2009: the year of nurse wellness.

"Hobby, you ask? What nurse has time for a hobby?"

Truth is, whether it's a hobby, regularly built-in time for playing, or some other self-care activity, we nurses can't afford not to take care ourselves. We typically give, give, give--to our clients, our families, our neighbors, our faith communities, our nursing organizations, and on and on. You know. You've likely told yourself, "I'm exhausted." Or, "I don't know how much more I can give." Or, your body has sent a signal that "the tank is nearing empty," including lethargy, headaches, and compulsive eating. Perhaps it is a behavioral cue--you get short with your children or colleagues.

Any of these signs point to our being less well than we need and deserve to be. We certainly want our clients to achieve wellness. What about ourselves? In this issue of the Tennessee Nurse, we begin a series of articles and resources focusing on nurse wellness. It is our hope that this will be an interactive endeavor. We want to hear from you! What are you doing--either individually or collectively with nurse colleagues--to maintain your own wellness? What has worked or not worked for you? What efforts are being taken by your employer to support your wellness? What ideas do you have on how TNA can support nurse wellness across our state? As an incentive to get everyone involved in sharing and supporting each other, anyone who responds to this column will be entered in a drawing to receive a $50 gift card from TNA!

It seems that often we forget that we have needs just like everyone else. Margie Gale, MSN, RN, Nurse Wellness Specialist at Vanderbilt University, uses the analogy of a vending machine. There really are no secrets when it comes to self-care. Individually, we need to:

* Operate from a sense of personal power and control. We can't control what is said and done to us, but we can choose how to respond to what life and others deal us.

* Practice seeing the beauty and wonder in life. Canadian essayist Robertson Davies once wrote, "Life will bring you pain and joy. You will not be able to escape the pain completely, but unfortunately it lies within your power to reject the joy utterly." Look for joy and embrace it!

* Take care of the basics--sleep, nutrition, exercise. Discover what makes your body sing! Is it walking, yoga, meditation? Practice and enjoy!

* A word about exercise--when what you are doing becomes "routine, boring, and sheer maintenance," the emotional pay-off begins to diminish. It is important to keep exercising, but you may need to engage in a second activity that is more joyful and recreational.

* Use the magic of humor to lighten the day.

* Learn to recognize your body's signals of stress. Prioritize--ditch the perfectionism!

* Set and maintain personal boundaries that respect your needs.

Nurse leaders also have a responsibility to make a difference. Leaders need to focus on developing and maintaining supportive work environments by:

* Using praise and dropping the blame culture.

* Implementing mentoring programs.

* Treating nurses as people with lives and responsibilities outside of nursing.

"Inspiration does not beget action. Action begets inspiration" Chinese Proverb 

Most of us know what we need to do to take care of ourselves. It's the "doing" that is the problem. Being intentional and prioritizing our own wellness is essential to the "doing." Being intentional is a mental process, not just a thought about doing something. The thought alone will not make the intention come true. Rather, the outcome will be influenced by your desire combined with action steps. Being intentional is an active and direct process that includes knowing what you want, taking action, and soliciting support. Stephen Covey, author of The Seven Habits of Highly Effective People, says "start with the end in mind."

Ask yourself what your wellness activity might look like. Get a clear picture in your mind. Do you want to be with others or engage in a solitary activity? Do something indoors or outdoors? And, try to visualize how you might feel when you are taking better care of yourself. Next, make an action plan to make your wellness activity happen. List the action steps that must take place. Then start checking them off, one by one. For example, you might want to try yoga, but think you are more likely to do so if a friend comes along. Your action plan would include such steps as pricing yoga at several studios and lining up a friend to participate with you. Finally, you will need to solicit support. Identify who is in the best position to support you and hold you accountable for taking good care of yourself. Explain your plan for achieving wellness and be specific about what your support person can do to assist you.

Prioritizing is something that we do in our nursing practices every day. We identify basic tasks and processes that must come before others. So, our own wellness must be a priority, and we must be intentional about taking care of ourselves. How do we do this? Evaluate your current self-care practices. Do you engage in them regularly? Are they fun and restorative? Do they relieve stress? If the answer is no, you probably aren't putting yourself near the top of the list for care-taking.

Back to the idea of a hobby--it's something we often talk about with our clients as a way of getting more out of life. Well, it's time to start practicing what we preach! Margie Gale has developed a Hobby Readiness Scale (at right). Responding to the scale will not only give you an idea about whether you are engaged in a hobby, but will also inform you as to aspects of hobbies that make them positive self-care activities, e.g., free/affordable, fun/not purpose driven.

Long time TNA member Ed Blackman has engaged in the same hobby for many years to maintain his own wellness throughout an active nursing career. "You can say that staying active has been a large part of my life, and bowling has helped me through many difficult times. While in graduate school in 1978-79, I looked forward to the Thursday night bowling league whereby I could unwind and release a lot of stress and tension on those 10 pins 90 feet down the lane. I have continued to bowl weekly in two leagues during the winter for over 30 years. Since 1987, I have bowled in a summer league for 14-16 weeks. With my wife's retirement in 2003, we now bowl together in a weekly senior Lunch and Bowl social affair."

"During my rehabbing from bypass surgery from February through April 2008, I found the desire to once again pick up a 14-pound ball was the gain from the pain. Plus, I truly believe one must keep a positive I can do this attitude in every endeavor. I have been a walker for a long time due to medical problems and discovered that walking aided my bowling success. My wife and I are both season ticket holders for the Vanderbilt football and men's basketball teams and season ticket holders for the Middle Tennessee State University baseball team. We have attended the SEC Women's Basketball Tournament since 2003, as my daughter is a University of Tennessee graduate and a fan of Pat Summitt and her team. She usually sits between our black and gold," Blackman said.

When asked if it was ever difficult to put his bowling and walking as priorities in his life, Blackman said, "No, it was not that hard. It is like when you quit smoking. You look back two or three months later and think, 'That was easy.' I really believe one will find time for things they enjoy doing. So, I found time to do those things. Everyone in my family knew that Thursday nights were my bowling nights, and it would have to be something extra special for me to be included in some other affair. But, over the past 30 years, I did yield once or twice (smile)."

Blackman's account of his hobby of bowling demonstrates several things:

* He found a hobby that he really enjoys.

* Thus it was easier to "find time" to engage in the hobby.

* He was intentional about scheduling time for his hobby and communicated its importance to his family.

* In recognizing the ways in which bowling was a stress reliever, he prioritized this as an important wellness activity.

So, Tennessee nurses, let's get going on our own wellness! Remember, we want to hear from you. Don't forget the incentive to get everyone involved in sharing and supporting one another: anyone who responds to these columns with thoughts and/or questions, will be entered in a drawing to receive a $50 gift card from TNA! Please submit your comments to Cheri Glass at [e-mail].

Hobby Readiness Scale *

I currently have a hobby.                                  True  False

I enjoy my hobby.

My hobby is a stress reliever.

I lose track of time when I do my hobby activity .

My hobby is different from my regular job.

My hobby complements (does not interrupt) my family life.

My hobby is free or very affordable to do it.

My hobby has few or no health risks.

My hobby is fun and not purpose driven.

My hobby is readily available/accessible to me.

* Developed by Margie Gale, MSN, RN, Nurse Wellness Specialist,
Vanderbilt University

by Fern Richie, DSN, APRN-BC

About the Author:

Fern Richie, DSN, APRN-BC, a member of TNA District 3, is a Clinical Nurse Specialist in Psychiatric-Mental Health Nursing. A member of the Tennessee Nurse Editorial Board, she is a therapist and consultant, and has adjunct faculty appointments at Vanderbilt University and Lipscomb University.