Nursing

As 2020 approaches it is a perfect time for personal, familial, spiritual, social, and professional reflection.

Ask yourself these simple questions about 2019:

1. PERSONAL REFLECTION

-Is there anything about myself that I feel I good about …that I want to continue in 2020?

-Is there anything about myself that I feel I would like to do differently in 2020?

– Is there anything about myself that I felt was challenging? And could I benefit from help and support from others in 2020?

2. FAMILIAL REFLECTION

-Is there anything about family relationships that I feel I good about that I want to continue in 2020?

-Is there anything about my family relationships that I feel I would like to change in 2020?

– Is there anything about my family relationships that I felt was challenging for me that I could benefit from help and support from others in 2020?

3. SPIRITUAL

-Is there anything about my spiritual practices that I feel I good about that I want to continue in 2020?

-Is there anything about my spiritual practices that I feel I would like to do differently in 2020?

– Is there anything about my spiritual practices that I felt was challenging? And could I benefit from help and support from others in 2020?

4. SOCIAL ACTIVITY

Is there anything about my social life practices that I feel I good about that I want to continue in 2020?

-Is there anything about my social life practices that I feel I would like to do differently in 2020?

– Is there anything about my social life practices that I felt were challenging and I could benefit from help and support from others in 2020?

5. PROFESSIONAL LIFE

LET ME PAUSE HERE AND SAY IF YOU DON’T HAVE A J.O.B OR IF YOU ARE RETIRED THIS STILL APPLIES TO YOU!

A professional life is what you choose to be engaged in…….whether its cooking, cleaning, art, volunteerism, knitting, crafts, mentoring, writing, working, working out, school, public speaking, etc.

Your passion as your profession!

You are NOT your job! You are not your career or lack of career.

YOU ARE YOUR PASSION

A special note to nurses……….Nurses – you are not your license. You are your passion.

Ask yourself here…..

– What was I passionate about in 2019?

-Do I want to take that same cause into 2020?

-Do I want to make my passion into a career or keep it separate?

-Do I want to do more with my passion or stay where I am?

-Do I want are need support from others to pursue my passion? If so, ask for it in 2020! This is your year!

These are important reflections for evaluating balance into our lives. We want to be whole, and connected. The opposite of addiction, depression, anxiety, and mental “unwellness” is connection to life in a balanced, healthy fashion.

Be Inspired,

Lisa Marie

It’s Time for Reflection

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Nursing

Journaling: Writing Affirmations and Gratitude Using the Power of ‘As Evidenced By’

Nurses are trained to assess, validate, and document reality. We do not rely on vague impressions; we look for evidence. Ironically, when it comes to self-care practices like affirmations and gratitude, many nurses struggle because the language can feel abstract, forced, or disconnected from real life.

If you have ever thought, “This sounds nice, but I don’t feel it,” you are not alone.

One simple shift can make affirmations and gratitude practices more grounded, believable, and effective for nurses: adding the phrase ‘as evidenced by.’

This approach bridges the gap between intention and lived experience, helping your nervous system recognize safety, progress, and truth.

Why Affirmations and Gratitude Can Feel Hard for Nurses

Nursing culture prioritizes action, competence, and resilience—often at the expense of self-reflection. Traditional affirmations like “I am calm” or “I am enough” may feel hollow when your body is exhausted, and your mind is racing.

Your brain resists statements that feel untrue.

By anchoring affirmations and gratitude in observable evidence, you reduce internal resistance and increase emotional credibility. This is not positive thinking—it is integrated awareness.

The Power of “As Evidenced By”

In nursing documentation, “as evidenced by” connects an assessment to tangible data. The same principle applies to self-care.

  • It validates your experience
  • It grounds the statement in reality
  • It allows progress to be small and still meaningful

Rather than forcing yourself to believe something, you are recognizing what is already happening.

Writing Gratitude Using “As Evidenced By”

Gratitude does not have to be dramatic or life-changing to be valid. For nurses, the most healing gratitude is often quiet and personal.

Example:

I am grateful for my recovery, as evidenced by my ability to show up for myself today.

This statement does not deny struggle. It acknowledges effort. It honors capacity without minimizing fatigue.

How to Write Your Own Gratitude Statement

  1. Begin with “I am grateful for…”
  2. Name something internal or external that supports you
  3. Complete the sentence with a concrete example

Additional Examples:

  • I am grateful for my resilience, as evidenced by getting out of bed despite emotional heaviness.
  • I am grateful for my support system, as evidenced by reaching out instead of isolating.
  • I am grateful for rest, as evidenced by choosing to pause without guilt.

Writing Affirmations Using “As Evidenced By”

Affirmations become powerful when they describe a state you are already touching—even briefly.

Example:

I am at peace with myself today as evidenced by being grounded in the present moment.

This does not require perfection or constant calm. It recognizes a moment of regulation, which is enough.

How to Write Your Own Affirmation

  1. Start with “I am…”
  2. Name a quality, state, or intention
  3. Anchor it with a lived behavior, feeling, or choice

Additional Examples:

  • I am honoring my limits as evidenced by saying no without over-explaining.
  • I am healing, as evidenced by noticing my emotions without judgment.
  • I am safe in my body as evidenced by taking slow, intentional breaths.

Why This Practice Supports Nervous System Regulation

The nervous system responds to proof of safety, not just words. When you pair affirmations and gratitude with evidence, you:

  • Reduce cognitive dissonance
  • Increase self-trust
  • Reinforce neural pathways associated with regulation and self-compassion

Over time, this practice helps nurses reconnect with themselves outside of productivity and performance.

A Simple Daily Practice for Nurses

At the end of your shift or before sleep, write:

  • One gratitude statement using ‘as evidenced by.’
  • One affirmation using ‘as evidenced by.’

Keep it brief. Keep it honest. Consistency matters more than depth.

Closing Reflection

Nursing asks you to witness others with compassion and clarity. You deserve the same level of attentiveness toward yourself.

Affirmations and gratitude are not about pretending everything is fine. They are about recognizing what is real, supportive, and healing, right now.

Sometimes, showing up for yourself is the evidence.

Be Inspired,

Lisa Marie

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Nursing

Entering 2026: Reflection for Nurses, Caregivers, and Clinicians

As 2026 approaches, many nurses, caregivers, and clinicians are not in need of another productivity plan or resolution list. What is needed instead is reflection—honest, grounded, and human-centered.

Reflection is not indulgent. In caring professions, it is essential. Without it, exhaustion becomes normalized, moral distress goes unnamed, and disconnection quietly takes root.

Before asking what you will do in the year ahead, it may be worth asking who you have been required to be.

Taking Stock Without Minimizing

Care work leaves a mark. Some moments strengthen us; others stay with us in ways we cannot easily articulate. This is not weakness—it is evidence of empathy.

As you look back on the past year, consider:

  • What moments still live in your body or thoughts?
  • Where did you show skill, steadiness, or compassion under pressure?
  • What did this work ask of you emotionally and ethically?

Identity Beyond the Role

When your professional role becomes your identity, burnout is no longer a risk—it becomes inevitable.

Ask yourself:

  • How much of my self-worth is tied to being needed or competent?
  • Who am I when I am not caring for others?
  • What parts of myself have been set aside to sustain my role?

You are not your license. You are not your productivity. You are a human being who happens to work in a helping profession.

Moral Distress and Fatigue

Moral distress occurs when you know the right thing to do but cannot do it because of systemic or situational constraints. Over time, this erodes meaning.

Reflect on:

  • Where did I feel misaligned with my values this year?
  • What have I been carrying silently?
  • How has fatigue shown up—in my body, mood, or relationships?

Naming these experiences does not make you less professional. It makes you honest.

Boundaries and Sustainability

Boundaries are not barriers to care; they are acts of professional integrity.

Consider:

  • Where do I consistently overextend?
  • What expectations have I accepted without question?
  • What would need to change for this work to be sustainable—not just survivable?

Endurance is not the same as health.

Reconnecting With Meaning

A calling evolves. It is allowed to change as you change.

Ask yourself:

  • What initially drew me to this work?
  • Does that meaning still fit my life today?
  • Where do I find purpose when systems fall short?

Closing Reflection

As you enter 2026, pause with this question:

What would it look like to care for myself with the same seriousness and compassion I offer others?

Reflection does not require fixing yourself. It simply asks you to remember that your humanity matters.

Be inspired,
Lisa Marie

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Nursing

Doctor Is a Title Earned, Not Owned

By Lisa Marie Reyes-Walsh, DNP, PMHNP-BC, FNP-BC, CARN-AP, CNE

A recent California court decision banning doctorally prepared nurses and other non-physician clinicians from using the title “doctor” in clinical settings should give us all pause. While the 1937 law behind the ruling was intended to protect the public from confusion, enforcing it today reveals something deeper—an outdated hierarchy that denies recognition to the many doctorally educated professionals who make modern healthcare possible.

Let’s be clear: Doctor is an academic title, not a synonym for physician. It signifies the highest level of education in a discipline—whether medicine, nursing, psychology, pharmacy, or education. When a nurse earns a Doctor of Nursing Practice (DNP) or a PhD in Nursing, that title represents years of rigorous study, research, and clinical mastery. Denying these professionals the right to use the title they have legitimately earned is both professionally dismissive and intellectually dishonest.

Patient Confusion or Professional Control?

The court cited an American Medical Association (AMA) survey suggesting that 39% of patients are confused about who is or isn’t a physician. But confusion is solved through education, not erasure. The answer is transparency, not title policing. A nurse who introduces themselves as “Dr. Reyes-Walsh, Doctor of Nursing Practice and Psychiatric Nurse Practitioner,” is being truthful and clear. The public deserves honesty, not an outdated ban designed to preserve one group’s dominance.

This ruling perpetuates physician exceptionalism—the belief that only MDs and DOs deserve full professional acknowledgment. Yet today’s healthcare system is interdisciplinary by design. Patient safety and access depend on collaborative teams that include doctorally prepared nurses, psychologists, pharmacists, and physical therapists. Their doctoral preparation enhances—not endangers—public health.

Truth in Advertising or Truth in Exclusion?

California’s “truth-in-advertising” statute was written nearly ninety years ago, long before advanced nursing practice existed. Applying a 1937 framework to 2025 healthcare ignores decades of evolution. Back then, few women held doctorates, and the idea of a nurse practitioner was unimaginable. Today, the DNP and other professional doctorates are standard pathways for clinicians dedicated to leadership, evidence-based practice, and quality improvement.

The law assumes patients can’t understand the difference between a Doctor of Nursing Practice and a Doctor of Medicine. That’s a paternalistic view of the public and a disservice to patient literacy. Americans can navigate insurance policies and treatment plans; surely, they can comprehend credentials when practitioners clearly identify their discipline and scope of practice.

Why It Matters

Restricting the use of doctor to physicians alone silences a vital part of the healthcare workforce. Nurse practitioners and other doctorally prepared clinicians provide over a billion patient visits annually, often in underserved areas where no physician is available. Their expertise improves outcomes, expands access, and saves lives.

This ruling also sends a troubling message to future healthcare leaders: that one’s highest academic achievement can be dismissed for political reasons. When the law undermines respect for education, it discourages excellence. In a system already strained by workforce shortages, that’s a loss none of us can afford.

The Way Forward

Healthcare deserves transparency, not territorialism. Every professional should disclose their credentials and scope of practice. Patients have a right to know who is treating them—but doctorally prepared nurses have a right to identify themselves accurately.

As Palmer et al. v. Bonta et al. moves to the Ninth Circuit Court of Appeals, the broader issue remains: do we value all who dedicate their lives to healing, or only those within a specific title tradition?

Respect for the word doctor should depend on education, integrity, and contribution—not on one profession’s monopoly over language.

When we start restricting who may be called doctor based on politics rather than merit, we don’t just diminish nursing—we diminish the truth itself.

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Nursing

My Passion for Teaching: Shaping the Future of Nursing Through Purpose and Connection

My Passion for Teaching: Shaping the Future of Nursing Through Purpose and Connection

Teaching is not just what I do — it is who I am. For me, being an educator is more than sharing knowledge; it’s about inspiring others to discover their potential and empowering the next generation of nurses to lead with compassion, integrity, and skill. Nursing is a calling, and teaching allows me to nurture that calling in others, creating a ripple effect that reaches countless patients, families, and communities.

From my earliest experiences as a clinician to my current role as a leader in psychiatric mental health nursing education, I’ve always been driven by a deep sense of purpose. I believe that education is transformational — not only for students but for the entire healthcare system. Every lecture, discussion, and mentoring session is an opportunity to shape the way nurses think, feel, and lead. It’s about preparing them to meet the ever-evolving challenges of our profession while staying grounded in self-care and ethical practice.

One of the greatest joys of teaching is witnessing those “lightbulb moments” when a complex concept finally clicks, or when a student realizes they have the confidence to advocate for a patient or challenge an outdated system. These moments remind me why I do this work — because every student’s growth represents a brighter future for nursing.

My passion for teaching also extends beyond academics. I am deeply committed to fostering an environment where students feel seen, valued, and supported. Nursing is a demanding career, and burnout is a real risk. That’s why I emphasize self-care and resilience in my teaching, encouraging students to care for themselves as diligently as they care for their patients. When nurses thrive, the entire healthcare system benefits.

As a lifelong learner myself, I am constantly inspired by my students and colleagues. Their questions, insights, and diverse experiences challenge me to grow and evolve as an educator. Teaching is a partnership — one built on trust, curiosity, and a shared vision of improving mental health care and advancing our profession.

Ultimately, my passion for teaching is rooted in a belief that education can change lives. By investing in the next generation of nurses, I am contributing to a legacy of compassionate, evidence-based care that will impact individuals and communities for years to come. Teaching allows me to merge my love for nursing with my dedication to service, leadership, and innovation — and that is a privilege I never take for granted.

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Nursing

One Corporation Helped Me Survive The Pandemic

I will never forget that uneasy feeling I had when the governor mandated a shut down.

As a business owner, an extrovert, and a health practitioner who cared for vulnerable populations, I felt a sense of doom. I wondered how my patients would respond to this situation. This was very challenging times for patients that live with substance use disorders who rely on connecting to others for survival and recovery.

The first day of the shutdown I felt like a trapped animal. Overnight, life as I knew it was now completely different. I searched for some kind of normalcy. I got in my car that first day and went for a drive. I didn’t see many people on the road. Parking lots were empty. My neighborhood had an eery abandoned feeling.

My normal daily routine included driving to my favorite Starbucks every morning for an almond milk latte. As I was driving I was on autopilot and found myself sitting in the parking lot of Starbucks. I saw a few cars in the parking lot and decided to walk to the front door to see if anyone was in the store. There was a sign on the door that said the drive through was opened! I was elated. I drove through and ordered my drink and chatted with the barista only to find out Starbucks was staying opened. The state mandate allowed essential businesses to remain opened. Starbucks considered themselves an essential business. I absolutely agreed! It was essential to me to have some sort of normalcy in my life!

Driving to Starbucks every morning for my morning coffee, chatting with the baristas for a few minutes and thanking them for showing up everyday left me feeling hopeful. While continuing to see patients, in person, to provide some with lifesaving medications, I needed to feel hopeful.

During that time period I lost patients to overdoses. It took a toll on me. I was unsure of how my patients would survive transitioning to meetings on Zoom, less connection and less accountability. I also feared for my family and friends and hoped a vaccine would be available soon. I went above and beyond to help patients who needed care and was very creative at times in finding ways to deliver patient care. When supplies were limited I made face shields out of plastic report covers, hot glue, and elastic. I could write a whole chapter on the creative things I did like this to continue patient care while protecting myself. So many uncertainties existed at that time, and as a mental health provider I always took great care of my emotional and mental wellbeing throughout my career. But the pandemic was something I had never experienced. Some of my self-care practices included socializing with friends and family-in person-and giving and receiving lots of hugs from my grandchildren. So many things changed for me, my patients, and the world. As I continued to watch the pandemic progress I lived with anxiety about my future, my family, and my patients future. I had to rethink my self-care strategies and practices to cope. For me, I realized I could count on Starbucks employees being there everyday to make my morning coffee. Connecting with Starbucks employees also was such a gift during those very trying times. My drive to Starbucks was now a strategy, a self-care approach. It was not longer just my morning coffee run.

I was recently asked to participate in a qualitative research study that asked how psychiatric mental health nurse practitioners made it through COVID-19 and how COVID-19 impacted their mental health. I told the researcher my story, and ended with how Starbucks really helped me feel normal and make it through the pandemic. She suggested that I write an article, about my experience and share it with others. That is the reason for this blog, but more so, in sharing my story with her, I deeply realized how forever grateful I will be for that one corporation that stayed open and helped me make it through the pandemic. Thank you, Starbucks!

In closing, I will tell you, I experienced a great deal of loss during the pandemic and processed my grief many days in the Starbucks parking lot in my car with my journal and an almond milk latte. Today, I honor the memories of the patients who died during that period of time every morning when I go to Starbucks.

Rest in peace.

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Nursing

Two years later

My last post was two years ago! Overwhelmed with juggling work, school, and navigating COVID I can’t believe two years later I am just now getting around to blogging. I am finally finished with school which is such a relief! It was incredibly challenging trying to finish school during COVID. However, I am not the only one. Many, many nursing students trudged the road to finishing their degrees during the pandemic. Bless you ALL!! We did it!

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Gratitude

Waiting on my plane I had no idea what to expect as I was about to travel on a journey to the Dominican Republic. I watched the sunrise at the airport praying for a beautiful experience. It started with the sunrise.

When I boarded the plane I sat next to a young lady with a shaved head and I mask. I worried about myself getting sick! I didn’t know if this young girl was sick and I selfishly thought about myself and my trip. I didn’t want to be sick, for I had work to do! I was humbled when she started talking to me about herself. She sold everything she had and shaved her head because her sister who has been battling cancer was at the end of her journey. She was flying home to be with her. Her sister didn’t know that she was coming. She was so excited about surprising her! With her sisters illness and impending passing this young lady decided after 5 years of living in the states that it was time to go home.

This was the beginning of an amazing experience. I knew in that humbling moment my heart would be changed forever…….

Be Inspired,

Lisa Marie

Part II Coming soon……

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Nursing

One Year Later…..

It’s been a year since my last blog! Almost to the day…..

I can’t believe how much has changed and how much I’ve accomplished! One great lesson I have learned this year is that I don’t give myself enough credit and honor for how hard I work. I almost have this expectation that I’m supposed to successful and work hard.

I am learning to honor myself by acknowledging my hard work and effort I put into my personal growth, my recovery, my work, my relationships, my teaching, my school work, the volunteer activities I participate in,  etc.

I am deeply grateful for the desire, willingness, and effort I put forth every day of my life to be the best I can be. I want to show up to the world as ‘my best self’……..always.

Be Inspired 🙏🏼
Lisa Marie

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