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Self-Care for Nurses Starts With Leaders' Support


It's no secret that self-care is an important part of maintaining overall health. But finding the time to nourish their bodies, minds, and spirits can be a challenge for nurses.

"Nurses are trained to provide compassionate care for patients, yet we're not trained in the compassion of caring for ourselves," says Pam Ressler, MS, RN, HNB-BC, founder of in Concord, Mass.

Over the past two years, the COVID-19 pandemic has hit nurses especially hard. A recent survey conducted by the American Nurses Association (ANA), found that one out of three nurses reported not feeling emotionally healthy. Most reported feeling stressed (75%), frustrated (69%), and overwhelmed (62%).

In a news release, Kate Judge, ANA Executive Director, said "The data collected from this survey overwhelmingly demonstrates the need to provide consistent and comprehensive support for our nation's nurses."

[caption id="attachment_104200" align="alignleft" width="238"] Pam Ressler, RN[/caption] Ressler agrees, noting that self-care needs to start at the top with nurse leaders serving as role models for their staff, prioritizing their own self-care, and providing a supportive environment where nurses are encouraged to take regular breaks and lunches. Ressler regularly consults with healthcare leaders and others, teaching them how to cultivate "sustainable resilience."

"One way to create more sustainable resilience is by cultivating mindful moments throughout your day," Ressler said. "Look for the beauty in your surroundings. One of my favorite quotes is from the late writer, Lisa Bonchek Adams, who said, 'Find a bit of beauty in the world today. If you can't find it, create it.'"

If finding time for self-care is difficult -- as it often is for nurses -- nurse experts recommend the following resources:

Lead by Example: In their book, "Human-Centered Leadership in Healthcare: Evolution of a Revolution," authors Lucy Leclerc, PhD, RN, NPD-BC; Kay Kennedy, DNP, RN, NEA-BC, CPHQ; and Susan Campis, MSN, RN, NE-BC, discuss human-centered leadership, a concept that puts people first by making employee wellness a priority. The three tenets of human-centered leadership are empathy, vulnerability, and humility. The three nurses launched a company, uLeadership, that offers consulting, in-person workshops, and virtual workshops for nurses, including "Care for the Caregiver: It Starts with You." "One thing we found in our research is that there isn't a leadership approach specific to health care," Leclerc said. "We found that strong nursing leadership thrives on self-care -- nurse leaders advocating for their own self-care and encouraging their nurses to do the same. That self-care then extends to their teams and subsequently their patients. That's why one of our taglines is 'It starts with you but it's not about you.'" Leclerc said in a news release issued by Kennesaw State University. The book offers guidance for nurse leaders on the value of "starting with self," which includes practicing self-care, self-compassion, self-awareness, and mindfulness.

Practice Pam's 1-5-7 Plan: Ressler put together a list of ideas ranging from choosing to be gentle with your body by spending five minutes each morning doing gentle stretches or connecting with your breathing. Nurse leaders can use this list to model self-care for staff. Another idea: starting a short reflective practice of creating such as doodling, Mandala coloring, or Pam's personal favorite: writing a daily Haiku. Ressler encourages nurses to choose one idea from the 1-5-7 plan and engage in it for 5 minutes per day, 7 days a week.

[caption id="attachment_104202" align="alignright" width="300"] Xiomely Famighetti, RN[/caption]

Practice Affirmations: Xiomely Famighetti, RN, traveling critical care nurse, and author of the book "Self-Care for Nurses: 100+ Ways to Rest, Reset and Feel Your Best" and the Instagram blog, @healthy.scrubs, says using positive self-care affirmations boosts confidence and self-esteem, while also helping to control stress and anxiety. Some of Famighetti's favorite self-care affirmations include: I am strong enough to get through this shift, I am competent enough to provide the best care for my patients, and I am willing to prioritize my own needs today.

Simplify Mealtime: Audrey Auer, PhD, MSN, RN, Director of Nursing Education Services, Nightingale College in Salt Lake City, Utah, knows that when nurses work 12-hour shifts, planning a nutritious dinner can seem like one more chore on their to-do list.

"There are so many YouTube videos and websites that feature easy, healthy recipes," Auer said. "For example, make a homemade burrito, by using a skillet to warm a tortilla, melt cheese, and adding cooked refried beans and veggies."

[caption id="attachment_104201" align="alignleft" width="225"] Audrey Auer, RN[/caption]

Auer recommends finding four to five easy, nutritious recipes that can be made quickly and with ingredients on hand. Or join the Instant Pot craze and find quick, easy, nurse-approved recipes here.

Choose Short Meditations: Knowing nurses often don't have time to fit a yoga or meditation class into their schedule, Ressler developed a free series of meditations that can be done in 10 minutes or less. Entitled "Nurses Pause with Pam," the meditations cover topics such as mindful movement, compassion, stillness, and more.

One study encouraged leaders to consider workplace health programs for nurses like Ressler's that emphasize mindfulness-based stress reduction, finding these interventions were helpful in improving self-care and reducing burnout in nurses.

Fit in "Me" Time: Ressler says nurses can try to add a little self-care into their workdays with simple practices. "Even if it means riding the elevator or taking a walk down several flights of stairs, take an intentional break where you remove yourself from what you're working on and disconnect for a few minutes," she said.

Katrina Emory, a clinical nurse at the University of Utah Health, started the Restorative Break Initiative, to help nurses take the breaks they deserve. It's an initiative that other nurses can implement at their own workplace.

Seek Out Help: Nurse leaders can also help their staff connect to counseling, employee assistance, and other programs if they're feeling stressed. Auer said Nightingale College has a full-time wellness coach on staff to help nurses cope with compassion fatigue, while also emphasizing the importance of self-care.

Auer notes that online support groups tailored to nurses can help to ease stress while interacting with others who understand what it's like to be a nurse. Compassionate Listening Circles, offered by The Compassion Caravan, a national project of holistic nurses, offers 60-minute virtual listening circles on different days/times. PeerRXMed is a free peer-to-peer support group launched by a physician that provides support, encouragement, and resources to help healthcare workers avoid burnout.

Choose Nutrition Over Comfort Foods: It's easy on a busy day to grab salty chips or sugary candy from the vending machine, but while they may offer instant gratification, they don't offer sustained energy. "Come to work overly prepared with healthy food and snacks and a water bottle to stay hydrated," Famighetti said. "Pack things like almonds and dark chocolate or apples and peanut butter, yogurt, fruit or chopped veggies, that will help you get through the workday."

One study found that workplace interventions for nurses that target physical activity, stress reduction, and diet, can be successful without being expensive or time-consuming.