"Eat your vegetables." "Drink your milk." "Wash your hands." "Go outside and play." Sound familiar? I'm willing to bet that most of us heard things like this from our parents and teachers. Why did they say such bossy things? Because they cared about us. We were important to them. Who do you care for in your life today? Your family? Your patients? Who takes care of you? Do you take care of yourself? As nurses, do we take care of each other?
Many times I, as a nurse, have said to a weary family member keeping vigil at a loved one's bedside, "Go home. Sleep in your own bed tonight. We will watch over your mother. If you get sick too, you can't do her any good." Yes, we need to care for our patients, but our care needs to extend to those closest around us, the people we work with every day. You and your fellow nurses are the caregivers. If you get sick, who will care for your patients?
In 1990, Robert Fulghum published a simple credo that became a number 1 best seller, All I Ever Really Needed to Know I Learned in Kindergarten. To paraphrase one of his thoughts, we should live a balanced life, learning, thinking, playing, and working every day. He said we should watch out for each other, "hold hands, and stick together."
Caring for the caregivers is so important that NAON has a position statement on the importance of a healthful work environment for all nurses. Patients require increasingly complex care and the environment in which that care is given should support nurses' efforts and not compromise nurses' health and safety. A key component of a healthful work environment includes minimizing health risks for the nurse. Infection control and safe handling of sharps help to minimize health risks to nurses.
In its healthful work environment position statement, NAON agrees with the American Nurses Association's statement "manual handling of patients is unsafe and is directly responsible for musculoskeletal disorders suffered by nurses." Through the NAON Safe Patient Handling and Movement Task Force developed in 2006, NAON made important contributions in developing algorithms to offer solutions to safely performing those orthopaedic tasks identified with high risk for musculoskeletal injuries. These algorithms were based on principles of ergonomics and scientific evidence. The algorithms, as well as background on the genesis of the Safe Patient Handling Task Force, can be found on the NAON website, http://www.orthonurse.org/ResearchPractice/SafePatientHandling/tabid/403/Default. It is important that, as orthopaedic nurses, we practice what we preach, using the tools and methods to avoid injury to ourselves and those with whom we work. If your place of employment does not already have a Safe Patient Handling policy and the tools you need to move patients without injury to you, speak up and ask for them!
Caring for ourselves continues after we change out of our scrubs and put away our stethoscopes for the day. Information provided by the 238,000 dedicated nurse-participants in the Nurses' Health Study II, through the Harvard School of Public Health, has led to new insights on health and disease. Results show that diet, physical activity, and other lifestyle factors can powerfully promote better health. For a bit of background, Dr. Frank Speizer established the Nurses' Health Study in 1976 with funding from the National Institutes of Health. Registered nurses were selected to be followed prospectively because it was anticipated that nurses, because of their education, would be able to respond with a high degree of accuracy to brief, technically worded questionnaires and would be motivated to participate in a long-term study. What a compliment that was! And, indeed, the researchers were right on the money in choosing RNs to participate: the response rate for questionnaires is at 90% for each 2-year cycle!
I'll put in a plug here for the Nurses' Health Study III. Enrollment is currently under way for the third cohort of nurses aged 22-42 years. The new cohort will be entirely web-based and will examine how new hormone preparations, dietary patterns, and nursing occupational exposures impact women's health. Another important goal for the study is to include women from more diverse ethnic backgrounds than are participating in the other two ongoing studies. For more information on the study or how to participate, visit http://nhs2survey.org/NHS3/.
Other components of a healthy work environment include collaborative decision-making between healthcare providers, a values-driven culture, and professional growth and accountability. Nurses who work long days and full weeks often spend more time with their coworkers than they do with their family. Nurses play a critical role in creating a culture of civility and respect, both in nursing education and in nursing practice environments. Civility is an authentic respect for others. Treating one another with respect is essential to communicate effectively and create high-functioning teams.
Last summer, I had the opportunity to visit New York City. Walking through the airport and riding the subway, I saw signs encouraging people, "If you see something, say something." What great advice. When we are witnesses to less than civil behavior to either ourselves or our colleagues, we have an obligation to stand up and say something. Incivility should be a concern to all of us. Consequences of incivility include students leaving nursing programs, nurses leaving the bedside, and educators leaving the classroom. Nursing as a profession suffers and, ultimately, our patients suffer.
Healthy minds, healthy bodies, healthy spirits. That's what caring for the caregivers means to me. Do something for yourself today!
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