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Loneliness is as lethal as smoking 15 cigarettes a day

By Kelly Klund, LPN
Resourse Nurse, Empira

You have held on through this pandemic and tried to do the right things: you get eight hours of sleep a night, you eat your bright green and orange vegetables, you drink eight glasses of water a day, and you hold doors open for strangers and then POW!!!!!!! You read a blog and learn that loneliness is as lethal as smoking 15 cigarettes a day. As a former smoker I can tell you that smoking 15 cigarettes a day makes you feel like garbage. As a person who was separated from many of the people who are important to me during the height of the Covid-19 pandemic I can tell you that felt like “garbage” too. I get the parallel, but I don’t think that you need me to tell you that the loneliness we have all suffered over the last year because of the lockdowns and quarantines has taken its toll on our mind, body and spirits.

Empira dug into the effects of loneliness and learned some startling facts about the price we pay when we are lonely. The biology of loneliness can accelerate the buildup of plaques in our arteries, help cancer cells grow and spread, and promotes inflammation in the brain leading to Alzheimer’s disease (Social isolation, loneliness in older people pose health risks, 2019). If we experience prolonged periods of loneliness we are more at risk for poor decision making, depression, anxiety, at a higher risk for stroke, we have higher rates cardiovascular impairment, more complaints of chronic pain, and a tendency to fatigue more easily. There is a 50% increased risk to develop dementia and a 26% increase in mortality. Loneliness can kill us, loneliness is just as lethal as smoking 15 cigarettes a day!

Here is the interesting thing about loneliness, it is subjective. Alone ≠ loneliness. According to Cacioppo, loneliness is defined as a state of mind characterized by a dissociation between what an individual wants or expects from a relationship and what that individual experiences in that relationship.

Before we can understand the totality of the impact that loneliness has had on us it is important that we understand the different types of loneliness that we may have been feeling:

  • Personal or intimate loneliness is the absence of a significant person (spouse/ partner, pet) who provides emotional support and affirms one’s value as a person. Did you have to quarantine in your home away from your loved ones? Was it hard?
  • Relational loneliness is the absence of a sympathy group. This is usually about 15-50 people who regularly interact with one another. Examples: Card group, prayer group, immediate family, coworkers. This is a group that you meet with who are going through the same things that you are. Did you cancel family gatherings or suddenly start working from home?
  • Collective loneliness is the absence of a network. Your network is made up of 150-1500 people, who provide support just by being together as part of the same group. Examples: Church family, extended family, organizational memberships. Did your church stop in-person services, did your concert or sporting event tickets get cancelled?

In order to avoid some of the negative mind, body and spirit risks associated with loneliness we must first do some quiet, introspective evaluation. Where in our lives have our expectations about our relationships not been met, either because of forced distance from lockdown or quarantine, or because of other factors in our lives that may have existed or been exacerbated because of Covid?

Knowledge is power, and now that we have learned about the different types of loneliness we may be experiencing it is important that we see some ways that we may respond to address them.

  • Personal or intimate loneliness – what is the “Next best thing”? Can you hug a pillow with your loved ones perfume or cologne?
  • Relational loneliness – Zoom happy hours have replaced the after work get together, and many movie streaming companies have develop the ability to have “watch parties” so people can watch movies together, but from their separate homes. With the CDC relaxing guidelines, is there are small group of your friends and family that can now safely gather?
  • Collective loneliness – Can you join in online events? Most of our Church services are now streamed, many community organizations have moved their meetings to ZOOM or “live” broadcasts. I personally, am much more likely to attend services at home, on the couch in my PJ’s than I was before Covid when services were in person. Some of my favorite performers have hosted free online concerts that can be cast to your living room television and although not in person, I can watch along with other people like we were all together in an arena, without the long drive home.

Addressing your loneliness may require a bit of creativity. Just like many smokers ditched that nasty habit to better their health, I challenge you to take care of your mind, body and spirit and tap into your creativity to connect with the things and people that are important to you.

Cacioppo, S., Grippo, A. J., London, S., Goossens, L., & Cacioppo, J. T. (2015). Loneliness. Perspectives on Psychological Science, 10(2), 238-249.
Galambos, C., & Lubben, J. (2020). Social isolation and loneliness in older adults: A national academies of sciences, engineering, and medicine report. Innovation in Aging, 4(Supplement_1), 713-713.
Holt-Lunstad, J., Smith, T., & Layton, J. (2010). Social relationships and mortality risk: A meta-analytic review. SciVee.
O’Donnell, E. [Woman on window ledge with cigarette].
Social isolation, loneliness in older people pose health risks. (2019). US Department of Health and Human Services – NIH National Institute on Aging.
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The (Circadian)Rhythm is Gonna Get You

Written by Brittni Peterson, BSN, RN
Resource Nurse, Empira

I was today years old when I learned that yesterday, March 15, 2021, was National Napping Day. I’ll be honest, I had no idea that naps were a big enough concept to warrant a special day.

If you are an adult, chances are you enjoy taking a nap. If you are like my dad you enjoy “resting” your eyes.

The older I become the more I appreciate a good nap. When I lay down for a nap I can’t help but think about the irony of being young and hating that you are forced to nap compared to an adult who would love the elusive nap.
The human body is constantly preparing you for sleep from the moment you wake up to the moment you close your eyes. This is known as the circadian rhythm or in simpler terms, the human biological clock. It is also referred to as the sleep/wake cycle. This very important cycle involves hormones and neurotransmitters and their response to light, dark, activity, and rest. Amazingly enough, nearly all life forms on this planet display circadian rhythms, this includes bacteria, fungi, plants, fruit flies, and of course humans.

Every time I write the word rhythm in my head I start singing “The Rhythm is Gonna Get You” by Gloria Estefan. This actually is a great song to represent your circadian rhythm, because it’s gonna get you each night. Anyways, I’ll get on with it.

Two of those hormones I mentioned a little bit ago, are serotonin and melatonin. They are the ying to the others yang. When there is darkness, your body releases melatonin. Your melatonin increases as the evening goes on and eventually makes you calm and sleepy as your temperature and blood pressure drop. Serotonin is triggered by sunlight or blue light (examples are light from computers, phones, televisions) and provides us with energy. Serotonin also stops melatonin production, which is why experts recommend turning off electronics at least an hour before bed.

Anytime we close our eyes, whether it is for a daytime nap or because it is time to go to bed, our body begins moving through the 4 stages of sleep. The first stage lasts about 5-15 minutes and during this stage our brain waves begin to slow and our muscles begin to relax. After about 15 minutes our body moves into stage 2 where our brain waves continue to slow down, and our body relaxes more. During this stage, an individual is not easily aroused and may only react to selected noises like hearing their name. Stage 3 of the sleep cycle is when the brain is completely at rest and when healing of skin and deep tissue occurs. The next stage is rapid eye movement (REM). Much like stage 3, the REM stage also plays a role of healing the body, except the REM stage is associated with mental and emotional healing rather than physical healing. During this stage, brain wave activity is increased, and paralysis of the muscles occur. Throughout your whole night’s sleep you will generally move through these stages a few times.

Now when it comes to naps, as great as they may seem, they can definitely be detrimental to your evening slumber. As we have all experienced though, some days you just need to take a nap. If this is the case, your nap should not be longer than 20 minutes. Why? Well, there are two reasons:

  1. When we are active throughout the day, our bodies produce and build up a chemical known as adenosine and this chemical is what helps our body get a full night’s sleep. In other words, when we go to bed at the end of the day chances are you have a fairly high amount of adenosine in your blood, which become decreased as you sleep. If you take a nap sometime during the day, those levels of adenosine already begin to drop while you are resting which may make it difficult for you to fall asleep at night and to get a solid nights rest. We at Empira like to compare the human body to that of a rechargeable battery. If you have ever owned a cell phone or other similar device, most manuals instruct users to completely drain the battery before charging. Think of the human body like a cell phone battery, we want to be active (drain our batteries and increase adenosine) throughout the day, so when we go to sleep at night we can fall into those deep stages of sleep (charge the battery).
  2. When we nap for longer than 20 minutes, we begin to fall into those 2nd and 3rd stages of sleep. Remember that in those 2 stages our brain and body really begin to relax and prepare itself for the 3rd and 4th stage of deep sleep. When we are woken up in the middle of stage 2-4, our mind and body may feel groggy and remain that way the rest of the day. When we are woken up in the middle of stage 1, that’s okay because our brain waves are still fairly active and our body hasn’t fully relaxed.

If you are going to participate in National Napping day (next year, since we missed it this year), read below to ensure your nap is as successful as it can be.

The Dos and Don’ts of Napping

  • Do set an alarm.
  • Don’t nap longer than 20 minutes. The longer you are asleep, the deeper into the sleep stages of sleep you go. This increases the chances of waking up feeling groggy and you may find it harder to fall asleep at night.
  • Do take naps early in the day.
  • Don’t wait until after work to take a nap. The later in the day you take a nap, the more it can inhibit the quality of sleep you get at night while also making it harder to fall asleep.
  • Do create a peaceful environment.
  • Don’t nap in a noisy, uncomfortable area. Trying to nap in an environment that is not comfortable and rather noisy may make it hard to fall asleep which may prolong the amount of time you have allowed yourself to rest.
  • Do nap if you feel yourself becoming drowsy, irritable, and/or fatigued. This will allow you to hit a “reset” button on your day and allow you to be more productive rather than fighting the urge to stay awake.
  • Don’t force yourself to nap if you are not feeling tired.

Not everybody is a successful napper and not everybody needs to nap every day.

Snooze on!

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Limitations: What the Arts can Teach us

Written by Heather Johnson, RN
Resource Nurse, Empira

“I don’t know how to do that and I will never be able to learn.”

“That takes too much time.”

“The way things are now is just fine.”

“No one will listen to me, anyway.”

This way of limited thinking squashes creativity. Some people look at their limitations as a challenge and reason to push forward. I am challenging you to think of limitations in a way that inspires you, motives you, and allows you to think outside of the box and to be creative.

My daughter, Erika, is an artist and she loves to work with different mediums and textures in the pieces that she creates. She loves to learn, and, she thrives when she can mix her textbook learning with the art platform as part of her Arts Magnets program. By connecting the right-sided artistic part of her brain with her left side, she has mastered working with watercolors, chalk, charcoal, clay, and water-soluble paints. Most recently she has started to work with oils in her paintings. To do so, she has had to move outside of her comfort zone and risk some failure. She has had learn the qualities of oils, and the varied types of oils. She has needed to work to understand how the oils react under the stroke of her brushes, and she has needed to be observant, disciplined, and maintain perseverance in her commitment to mastering this new art form.

Portrait painted by Erika Johnson

Limitation is the catalyst for creativity!

Oils, like any other medium, have their limitations, and the artist must learn what those limitations are if they aspire to create a masterpiece of their own. Oils can be challenging and less forgiving than other art mediums, yet, oils can provide some of the most interesting and unique landscapes and portraits one could ever imagine. The brilliant textures and colors of oils bring a piece to life. I like to think that Erika grows stronger in her artistic journey, and in her life journey, each time she attempts to acquire a new skill.

One lesson that I am learning from my daughter, the artist is that limitation is the catalyst for creativity! I will say it again………… Limitation is the catalyst for creativity!

The artist works within the limitations of space, medium, and present skills and knowledge, to create something beautiful and unique. The successful artist challenges themselves to grow and explore. When we acknowledge our limits or limitations, and yet press on, it thrusts us into a new way of thinking creatively. Like an artist that has been provided with a 16 x 20-inch canvas and who is challenged to work with a medium within the parameters of that canvas, we can be inspired to work creatively within any limitations or parameters given to us.

In long term care we have limitations in the form of regulations that must be followed, and with reason. We are likely to also experience limitations in forms of resources, time, skill, and now COVID restrictions and response. Don’t allow those limitations to stifle your creativity in providing excellent care and opportunities for those you care for. Instead, think of those limitations as the catalyst to spark your creativity. Recall, limitation is the catalyst for creativity.
Think of some ways to accomplish your mission and develop them within in your teams.

Ask yourself and team the following questions:

What is our goal?
What can we do different to achieve the outcome(s) we want?
Who are the activators on your team?
What if we fail?
How will/do we push through potential barriers?

Don’t let your limitations stop you

In closing, and on a lovingly personal level, I enjoy sharing a particular story of my grandmother who prided herself on her many talents and who also worked to develop those things she considered to be her limitations. In her later years she chose to work on her creative side by taking a painting class. You could say learner was in her top 5 strengths (referring to StrengthFinders). The class syllabus required the student artist to complete one type of subject and/or medium before being able to move on to the next one. She progressed through chalks, watercolors, acrylics, still life, landscapes, and even portraits. Then came the challenge of painting animals.

My grandmother believed she had reached her limit, and told the instructor that she just was not capable of doing animals. That was met with strict opposition from the instructor. No animals, no progression. I can just imagine the lightbulb going off in my grandmother’s head, and, in true adherence to the premise that limitation is the catalyst for creativity, my grandmother set to work and at the next class she proudly turned in her accomplished assignment to paint animals.

The teacher was understandably puzzled when she saw what appeared to be a painting of a forest. When she asked about the animals, my grandmother clearly pointed out the squirrel tail showing from under a bush, the deer antler protruding from behind a tree trunk, the snout of a turtle emerging from the edge of the pond, and the beaks of some tiny hatchlings poking up out of a nest.

Recognize, respect, and then stretch your limitations. You may surprise yourself and others. Let’s all take a lesson from an artist.

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Maybe Christmas, perhaps, means a little bit more

Written by Kelly Klund, LPN
Resource Nurse, Empira

Most of us know the story of the Grinch, a crabby green creature who has lived a lonely spiteful life. He has a deep dislike for the people who live in the town of Whoville and detests their love of Christmas. He hatches a plot to sneak into Whoville on Christmas Eve and steal the decorations, gifts and food. In the middle of his attempt to ruin Christmas he comes across Cindy Lou Who, an innocent child who has the beauty and magic of Christmas in her heart.

The Grinch continues with his plan and once he gets back to his home with all of the town’s Christmas swag he is amazed to learn that all the Whos in Whoville have not had their Christmas ruined, but instead are anchored in the value of being together and sharing Christmas love. Seeing this, the Grinch’s icy heart grows three sizes and he returns “Christmas” to Whoville and celebrates all the beauty and love with the Whos on Christmas.

“Then the Grinch thought of something he hadn’t before! Maybe Christmas, he thought, doesn’t come from a store. Maybe Christmas, perhaps, means a little bit more.”


When we hear the story of the Grinch we often think of that little bit more as generosity, family, the gift of giving or the celebration of Christ’s birth if you are a Christian.

This year most of the ways we traditionally celebrate the Christmas holiday are likely to be turned upside down. Like at Thanksgiving, we were being asked not to gather in our large family and friend groups. The prevalence of unemployment may make gift giving a source of tension for some families. Church services are not likely to look like they have in years past. Getting together with our friends for holiday baking or cookie exchanges will have to be reinvented and gathering at the knee of Grandma or Grandpa to hear our families’ Christmas stories is a much loved tradition we will likely have to forego.

In normal times 46.9% of people report some sort of grief during the holiday season with social isolation being one of the biggest factors in that grief. In addition to holiday grief, according to the CDC, U.S. adults reported considerably elevated adverse mental health conditions in relation to COVID-19. Compound the impact that COVID-19 has had on our mental health with the holiday grief that is normal and we are ripe for a holiday season that is lacking holiday cheer.

But what if we thought about it differently?

What if this year’s little bit more was about the gift we could give to ourselves; the gift of time for self-reflection and the gift of exploring what matters most.

In Empira’s ResoLute grant we explore something we’ve titled Work of Aging. This work begins when people start to reflect on their life and confront their own mortality. Work of Aging is used to describe conversations or actions that support one in reaching wisdom recognizing what matters most in living and dying.
When we explore our Work of Aging we are looking into seven domains that can cause us despair or be a source of peace and joy in our lives:

• Life story – What role does our story play in who we are today?
• Condition – How does your health affect your quality of life
• Purpose – Why do you wake up in the morning?
• Relationships – What relationships do you want to honor or reconcile?
• Spirituality – Do you feel connected to something bigger than yourself?
• End of Life – Have you prepared for the end of your life?
• Legacy – What do you want others to think when they hear your name?

What if this year’s little bit more is about taking advantage of the time we have alone or with a smaller group of loved ones to reflect on recognizing what matters most and sharing those conversations with the people closest to us?

Was the Grinch crabby and bitter because he needed to explore his Work of Aging? Did seeing the Whos in Whoville singing on Christmas morning open his eyes to being connected to something bigger than himself? Did returning Christmas to Whoville empower him to shape his legacy?

This Christmas we will all have decisions to make about if and how we celebrate and as we are making those decisions I invite you to also explore your own Work of Aging.

For more information on a tool that guides Work of Aging conversations check out the Work of Aging Reflection Journal.

This image has an empty alt attribute; its file name is Reflection-Journal-no-background-225x300.png

We wish you a Merry Christmas and a much better New Year!

If you are struggling with mental health or addition and need assistance there are many resources available including the Substance Abuse and Mental Health Serves Administration National Helpline 1-800 – 622-HELP (4357)

“Dr. Seuss” Geisel, T. (1957). How the Grinch Stole Christmas! Random House.

Wirz-Justice, A., Ajdacic, V., Rössler, W., Steinhausen, H., & Angst, J. (2018). Prevalence of seasonal depression in a prospective cohort study. European Archives of Psychiatry and Clinical Neuroscience, 269(7), 833-839. doi:10.1007/s00406-018-0921-3

Mental health, substance use, and suicidal ideation during the … (2020, August 13). Retrieved from

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What I need isn’t another day off – Celebrating Labor Day in the midst of COVID-19

Written by Kelly Klund, LPN
Resource Nurse, Empira

In normal times many American’s look forward to the first Monday in September as a paid day off of work. We celebrate by spending a long lazy weekend at the lake, having a picnic or BBQ with friends and family or enjoying a community parade.

Just a Little History

Labor Day was first celebrated on Tuesday, September 5, 1882, in New York City and was created to celebrate the achievements of American workers. On June 28, 1894, Congress passed an act making the first Monday in September of each year a legal holiday.

Another Day Off

In the age of Covid-19, with nearly 25 million Americans unemployed, 2020’s Labor Day looks and feels much different than past years. With astronomical numbers of Americans currently out of work, this crisis has likely touched all of us in one way or another. We may be unemployed ourselves, have a loved one who has suffered a job loss, or we may see the effects of unemployment in our communities. In light of the wide reach and reality of the number of people out of work, we must face the mental health impact that unemployment can cause. According to the Journal of Labor Economics, this reality includes people self-reporting feelings of worthlessness, uselessness, feelings of despair, inability to find enjoyment, and an increase in the number of people being diagnosed with depression or anxiety.

I believe, that if we take a deeper look, we will find that unemployment is just one facet of the struggle that people are having and that by identifying a sense of purpose in our daily lives we can ease some of this despair. Having a sense of purpose means having an anchor that influences our behavior, helps shape our goals, offers us a sense of direction, and gives meaning to our lives. Studies show that identifying a sense of purpose in life may help people deal with early onset stressors and maintain overall quality of life. People who attach their sense of purpose and contribution to their employment, may be struggling with questions such as “Why should I wake up?” or “What difference am I making?”

Finding Your Purpose

If this resonates with you, your next question is likely, “How can I find my purpose?” I recently came across a Ted Talk that can help to answer this question with five simple self-reflections.

  • Who are you?
  • What do you do?
  • Who do you do it for?
  • What do those people want or need?
  • How do those people change or transform as a result of what you give them?

Let’s break it down a little further with an example:

Who are you? Say your first name. It’s as easy as that.

I’m Kelly.

What do you do? What do you love to do? If there are too many options. Change it to, what is one thing that you feel supremely qualified to teach other people?

I teach people how to have fun parties.

Who do you do it for?

I do it for my friends and family.

What do those people want or need?

They want to laugh and have fun.

How do they change or transform as a result of what you give them?

They make memories.

I’m Kelly and I’m a memory maker.

My purpose can be part of my work day, but it doesn’t have to be defined by it. This Labor Day I challenge both the employed, who are appreciating in a much needed day off, and the unemployed, who may be struggling with one day blurring into the next, to identify their sense of purpose by asking themselves these questions. Who are you? What do you do?

After you answer those questions go do more of that thing that can fill your soul and give you a reason to wake up! As for me, I’m headed off to plan a virtual birthday party for my mom!


Farré, L., Fasani, F., & Mueller, H. (2018). Feeling useless: The effect of unemployment on mental health in the Great Recession. IZA Journal of Labor Economics, 7(1). doi:10.1186/s40172-018-0068-5

Historic unemployment weekly claims | Unemployment data. (2020, April 17). Retrieved July 17, 2020, from

History of Labor Day. (n.d.). Retrieved from

Leipzig, A. (2016, August 7). How to know your life purpose in 5 minutes | Adam Leipzig | TEDxMalibu [Video]. Retrieved from

Yeung, P., & Breheny, M. (2019). Quality of life among older people with a disability: The role of purpose in life and capabilities. Disability and Rehabilitation, 1-11. doi:10.1080/09638288.2019.1620875

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4th of July Traditions

Written by Birttni Peterson, RN
Resource Nurse, Empira

There is no doubt, that for many people, Independence Day is one of the most looked forward to days of the summer. What’s not to love? Time spent with family and friends, fireworks, tasty food, bonfires, and if we are lucky, as Minnesotans, nice weather. I’m pretty sure that most people understand the symbolism of the fireworks, like it says in the Star-Spangled Banner: And the rocket’s red glare, the bombs bursting in air. But for many people the 4th of July is like many other holidays; a perfect reason to get together and celebrate with family. Many of those families have traditions and unfortunately with this COVID virus right now most will not be able to celebrate as they would like.

Vintage American Flag With Sparklers And Smoke On Rustic Wooden Background - Independence Day Celebration ConceptWhat is the reason we celebrate with fireworks, parades, and red white and blue on the 4th day of July? Well, here’s a brief history on it.

The Revolutionary War began in 1775 and ended in 1783. The cause of this war was due to growing tension between Great Britain’s 13 colonies and the Colonial Government. On July 2nd of 1776, there was a vote to gain their Independence, it wasn’t until two days later that representatives from the 13 colonies and Continental Congress officially adopted the Declaration of Independence.

“Fun fact, John Adams thought that July 2nd would be the date that Americans would celebrate their independence.”

Now, I’m not much of a history buff… but do you know who is? Our good friend Andy Griffith.

A family tradition of mine is adventuring to my Grandparent’s house in Deerwood Minnesota. We would attend the Crosby-Ironton parade during the day. Our parade spot was right across from a Dairy Queen, so of course we always bought a treat before the parade started… even if it was only 10 o’clock in the morning. The parades have been getting shorter and shorter each year, but average to be a little over an hour. Which for a kid looking to fill her bag with candy, it wasn’t long enough. We would then make the drive home to grill hamburgers and hot dogs for lunch and if my parents were lucky, us kids would let them take a nap before our evening festivities. We would finish our 4th of July day off by being mesmerized by fireworks in the evening. What are your family traditions for Independence Day?

Like I said earlier, the 4th of July, 2020, for most Americans, is going to be celebrated differently this year. Those most affected are the residents of long term care facilities. A lack of togetherness with their families will only be amplified during this holiday. Although recently the MN Department of Health has put out guidance for long term care facilities to have outdoor visitations, it just won’t be the same.

But there are a few other ways that you can celebrate with your loved ones this 4th of July.

Bring the tradition to them. Since visitors are not allowed in nursing communities and we don’t know how the outdoor visitations will work, bringing the tradition to them may be a bit more difficult this year. A way you can still celebrate with your loved one is by decorating the outside of their window with an American Flag, window decals, and/or flowers.

Cute American Kids watching Fourth of July ParadeCall and Reminisce. If you aren’t able to carry out your normal family traditions, call and reminisce about what you have done in the years past. Take it one step further by writing down your 4th of July memories and make it into a keepsake for you and your loved one(s).

Just remember that the biggest thing for people facing tough times, especially around holidays, is that they know you are here for them and that they are cared for.

Firework and bokeh lights at night in the colors of the flag from the united states of america (blue, white and red)Resources

Click to access ltcoutdoor.pdf

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Memorial Day – Remember to Remember

Written By Heather Johnson, RN
Resource Nurse, Empira

Think about what Memorial Day means to you.

Does it bring up childhood memories of a long weekend with family and friends?

Memorial Day is known to many of us as the unofficial start to summer. You may also know it as:

  • Ear-marking the final days of the school year
  • The start of the camping season and warmer weather
  • The first bonfires of the year
  • Celebrations at the lake
  • Mattress sales
  • Picnics galore
  • Large BBQs
  • Well attended parades
  • A paid day off of work
  • Brilliant fireworks
  • Family traditions, reunions and celebrations

Do any of your memories and plans include decorating gravesites and paying respect?

Do you know the history of Memorial Day and the significance in our American history?

Memorial Day is so much more than an extended weekend.

Here is a little bit of history.

By the late 1860’s and with death tolls rising from the American Civil War, Americans began holding springtime tributes to the fallen military heroes by decorating the soldiers’ graves with flowers and memorabilia and reciting poems and prayers. The first such memorial is believed to have originated in Charleston, South Carolina, and was coordinated by freed slaves.

Decoration Day, now known to us as Memorial Day, was first proclaimed by General John Logan on May 5th, 1868. A solemn day of reflection and respect. He recognized the need to honor the more than 620,000 soldiers who died during the American Civil War. He chose May 30th as the declared day because it was not an anniversary date to any particular battle. Some historians believe the date was selected to ensure that flowers across the country would be in full bloom.

Arlington National Cemetery

The Proclamation reads:

“The 30th day of May, 1868, is designated for the purpose of strewing with flowers or otherwise decorating the graves of comrades who died in defense of their country during the late rebellion, and whose bodies now lie in almost every city, village, and hamlet churchyard in the land. In this observance no form or ceremony is prescribed, but posts and comrades will in their own way arrange such fitting services and testimonials of respect as circumstances may permit.”

General Order No. 11

For more than 50 years, the holiday was used to commemorate those killed just in the Civil War, not in any other American conflict. It wasn’t until America’s entry into World War I that the tradition was expanded to include those killed in all wars.

Memorial Day was not even officially recognized nationwide until the 1970s

In 1968, Congress passed the Uniform Monday Holiday Act which moved Memorial Day from May 30th to the last Monday of May. Making it a three-day weekend for federal employees and in this same law also declared Memorial Day a federal holiday which went into effect in 1971. Many argue that in making Memorial Day a three-day weekend, it commercialized the day and made it less significant and easier for Americans to treat the weekend as more of a celebration and in return losing its significance.

Now, I don’t believe there is anything wrong with this type of celebration. To be honest almost everyone likes a good time. Remember our freedom does bring us life, liberty and the pursuit of happiness. But for those who were forged into adults on the anvil of war or those who lost dear friends and faithful comrades or those who have a personal connection we can’t help but to having a slightly more respectful attitude about the sacrifices that produce our safety and liberty. Being able to live in freedom is an incredible stroke of good fortune, but the freedom itself exists only because hundreds of thousands of our service members perished for it.

So while none of us should ever dodge a chance to take a break, spend some time with family and overeat a bit, we should also remember why we have the freedom to do it, even if it’s just on this single day at the end of May.

So what can we all do for those we serve in our communities?

Start by reflecting on the history of Decoration Day/Memorial Day and how that history affects those who serve, and have served our country. Here are some other ideas:

  • Share the history with the younger generation.
  • Take time on this day to honor the men and women who gave their lives in service to our country.
  • Reflect on how the memories of the fallen impact those in our communities.
  • Find meaningful ways to bring that history, honor, and respect into your communities.
  • Reach out to your local Veteran’s groups.
  • Personally, take part in Memorial Day.
  • Pause and pay your respects.

Show the world that this day has not lost its reverent meaning.

A simple gesture is to wear a red poppy, a tradition that began with a World War I poem written in 1915 in which the author gave voice to the soldiers who had been killed in battle and lay buried beneath the poppy-covered fields.

Red Poppies in Flanders Fields

“In Flanders Fields” by John McCrae

In Flanders fields the poppies blow
Between the crosses, row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.
We are the Dead. Short days ago,
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.
Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

In memory, with reflection, of my Great Uncle Pfc. Henry Mattson

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I’ll Do It Anyway

Written By Adrienne Duncan, RN, BSN
Resource Nurse, Empira

The year of the nurse is here!


Although this year has been rough so far, it has cast the light on the profession of my choice and on the millions of other nurses around the world. Caring for those with illnesses can be scary, but we do it anyway.

Although even more attention is on the profession during this pandemic, the truth is nurses have been highly regarded by the public for a long time. Actually, according to a yearly poll done by Gallup, nurses were rated by Americans as the #1 most trusted profession. This has been the case for an impressive 18 year streak! 85% of Americans rated nurses’ honesty and ethical standards as high or very high. This honor is crazy impressive considering the poll included other medical professionals like physicians, dentists, and pharmacists. 85% is also impressive given next most honest profession was engineering coming in at 66%.

Nurses are seen as compassionate, dedicated, educated, advocates who will do right by their patients and uphold high standards. People come in contact with nurses during some of the most vulnerable times of their lives. During this vulnerability, trust is surrendered to those caring people who are caring for you and that can be scary. But as nurses we meet these challenges almost daily and still rise to the calling and do it anyway.

If you take a look back at history to one of the first nursing pioneers in the field, you will find an amazing woman named Florence Nightingale. You may have heard of her before but you probably don’t know how much she actually influenced healthcare and social reform.

Portrait of Florence Nightingale

She was a world traveler who grew up in an affluent, proper family with two homes. She defied her family’s plan for her to become a socialite in the upper class to pursue a nursing career. She was deeply religious and was answering a call from God to be of service. In that era, nurses made little money and were not as respected as they are today. Florence did it anyway.

Her influence is world-renowned, from her work with soldiers during the Crimean war, to opening one of the first nursing schools in England. (I know what you are thinking: Crimean war??? I didn’t know what it was either, it was a military conflict fought from 1853 to 1856. Russia was there, so was the Ottoman Empire, France, United Kingdom and Sardinia. Feel free to look it up if you want to know more.) Ok, back on topic.

Florence realized the impact of the environment on the overall well-being and outcomes for her patients. She promoted nutritious food, clean linens and clothing, fresh air and ventilation, and sanitization. She and her team of nurses were able to significantly reduce the mortality rate of soldiers in military hospitals, from as high as 40% to nearly 2%. Thank goodness for people like Florence, who do it anyway.

And the world needs more. More individuals to answer the call of service to the nursing field. According to the American Association of Colleges of Nursing, the U.S. is projected to have a shortage of nurses that will only increase as Baby Boomers age and nursing schools are also having a hard time increasing their capacity to meet the demand.
According to Purdue Global, here are the top 10 Reasons to become a nurse:

  1. Nursing is an opportunity to make a real difference in people’s lives
  2. There are ample job opportunities
  3. Nursing is a trusted and respected profession
  4. There’s significant opportunity for inter-professional collaboration among a variety of health care disciplines
  5. Nursing offers a high degree of job satisfaction
  6. Employment choices are wide and varied
  7. Work full time, part time, varying shifts
  8. Nurses receive excellent benefits
  9. Nurses can travel the world
  10. Nurture a love of learning

Nursing is beautiful and it can be very hard, but it’s worth it. I would never take back the times I decided to do it anyway. When I was told I was too young to be taken seriously, I did it anyway. When my residents with Alzheimer’s didn’t know who I was, I smiled and loved them anyway. When I was really busy at work and I thought I didn’t have the time to sit at the piano at 10pm on Christmas Eve and sing with Edith, I did it anyway.

When I decided education was my best way to use my strengths and support other nurses, I was filled with both nerves and excitement and I did it anyway. Here’s to a profession that gives, and takes, but mostly gives.

“To do what nobody else will do, in a way that nobody else can do, in spite of all we go through…that is what it is to be a nurse.”

Rawsi Williams

No matter what, we’ll always take care of you!


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Why I Don’t Hate COVID 19

Written By Kelly Klund, LPN
Resource Nurse, Empira

Now that I have your attention let me explain.

I do hate that people are dying. I do hate that people are sick. I do hate that people are separated from their families. I do hate that people are losing their jobs. I do hate that our economy is crashing. I do hate that we don’t have a perfect health care infrastructure. I do hate that small businesses are suffering and some may not survive, and I do hate that our children’s education has been disrupted.

Where there is tragedy there is also triumph, and somewhere on the other end of this unprecedented time we will see that there may be things that are better because of what we have been through.

I think about the poem “I miss September 12th” by Elizabeth Gray.

I miss September 12, 2001. I would never want another 9/11, but I miss the America of 9/12. Stores ran out of flags to sell because they were being flown everywhere. People were Americans before they were upper or lower class, Jewish or Christian, Republican or Democrat. We hugged people without caring if they ate at Chick-fil-A or wore Nikes. On 9/12 what mattered more was what was uniting us than what divided us.

Elizabeth S. Gray

In a study completed in 2015 Pollak and Wilson found Advance Care Planning (ACP) conversations to be uncommon. The category of frail elderly patients was identified as a population with limited or no meaningful engagement in ACP. COVID 19 is forcing all of us to have hard, but necessary conversations about our health care wishes. This is a positive that has come from COVID19.

In 2017 Walmsley and McCormack published a study that showed the difficulty that family members encounter when trying to stay engaged. We all know of someone who visits their loved one in a nursing home every Sunday because it is the right thing to do, but they often don’t know what to talk about. With the strict visitor restrictions aging services has appropriately imposed many of those families have had to embrace technology as a way to stay connected. My hope is that when this is over those families continue with their meaningful good night or good morning video chats, as opposed to their weekly obligatory visits. That would be a positive that came from COVID 19.

I have a friend who hosts daily what’s for supper video chats with her girlfriends who struggle in the kitchen. Whether eating curbside pick-up or home cooked meals, people are congregating around the dinner table. This is a positive from COVID19.

I live in a small town in Wisconsin and our main street cafe posted on their Facebook page that they have had some of their busiest days ever. People are pulling together to support local businesses differently than before. This is a positive from COVID 19.
I don’t hate that COVID 19 cancelled my large family Easter celebration. Instead of the hustle and bustle of a house full of people, my husband, college aged daughter, adult son and I had a lovely family dinner at home. The belly laughs were abundant and the memories are priceless. This is a positive from COVID 19.

In the article “Forget Happiness, find Meaning” the author, Kaufmann, says that we should focus on empathy, compassion and gratitude when faced with challenges. There is meaning in COVID 19 for all of us, the challenge is for us to embrace that meaning and grow from it.
I am finding meaning in community, family and appreciation and that is why I don’t hate COVID 19, it is about perspective. I wouldn’t want this new way of life to last forever, but I can find the gifts.

In this time when everyone’s world has been upended where can you find opportunities for empathy, compassion and gratitude? I challenge you to find the September 12th moments in your life.

Kristian Pollock, Eleanor Wilson. Care and communication between health professionals and patients affected by severe or chronic illness in community care settings: a qualitative study of care at the end of life. Health Services and Delivery Research. 2015;(31). doi:10.3310/hsdr03310.
Kaufman SB. Forget Happiness, Find Meaning. Scientific American Mind. 2019;30(6):21. Accessed April 13, 2020.
Walmsley B, McCormack L. Severe dementia: relational social engagement (RSE) during family visits. Aging & Mental Health. 2017;21(12):1262-1271. doi:10.1080/13607863.2016.1220923.