‘Education is important but camping is importanter’ – Strategies in self care

More from In Pursuit of Excellence here

Other similar articles on self care and wellbeing here

‘Education is important but camping is importanter’ – Strategies in self care

Since I’ve recently broken out my favourite annual leave meme (hence the first part of the title) and taken my camper trailer into the wild west of NSW, I thought it might be apt to talk about self-care and why, regardless of how much you may love what you do, regular self-care is so important.

Self-care has been defined by many, with most definitions sharing a similar theme around a proactive self-approach to health and well-being. I perhaps most enjoyed the definition provided by Mills, Wand and Fraser (2018) in the conclusion of their article ‘Exploring the meaning and practice of self-care among palliative care nurses and doctors: a qualitative study’ which identified ‘self-care is a proactive and personalised approach to the promotion of health and wellbeing through a variety of strategies, in both personal and professional settings, to support capacity for compassionate care to patients and their families’.

While the concept of self-care has been around for a long time, and is intricately linked to the prevention of compassion fatigue and burnout, self-care has again been steadily gaining popularity in nursing circles as the challenges of the pandemic continue and its impact on staffing threaten the profession.

These two things have and continue to place a massive burden on nursing staff to keep doing more, being more, and if this cycle cannot be broken, we (nurses, employers and the profession) will find ourselves in a very precarious position. Experienced nurses will continue to leave the profession, and new generations may opt not to enter it entirely. To care for others you first have to care for yourself. Check for danger and keep yourself safe – it’s the most basic principle of first aid. 

Now I am as guilty as the next person at having been not so good at this throughout my career. One of the most confronting things I learned about myself was through clinical supervision a few years ago: I had a complete lack of self-awareness when it came to my own well-being. In hindsight I was absolutely suffering from compassion fatigue both personally and professionally.

My supervisor said to me, as I threw out a bunch of words that didn’t quite fit as I was trying to describe the role I was in, ‘I’m going to offer you a word, maybe it’s not the right word, and it’s okay if it’s not, but the word I’m hearing is martyr’.

Ouch. I sat in the discomfort of that just long enough to realize she was right. Now I wasn’t literally riding out into battle prepared to take a sword in the chest for the sake of freedom, but was I making decisions, conducting myself in a way that fought for a perceived cause at the expense of my health and well-being, yes, 100% I was. It was the kick in the pants I needed to start working on changing the way I approached myself. And as I examined my exhaustion under the microscope I realized it had to start with routine leave planning and better boundaries.

Annual leave is a common place to start when we’re looking for a sustained break. There’s a reason it’s built into employment agreements: people need regular timeout. Time to switch off. Unfortunately, it’s more common that people only start looking for this break when they’re a long way beyond tired – and it’s so much harder to fill a completely drained cup than it is to top one up (trust me on that, I know).

Annual leave might be a holiday, or time to catch up with people you haven’t seen for a while, or it can be just spending time at home in the garden, the kitchen, or watching Netflix. Whatever it is, my advice is plan it and give yourself something to start looking forward to.

For me, my most recent annual leave was a fabulous combination of all those things I mentioned above (except gardening, I don’t do gardening). Hitting red dirt, road train country, where the mandatory wave as you pass other fellow caravaners starts (yes, there’s a magical line where this begins and ends), gave me the opportunity to really start to unwind. There were hours without phone service and the computer stayed at home. I did not access for emails for two glorious weeks (yes, that was a boundary I set for myself!).

I spent many happy hours around the campfire with my family, saw some awe-inspiring sites, watched beautiful sunsets, and finally got a few days at home to catch up on sleep and watch some mindless TV (oh and attend to the mountain of washing from my travels). I return to work feeling vitally refreshed… but because I expect that feeling may last for about a week if I’m lucky, it becomes important that I think about other strategies that will help me care for myself between such chunks of time off. Things that adhering to those good boundaries should provide me with some time to achieve.

While on leave I read Chelsea Pottinger’s book titled ‘The Mindful High Performer’.  What drew me to this book was the honesty in which she told her own personal story through postnatal depression and her admission into a psychiatric facility. She has since founded EQ Minds and works as a corporate wellness presenter and coach.

The book goes on to discuss strategies for how one can integrate self-care into the daily routine of their lives through things such as reflecting on one’s purpose and goals; reframing thoughts through a more positive lens; setting boundaries and respectfully saying no; committing to exercise; achieving high quality sleep; eating well (well most of the time); connectedness (to others and to activities one enjoys) and practicing mindfulness.

Having a combination of strategies that can be regularly and routinely implemented to holistically address health provides the best chance of success. And the benefits are hard to argue with, the National Institute for Mental Health acknowledging that self-care helps to reduce stress and anxiety, lowers ones risk of illness and increases energy levels and productivity.

Interestingly, Mills et al (2018) identify that self-care is a joint responsibility between individuals and their workplaces. Why this is reasonable is perhaps best explained by Fearon & Nicol (2011) in their article ‘Strategies to assist prevention of burnout in nursing staff’. They explain burnout occurs when a prolonged mismatch occurs between what an employee provides and expects in the workplace and what they get back from their employer.

Burnout is characterized by emotional exhaustion, decreased perception of personal achievement, and depersonalization and impacts negatively on productivity, engagement, compassionate care delivery and capacity to retain staff. As such, employers should be taking all necessary steps to prevent such erosion of the very core value of nursing – to care.

This requires commitment, quality leadership, proactive planning, contemporary workforce strategies, access to growth opportunities, access to clinical supervision, regular reflection and debriefing, and sustained positive workplace culture. In the words of Richard Branson ‘Take Care Of Your Employees And They’ll Take Care Of Your Business’.

To finish off, the Black Dog Institute have a great self-care planning document that can help you get started on making time for you. Fill it in, print it out and hang it up somewhere you can see it. Make that contract with yourself, for yourself (https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/COVID-19_Self-Care-Planning_Black-Dog-Institute.pdf).

References

Mills, J., Wand, T., & Fraser, J.A. (2018). Exploring the meaning and practice of self-care among palliative care nurses and doctors: a qualitative study. BMC Palliative Care, 17(1):63. doi: 10.1186/s12904-018-0318-0

Fearon. C., & Nicol, M. (2011). Strategies to assist prevention of burnout in nursing staff. Nursing Standard. 26(14), 35-39. doi: 10.7748/ns2011.12.26.14.35.c8859

Black Dog Institute. (2020). Importance of self-care planning COVID-19 mental health and wellbeing resources. https://www.blackdoginstitute.org.au/wp-content/uploads/2020/04/COVID-19_Self-Care-Planning_Black-Dog-Institute.pdf

National Institute of Mental Health .(2021). Caring for your mental health. https://www.nimh.nih.gov/health/topics/caring-for-your-mental-health

Pottenger, C. (2022). The mindful high performer. Murdoch books Pty Ltd.