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 

Tired looking dog on leash

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

two rule books

Lead by example!

Living by one’s core values can be a difficult thing to do. To help me live by mine, I have some mantras which guide and motivate me to stay on my chosen path. 

“Lead by example” is one such mantra which was added to my repertoire when I was in my teens and active with the sea cadets. 

As a nurse practitioner, I often find myself in a position to provide advice, to expect others to follow my instructions. Most of the advice I offer is well received and some is no doubt, hard to follow.  

How do I know that? I know because from time to time, when I find myself in a difficult situation I think to myself: “what would I advise my self, if I were my patient?”

If I have sound advice for my self then I know that I must try to follow it. I know I do, especially if I also want to be able to feel authentic the next time I advise someone else to do the same. 

My experiences and the empathy I feel for my patients, fuels the compassion I can show to them as they take those difficult steps toward a steadier and happier self.

As a leader, a supervisor, a parent are you leading by example? Are you following your own advice or are you living your life with two rule books: one for others and one for yourself?

If you’d like help with that, reach out ! I’m here to help you.

To discover some of my other helpful mantras come back soon. 😉

Nathalie

paddlers in the morning mist

Second chances

Who doesn’t like getting a second chance?

December 5 is the last Wellness Seminar of the Fall Series.

Sadly I had to put the boats away for the cold months. Sigh!

The weather was not cooperating on November 21 so I held on to the talk scheduled for then and will be presenting “Let’s Talk about Addictions” on December 5, 7-9 pm.

Reserve some time in your agenda to join us at the Almonte Branch of the Mississippi Mills Public Library to learn some useful information about addictions and how to support those you love who might be struggling during the holiday season.

New to the Wellness Seminars? Find out more at EvenKeelHealth.ca

I look forward to seeing you. RSVP are appreciated.

Nathalie

ballons

Happy Nurse Practitioner Week!

I want to take a moment to celebrate my Nurse Practitioner colleagues. This week is National NP week. A good time to take a breath and recognize the valuable contributions of these amazing healthcare providers.

Some people say Nurse Practitioners are “fairly new.” Really!? How long do you have to be around to no longer be fairly new? I guess everything is relative. Still, did you know that we’ve had nurse practitioners providing care in Canada for nearly 50 years? At first, we saw most of them working in remote and rural areas but now we’re in acute care hospitals, family health teams, community health centres, Physicians’ offices, NP-Led clinics, private practice and many other places where health care is needed.

My post graduate nursing education has prepared me to expand my scope of practice and allowed me to really grow as a nurse. I love that as an NP we can diagnose illnesses, order & interpret diagnostic tests, refer to other health care professionals and specialists, provide counselling and education, provide treatment, prescribe all medications and manage chronic diseases.

I, personally, feel most passionate about helping people recover from mental health and addiction problems. I feel strongly about integrating my patients’ mental health and or addiction problems within their overall health care plan. My mission : to get you back on an even keel.

Please join me in celebrating the Nurse Practitioners in your life.

Learn more about the 3,700 Nurse Practitioners in Ontario at NPAO.org

Learn more about Nathalie Héloïse Graveline, Nurse Practitioner at EvenKeelHealth.ca

ballons

Photo by Adi Goldstein on Unsplash

hands reaching toward each other

It doesn’t have to be this hard!

Those who know me well, know that I’m not really good at asking for help. I’m working on it. The journey to get to this success has been a difficult one. I will not bore you with the details but suffice it to say that when I first set out to start building my nurse practitioner private practice, I reached out to several people to help me with web design and after several very disappointing attempts I decided to create, on my own, the original version of evenkeelhealth.ca. It was ok. I learned a lot in the process but it didn’t have to be this hard.

I live by a few mantras. One which I learned when I was in the sea cadets is  “Lead By Example.” When I’m talking myself into doing something hard, I think to myself: what would I want my patients to do? Be brave, ask for help, and if at first you don’t succeed, try and try again. 

Asking for help isn’t easy but struggling alone isn’t either. Reach out! Do it once, do it twice, do it as many times as it takes to find your match. If you haven’t found the mental healthcare you need I encourage you to give me a try. Book a free introduction session and find out how I might be able to help you.

Nathalie

Pills spilling from a bottle

Let’s Talk About Addictions – November 21 Seminar

Have you ever wondered if…

  • your alcohol consumption has more to do with coping with life than simply enjoying a nice beverage with friends?
  • the pain meds you’re still using are for more than physical pain?
  • someone you care about is struggling with substance use disorder?

It is easier to stop avoiding these worries once you know what to do.

Help yourself! Help others! Join us to learn how to tackle addiction problems.

The next in our Wellness Seminar Series will take place on Thursday, 21 November 2019, at the Almonte Branch of the Mississippi Mills Public Library (155 High Street, Almonte, Ontario). We meet from 7 – 9pm.

RSVP with your host Nathalie Héloïse Graveline, Nurse Practitioner, by email at healher2@gmail.com or by phone or text at (613) 558-1967.

Hand above water

Let’s Talk About Mental Health – November 7 Seminar

Have you ever gone to your health care provider’s office concerned about your mental health and found yourself walking out without having managed to get the words out?

Have you ever had a loved one hint that something wasn’t quite right and found yourself changing the subject? You just didn’t know what to say.

Those scenarios are very common.

Join us for the next in our Wellness Seminar Series on Thursday, 7 November 2019, at the Almonte Branch of the Mississippi Mills Public Library (155 High Street, Almonte, Ontario). We meet from 7 – 9pm.

We will talk about the challenges we face when seeking help and how we might all do better talking about mental health.

RSVP with your host Nathalie Héloïse Graveline, Nurse Practitioner, by email at healher2@gmail.com or by phone or text at (613) 558-1967.