Taking care of ourselves in order to improve the care we give

Nursing is a tough gig. We see people at their best and their worst. We work long hours at work that can be back-breaking (really). We give a lot of ourselves to strangers who need our care and compassion. Sometimes we give so much that we hurt. Far too many nurses fall prey to burnout or compassion fatigue.

So, how do we avoid the pain of burnout or compassion fatigue? What we need is a dose of care and compassion. Sadly, we are better at giving to strangers than to ourselves or each other. For this year, as president of the Inland Empire Nurses Association, I will be talking about how we can be kinder and gentler to our most important patient care tools—our brains and our bodies.

Let’s first take a look at what causes burnout. According to Laschinger and Leiter (2006), burnout is the result of organizational factors such as insufficient staffing, poor leadership support and a lack of input into nursing practice that lead to decreased engagement, increased frustration and physiological symptoms. These factors also negatively impact patient outcomes that further exacerbate the stress for nurses.

Some of these factors are largely beyond our control. But I would argue that we can be more powerful than we think. Shifts beyond 12 hours and more than 40 hours per week put great money into our pockets but may injure our bodies and increase the risk to our patients. It’s time for us to stop enabling staffing practices that further harm us and our patients. Dr. Thomas Skovholt calls for “altruistic egoism”—the practice of caring for ourselves in order to care for others more effectively. I call it self-care and safe practice. I challenge you to say no. Spend that extra time doing something that brings you bliss and protects you from the perils of work stressors. If you are short on time, remember, 15 minutes in a bubble bath is far cheaper than therapy!

Another thing that we can do to better protect ourselves from burnout is to participate. We are all so tired, and it seems counterintuitive to add activity to our already packed schedules. However, in order to really change the culture on our units, we have to advocate for ourselves and our patients on our unit-based councils, nursing practice committees and other self-governance opportunities. Although it may feel like these actions have no effect, only our numbers will actually make the difference. In the meantime, thank those nurses who are advocating for you.

Finally, be kind to each other. This can be tougher some days than others. Some of us cope with stress in ways that can create more stress for their colleagues. I challenge you to offer your empathy and compassion to those who are having a rough time. We, none of us, are immune to the effects of a horrible, no good, very bad day. Rather than take it into the break room, ask them how things are going. If you have the time, offer to help. Perhaps these acts of kindness will be returned in kind.

References:

Laschinger, H., Leiter, M. The impact of nursing work environments on patient safety outcomes: The mediating role of burnout/engagement. J Nurs Admin. 2006;36(5):259-67.

Skovholt T, Trotter-Mathison M. The Resilient Practitioner: Burnout Prevention and Self-Care Strategies for Counselors, Therapists, Teachers and Health Professionals. 2nd ed. New York:: Routledge, Taylor & Francis Group; 2011.