Self-Care for Nurses.
Let's face it. The nursing profession is demanding. Not only are the physical demands of a nurse's workload challenging, but the role also has mental demands. Nurses provide emotional support to patients and their families, which carries psychological burdens (American Nurses Association [ANA], 2024). Over time, the physical and mental demands of nursing take a toll on nurses who care for patients every day, often leading to burnout (Crabtree-Nelson et al., 2021). According to the ANA (2024), nurse burnout is a growing problem in the United States. In 2020, approximately 62% of nurses experienced burnout. However, this problem is more common among nurses under age 25. Because nurses represent most of the healthcare workforce, nurses leaving the profession due to burnout has widespread impact on the healthcare system (Shah et al., 2021).Burnout is due to workplace stress (ANA, 2024). For nurses, demands of the clinical environment have grown. A combination of the growing work demands related to inadequate staffing, overwork due to increased overtime, and the impact of the COVID-19 pandemic have contributed to a stressful environment that leads to burnout over time. In 2007, 17% of nurses left their role due to burnout; by comparison, 31.5% of nurses in 2017-2018 acknowledged burnout as the reason for leaving their positions (Shah et al., 2021). When nurses leave, remaining staff experience additional stress and workload (Yu et al., 2019).
While the effect of burnout on the nursing profession has been noted, it is equally important to consider the impact on the individual nurse. Physical and mental health are affected by burnout. Physical symptoms may include fatigue, illness, and other complaints. Mental health also is impacted greatly by burnout. Depression, sleep disturbances, grief, anxiety, and hopelessness affect nurses' health (Crabtree-Nelson et al., 2021). Nurses are always concerned with the health and wellbeing of their patients, whose needs are placed above the individual nurse's needs. For nurses to be able to care effectively for patients, they first must take charge and prioritize their self-care (Yu et al., 2019). Self-care strategies are important in balancing the demands of the profession. While many self-care strategies are available, each nurse is unique in determining which ones may be most useful.
Self-Care Strategies
The American Psychiatric Nurses Association (APNA, n.d.) emphasized the need for holistic self-care similar to the care provided to patients. Self-care focusing on mind, body, and spirit helps to achieve this holistic approach when nurses are caring for themselves. To align the mind, body, and spirit focus into self-care, Wei and Wei (2020) provided the ENERGY acronym, which represents six self-care strategies to promote well-being:
E = Energy source
N = Nurturing kindness
E = Emotional hygiene
R = Refocusing purpose
G = Germinating positivity
Y = Your uniqueness
Energy Source
An energy source is important so a person can recharge not only physically but also mentally. Energy sources come through exercise, nutrition, and adequate sleep. In addition, social support is needed to balance the mind (Wei & Wei, 2020). Practicing mindfulness is one way to prevent being immobilized by stress that often leads to burnout (Kurosaka & Payton, 2020).
Just as a person writes the work schedule on a calendar, it is important to schedule exercise and stick to it, to be realistic in what can and cannot be done. Activities of interest to the individual should be selected. Doing so helps goals to be achieved (APNA, n.d.). Exercise has been shown to relieve stress, and it does not have to be intense exercise (Texas Woman's University, 2023). While relieving stress, it also improves cardiac health and strength to help with physical demands of nursing. Exercise can come in many forms: outdoor activities, such as walking, hiking, and swimming, or indoor activities, such as going to the gym (ANA, 2024).
Nutrition is another important component. Food for healthcare providers in the work setting is not always the healthiest. Often, desserts and other unhealthy options are available on clinical units. With limited time to eat during a shift, making nutritious choices can be challenging. Small changes are often important. Packing meals is often a better alternative to ordering out or grabbing something quick from the facility. Also, smaller snacks could be packed because time can be limited while working (APNA, n.d.).
Prioritizing sleep is needed to be productive at work and at home. On average, nurses sleep 1.5 hours less than what is recommended (Texas Woman's University, 2023). Sleep offers time to disconnect and unwind. This means turning off electronic devices to have time to unwind from the shift (APNA, n.d.).
In addition to taking care of the body, balancing the mind is critical. Activities, such as yoga and spiritual practices, may help restore balance (APNA, n.d.). Another component of balance is social support. Support can come from family, friends, or colleagues. Wei and Wei (2020) noted having this support helps a person feel connected while increasing a sense of belonging.
Nurturing Kindness
A range of emotions can be experienced in the healthcare environment on a daily basis from staff, patients, and families, including negative emotions such as anger and depression. In addition, incivility is seen often in the healthcare setting and impacts staff morale. To help combat these issues, Wei and Wei (2020) suggested the importance of increasing personal happiness and acts of kindness.
Emotional Hygiene
When considering self-care, emotional hygiene is needed (Wei & Wei, 2020). Practicing mindfulness meditation is a useful tool in managing stress. It helps reduce or release negative emotions. With meditation, the nurse sits in a quiet environment and focuses not only on breathing but emotional energy. Breathing exercises are helpful in refocusing and maintaining a level of calmness. Stress is reduced from these exercises by slowing the heart rate and body. Just 10-20 minutes of meditation a day can make a huge difference in refocusing emotional well-being. In addition to meditation exercises, it is important to be aware when professional help is needed. It is no longer taboo to seek mental health care. If finding balance with emotional well-being is a struggle or if the nurse is feeling overwhelmed, help can be sought from a healthcare provider or resources available through the nurse's employer (Texas Woman's University, 2023).
Refocusing Purpose
Nurses remember why they wanted to go into the profession. However, the complexity that exists in health care can cause this purpose to be forgotten. Significant challenges and stressors impact nursing every day. Wei and Wei (2020) suggested nurses pause and reflect on their purpose in becoming nurses when their passion for nursing strays. Remembering the purpose in nursing can impact health and career outlook positively.
Germinating Positivity
Having a positive attitude not only improves a person's mindset but also impacts those around the nurse (Wei & Wei, 2020). When thinking about positivity, the nurse's first priority is practicing a level of self-compassion. It means the nurse extends the same type of compassion to self as to friends. Many times, nurses are harder on themselves with self-criticism, self-judgment, and feelings of failure. It is important to give daily grace and compassion to oneself (Hofmeyer et al., 2020). Ways to promote positivity include practicing a growth mindset and seeing difficult situations as only temporary. Another activity that increases positivity is writing a daily gratitude list or gratitude journal. On a larger scale, promoting positivity can be shown with colleagues. Focusing on positive events or showing appreciation for colleagues can create positivity for the entire team (Wei & Wei, 2020).
Nurses' Uniqueness
Each nurse is unique with individualized strengths and limitations. Nurses have two kinds of power: internal and external (Wei & Wei, 2020). Internal power refers to self-confidence. External power is provided from an external source. Nurses need to understand their self-worth and appreciate their uniqueness as individuals. Similar to germinating positivity, they should think about themselves positively while promoting their self-worth.
Conclusion
Nursing is a rewarding profession. However, nurses' daily stressors impact not only their physical health but also their mental well-being. While nurses are focused on patients' care, their self-care can become neglected. To maintain balance from professional and personal perspectives, nurses should maintain a level of self-care. A self-care routine is unique to the individual, but there are common activities to promote well-being and balance (ANA, 2024).
https://doi.org/10.62116/MSJ.2024.33.4.201
REFERENCES
American Nurses Association. (2024, April 25). What is nurse burnout? How to prevent it. https://www.nursingworld.org/contenthub/resources/workplace/what-is-nurse- burnout-how-to- prevent-it/
American Psychiatric Nurses Association. (n.d.). Self care tip sheet for nurses. https://www.apna.org/wp- content/uploads/2021/03/APNASelfCareTipSheet.pdf
Crabtree-Nelson, S., DeYoung, P.M., Vincent, N.J., Myers, T.P., & Czerwinskyj, J. (2021). Compassion fatigue, compassion satisfaction, and burnout: A study of nurses in a large Texas health-care system. Journal of Nursing Scholarship, 54(6), 720-727. https://doi.org/10.1111/jnu.12780
Hofmeyer, A., Taylor, R., & Kennedy, K. (2020). Knowledge for nurses to better care for themselves so they can better care for others during the COVID-19 pandemic and beyond. Nurse Education Today, 94, 104503. https://doi.org/10.10167j.nedt.2020.104503
Kurosaka, A., & Payton, J. (2020). Prevention strategies to cope with nurse burnout in nephrology settings. Nephrology Nursing Journal, 47(6), 539-563.
Shah, M.K., Gandrakota, N., Cimiotti, J.P., Ghose, N., Moore, M., & Ali, M.K. (2021). Prevalence of and factors associated with nurse burnout in the US. JAMA Network Open, 4(2), e2036469. https://doi.org/10.1001/jamanetworkopen.2020.36469
Texas Woman's University. (2023, March 1). Self-care for nurses: Tips and strategies to avoid burnout. https://onlinenursing.twu. edu/blog/self-care-for-nurses
Wei, H., & Wei, T.L. (2020, October 5). The power of self-care: An ENERGY model to combat clinician burnout. American Nurse. https://www.myamericannurse.com/the-power-of-self-care-anenergy-model-to-combat- clinician-burnout/
Yu, F., Raphael, D., Mackay, L., Smith, M., & King, A. (2019). Personal and work-related factors associated with nurse resilience: A systematic review. International Journal of Nursing Studies, 93, 129140. https://doi.org/10.1016/jJjnurstu.2019.02.014
Sonya Blevins, DNP, RN, CMSRN, CNE, is Director, Nursing Licensure and Compliance, Southern New Hampshire University, Manchester, NH.
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| Title Annotation: | Professional Issues |
|---|---|
| Author: | Blevins, Sonya |
| Publication: | MedSurg Nursing |
| Article Type: | Report |
| Geographic Code: | 1USA |
| Date: | Jul 1, 2024 |
| Words: | 1654 |
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