First Things First

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By Donna Cardillo, RN, MA, CSP, FAAN

A lot has changed in nursing and health care over the last few decades. Resources are diminished, patient acuity is up, and everyone is expected to do more with less. Nursing has never been an easy profession, but it seems to be pushing our limits these days.

Nurses are caregivers by nature and by profession. That means we traditionally take care of everyone else first and have little time and energy left for ourselves. The result is stress, illness, short tempers, loss of focus and perspective, and poor judgment. When your system is taxed, things start to go wrong on some level.

While it’s impossible to avoid stress, using these essential elements of self-care can combat its effects:

Find respite in your day
To be effective and efficient, “disengage” from work, even for short periods of time. That’s the recommendation from Jim Loehr and Tony Schwartz, the authors of The Power of Full Engagement, for people in fast-paced, high-stress situations. They claim that when you work nonstop for extended periods, you start to become less effective and more prone to mistakes. Yet, many nurses regularly skip breaks, including meals. No matter where you work or what you do, it’s imperative to take periodic breaks for recovery and renewal, even if it’s only for five minutes at a time. Consider stepping outdoors, sitting in a chapel or meditation room, or finding another quiet spot where you can shift your thoughts to other matters. Disengaging for even a few moments is the pause that refreshes.

Reconnect with yourself
Many of us have gotten so caught up in a cycle of “doing” — working at a constantly frantic pace in everyday life – that we’ve lost our sense of self. I often ask nurses what they enjoy doing. Some cannot answer the question because it’s been so long since they did anything for fun. Some nurses tell me they don’t know what to do for fun when they have free time because they’re so unaccustomed to it. Journaling, creating self-portrait collages (cutting out words, images, and symbols from magazines that you identify with), and listening to music from your youth can help you regain a sense of self. Artistic pursuits, hobbies, and time spent communing with nature can also help. You must nurture and develop all parts of yourself. You’ve got to create a full, satisfying life outside of work to balance the demands of your profession.

Get physical
The concept of humans as psychosomatic entities dates back to the time of Aristotle. The mind and body interact in a direct and complex way. Exercise lowers stress, improves health, keeps weight under control, improves mood, and energizes the mind. Nurses are aware of this, but they often ignore it in relation to themselves. Don’t confuse being busy all day with exercise. These are two different things. Joining a health club or fitness center works for some people. Not only do these places provide a forum for physical activity — they offer opportunities for socializing and a haven from the workaday world. For others, getting into a walking routine is beneficial. Aside from the exercise value, walking allows you some time with your thoughts if you walk alone or time for sharing and venting if you walk with a buddy. Dancing, cycling, and swimming are great, too.

Use relaxation techniques
When you regularly expend physical and emotional energy, you have to refill the well, or it will run dry. Meditation, deep breathing, and stretching refresh and rejuvenate, and they can be done virtually anywhere. Lots of good books have been written on all three subjects to teach you proper technique. Even a few minutes here and there can make a world of difference. Massage, Reiki, and acupressure are not luxuries; they are necessities for nurses. They ease tension and tight muscles and realign body energy. Many health care facilities now have massage therapists and Reiki practitioners on staff to take care of employees. If you’ve never had a massage, you don’t know what you’re missing. Ask for gift certificates to salons and spas for birthdays and holidays, or treat yourself. Relaxation is routine maintenance for the body, mind, and spirit.

Know your limits
Many nurses are working 12-hour shifts these days which research tells us is detrimental to the body, mind and spirit. It pushes us to our limits and beyond, especially when working on consecutive days. And because this allows nurses to work only 3 days per week to accrue full time hours, some nurses then work at additional jobs or shifts on their days “off.” This is a recipe for rapid burnout not to mention negating a family and personal life and upping the ante on acquiring illness and worse. Nurses are not machines. There are limits to what we can do. All work and no play will eventually disrupt every aspect of your life and health. Pace yourself, create balance and learn to say ‘No’ when necessary.

Take care of yourself first, and you’ll have more energy, focus, stamina, and enthusiasm to take care of everything and everyone else.

©Copyright Gannett Healthcare Group ( All rights reserved. Used with permission.

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