Making Self-care a Priority

As a nurse, you’re empathetic and compassionate and go out of your way to ensure you provide your patients with the best possible care. But when it comes to looking after yourself, self-care may get prioritized far down the list – or not at all.

Such a mindset may be harmful to you and, ultimately, your patients. Nurses are great patient advocates, but “we do need to start advocating for ourselves because you can’t keep helping everyone. Then you don’t have anything left in your reserves,” said Linda Roney, EdD, RN-BC, FAAN, associate professor, Egan School of Nursing and Health Studies, Fairfield University.

“I think you have to be selfish, which is hard in a selfless profession to balance, but I think that is one of the ways that we can keep ourselves healthy. You have to prioritize yourself,” said Crystal Smith, DNP, RN, NE-BC, director of the medical-surgical unit at Children’s Nebraska.

As healthcare professionals and organizations celebrate Nurses Week with its theme of “Nurses Make the Difference,” now is a perfect time to assess your attention to self-care. In this article, we’ll offer practical strategies to help you care for yourself.

No Perfect Time

When it comes to self-care, “one of the biggest lessons for me is that self-care is not a one-size-fits-all,” said Roney. Nurses need to be aware of their unique needs.

Another awareness is not to wait for the perfect time for self-care. Roney said you can work on “small, incremental changes” for five or ten minutes that can accumulate over a day. You might try “habit stacking”: combining a potentially burdensome task with something enjoyable, notes Roney.

Days Off and “Zen Dens”

Smith meets with her new nurses at Children’s Nebraska in Omaha to discuss a self-care plan. If a nurse is struggling, Smith can consult the nurse’s plan and see the measures that might help that person.

One self-care policy at Children’s Nebraska allows nurses to take a day off if they need to recharge—if “your tank isn’t full enough to come in and give all of yourself that day,” said Smith. There are no negative repercussions should a nurse choose to do so.

Nurses are also encouraged to disconnect completely when they need a break. “It’s very hard to get away from the work when you’re at work,” Smith explained. Nurses are encouraged not to take their work phones on break but to trust that the staff can handle the patients while away.

Another self-care tactic involves “Zen dens.” When the hospital opened a new tower two years ago, these rooms were built into each unit. Zen dens have a lock, a massage chair, essential oil diffusers, books, and low lighting. A nurse can connect a phone to a speaker to play quiet music. “You can go in there and decompress how you need,” said Smith. 

Smith noted that accessibility of these Zen dens is key. “We as organizations have always had places for people to do that, but never right on the unit. It’s tough to get a nurse or even a doctor to leave the unit where their patients are without any way to communicate with them.”

Added to these measures is a “Thrive” team, a department dedicated to employee wellness, noted Smith. Two members of Thrive are Howie, a golden retriever, and his handler, David. They may, for instance, join the staff for a debriefing after a difficult patient or family situation. Besides Howie and David, Thrive has a team of trained peer supporters and group facilitators available 24/7 for clinical and non-clinical team members.

What’s more, staff are encouraged to go home after a death in the facility. Death in general is very hard, noted Smith, “but I would say especially in pediatrics, it’s usually very traumatic. To expect the nurse who just went through that with a family and a patient to turn around then and take an entirely new patient, the mental load of that is really heavy. And so, to the best of our ability, we try to give them the option to go home.” At the same time, the facility understands that a nurse may want to stay at work instead of going home as a way of coping.

Back to Basics

As a nurse, you also need to take to heart the common-sense advice you probably give to patients about self-care, such as the following:

• Sleep and downtime. You may want to spend some downtime on your phone, but be wary of it, noted Roney. “You feel as if you are relaxing and having a positive experience. But all this time is going on, cutting into your sleep/wake cycle.”
• Nutrition and hydration. “If you talk to any nurse, most of us would agree we would put our needs after our patient, so there are many times we might miss a lunch break, or we may eat several hours later than we usually do because there might be something going on with our patient and we need to put their needs first,” said Roney. As a solution, “really be intentional and plan on bringing your meals and snacks to work.” Stay hydrated throughout your shift, noted Roney.

Simple measures such as making sure to take your breaks, eat your meals, and use the bathroom regularly while on shift are a start for self-care, according to Sarah K. Wells, MSN, RN, CEN, CNL, clinical practice specialist, practice excellence team, American Association of Critical-Care Nurses (AACN). Next, prioritize quiet times and activities that bring you joy each day.

Moments of Gratitude

Practicing gratitude can also help with self-care. In talking to an experienced nurse who was struggling, Smith told her, “You guys have to remember that the tiniest things you do make the biggest difference.”

Smith says, “Sometimes we must find and center ourselves around those tiny moments of gratitude. It’s easy to leave work and feel like your entire day was terrible. But really, you probably did many good things throughout the day.”