You collapse into bed after a long shift, sometimes without even washing your face. You’re tired, stressed out, and your body aches. And so much of it, you may realize, is due to the long hours and stressful conditions of your job.What is ironic, however, is that your job is based on the very thing you’ve neglected to do for yourself: care. Why do nurses so often put self care at the bottom of a very long to-do list? You are familiar with Maslow’s Hierarchy of Needs, and you know that food, sleep, and health are among the most basic of human needs. And yet we still sacrifice many of these things for the good of others or the demands of our jobs. On some level, we know that if we are depleted, we won’t be able to care for others well. Our own wellbeing is at the heart of being a good nurse. So how can we begin to, as the flight attendants remind us, put our own oxygen masks on before assisting others with theirs? Here are some ways nurses and CNAs can begin to become participants in our own, vital self-care.
Movement and Mobility
Movement is beneficial to the mind, body and soul. Multiple studies have confirmed the physical and mental benefits of exercise, and you’re sure to have studied the wide variety of ways that physical activity can help with overall well-being.But just because we know it’s true doesn’t mean that we’re always good at putting activities like these into practice in our own lives. To help you stay consistent and motivated in your exercise, choose activities that interest you and you feel excited doing. Consider HIIT (high intensity interval training), Yoga, Tai Chi, Pilates, Martial Arts, or team sports. Or, go for a run or hike in your neighborhood or local park!Additionally, advancement in technology is now allowing easy (and less expensive) access to exercises on your electronic devices with a diverse selection of workout apps.
As nurses and CNAs, we are always on the run, and it’s easy to forget to drink water - or even eat! The recommended daily water intake per day is 3 liters for men and 2.2 liters for women. Many of us don’t reach this mark, so watch out for signs of dehydration such as headaches, thirst, muscle cramps, dizziness or lightheadedness and, in severe cases, confusion. Here are a couple of good ways to stay hydrated during the day:
- Eat foods high in water content like watermelons, tomatoes or lettuce (keep an eye on the sugar content though!).
- Take a reusable water bottle with you to have easy access to water and establish a “water routine.” You can also keep multiple water bottles in regular places (work, gym locker).
- If it is not time for a regular meal, try drinking something first. Our bodies often confuse thirst for hunger.
- Avoid sugary drinks, which can actually increase the risk for dehydration.
- If you dislike plain water, try sparkling water or squeeze some lemon juice in there. Another inexpensive option is to keep an infuser in the fridge with herbal teas, berries, slices of cucumber, or herbs like mint, for a tasteful sip without the sugar.
Nutrition is often one of the first self-care priorities neglected when we get busy and stressed. These days, there is an abundance of resources available to help with food prep and meal planning to save time and money, reduce stress and eat healthfully. Functional Medicine, which focuses on treating the whole individual and not just the symptoms of the disease, takes an individualized approach to nutrition incorporating:
- Core principles of healthy eating
- Health maintenance
- Disease prevention
- Awareness of one’s relationship with food
If you are looking for a nutritional guide, the Institute of Functional Medicine has an excellent Core Food Plan to steer you on your way to better nutrition.
Rest and Relaxation
Sleep is an essential part of rest and one of the foundations of Maslow’s hierarchy of needs. When we sleep, our muscles get a chance to repair and memory consolidation takes place - which helps with the formation of long term memory. Sleep also regulates our mood and can impact our judgment. Studies show that chronic sleep deprivation can lead to health concerns from high blood pressure and obesity to increased stress, and suggest that adults get 7 to 9 hours of sleep a night for adequate rest. Some tips to getting a good night’s sleep:
- Reduce screen time at least 30 min before bed - 2 hours is ideal. The screen emits a blue light which can affect your circadian rhythm by suppressing the production of melatonin (sleep inducing hormone). If you have to utilize some screen time before bed, many computers and phones now have a “warm light” setting to ease stress on the eyes and limit interference with sleep.
- Limit or omit caffeine late in the day.
- Prepare your body for sleep by introducing a bedtime routine.
- Incorporate relaxation techniques such as focussed breathing or meditation.
Even though essential, sleep is not the only way our bodies can get rest and relaxation. Here are some ways to sneak in periods of rest throughout the day:
- Take a warm bath to increase circulation and for muscle relaxation. The increase in temperature additionally contributes to melatonin production to induce sleep.
- Get a massage to relieve aching muscles.
- Listen to soothing music or sounds. Insight Timer is a wonderful app that provides a gateway to beautiful relaxing sounds (some even attuned to changing brain waves).
- Practice meditation. Set aside some quiet time for focused and mindful thoughts, breath, and/or body movement; or, just have an intent to not thinking about anything at all to clear your mind and take a step back from our habitual narrating brain.
- Take a break. Whether it is a couple of minutes at work, a mental health day, or a vacation, make sure you incorporated time to recuperate.
- Be out in nature. Even a brief walk outdoors on your lunch break can result in a naturally calmer and more centered mind and body.
Investing in your own mental growth will not only boost your self-esteem, but it will also give you a renewed sense of purpose. This can mean furthering your knowledge of your field or trying out something totally new. Expressing yourself in a creative way-- writing, playing music, or taking a painting class, for example-- allows you to challenge your brain in new ways. Here are some additional avenues of continued learning you may want to try:
- Read, read and read some more.
- Take a class at your local community college or library
- Try a masterclass online!
- Visit museums, which are often free on certain days of the month.
The negative physiological and mental response to chronic stress is well documented. Managing stress is an integral part of self care; it is therefore imperative that we have the tools to help us.One approach to handling stress effectively is to change the way we think about stress, or what we stress about. To have a more positive outlook on stress, and not have the expectation to do things perfectly or think all stress is debilitating, may take the pressure off on how stress is perceived and reduce stress.Additionally, getting yourself organized by decluttering, creating a routine, and prioritizing your goals will help reduce the mental work and decision fatigue of each day. For more information on creative ways to reduce your stress level, please check out 8 Ways for Nurses / CNAs to Manage and Prevent Stress.
The fourth level of Maslow’s needs talks about self esteem: the need for people to feel valued and that they are contributing to the greater good. As nurses and CNAs, we often see people at their worst, but also share times of great joy. In both situations, nurses often find themselves within the paradox of immense gratitude and guilt. How do we allow gratitude into our own self care without the burden of guilt? I have a box where I place all the thank you notes or cards that patients, patient's family or colleagues have given me. On days that I may feel overwhelmed or “stressed out,” I read a few of the notes from my Gratitude Box and feel grateful - knowing that what I’m doing is making a difference in someone’s world. Often we are so focused on looking ahead and reaching a goal, we do not see the beauty of what we already have around us.
Nurses and CNAs have to show empathy and compassion to patients daily. Those, without a doubt, are some of the beautiful qualities that make us good nurses. However, the same qualities of being sensitive to others' needs can be draining and put us at risk for compassion fatigue and burnout. Here are some ways you can show compassionate to yourself:
- Allow “me” time. Take a moment to do something you want. No, you are not selfish. This is a mindful act of kindness!
- Set boundaries. Setting boundaries can be challenging as some habits have been a part of us for a very long time. Start small by e.g. setting limits to screen time, or protecting 15 minutes of your time to ground yourself after you arrive home from a busy and challenging work day.
- Find time for social connection. Join a team sport or a book club-- something totally unrelated to your job or responsibilities.
- Let go of the “should haves” and “could haves,” and be mindful of the “wants.” Dwelling on the past or wanting to change or control the future can leave us with feelings of guilt and dissatisfaction. We cannot change the past any more than we can predict the future. So change the way you engage! Past experiences provide wonderful opportunities for reflection and learning, and thinking about future “wants” can be a gentle guide and provide us with a sense of purpose.
Incorporating self-care into your life can happen in a variety of ways, but there is no better investment than the one you make in yourself. So start small and don’t despair. You’ll find that the time you spend caring for yourself will be well worth it!