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

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