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Why it’s important nurses take time for self care

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Carol Taylor, RN

Hypothetical Case

The School of Nursing’s board pass rate for its BSN program has dropped steadily in the last five years from an impressive 98% rate to the current 82%. The long-serving director of the program retired four years ago. The new director has yet to establish rapport with his faculty. At present, every faculty member seems intent on going his own way with little concern for the school as a whole.

Two recent MSN graduates have been added to the faculty. Both are intent on qualifying for tenure as soon as possible. Ann Malic, a critical care nurse specialist, has an ACCN mentor, and is already working on a pilot research study. She has been told to zealously guard her time when not teaching and to focus on her scholarship.

James Nantz, the public health nurse, already has a history for volunteering. He serves on the curriculum revision committee and has been asked to lead a task force to figure out how to re-establish higher pass rates. Popular with the students, Nantz also is a faculty mentor for the local chapter of the student nurses’ association. He has many students involved in health projects with the underserved community that borders the school. At the end of his first year, the director asks Nantz if he would consider becoming the president of the school’s Sigma Theta Tau chapter — which at present is moribund.

Provision 5 of the ANA Code of Ethics for Nurses (2015) makes clear that the nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth (p. 19).

Professional growth requires a commitment to lifelong learning. Such learning includes continuing education and self-study, networking with professional colleagues, professional reading, achieving specialty certification, and seeking advanced degrees. Nurses must continue to learn about new concepts, issues, concerns, controversies, and healthcare ethics relevant to the current and evolving scope and standards of nursing practice (p. 22).

Scenario 1:

James Nantz is well on his way to becoming the beloved of all — students, colleagues and the communities he serves — at the expense of his own professional development. He is surprised at the end of his first academic year to discover as he prepares his personal evaluation that he hasn’t even attempted to write the manuscript that should flow from his master’s research. He thought this would be a cinch since the research was finished. He ponders with satisfaction his involvement in the school of nursing and university service, but he knows that he expected more of himself. He definitely plans to pursue a DNP and wonders how he will be able to juggle those studies with his current workload. He is hesitant about accepting the Sigma Theta Tau presidency, but he figures he has more time than his married colleagues with children. He honestly does want to give 100% to the school and knows that much needs to happen if the program is to flourish again. Nantz hasn’t had time to talk much with Malic, but he heard she’s been accepted into a prestigious DNP program and wonders when she had the time to apply.

Scenario 2:

Emilio DeSantis is a tenured professor in the school of nursing. He invites Nantz for a beer before the semester ends and talks with him about his first year. He listens as Nantz shares his joy about his involvement with students and colleagues as well as his frustration about his own development and scholarship. He nods as Nantz talks about his reluctance to assume the presidency of Sigma Theta Tau. DeSantis asks Nantz if he ever heard the adage: “Love your neighbor as yourself.”

“Most nurses do not do such a good job of taking care of themselves,” DeSantis said. “I think that’s why our code reminds us that we have duties to self, including to continue our personal and professional growth. Sounds like you’ve been too busy helping others to do much for yourself.” As Nantz listens he realizes that he enjoys all the positive feedback he gets from being helpful and that it has come at a cost. He thanks DeSantis and promises to do some hard reflecting on his priorities. For his part, DeSantis promises to talk with the head of the faculty development committee because there isn’t a structured process for bringing tenure eligible junior faculty on board and promoting their development. “This should be a matter of justice,” DeSantis will say. “We can’t keep exploiting folks with good and generous hearts.”

Source: American Nurses Association.  (2015). Code of Ethics for Nurses with Interpretive Statements.  Silver Spring, MD:  Author.

By | 2016-11-22T21:47:03+00:00 October 15th, 2016|Categories: Nursing news, Nursing specialties|Tags: |4 Comments

About the Author:

Carol Taylor
Carol Taylor, PhD, RN, is a senior clinical scholar in the Kennedy Institute of Ethics at Georgetown University, a professor of nursing and the former director of the university's Center for Clinical Bioethics. Taylor directs an innovative ethics curriculum grounded in a rich notion of moral agency for advanced practice nurses. She teaches in the undergraduate nursing curriculum, directs a practicum in clinical ethics for graduate students in the philosophy program, conducts ethics rounds and ethics case presentations, and develops professional seminars in clinical ethics for healthcare professionals and the public. Her research interests include clinical and professional ethics, and organizational integrity. She lectures internationally and writes on various issues in healthcare ethics and serves as an ethics consultant to systems and professional organizations. She is the author of "Lippincott, Williams & Wilkins Fundamentals of Nursing: The Art and Science of Nursing Care," which is in its 8th edition, and co-editor of "Health and Human Flourishing: Religion, Medicine and Moral Anthropology" and the 4th edition of "Case Studies in Nursing Ethics."

4 Comments

  1. Elizabeth Longbothum MSN, RN-C, ANP-BC, GNP-BC October 25, 2016 at 5:53 pm - Reply

    captivating discussion re: the importance of caring for self. Selfishness is good, self-centeredness is pathological.

    Thank you for your work

  2. Maggie October 29, 2016 at 5:34 pm - Reply

    I’m wondering how much of the lack of BSN completion has to do with a lack of monetary difference between one having their ADN and their BSN. At this point, I think having a BSN may be seen only as a stepping stone towards an MSN, and not all who begin a BSN program have a further goal in mind.

  3. Cheryl Fortin January 16, 2017 at 1:52 pm - Reply

    I think these scenarios are interesting but there is an aspect that could also be considered in the scenario. I am one who is continuing my education towards my BSN but I am also part of the “sandwich” generation. Two years ago as I was in the midst of an online course, I lost both my parents within 5 weeks. As any “good nurse” would do, I pressed on, striving to be strong and continuing to press through the course. On top of it my boss wanted me to complete an additional certification as soon as I finished in May. At the end of June, I was feeling like I was on a spinning merry-go-round with no way off. Thankfully, I had a friend speak truth to me and said she was worried for me. I called my doctor immediately and was told I couldn’t get in for a month. I explained to the staff person that if I didn’t get in sooner I may end up in the Emergency. They were able to get me an appointment within 2 weeks. I was still working and when I left work one Friday, I could feel myself experiencing a “body-mind” separation. It was that weekend that I crashed emotionally. I was struggling to call in sick but I felt “physically fine”. Thankfully my pastor and his wife came for a visit during that weekend and spent 5 hours with me by the end of the conversation, I called in and planned to talk to my boss on Monday. I ended up out of work for 4 months because I had forgotten about taking care of myself, striving to be strong and still trying to cope with the loss of my parents. I can’t advocate enough, how important it is to take care of ourselves for the sake of our families and our patients.

    • Ginny Scott January 16, 2017 at 6:00 pm - Reply

      Wow! Cheryl you have had a go of it! I pray that you heal mind, body and soul. I think that you are right. We as nurses have the we need to keep going until there isn’t much left. And then the crash comes. I am currently full time in the online RN/BSN program as a non traditional student. I am 40, married and have 4 children ages 17 to 14months. I am strongly thinking about the going into the educational side of nursing. This is a topic I would love to constantly talk about. The
      “crash” of nurses. We go go go not stopping to take care of our selves until it is almost to late.

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