Young female African American nurse gives herself a hug

What Is Self-Care?

According to the World Health Organization (WHO), self-care is defined as "what people do for themselves to establish and maintain health, and to prevent and deal with illness."

Self-care is a skill many nurses neglect. It is a set of practices and activities nurses should engage in regularly to help decrease stress levels and help nurses live longer, healthier lives.

RELATED: Self Care: NCLEX-RN

Why Is It Important for Nurses to Participate in Self-Care?

It's important for nurses to engage in self-care because as the old adage goes, "You can't pour from an empty cup". Nurses have to take care of themselves to do their jobs effectively and be the best caregiver to their patients that they can be.

Why Is It Neglected?

The nursing career is exhausting physically and emotionally. Nurses are experiencing burnout related to caregiving overload. Nurses give so much of their physical and emotional being to their patients and families. When it comes to themselves, self-care is often left behind.

The Effects on Nurses and Patients If Self-Care Is Neglected

The neglect of self-care can lead to unwanted, unhealthy lifestyles. According to a 2012 survey of 2,500 registered nurses, 71 percent of them experienced musculoskeletal pain and 18 percent experienced depression. This is particularly dangerous, because: "Nurses who aren't present and caring for themselves have higher patient falls, medication errors, and lower quality of care scores". This demonstrates how neglected self-care can be detrimental to both the nurse and his/her patients.

Furthermore, stress contributes to chronic disease. The stress hormone cortisol and the hormone adrenaline can build up in the bloodstream and lead to hyperglycemia, hyperinsulinemia, arteriosclerosis, hypertension, and a decrease in the function of the immune system. Ignoring stress can also lead to chronic fatigue or depression.

RELATED: 8 Ways Nurses Can Build Stronger Immunity

If nurses aren't caring for themselves, other health issues will eventually arise - which can affect them both professionally and personally, sometimes leading to leaving the nursing profession altogether.

The Eight Areas of Self-Care

There are 8 areas of self-care for a nurse to look at. They include mental, physical, emotional, spiritual, social, personal, professional, and medical aspects.

Many hands together forming heart

Mental

Mental self-care helps nurses intellectually. Taking time to expand or gain knowledge helps the nurse gain insight into things outside of bedside care, and can strengthen confidence.

At Work

  • Completing a CEU course
  • Engaging in a committee
  • Reading a journal article
  • Precepting a new nurse

At Home

  • Try a new hobby
  • Piece together a puzzle
  • Play a game
  • Read a new book or join a book club
  • Explore a nearby museum or nature center
  • Listen to audiobooks
  • Listen to podcasts (some nurses love to do this on the way to work)
  • Start a journal and try a prompt a day
  • Write a letter to a friend

Physical

Nursing is a physical career, but that doesn't count for physical activity that the CDC recommends. The CDC recommends "2.5 hours of moderate aerobic activity, such as brisk walking, one hour and 15 minutes of vigorous-intensity aerobic activity, or some combination of the two. You also need two or more days of strength activities that work all major muscle groups."

As exhausting as that may sound, these ideas below can help you brainstorm activities you like so you can stick with it to keep yourself healthy.

At Work

  • Park far away from the building
  • Use the steps instead of the elevator
  • Stand while you chart
  • Walk the halls during downtime
  • Bring your own healthy lunch and snacks - avoid ordering takeout food or going to the cafeteria

At Home

  • Make a meal plan for the week
  • Order groceries to be delivered to your home (avoid that grocery store run while you are starving!)
  • Prioritize healthy food choices - as tough as it can be it's really important for nurses to have nutritious foods on hand. Think of things like:
    • Almonds
    • Hardboiled eggs
    • Cans of tuna
    • String cheese
    • Cut up fruit and vegetables
  • Find exercises you enjoy
  • Join a gym to get social and be a part of a class
  • Have a dance party with yourself, kids, or spouse!
  • Try intermittent fasting
  • Take a nap – even if it's only 20 minutes
  • Go to bed early and wake up the same time every day
  • Strive for 7-9 hours of sleep a night
  • Schedule a massage and enjoy the benefits

Emotional

Nursing can be hard on your emotions. While you will often feel the highs of helping patients succeed, there are also the lows of seeing patients with conditions that deteriorate despite your best efforts. You may even lose patients who you've built warm relationships with. This can take a toll on your work performance as well as your home life. It's important to make sure you have an outlet to express these difficult emotions.

At Work

  • Have conversations that include humor
  • Praise others for their accomplishments
  • Praise yourself
  • Write something in the breakroom to help coworkers smile
  • Be kind to everyone
  • Smile at everyone you walk past
  • Do something you enjoy on your breaks - text a friend or loved one, watch a funny video clip, or go outside and enjoy a little fresh air and sunlight

At Home

  • Channel emotions through hobbies like drawing/coloring, cooking or playing music
  • Be creative, build something, make something, or write something
  • Look at yourself in the mirror and say words of affirmation
  • Give yourself permission to laugh, cry, and feel emotions
  • Let yourself sit and watch funny or uplifting TV shows or movies
  • Create a playlist that brings you happiness and try binaural beats
  • Call a friend
  • Plan lunch with a loved one
  • Daydream - plan the perfect vacation, consider new paint colors or furniture for your home, look up the specs on that car you've been eyeing - whether you act on them or not, a little daydreaming can be fun

Spiritual

Spirituality - whether religious in nature or not - can be a key component to self-care and wellness.

At Work

  • Become mindful with meditation
  • Help patients practice mindfulness
  • Respect and try to understand patients' and coworkers' religious beliefs
  • Advocate for patients who want prayers or a Chaplain
  • Go outside or at least near a window to appreciate nature on a break

At Home

  • Try Yoga, there is a variation for everyone
  • Keep a gratitude journal – benefits of gratitude
  • Volunteer for something you are passionate about by yourself or with your family to help your mood
  • Make "think time" a time for reflection on yourself and life
  • Join a religious group
  • Try Tapping
  • Deep breathe and be present - it can change your brain
  • Declutter your home drawers, computer files, closets
  • Unplug from social media, television, and tablets for a day

Social

Humans are social creatures. Connection and community can be very important to nurses, as they tend to be natural nurturers.

At Work

  • Ask co-workers about their day
  • Eat lunch with someone
  • Buy an Instant Pot or slow cooker for the unit and cook together
  • Celebrate with coworkers – birthdays, baby/bridal showers, etc.
  • Talk to the maintenance person, housekeeper, and secretaries about their days

At Home

  • Call a loved one and invite them over for dinner
  • Go out with a friend
  • Plan a date night
  • Take your kids on a road trip

Personal

This may come as a shock to some, but nurses are also people. Cultivating interests and an identity outside of "nurse" can help you feel more fulfilled and give you some respite from your career.

Try these ideas:

  • Participate in a new hobby: cooking, baking, sewing, gardening, bird watching?
  • Add adventure with a hike, canoeing, or cross country skiing
  • Purchase your favorite drink
  • Set up a home wellness space
  • Go get your hair and nails done
  • Try essential oils

Other ways to de-stress your life and incorporate more self-care include:

  • Divide the housework
  • Only commit your family to activities and social engagements that you can manage (i.e., don't overextend!)
  • Hire someone to help you with housework, childcare, or other "services"
  • Make a manageable daily to-do list of a limited amount of tasks and then enjoy yourself

Professional

There's a lot more to being a nurse than just caring for patients. Keeping your professional life organized and on-track can help you stay sane.

Try these ideas:

  • Declutter your work bag
  • Clean your scrubs and iron them to feel professional and put-together
  • Be a good team member: help others with their patients and they will help you with yours
  • Create career goals
  • Join a work Self-Care class - If your employer offers a self-care class, join in. It will help you connect with coworkers and learn to de-stress together
  • Arrive at work early and take a few minutes to walk outside, focusing on your breathing
  • When you've clocked out, make sure you are truly clocked out: avoid calling coworkers or the unit after your shift ends to see what's happening

Medical

Nurses know that medical self-care is important for their patients, but what about themselves? Medical self-care includes a focus on:

  • Daily Physical Activity - Working doesn't "count" as physical activity. Try to add in a walk for 15 minutes before or after work.
  • Healthy Food and Drink Choices - Pack your food and always drink water to fuel your day.
  • Healthy Weight Management - Weigh yourself to know where you are right now, and pick a small goal to start.
  • Routine Preventive Care - Choosing a primary care physician to oversee your health can help you stay on track with your overall health.
  • Know Your Health Numbers - Take a look at your BP numbers, your BMI, and your lab values to see if you're at risk for chronic conditions.
  • Quality Sleep - Maintaining quality sleep has incredible benefits for your health.
  • Managing Stress - Promoting your own self-care can help this.
  • Tobacco Cessation - If you smoke or vape, it's time to stop. Nurses know there is no benefit to smoking or vaping habits.
  • Quality Health Care Services - Making sure quality healthcare is available is important for both patients and nurses.

Self-Less Gifts for Nurse Self-Care

  • If you have any pain from work in your back, legs, or feet, buy some new shoes, compression socks, or insoles
  • Create a small home gym with workout equipment like resistance bands, a few free weights, and a yoga mat
  • Buy some fresh flowers to help brighten your mood
  • Buy your favorite drink, smoothie, or coffee
  • Buy an adult coloring book
  • Buy and keep a journal
  • Order a meal kit service
  • Rent an AirBnB for a quick getaway

Apps for Nurse Self-Care

Technology can be a wonderful thing! Check out these apps to help you stay on target for self-care:

  • Headspace - Headspace is an app to help anyone start meditating. The guided voice will help you feel calm.
  • Talkspace - Talkspace lets you schedule sessions with an online therapist.
  • Shine - Shine is an app that helps keep you motivated with positive words.
  • Pacifica - Pacifica helps you track your mood, meditate, and can start you up with cognitive-behavioral therapy.
  • Class Pass Go - Class Pass Go is an app that offers ready-to-play workouts that vary in length and difficulty.

Self-Care Resources for Nurses

This emergency self-care worksheet can help you have a plan when you are stressed.

Don't know where your time goes? This "Where is your time going worksheet" can help you figure out where you can fit in time for self-care.

Want to learn mindfulness, but don't know where to start? Mindful.org helps with this post titled, "Getting started with mindfulness".

When meal planning, you may need to refer to dietary guidelines. The USDA offers this resource, "Dietary Guidelines for Americans"

Ready to add some exercise to your self-care plan? Try this "Move your way worksheet" to find what works best for you.

Feeling stressed at the workplace? Ohio State University has put together a series of videos to help the distressed clinician.

Yale offers the "Science of Wellbeing" course.

Join the Healthy Nurse, Healthy Nation™ Grand Challenge. The Healthy Nurse, Healthy Nation Grand Challenge is "an initiative to connect and engage nurses, employers, and organizations around improving health in five areas: physical activity, nutrition, rest, quality of life, and safety."

Janine Kelbach, RNC-OB
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