Real Talk: Community Health Care in Action
A community health initiative brought to you by Frontier Nursing University and Woodford County Chamber of Commerce to improve community health and increase healthcare awareness.
Learn more about Frontier Nursing University at frontier.edu.
Real Talk: Community Health Care in Action
Help with Stress
Don't stress! Episode 1 of Real Talk: Community Health Care in Action is here! Your host, Quincy, is joined by Frontier Nursing University's Department Chair of the Psychiatric-Mental Health Nursing Dept. Kevin Scalf, DNP, APRN, PMHNP-BC, CNEcl. They talk all things stress, why we feel it, and how to handle it. Please enjoy the inaugural episode! We are excited to bring you more for your health.
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Speaker 00:Welcome to episode one. My name is Quincy Fuehne and I am with Frontier Nursing University. This podcast is a community health initiative brought to you by Frontier Nursing University and the Woodford County Chamber of Commerce to improve community health and increase healthcare awareness. We plan to release new episodes each month. In today's episode, we are going to talk about stress and adulthood. Stress is something we all deal with. And according to an American Psychological Association survey, around three in five adults 62% said that they don't talk about their stress overall because they don't want to burden others. Joining myself and producer Corey today is psychiatric mental health nurse practitioner Dr. Kevin Scalf. Dr. Scalf is the department chair for the Department of Psychiatric Mental Health Nurse Practitioner Program at Frontier Nursing University. And he continues to work clinically as a PMHNP, helping to provide care to individuals who are experiencing acute mental health crises. I want to
Speaker 01:clap. I want to clap. That's awesome. I just met you, Kevin. Great to
Speaker 02:meet you. Thanks for being here. Nice to meet you. Thanks, Quincy.
Speaker 00:Yes, thank you. And can you tell us a little bit about your background and why you became a PMHMP?
Speaker 02:Sure. Well, I started off, I've been a nurse since 1997, I guess. And during that course of time, I spent most of my time in critical care units. And just by looking around at the unit at any given point in time, you know, I could pick out probably 80% of those patients struggled with some type of mental health issue that really, you know, it either directly caused their admission or it made things worse, requiring them to be admitted into the ICU. And, you know, during the course of that time, we did a really good job of just like managing the medical issues and things, but we hardly ever talked about the mental health aspect of things. And that just really sparked my curiosity and I learned more about this this role and I went to school and fast forward a few years later here I am so it's always been a it's always been a big interest of mine
Speaker 00:yeah and you you practice in rural eastern Kentucky is that correct
Speaker 02:I do I do my current practice is in an inpatient psychiatric unit and I've also practiced outpatient mental health as well saw people across the lifespan, children, adolescents, young adults, older individuals, that sort of thing. But right now, I primarily work with adults.
Speaker 00:Yeah, that's awesome. So you are the perfect person to talk to us about stress and adulthood. And might I add, Kevin, your voice is so soothing. I don't know. Now we're getting somewhere. Anytime I have a meeting with you, he just brings me peace. Thank you.
Speaker 01:That's beautiful. That's so true. Like you said that, I'm like, oh my gosh, yes. I needed that today. So check that box out.
Speaker 00:I got that down. So can you provide us a basic definition of stress?
Speaker 02:Absolutely. That's a great question. So stress is something we all experience, right? But it's often misunderstood. At its core, stress is really the body's response to any type of demand or challenge let's say, that we're facing. That can be either a physical challenge, an emotional challenge, a psychological issue. Basically, stress occurs when we feel pressure, we feel uncertainty, or really, we don't really feel we're in control of a situation, so to speak. And so, basically, stress, I think, is a natural reaction of our body to adjust to those challenges and changes. And it's kind of like an alarm system sometimes. Stress is like our body's alarm system to let us know that there could be some danger ahead and it gets us prepared to deal with that. Man, I mean, just
Speaker 01:hearing you say the definition is incredible. We all live with stress, but man, hearing you say exactly what it is, it just makes you think. You don't hear that. You don't think about what it means too often. You just think, oh, I'm stressed. Exactly. Everyone knows
Speaker 02:what stress is, right? If we say I'm stressed out, we kind of get the meaning of it. But how often do we really think about what is that then? What is the stress?
Speaker 00:Yeah. Okay. not to put you on the spot, but like something for me, I guess, what is the difference between stress and anxiety?
Speaker 02:Great question. Great question. So stress is more of like an inward response to something that we perceive as being a challenge, right? So we perceive something as being a potential threat to us in some way that creates this inner feeling kind of like a some things in line here. Anxiety is more so like a symptom of stress. And so we see the stress, then we kind of turn that around in our brain. We interpret what that means to us. And then if that causes anxiety, we see that kind of as an external symptom. And that's different for everybody. Sometimes people say, well, what are the symptoms of anxiety? Well, it depends on that individual. Some people deal with anxiety in many different ways compared to other people. And so it's all subjective, right? It's all subjective. But anxiety, I think, stems from stress. Yes. And so anxiety, I think, is more of like an apprehension. I'm uneasy about something. You hear sometimes people say, I feel nervous about it, right? That's more like anxiety. And so stress, I think, is the root cause of a lot of anxiety.
Speaker 00:Okay. So anxiety equals stress, but stress. Stress does not necessarily equal anxiety. Correct. Okay, perfect. That's helpful for me to know. Okay, so we talked about, you mentioned symptoms. Yes. What are some symptoms that we might have as a result of stress? I feel like sometimes people might have... I'm going to just say like migraines, and you're not attributing it to stress, but I think that's important to know the root cause of some of our symptoms. So what symptoms should people kind of look out for for stress or maybe our bigger red flags? Sure. Yeah,
Speaker 02:that's another great question. And again, it's different for everybody, right? But stress can show up in really just– many, many, many different ways. Physically, it can show up in our life. Emotionally, and also even like how we behave and some of our behavior patterns. And so if you think about, let's say, emotional response to stress, for example, stress can make us feel anxious, like we just talked about. It can also make us feel irritable. We can feel overwhelmed, even depressed sometimes. And you make notice, sometimes there's subtle things that just pop up here and there, right? you may notice that you're more short-tempered than usual. Maybe little things that wouldn't normally bother you suddenly feel like this huge deal. It can also be really hard to focus or make decisions during increased times of stress. It's almost like your brain is just too overloaded to think clearly and make good decisions. And so that's some emotional responses that we see, right? But you also mentioned some physical things too. Right. Physically, stress can cause things like headaches, muscle tension, fatigue, even maybe some stomach issues. Have you ever really just had like a really stressful day and suddenly your neck and shoulders feel kind of tight and you're like, what's up with that, right? Well, that's stress at work. It's just manifesting in your physical body. And so it can also mess with your sleep. Some people struggle with insomnia. Other people maybe sleep too much because they're trying to escape that bad feeling associated with stress, right? And so sometimes we see that. Also, let's not forget about the impact on the heart and the cardiovascular system. I think that's really, really important. Stress, we all know, can lead to high blood pressure, right? It can also lead to heart disease. It can lead to a heart attack or a stroke. And so it really does have some high stakes value when we're looking at somebody's overall health, right? So physically, you know, that's the thing. And then I mentioned also behavioral symptoms, changes in appetite, whether you're eating too much, much too little maybe sometimes or maybe you're with starting to withdraw from your friends your social connections like from just life you just do the bare minimum that you can get by with um that's another thing that we see with stress sometimes and then the other thing that we see sometimes is procrastination oh have we ever had things that were uneasy or were nervous about it's it's hard it's a challenge definitely we keep putting it off right oh my gosh i'll do this tomorrow I'll do it next week. It sits on my list forever. It's forever. Yeah, yeah, yeah. So those are some things that we see, you know, symptoms of stress that we can see in just typical everyday life. And if you don't think about it, maybe you don't really connect it as good as what we should.
Speaker 00:Right.
Speaker 01:We have something interesting here, Quincy, that I've never done before on a podcast. So this is a first first, and I love it. We have another guest that just popped
Speaker 00:up. Just popped in. I
Speaker 01:love it. And it fits perfectly with the podcast. what we're talking about, but that's why I'm here, all right? I'm here to help produce. So please.
Speaker 00:We have Carrie with Elemental Yoga here in Versailles. So Carrie, do you want to introduce yourself and your background?
Speaker 04:Sure, absolutely. I am Dr. Carrie Davidson here from Elemental Yoga and Wellness. I have been running the studio for almost three years now,
Speaker 03:but
Speaker 04:my background is exercise physiology. That's what I am by degree. I've been the fitness manager for over 20 years. I've at University of Kentucky, actually. And then I run the studio here, too. So lots of irons
Speaker 01:in the fire. How cool is this that we were just talking about the physical? It's so awesome.
Speaker 04:The synchronicities,
Speaker 00:man. And Carrie can really speak to the part of alleviating the stress and all of that good stuff. But I want to go back to the symptoms really quick because personally, personal experience, I know... you mentioned like irritability and I wouldn't consider myself a super irritable person, but I will notice that if I'm, Having a stressed out day, and I don't really acknowledge that the day was stressful. In the evening, like with my kid, I'm gonna be a little not as patient, and I'm like, oh my gosh. That is
Speaker 02:so hard to believe. I've never seen you that way.
Speaker 00:And my husband would be like, are you good? Why are you acting like this? But then I realized, oh my gosh, I'm just so stressed. I need to breathe. And then I want to go back to, so one of the physical things symptoms, the heart. So how do we identify that before it leads to something like a heart attack or a stroke like how do you say oh there's an issue and we need to take control absolutely that is
Speaker 02:such a great topic right because you know we need to really catch these things before they could become this huge snowball right and they become this huge problem in our life because we have to remember sometimes it's a little bit and a little bit and a little bit and before we know it it's enough to tip the scale and then all of a sudden we're starting to have a lot of problems so that earlier we can catch things, the better, right? So, you know, I tell people sometimes When you start to feel different about certain things, you know, that's, I think that's a opportunity for us to stop and ask ourselves the question, why am I feeling this way? You know, when I'm confronted with X situation and I, all of a sudden I start to feel irritable, like you just talked about in the evenings, right? People are just getting on my nerves and usually that doesn't happen to me. You know, that's an opportunity for me to just imagine this big red stop sign and say, okay, I need to stop for a minute what's really going on here, right? And really do some reflection and figure out what's causing some of this stuff. So anything out of character. we have different feelings about things. That's an opportunity for us to stop and just kind of take inventory.
Speaker 04:I would add to that as well, not just feeling that irritability, but anything that is your normal routine that comes out of alignment. So are you sleeping differently? Are you having trouble going to sleep? Are you having trouble staying asleep? Are your eating habits different? Have your exercise habits changed? Anything that is the norm for you that is no longer the norm, those are all going to be telltale signs is that there's too much on the calendar.
Speaker 00:Right. Right. And I think a lot of people, I mean, me especially, like how do we alleviate that? Like, okay, so we identified there's a problem. Now what? And so I think that's a huge question. But also, like... I think preventative health care and preventative care in general. So whether that is exercising or finding a meditation or you always say everyone can benefit from a good therapy session. Absolutely.
Unknown:Absolutely.
Speaker 00:I'm going to
Speaker 03:agree
Speaker 00:with
Speaker 01:that. Yes. Absolutely.
Speaker 00:But tell me about getting that preventative care and what are some... some ways that we can do that and what are, what's a preventative care that we need to prioritize. So Kevin, I'll start with you and then we'll move to you.
Speaker 02:Sure. You know, one of the things that I hear from people all of the time is life is just so busy. Um, there's one deadline after another deadline, there's 24 hours in a day and I don't know how to manage everything. And so I talk to patients a lot of the time about good life work balance. And part of that is setting boundaries and learning to say the word no.
Speaker 04:Cool. You're stepping on some toes,
Speaker 02:I think. Yes, yes. And, you know, it's really important because we have to recognize our limitations. We cannot be all things to everybody all of the time. And so we have to kind of take an inventory of what's the resources I have to give because I have to give some to myself, right? Because self-care is not selfish. It's essential. But we have to. I know, I was like that. Yeah. That is good. We have to. But we always put ourself last for some reason. But it's really important for us to, I think, be aware of what we have to give as far as resources go. And not to overextend that. I think that's a really important point when we're looking at trying to prevent things. Like we said, stress is part of life, right? There's good stress, there's bad stress. A little bit of stress is good for us because it keeps us motivated. It keeps us on our toes. But when we start to cross over into that land of pathology, it starts to work against us. And so I think the first thing is recognizing what What's my resources? What are my limitations? What can I handle to maintain a good life balance?
Speaker 00:And I think, sorry, just one thing on that work-life balance. What about within the workplace can help their employees avoid stress or feeling
Speaker 02:overwhelmed? Great question. You know, I think one thing is I think employers... need to work to make sure that their staff, their employees feel safe, number one. Because we always have to feel safe in our workplace. I think people need to be and feel supported by their employer. I think their employer needs to look at workload. Is this a reasonable amount of work for what we're trying to get done? And then the pace of the work. Not everything has to be done tomorrow. We need to leave a little bit for next week and maybe next month. And so how can we kind of pace this work out a little bit? Again, going back to realistic expectations and recognizing this is a person that's part of our team. And one of the things that we see across the nation is when, let's say, the community's stressed, whether it's been a natural disaster or something big has happened in the community, what do we see? Well, we see decreased productivity in the workforce because people are distracted. People have other things on their mind. And so I think that's one of the biggest things employers can do is help each other achieve that work-life balance because that's really where the productivity, I think, really is maximized.
Speaker 00:That's good.
Speaker 04:One of the things I do with my staff, whether it be at my studio or elsewhere, is that I check in with them on a regular basis. I have an every-two-week standing meeting on an individual one-on-one with everyone, and I say, are you eating? Are you sleeping? Are you working out? How are your grades if they're a student? Is there anything I can do for you? Do you need anything from me? Is the way that we communicate working for you? Do you need that to change? That's awesome. And it's just a check-in.
Speaker 00:Yeah, this is a good list.
Speaker 03:That's a good list. Yes, yes.
Speaker 04:It's just a check-in, and sometimes there'll be, you know, I'm really not getting enough sleep. Is there any way that somebody else can take my 5 a.m. shift? Yeah. Yeah, we can do that, right? We can make those switches. And don't ask the question if you're not willing to then also make the changes to meet their needs, right? Don't
Speaker 02:ask the question. Exactly. That wouldn't go too well. Yeah, yeah. Well, sorry about
Speaker 04:that. Have a good day. That might be a problem. But I also want to speak a little bit, too, to self-care. And you said self-care is essential. It's not selfish. And I absolutely agree with that. And I tell people all the time, you cannot pour from an empty cup. And if all you do is give and give and give and give, then there's nothing left to give. And you're going to be a better mom. You're going to be a better employee. You're going to have better morale, a better wife, a better husband. Whatever role you play, you'll be better if you're taking care of yourself first because it's your job. Right. It's no one else's job to take care of your own self. Right.
Speaker 00:I
Speaker 02:love
Speaker 00:that. Yeah. It's very powerful. It's a
Speaker 04:little harsh, but that's why I'm here.
Speaker 02:I
Speaker 00:love
Speaker 02:that.
Speaker 00:So what are some forms of self-care?
Speaker 04:Oh, gosh. I think it's very individual, but absolutely sleeping the appropriate amount of time, eating a healthy diet instead of what's convenient or what you can just grab, mindfully, intentionally choosing things that are going to nourish your body right movement of whatever sort whether that be walking running lifting yoga movement is essential to making sure that we're taking care of our physical bodies um you know at the studio we offer a variety of classes and i don't expect every member to come to every class that's not why we do it right we do it because not everything speaks to everyone right so it can be very individual sometimes you know it also depends if you're an extrovert or an introvert yeah and if you're an extrovert you you get energy from being with other people and you need that. That's what fills you up. And if you're an introvert, you need some alone time. That's what fills you up. Right. So it's a little bit personal. It's a little bit individualistic, but there are some generalized things like eating well, sleeping well, moving well that are going to go a long way.
Speaker 00:Right. Okay. And so speaking to the eating part, and this is, I mean, it goes with stress, but it kind of is overall health, but eating right. I know can be hard for some people just due to access to good and healthy food. So do you have ideas for people who might not have access or might not be able to access the fresh fruits and vegetables or whatever that looks like
Speaker 04:sure and right now we're not in season for a whole lot especially here in kentucky it's pretty snowed over right now but even going to the frozen food section or the canned food section you may not get as many nutrients in a canned vegetable or a frozen vegetable as you do a fresh but it's still better than grabbing a bag of chips right and it's also cheaper
Speaker 00:right right yeah
Speaker 02:that's a good point yeah yeah
Speaker 04:yeah
Speaker 00:OK, so can you speak to like a meditation, especially in the workplace? I was actually before coming here, I was looking at like Workplace yoga, workplace meditation and how that looks. So can you talk to us? Maybe we can walk us through that.
Speaker 04:Sure. Well, you mentioned it earlier. You said when you get irritated and it's late at night and you're tired and you're kind of at the end of your rope, you have to just breathe. And the breath is something that is with you all the time. You don't think about it, but the breath is with you all the time. And so if you can take a big, deep inhale, and we're all just kind of chilling here, like we're all slumped over a little bit, but this does not give our diaphragm room to breathe. So if you just sit up tall and create the space that you need, then you can actually take a deep breath. And it's really not the inhale that's so helpful for stress. It's the exhale. So the exhale really stimulates parasympathetic nervous system. So think about that, right? Like saber tooth tiger, you're in your fight or flight. And so you breathe fast, breathe fast, breathe fast. So you can run, so you can fight, right? And you breathe fast and you breathe fast. But then when that's all over... Then you exhale. It's that relaxation. And that's what moves you into the parasympathetic, out of your sympathetic nervous system.
Speaker 00:And is there something to... audibly exhaling?
Speaker 04:Yes, there is. I feel like there might be. There is. I'm so glad you asked. Yeah, so people don't understand or maybe they underestimate the power of sound. We're getting ready to do a workshop actually in March on the power of sound. But you vibrate the back of the throat with the exhale. And I just happen to look around. There's a lot of horses here in Kentucky. Think about that horse breath whenever they exhale.
Speaker 02:That is true. Yes.
Speaker 04:Sounds like a horse. Yeah. But that's what they're doing. They know how to regulate. Animals just know how to regulate. So there's something to that vibration, whether it be the horse breath or what we call Ujjayi breath. It's a whisper breath where you vibrate the back of the throat or even just chanting a prayer or a sound or your intention, whatever that is. There's absolutely science behind it. That's
Speaker 01:very cool. I'm going to send my wife to you all when she gets on to me for walking around the house. Okay. Sure.
Speaker 04:Stress relief. Do you want to come and teach some of
Speaker 01:that? I'm down. Give me a day or two to perfect it.
Speaker 00:We've been trying to teach our one year old. We have a one year old son at home and we've been teaching him deep breaths and he does it with us, which is really cool. But we do the with him. And so I think we're going to be doing that. And I know I've read before about like filling your belly, like you're, lungs all the way down to your belly button, filling your lungs that far down to help.
Speaker 04:I'm not sure if you want a whole anatomy lesson, but if you, in your mind's eye, okay, well, in your mind's eye, think about a skeleton. You have a rib cage, and your rib cage has your heart and your lungs. Those are your most vital organs. You can't function without heart and lungs. And so the cage protects those vital organs. And then you have a diaphragm right below the rib cage, and that's your major breathing muscle. That's your prime mover. Okay. And so under that, then you have all the other organs, right? Okay. stomach, your intestines, and all the other things that are underneath. So when we inhale, the diaphragm pushes downward so that we create the vacuum and the air rushes in to fill the lungs. But when the diaphragm pushes down, all of this belly stuff, there's no cage. It has to go somewhere so the belly pooches out. So we really aren't breathing into our belly. We're breathing into the deepest capacity of the lungs, but the diaphragm's working and it makes all the other internal organs pooch out. And then when we exhale, the diaphragm relaxes and then expels that air to push it right back out again. So that's why I said we can't do it if we're all slumped over. Which is what we do at our desk. All
Speaker 02:day long.
Speaker 04:Or at our car. Or at our smartphone. Or whatever it is that we have. So if we can just sit up, we're going to go a long way to taking a deep breath.
Speaker 02:Makes you feel better.
Speaker 04:Absolutely. And I lead a lot of corporate events and wellness groups and things like that. And when I have people sit up straight and take a deep breath, it never fails. I get a yawn. And I'm like, thank you for the yawn.
Unknown:It means it's working.
Speaker 03:It's working.
Unknown:It's working.
Speaker 00:Yeah, cool. Yawns are not bad. That's right. That's
Speaker 03:right.
Speaker 00:I'll take it. All right. Anything else you two have to add or words of wisdom for people to follow with stress and... taking care of themselves?
Speaker 04:I mean, the breath is always with you, and so that's like my number one go-to tool. But there are definitely meditations that you can do, mindfulness activities that you can do. And again, I don't know if you want this whole lesson on mindfulness, but the definition of mindfulness is paying attention on purpose to the present moment without judgment. So there's four parts to that. I know, right? It's packed. That is good. You can thank Jon Kabat-Zinn for that definition. But the without judgment piece, That's the piece that really made a difference for me. You can maybe recognize that you're having these thoughts, that you're having these emotions, that these things are coming through, but if you can look at them as a neutral witness, just like you're watching things on a screen go by, and you're not judging it as good or bad, or I've got to fix that. I
Speaker 02:love that.
Speaker 04:No judgment. You're just a neutral witness. That's the hardest part for me, personally. But that can also really make a difference in how how you go about your day.
Speaker 02:That's powerful. I like that. I love
Speaker 00:that. Okay. My little tidbit, not expertise, but I clench my jaw all the time. And so that's one thing that I catch myself, especially if I'm having trouble sleeping. I'm like, open your mouth, open your jaw, drop your jaw. So anyway, thank you both so much for joining us today. This was a great episode. And I feel so much calmer. Our job is done.
Speaker 02:Yes. Success.
Speaker 00:So we hope this episode was insightful and that you are able to take away some ways that you can manage your stress and prioritize your health. Prioritizing your health creates a happier and healthier overall community. We will see you next time.
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