Your feet are aching, your bladder is stretched, and you are smiling. You just finished another 12-hour nursing shift, and although your body is exhausted, you feel satisfied and even energized.
Is this an impossible scenario? No, it is not impossible, but unfortunately, it is not common, either. Inherent in the nursing profession, in which you are constantly giving to others, is the physical and mental fatigue that often accompanies the constant outflow of energy. Nurses need to apply their own healing actions to themselves to "heal the healer" within. Physical and emotional burnout in the nursing profession is not only common but also dangerous to one's physical and emotional health.1
Self-applying nursing assessment
Healing the healer can restore your energy, health, and even excitement for the nursing profession. In order to be skillful in the art and science of healing others, we must start with ourselves. Visual observations help us make quick assessments about our patients, and we can apply those same skills to ourselves. What does the mirror say to you in your reflection? Your skin, hair, complexion, and eyes reveal messages to you about your general health. Is that mirror declaring it is time for fresh air and vitamin D therapy from the sun as the pale complexion and dark circles under your eyes stare back at you? Is your limp hair telling you it is time for better personal hygiene? Have your dull eyes lost their light and vision, both literally and metaphorically?
What the mirror does not tell you is that your body is worthy of honor and respect, and you only get one vessel. Nursing is a demanding job, and self-care is important for individual health. Additionally, nurses should be role models for their patients and promote healthy lifestyles. Self-care includes taking time for your own restorative sleep, energizing exercise, healing, nutrition, health promotion, and disease prevention practices. Nurses who neglect their own health risk becoming the patient rather than the healer.
Personal risk factors for disease
Nurses need to examine their own physical condition as well as mental and spiritual health. Emotional unhappiness often results when physical health is challenged. Job dissatisfaction in nurses has been studied extensively, and results indicate a link between inadequate staffing, patient mortality, and nurse burnout.1 Burnout is often accompanied by illness and general fatigue. It is a lofty goal to become a role model of health, especially when research reveals nurses suffer from the same health risks as the general public, including smoking and obesity. In the landmark Nurses' Health Study established in 1976 and continued in 1989, over 121,000 female RNs were followed to assess cardiovascular disease and their risk factors.2,3 It was the largest study on women's health conducted in the United States.
As one of the largest health studies for women, it was proposed that nurses would be in better health than the general population because they were involved in the healthcare field. Results revealed, however, that nurses were at the same risk of cardiovascular disease and cancer as the general population. Conclusions from the longitudinal study confirmed strong relationships between weight gain and heart disease, diabetes, colon cancer, hip fracture, and mortality. Overweight is defined as a body mass index (BMI) between 25 and 29.9, and obesity is 30.0 and above. BMI is calculated by weight (kg)/height (meters).2
In addition to overweight and obesity, smoking is a strong risk factor for chronic disease. A nurse who smokes is at greater risk for mortality.3 It is difficult to tell a patient to stop smoking when you have residual cigarette smell in your own hair and clothes, or to tell a patient to lose weight when you are obese and cannot bend down to help them. Interested nurses can learn more or even volunteer to be a part of the third stage of the Nurses Health Study by visiting http://www.nhs3.org.
Time for an intervention
After a thorough assessment, nurses move to the nursing diagnosis, planning, and intervention stages of the nursing process to help patients heal. Applying those same skills to yourself means being truthful with your current health status and diagnosing what is in your control to change, including: being overweight, obesity, impaired sleep, impaired stress management, knowledge deficit, or even self-care deficit. Remember that weight is only part of the whole picture of health, and it gives honest feedback regarding your eating habits. Restoring joy to your chosen profession can begin by taking proper care of your own physical needs. Become a catalyst for change in your own nursing department by planning ahead for nutritious meals and snacks during your shift.
For those special potlucks, initiate a list that includes fresh fruits and vegetables and energizing foods instead of high-sugar, low-energy crashing sweets. As you begin to incorporate healthy eating practices into your daily routine, you may be encouraging your nursing peers to be inspired by your actions. Schedule realistic exercise and routine sleep hours so that you will have the needed energy for your busy workdays. It requires planning and making your health a priority. A phrase to remember is he who does not have time for his health today will not have his health when he has time tomorrow. (See Healing the healer strategies.)
Making healthy choices
Just as the nursing process takes time and cyclic evaluation and adjustment, healing your own body takes time. Good habits require repetition and daily motivation toward desired results. (See Idea blitz for your body.) The American Nurses Association's (ANA) Healthy Nurse program confirms the concept that a healthier nurse is better equipped to provide high-quality patient care and can be a role model for wellness.4 Resources for practical ideas on meal planning, low-fat cooking, exercise activities, stress-relief strategies, and more can be found at ana.org. Making choices to live tobacco-free, receiving preventive immunizations and health screenings, and even using protective measures, such as wearing sunscreen and bicycle helmets, are ways nurses can be an example of healthy living. The ANA offers resources to help nurses quit smoking, back injury prevention strategies, and initiatives to help hospitals improve environmental practices that impact the health of their nurses. The ANA also offers a free comprehensive health risk appraisal at http://www.anahra.org.
Additional ideas to implement healthy habits include creating support groups from work with peers who are engaged in weight loss programs, such as Weight Watchers (https://weightwatchers.com) or Jenny Craig (http://www.jennycraig.com). Nurses can organize yoga or walking outdoors during lunch breaks or after work. Friendly competitions such as 5K runs/walks can be promoted at work. Because we spend so much time in our work settings, our peers often become our social support group. Regardless of what area you work in, from perioperative nursing to psychiatric nursing, the principles of healthy choices apply. As you share your health and fitness goals with work peers, you may receive the needed support and motivation. If each of the 3.1 million RNs increased their personal health, our country would be healthier, and nurses could make a powerful impact on our own families and others looking to use for guidance about health. The nursing profession is lucky to have you and your talents. Not only do we need more skillful nurses like you, but we also need more healthy nurses who can truly practice and apply the healer's art.
Idea blitz for your body
* Plan to eat 5 fruits and vegetables daily
* Wake up and do 15 minutes of exercise (such as stretching, yoga, or walking)
* Prepare a lunch with portion control
* Add fruit/vegetable/nut snacks for your work day instead of chips and sweets
* Create work potlucks with more food categories of fruits and vegetables
* Put your tennis shoes by your bed to remind you to exercise before work
* Wear a pedometer
* Download a food counting app to help with awareness of your intake
* Learn how to meditate for 10 minutes daily
* Update your own immunizations
* Take a yoga class
* Start a yoga group for lunch breaks
* Contact the human resources department to request a fitness incentive for all employees
* Have a weight loss competition at work
* If you smoke, go to http://www.smokefree.gov
* Organize and guard your 8 hours of sleep every night
* Talk to your hospital dietitian about a meal plan.
* Talk positively to yourself in the mirror instead of having self-deprecating messages
REFERENCES