There is evidence that nurses know that we should take care of ourselves and how we should be doing it, yet there is still a gap between what is known and what is practiced (Malloy, et al.). As a profession centered on caring, nurses spend much of our time providing care for others; unfortunately, we often do not give the same consideration to self-care – those activities we do to rejuvenate and refresh ourselves, our spirit, and our energy (Lombardo, et al). Kravits, McAllister-Black, Grant, & Kirk summarized the impact of poor self-care succinctly, “Nurses whose own emotional reservoirs are low are less equipped to meet the care needs of their patients, and this may negatively impact patient safety”.
The World Health Organization defines self-care as “activities individuals, families, and communities undertake with the intention of enhancing health, preventing disease, limiting illness, and restoring health”. According to the Buffalo University Master’s in Social Work Self-Care program, a successful self-care plan factors in six key areas: Physical, Mental and Emotional Wellness, Spiritual Needs, Positive Relationships, and School/Work/LifeBalance (Butler, et al). Exercising, journaling, eating well, meditating, maintaining outside interests, and praying, are examples of self-care strategies.
For many RNs, self-care is a concept that seems like a luxury that we do not have time for (Lombardo, et al). However, it doesn’t matter if you are a nursing student, new graduate, acute care nurse, or community health nurse, we all need to take care of our own wellbeing so that we can meet the challenges each of us will face at school, work, and home (Jackson, et al).
So how do you find the time for self-care? First of all it is important to acknowledge that there is no one-size-fits-all self-care plan. We each have different workloads, lifestyles, circumstances, interests, and needs. Therefore, it is important that each of us take a couple of minutes to identify our individual needs and priorities.
Self-Care Assessment – How are you doing?
As nurses, we are all familiar with the importance of eating healthy meals throughout the day, getting enough sleep, and exercising regularly but when was the last time you praised yourself? Belted out a song? How about made time to be sexual with yourself or your partner? These are all simple ways that we can recharge and refill our own personal energy stores. Butler et al. have created a comprehensive Self-Care Assessment Tool to help individuals evaluate their current self-care strategies. While I understand that this tool was developed by a Masters in Social Work program and not specifically for nurses, I believe it is a wonderfully comprehensive assessment tool from a fellow health care profession with similar caring and burnout concerns. Take a few minutes and follow this link to explore this assessment tool – you can’t fix what you don’t know! http://socialwork.buffalo.edu/content/dam/socialwork/home/self-care-kit/self-care-assessment.pdf
Make a Self-Care Plan
Butler et al (2014) recommend making a self-care plan to help you maintaina positive self-care regime. Examine your Self-Care Assessment responses and look for trends and annomolies. Are there any areaslacking in support? For each of the six areas (physical, mental, emotional, spiritual, relationships, school/work/life-balance), write out your current practice and then below it, write out your new practice. Some areas might need only slight alteration and others might never have been consciously addressed before. Keep your goals interesting to you and simple enough to fit into your current schedule. Follow this link to a sample self-care plan by Butler et al, (2014):http://socialwork.buffalo.edu/content/dam/socialwork/home/self-care-kit/my-maintenance-self-care-worksheet.pdf.
Make a Commitment
Once you have developed an initial plan, it is time to make a commitment to yourself and share your commitment with those around you. If you are able to articulate to your loved ones, classmates, coworkers, and friends why you are taking time for you and how you are also making space and time for quality relations with each of them, they are better able to support you and your wellness plan. Also recognize that this plan is a work in progress and will need to be reviewed and adapted as you incorporate self-care into your lives and especially as your lives change and evolve.
Wishing you all balance and wellness!
I am a 4th year student in the Bachelor of Science in Nursing program at North Island College in Courtenay BC with a 4.0 GPA. Being a full-time student, working part-time as an employed student nurse in addition to raising my young daughter, I have come to understand the need for self-care first hand. This topic has become so important to my own overall wellbeing that I have felt compelled to share my learnings with those around me. With this in mind, myself and several classmates have spent many hours outside of the classroom creating opportunities for our fellow nursing students to engage in self-care and to help them develop the self-care strategies they will need to be compassionate, engaged nurses in their future practice.
Butler, Rinfrette, & Reiser, (2014). Self-care starter kit. Buffalo University Master of Social Work Program. http://socialwork.buffalo.edu/resources/self-care-starter-kit.html
Jackson, J. & Gaudet, S. (2009). Self-care practices among nursing students. Canadian Nursing Student Association Positions and Resolutions. http://cnsa.ca/english/publications/resolutions-and-position-statements/position-statements/self-care-practices-among-nursing-students
Kravits, K., McAllister-Black, R., Grant, M., & Kirk, C. (2010). Self-care strategies for nurses: A psycho-educational intervention for stress reduction and the prevention of burnout. Applied Nursing Research, 23, 130–138. doi:10.1016/j.apnr.2008.08.002
Lombardo, B. & Eyre, C. (2011).Compassion fatigue: A nurse’s primer. The Online Journal of Issues in Nursing, 16(1). Retrieved from: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No1-Jan-2011/Compassion-Fatigue-A-Nurses-Primer.html
Malloy, P., Thrane, S., Winston, T., Virani, R., & Kelly, K. (2013). Do nurses who care for patients in palliative and end-of-life settings perform good self-care? Journal of Hospice & Palliative Nursing, 15(2), 99-106. doi:10.1097/NJH.0b013e31826bef72
WHO. (1984). Health education in self-care: Possibilities and limitations. World Health Organization, Geneva, Switzerland: WHO; 1984 Retrieved from: http://apps.who.int/iris/bitstream/10665/70092/1/HED_84.1.pdf?ua=1
Hello Maren, thank you so much for your blog entry on this important topic. I think that fitting in self care is something that most nurses struggle with. I think that this is especially important for nurses working shift work such as the 12 hour shifts with rotating days and nights that many nurses work as they face living in perpetual "jet lag" so to speak. Speaking from my own experience, I am often faced with the choice between sleep and spending time with loved ones and not missing out on social events. Maintaining our fitness to practice also means keeping balance and enjoyment in our lives!
Thanks for the tools,
Vancouver Island Director
Maren, MANY thanks for tackling such an important topic SO well! As a nurse educator I often worry that we aren't adequately teaching about (or providing opportunities for) self-care for our student nurses. Your blog provides faculty and students with a great learning resource!
Thank you for this blog post, it was very timely and much appreciated.