’m resuming my search for a great space and I’d like your help finding it.
I can imagine a few different scenarios. I’m sure there are many creative ideas out there but here are a few examples. I might be happy with…
- sharing an already existing professional office with one or a few other health practitioners
- getting together with kindred spirits and setting up a new space we find together
- setting up office by myself in someone’s unused space such as a small apartment in someone’s home ( I would need a private entrance )
- having an office space at an organisation where I could trade some of my services for space.
The “must have”
- I live on White Lake and I’d like to travel no more than 50 minutes to get to the office. In or near Almonte would be my favourite but I’d consider other places.
- With a practice focused on mental health and addiction, most of what I do can be done sitting in comfortable chairs, in a quiet, cozy space but I also need enough space to put up a portable massage table which I use as an exam bench when needed.
- The main room needs to be large enough to sit 4 people with enough space around to not feel crowded.
- Access to water in or near the room
- Access to a washroom
- Access to a waiting area
- Parking nearby
- Easily accessible for people with mobility restrictions
- Good mobile phone reception (I use Virgin i.e. Bell Network)
- I could use the space on at least 3 separate days, for up to 24 hours a week with some hours in late mornings, afternoons and early evenings
- Non-smoking space and minimal use of scented products
The “would be nice”
My time working as an outreach nurse prepared me to work out of a well organized backpack just about anywhere. However, given a choice, I prefer a well thought out space, engineered just right to help my people feel comfortable and safe, and help me be extra efficient and effective.
If you’ve got something that might be suitable, have some suggestions or would like to hear more about my vison for my next space – please contact me.
Nathalie
credit: Photo by Erda Estremera on Unsplash
Living in a pressure cooker?
For some people home isn’t a safe haven. I know. In the course of my professional life, I encountered and cared for many women, men and children who experienced abuse in their homes. Their stories came to mind, earlier today, as I meditated and took in the beauty of my surroundings. I was watching five goldfinches bickering over access to the feeder and boom, just like that I connected to some stored away memories.
Why write about it? I’m writing because we need to talk about it. We all agree that the added stressors brought on by this pandemic are bringing out our best and worst selves and everything in between.
What can we do about it?
It would be wise to keep ourselves in check
- Are you…
- … growing impatient and irritable?
- … snapping at people? Getting short-fused?
- … becoming rude?
- … isolating, feeling unfit for human interactions?
We need to protect ourselves and our kids
- Are you …
- … walking on egg shells?
- … hyper alert, constantly trying to anticipate someone else’s needs to help keep the peace?
- … feeling triggered?
- Sometimes highly stressful situations bring back unresolved past experiences and make it more difficult to cope with the current situation.
- … worried about your safety or the safety of your kids?
- … worried about how your kids are coping?
- … wishing you had someone else to think with?
We need to be on the look out for people who need help
- Are you …
- … disengaging from the people around you, worried about getting in the middle of something?
- … trying to convince yourself that something not right is none of your business?
Help is available!
It is important to restore the balance; level the scale. Imagine on one side of this scale all the stuff which contributes to raising the stress level and on the other side of that scale all which helps us cope and thrive.
We can positively affect the balance in two ways. We can work to decrease some of what is in the stress side and we can increase what is in the coping side.
As an Nurse Practitioner, I have the knowledge and experience to help you with decreasing your stress and improving your resilience:
- Together we can figure out a way to safety.
- Together we can equip you to deal with those in your life who are not coping well.
- Together we can affect what is in your scale and restore some form of equilibrium.
Become your best self, not your worst! It is possible.
Worried about finding some privacy?
We can talk over via a video conferencing platform or over the phone. Whether you are sitting in your car or walking around the block, reach out! We’ll figure out “the how” together.
Are you anticipating many barriers? Have you got many questions? Book a free introduction session to see if we can work them out together.
photo credit Lucas VanOort
Done with feeling off-kilter?
I don’t know about you but I’m ready to shift from surviving to thriving.
In the face of danger, our first response is often to run for our lives or to freeze. After the initial shock, we fight, we get busy dealing with the basic necessities of life. We function in survival mode. After a beat or two, or more, we then get into working the problem. Depending on our training and our past experience with traumatic events we go through the steps with varying speed and efficiency.
“Work the problem,” that’s one of my mantras these days. Repeating it to myself, keeps me from getting overwhelmed. Another good expression to remember is “two heads are better than one.” You may already know that I love puzzles, all kinds of puzzles. I’d like to help you with yours.
Too much stress can mess with your mental and physical health. Be brave! Be wise! Don’t wait! Get help!
Hire a nurse practitioner, a compassionate health puzzle solver. I’m here to help you get back on an even keel.
Need another reason? Looking after yourself well, will enable you to better look after those you love. It is the most worthwhile investment!
Currently, I’m using a health video conferencing platform. You can talk with me from the comfort of your home.
Running Scared?
Most people manage to tolerate high levels of stress for a little while but what happens when a little while turns into longer and then longer still?
Do you know how to keep your mind sharp and your body resilient while dealing with these highly stressful times? Do you know enough strategies to mitigate the effects of stress?
Before take off, travellers on airplanes are reminded that they should put on their own oxygen masks first and then help those requiring assistance. Making sure you remain at your best physically and mentally is not only wise, it is the best way of ensuring that you will be able to continue looking after your loved ones.
My psychologist and my physician have my back. Who’s got yours? I encourage you to get the help you need to look after yourself!
I’m using a health video conferencing platform. You can talk with me from the comfort of your home. You’ve got questions about how this works? Ask for a free introduction session.
Nathalie Héloïse Graveline, Nurse Practitioner
I miss you so much!
Two months ago my friend Jim died. Every day since, he has been on my mind at some point in my day. We didn’t know each other long, less than a year, but the time we shared was really meaningful. He liked that we could talk about anything and everything. I knew, as we became fast friends, that we might not have long, so I made a point of not missing out on opportunities to spend time together. Jim died just before celebrating his 94th birthday, following a short illness.
Our time together changed both of us for the better. My friendship with him, reminded me that I’m capable of being “all in” even if I know that it might be short-lived; that the pain of the loss does not out-weight the meaningfulness of the shared experience.
That was a valuable reminder. Over my many years working with very sick patients I’ve experienced a lot of losses. But even before that, I was someone who favoured having a few close friends and who experienced losses deeply. Prone to introspection, I often wondered how it was that some people seemed to manage multiple short-term connections and then more easily bounce back from their loss after they exited each other’s lives. The answer is a complex one and I’m still figuring out all its parts but here’s a bit of what I know about getting through losses.
Mourning
We need to mourn our losses. Mourning is when we take the grief we feel inside and find ways to express it outside ourselves.
I’m getting ahead of myself. Maybe I should tell you about grief first.
Grief
Grief is our internal experience of loss. The word is used to define our experience facing all kinds of loss. Today, I’m talking about the loss of a loved one, from dying.
There is no right or only way to mourn. However, I would venture to say that, in my experience, those who find a way to share their experience with others, tend to fare better.
Complicated grief
Some people have to deal with losing a lot of people during their lifetime. If there are too many losses, within too short a time span and the person hasn’t had the opportunity to “properly” mourn one loss then the impact can be further complicated. Sometimes a new loss can trigger the resurfacing of previous unresolved losses and make dealing with the new loss more difficult.
Unresolved losses can lead a person to adapt by emotionally withdrawing and avoid making new meaningful connections with others for fear that they might have to experience another loss. This seems very protective and is partly unconscious. It is also not the best coping strategy for the long run.
We can’t selectively cut out some of our emotions and feelings. Invariably, if we try, we end up cutting everything out and numbing ourselves. The consequence of this is that we end up depriving ourselves of the good stuff too.
If, as time passes, you feel like your grief is getting heavier instead of lighter, you might be experiencing complicated grief.
Here for you
You don’t have to struggle alone. If you’re concerned about the way you are coping, reach out! I can help you through this. If you are worried about someone else, reach out! I can help you learn more about this and help you help them.
During the “social distancing” period some of my services are available by phone and via secure video conferencing and my rates are on a sliding scale. Contact me for details.
Nathalie Héloïse Graveline, NP
In-person versus remote counselling sessions
I’ve always preferred face-to-face communication and no doubt always will.
Another truth about me is that I’m a good problem solver. I am one of these people who respond to challenges by “working the problem.” I love solving puzzles, to break problems down into manageable bits and to find solutions for the parts, and eventually for the whole.
COVID-19 is on everyone’s mind, too much, for some.
Like everyone, I have my own list of worries. More than anything, I worry about the long term effects of this pandemic. I worry we might be treating this problem like a sprint and not a marathon. I worry we might be all so focussed on COVID-19, the virus, the pandemic and its immediate effect, that we might be neglecting other problems and in particular other health problems. I worry that people might not be looking after their whole health and might be neglecting to work at building resilience to deal with what is happening now and what remains to deal with ahead. Getting through this will require resilience and stamina.
This time is a time for interdependence. We need to get “OK” with leaning on each other. If you’ve never learned to do that, if all your life you’ve been programmed to rely on yourself and on yourself alone then now is the time to challenge that way of doing things.
I predict that it is those who are drawing on the necessary internal and external resources, those who are accepting help and who are offering help to others, who will fare the best.
The wise will use all the tools available, to not only survive but also thrive. In these times of social distancing, we are all looking for new ways of doing things. We are all looking for new ways to cope. If you are struggling to cope during these extra challenging times, know that you are not alone. Do not isolate in every sense of the word! Maintain social distancing, yes, but also reach out. Accept the help available so that you may thrive not only survive. If you have ways to help – help out! We’re in this together. If you don’t need help but wish to help let me know, let others know. Someone might just be looking for what you have to offer!
I’ve now got things setup to offer services by phone or via secure video (doxy.me). I’m working from home so I’ve expanded my hours of availability.
If you’ve considered mental health counselling and never had the time or the opportunity to get started, then now might be the right time.
If your are a frontline worker and would like some support, I’m here.
I’m here for you all.
Let me help you get back on an Even Keel.
Nathalie Héloïse Graveline
Nurse Practitioner
Even Keel Health
I’m so tired!
What is fatigue?
Fatigue is such a common complaint. It is one of those symptoms which is too often not getting proper attention.
Everyone has, from time to time, felt overtired. Feeling temporarily fatigued after working too hard for too long is easy to understand and typically resolved with getting proper rest. Most people know what to do about that kind of fatigue.
I want to discuss a different kind of fatigue — that unrelenting exhaustion, that “I’m so tired I could cry” kind of tiredness. I’m talking about the kind of fatigue which isn’t resolved by rest alone. That weariness which has developed over time and seems to sap your energy, your motivation, your concentration. The kind which has got you disconnecting for the world around you and has got you thinking that you are “not fit for human consumption.”
Fatigue has so many causes.
Lifestyle factors
There are many lifestyle factors contributing to fatigue, such as the adverse effects of alcohol, drugs and certain over the counter medications such as allergy medications or cold remedies. Too much physical exertion or, conversely, a lack of exercise are also common causes. The better understood cause of fatigue is, of course, is lack of sleep or a lack of recuperative sleep. Or then again maybe a lack of quality sleep is not that well understood. With our frenetic schedules today we have created a problem by neglecting the need for good sleep hygiene.
Health conditions
A great many health conditions also present with fatigue as one of their symptoms. I won’t list them all. I will draw your attention to the fact that sometimes we attribute fatigue to one cause and we might have missed the culprit, or more likely the combination of culprits.
Another thing to consider when assessing fatigue is that ironically, some of the medications used to treat certain medical conditions cause some fatigue. The intensity of this undesired effect varies widely from person to person. That’s why it is worthwhile to find out if a smaller dose or a change of medication is indicated for you. Going though life feeling fatigued all the time is not ok.
Being a Nurse Practitioner with a practice focussed on mental health and addiction problems, I cannot talk about fatigue without including the fact that many mental health problems present with fatigue. If you’ve experienced grief before, you’ll remember that bone deep fatigue. People who suffer with depression also experience fatigue. So do those with PTSD and anxiety disorders. Many of my patients recovering from opioid addiction started out with and continue to struggle with chronic pain. Chronic pain is almost always accompanied by fatigue.
Why am I writing about this? I know what it’s like. Fatigue is a difficult thing to tackle but I’m a puzzle solver. One of my former, long time patients called me her “health detective.” I hate knowing that many people are out there slugging their way through life feeling tired all the time. It doesn’t necessarily have to be that way. If you are tired of being tired and you’d like some help figuring out your fatigue puzzle, reach out. I’m here for you.
Do you have what you need to get back on an even keel?
Happy New Year Everyone!
One of my plans for the next year is to set some new ground work with new information. If you’ve read my blog before, you might know that I feel strongly about the value of working near home, for personal and environmental benefits. Of course, not everyone is able to do this. But I want to work near home while contributing to the welfare of my community. That’s why I’ve created Even Keel Health, my private Nurse Practitioner practice.
So far, there aren’t many Nurse Practitioners in private practice. A private practice brings its own sort of challenges. One of which, is dealing with a provincial health care system which hasn’t yet made the requisite infrastructure changes to allow NPs to bill the Province for the health services they provide to its citizens.
In Ontario, Nurse Practitioners have been providing health care in various communities and settings for more than 45 years. So we are not exactly new. However, our scope of practice and where we practice our profession is in constant evolution as is all of healthcare. This might, in part, explain why so many people are unclear about what we do and what we don’t do.
A friend recently told me that someone vehemently argued with her that Nurse Practitioners only prescribe medications under the supervision of a physician. That isn’t so.
Her story, however, served to reaffirm in me the belief that more needs to be done to dispel misinformation about NPs. Is misinformation keeping patients and providers from finding each other?
You know what they say about those who assume. When you assume you make an ass of u and me. Please forgive the sassiness and consider this: I sure would love for people to feel comfortable to ask more questions about NPs. I would love it if people informed themselves instead of making assumptions. And I would love it if those who are misinformed stopped spreading inaccurate information.
This reflection led me to consider whether or not I am guilty of the same. Am I making assumptions about what health services, people in my community need?
Recently, I wrote a blog post titled Lead By Example! I encouraged people to behave as they would like others to behave. So here I am, putting that advice into practice.
I am aware of some of the gaps in the health services available in my region. I have taken some steps to inform myself about what is available and what is missing but I would really like to hear more about your experience seeking and accessing health services offered in this region.
Your answers to the survey will help me better understand what you are looking for and inform the choices I will make about how to best serve my community.
Please take 5 minutes to speak up via this survey. I am genuinely interested in learning and making informed decisions about how to best use my skills, knowledge and experience while serving my community. Spread the word the more answers the better! Answer now ! This will only be available until February 10 2020.
Nathalie Héloïse Graveline
Even Keel Health 