Oftentimes, nurses don’t take care of themselves like they should. While they focus on taking care of others, their self-care falls by the wayside. Especially during COVID-19 and the pandemic, they’ve put everyone else first.
Imani Wilform, MHC-LP, with Empower Your Mind Therapy, took time to answer our questions and give self-care tips on what nurses can do to make sure that they are making time for self-care. Our interview, which follows, has been edited for length and clarity.
Dealing with COVID-19 and the pandemic has been tough on everyone, but especially difficult on frontline workers such as nurses. Why should nurses be sure to practice self-care now?
As much as nurses care for everyone else, it’s crucial to pay attention to your own needs too. By its own true definition, self-care is about taking intentional care yourself: your mind, your body, your environment, and your spirit.
If we don’t practice self-care, we can become burned out, resentful, angry, and may even start feeling depressed. This also lowers your immune system and can make you feel tired and low. If you’re not feeling your best, how can you manage caring for others?
What are some things that nurses can do to be sure to remember self-care and to fit it into their busy days?
While the occasional self-indulgence like a spa day or getaway can be a great way to express some gratitude to yourself and all you accomplish, self-care is about more than an occasional treat. An intentionally cultivated daily self-care routine can make a huge difference in our lives and allow us to be balanced & more restored.
Today, ask yourself:
How do I typically take care of myself day to day?
Do I take time to regularly assess and address my needs?
How is that impacting both my mental and physical health?
I really want you to think about how (or if) you set aside time each day to take care of yourself. Do you have time to sit back and assess your needs? Do you listen to your body when it tells you that you need a break? When you’re mentally strained, do you have a routine that helps you rest and rejuvenate?
Is there anything they can do at work on a break or at home?
There are a lot of little things that are self-care, but aren’t exciting or Instagram-able. You can do these quickly:
Write down your to do list for the week to stop the constant nagging in your head.
Set a time to be done with screens before bed.
Make a meal plan that gets you excited to eat 3 meals a day.
Take a look at your calendar: are you overbooked, need a fun outing to look forward to, need to make a doctor’s appointment?
Call a friend to catch up.
Spend time outside.
What are absolute must-dos regarding self-care?
Assess your true needs: when we’re talking about daily self-care we’re talking mainly about wellness (mental & physical). For a week, keep a log of your physical and mental expressions of stress or strain. Are you tired? Do you have frequent headaches? Look at what comes up for you and come up with small, incremental steps to take action. Maybe you have constant headaches because you’re dehydrated. Start carrying a water bottle, set some reminders on your phone to actually drink from it.
Take a critical look at your routine: What is taking up your time on a daily basis? Often times we fall so behind on creating an actual daily routine that serves us that we end up playing perpetual catch up. Finding the right way to balance what you need day to day will help ease stress and keep you feeling more balanced and in control.
Prioritize rest: if you have to put it in your schedule or “to do” list to make sure you get time to rest and recharge then do it. Maybe it’s yoga, reading, taking a bath. Rest and rejuvenation should be a priority in your daily routine. Set aside small chunks of time each day where you stop the machine, ignore “productivity” and let yourself rest.
What would you say to a nurse who says s/he doesn’t have time for self-care because too much is going on?
Self-care can be something quick and small to help yourself with your own mental and physical well-being. As a nurse, it’s important to remember that you are just as important as your patients and family. Others rely on you, so rely on yourself too. Even if it’s a quick walk around the block during lunchtime or outsourcing personal to-dos to another family member—such as creating a shopping list or picking up a birthday gift for someone—try to take some time for yourself. Also remember that self-care shouldn’t create more pressure. If it’s too much to take time every day, start with setting aside some time once a month to check in with yourself.
There’s no questioning the difficulty of a career as a nurse. You may have to work long hours, deal with a variety of patients each day, and spend most of the time on your feet. You also have to deal with the risk of things like patient violence or the general sadness that comes from losing a patient you’ve been working with. But, nursing can be an incredibly rewarding career when you’re in the right work environment. A toxic work environment, however, is a different story. It can make getting your job done feel nearly impossible. If you come home each day feeling absolutely drained, and perhaps even frustrated or helpless, you might be dealing with a harmful environment at work.
So, how can you know what a toxic work environment looks like? What are your rights, as a nurse, to a healthy environment, and what can you do to make sure those rights are upheld?
What Does a Toxic Work Environment Look Like?
As a nurse, you probably already understand the importance of being able to adapt to different work cultures. If you’re not sure how to learn more about a specific culture or atmosphere within a workplace, there are a few things you can do to get a feel for it quickly, including:
Watching and learning from others
Asking questions
Staying transparent
The more you observe and the more questions you ask, the easier it can become to see if you’re dealing with an unhealthy work environment. Bear in mind that if you don’t like your job or you’re not satisfied with your work, that doesn’t automatically mean you’re in a toxic environment. You may need to try a different career path. But, toxicity in the workplace is very different. You can recognize it through some of the following signs:
There is an overall lack of communication
There are cliques, exclusions, or groups
The workers aren’t motivated to do their jobs
Growth is discouraged
Everyone is burnt out
Finally, there’s nothing wrong with going with your gut. If you get a “bad” feeling about your workplace, even if you can’t quite put your finger on it, don’t ignore those feelings.
How Can It Affect You?
A toxic work environment is more than just an inconvenience. It’s more than just something to “trudge through”. In fact, an unhealthy work environment can contribute to a variety of physical and mental health issues. Some of the most common problems include:
Fatigue
Upset stomach
Heart issues
Muscle aches
High blood pressure
The toll on your mental health is nothing to take lightly, either. You might find yourself constantly feeling stressed and overwhelmed at work. It doesn’t take much for that to carry into your home life if you can’t let the feelings of the day go when you walk in the door. That constant feeling of stress can lead to mental health conditions like anxiety, or even depression. As that continues, you may end up needing to get extra help just to deal with those conditions.
Working every day in a toxic environment can wear you down. So much so, that it can even weaken your immune system, making it easier to get sick. As a nurse, you know the importance of taking care of your mind and body. If you don’t make self-care a priority, it could impact your personal life in a negative way. Your work environment shouldn’t be the thing that compromises your health.
How to Find a Healthier Environment in Your Field
If you find yourself in a toxic work environment, the best thing you can do is leave. An environment that large isn’t likely to change, even if you address the issues. You need to prioritize your needs when it comes to your career and your overall well-being. But, leaving a job isn’t always easy if you need the income.
Waiting to leave until you have another job lined up is always a safer option. Or, you might consider going a more nontraditional route with a remote job. Remote jobs allow you to work from home (or anywhere!), eliminating everything from toxic employees to negative patient interactions. Working remotely can help to reduce your stress levels and offer more flexibility.
Obviously, not all nursing jobs are able to be done remotely, but there are some that will allow you to work from home while still caring for others, including:
Clinical appeals nurse
Health informatics
Nursing instructor
Nurse auditor
Telephone triage nurse
Some larger hospitals and even national health care groups are always looking for nurses who can work remotely and fulfill these needs. These particular jobs might be different from what you’re used to, but that could be exactly what you need to break free from a toxic environment. In doing so, you can learn to enjoy your work again, and find fulfillment in helping patients while taking care of yourself, too.
If your job offers an employee benefits package, it’s likely that there are some benefits you aren’t taking advantage of. In every job, the benefits package is almost as important (or sometimes equally important) as the salary you’re offered. Benefits cover everything from your health insurance to your vacation time. But in between those common benefits are some that you may overlook because you aren’t quite sure how much of a benefit they really are to you.
Commonly called an EAP, this option allows you to talk to a counselor when you need some guidance getting through a period of personal or work-related stress. Commonly, the EAP covers a set amount of free counseling sessions for each different issue you want to discuss (family members may also receive this same benefit for the same amounts of time). If, after the three sessions, you and the therapist feel like you would benefit from longer-term treatment, you can find those resources. But you may just have needed a new perspective and this benefit gives you that for no cost.
Financial Advice
If you have a retirement plan, you might have access to financial counselors as well. They can give you some guidance on your finances, steps you might need to take for a more secure retirement, or some guidance around saving for a home, educational costs, or a long-awaited vacation. And if your company offers any kind of retirement match, be sure you are taking full advantage of that benefit.
Additional Insurance
Organizations offer employees all kinds of additional insurance as employee benefits options. If you’re looking for life insurance or long-term care insurance options, you may be able to get it through your company. If you want the security of short or long-term disability insurance, find out what your company offers just so you’ll know if you need it. The amounts you are likely to pay through your insurer will be competitive (some organizations may offer life insurance for free up to a certain amount—take advantage of that) and it’s helpful to know you’re protected.
Wellness Reimbursement and Activities
Do you have a membership at the local gym? Do you take lunchtime yoga at work (a nice benefit in itself!) or use acupuncture to help with a sore neck? All of those services may be reimbursed or compensated in part by your benefits package. You may get a set dollar amount per quarter for health classes or gym memberships. More companies are also offering reimbursement for therapies and practices that were preciously not covered—for instance, chiropractic visits with designated providers. Your employer invests in these benefits because healthy employees are better employees. According to the Society for Human Resources Management, in 2019 employers shelled out an average of $15,000 per employee for health insurance benefits (that’s in addition to your annual costs), so keeping employees healthy keeps that number down.
Pull out your benefits package before the end of the year and commit to using at least one benefit you haven’t taken advantage of yet. You could save money, boost your wellness goals, and plan for a more secure future. Don’t let those benefits slip by you.
If you’re looking for special gifts to give to people you love or care about this holiday season, give them something they might not expect—even if you are a nurse—a healthy gift.
As for figuring out how to give healthy gifts, Dreher says, “Think in terms of gifts that support a healthy lifestyle and emotional well-being or that emphasize relationships over material things. Such gifts come in all shapes and price points. With a little thought, you can find such gifts for everyone on your list—from your nearest and dearest to your children’s teachers and your neighbors.”
1. A fitness track or smart watch.
For the person who wants to start up or increase their fitness program. “These irresistible gadgets can be highly motivational,” says Dreher.
2. A health club membership or session with a personal trainer.
These are great for someone who has been told to start a fitness program, but needs motivation. (We add that you should make sure this will be received well. Some folks might get upset if they wouldn’t want it.)
3. A getaway for two.
“People who take vacations live longer. Surprise your honey or your bestie with a long weekend somewhere warm and fun.”
4. A massage gift card.
“Who is the most stressed-out friend you have? Gift them with a soothing massage—a gentle reminder to slow down and take care of themselves.”
5. A pet.
“People would get out to walk a dog, thereby getting exercise as well as living longer and healthier. This is a personal gift, though, and should be wanted/needed and come with an offer to sit when the loved older person needs a break. Also think about the lifespan of each party. An older rescue dog who is housebroken may be ideal for a lonely senior. It gives them a reason to get up and care for someone else and is a source of unconditional love and affection. A mild-mannered rescue cat would be a wonderful gift. An older cat would be calmer and sleep on the lap of an older person, providing comfort for both of them.”
6. A gift card for a bookstore or books that will encourage learning or mental, physical, and spiritual growth.
“[Put them] in a basket with coffee/tea, a special mug, a warming neck wrap for sore muscles, etc. Wrap everything in love, not hints to control of change the person. Play on their interests.”
7. A season of snowplowing.
“The link between heart attacks and snow shoveling is real. A winter of snow-clearing services make a great gift for an older family member.”
8. An air fryer, hot pot, or sparkling water maker.
“These kitchen appliances encourage easy, healthful food prep. Pair with a cookbook and starter supplies.”
9. Nuts, dried fruit, or a fruit basket.
“A healthier alternative to cookies or candy. You’ll be surprised how many people will love this.”
10. A little of your time.
Don’t forget senior orphans—elderly people who are alone. “Not only do they have no one to exchange gifts with this holiday season, they may be silently struggling to get by. Bringing over an occasional meal and offering a little company allows you to keep an eye on them. And if at some point you see that they need help, contact your local senior organization or social service agency. Don’t let them fall through the cracks,” says Dreher.
Our health is something that we all have, and unfortunately, the condition of our health is not something that we have complete control over. We do, however, have the ability to enhance the quality of our health. We all have choices to make regarding our lifestyle and how we manage our health to make sure we ensure that our health never deteriorates and we can live a long, healthy, and fulfilling life. We can control our choices to improve the quality of our overall health, and a significant part of enhancing the quality of our overall health is making doctor’s visits a priority. Being inconvenienced with taking time off work or readjusting our schedules should become secondary to the need to seek medical attention when needed. The unfortunate aspect of health care utilization is that people often wait until it is too late before they decide to become committed to ensuring that their health is maintained and monitored.
The fragility of health became very real to me about 10 years ago when my persistence to my doctor, because I was not feeling well, finally resulted in an order for a CT of the lungs to reveal I had pneumonia. The previous x-rays of my lungs were always inconclusive. My health was in jeopardy, and I knew that I had to become intentional in my pursuit to get better. My persistence of seeking medical treatment reappeared with a vengeance in 2013 when my favorite uncle was diagnosed with stage 4 throat cancer. He was a mechanic who loved his family, and he was a very talented cook. He was one of those men who never had a lot to say, but he observed everything. It was easy to tell that he was not doing well, but I had to beg and plead with him to allow me to make him an appointment at a local clinic after we noticed that his health was declining. He was a proud man who did not like to admit when he needed some help. He was self-employed with no health insurance. His case was so difficult that
most of his medical team did not want to take him as a patient. One of the wonderful physicians believed in him, and she advocated for him. He went through major surgery, and he lived another two and half years that gave me and my family more time to spend with him.
Two days before my uncle passed away, I softly spoke to him and told him that I would finish my doctoral program and make him proud of me. He nodded his head, and I was blessed to keep my promise. I believe that if my uncle would have been treated sooner, the outcome would have been different. I did not know when my uncle passed away that I would devote my research efforts to racial health disparities, or that I would have such a passion for educating the African American community on the importance of seeking health care services. Through my sorrow, I have made it a part of my mission to educate African Americans regarding the importance of seeking timely and routine medical treatment.
It is so important for African Americans to seek medical treatment because of the high incidences of health diseases and conditions that plague that population, such as high blood pressure, high cholesterol, diabetes, and heart disease. In my experience from working years as a certified pharmacy technician, too many people do not treat their health like the important commodity that it is. We sometimes feel that our health is something that we will always have, and that it will always be good. Unfortunately, I know firsthand that it simply is not true. Our bodies give us signs when things are not right, but it is up to us to pay attention. We sometimes shrug things off when we notice that variance in our health occurs in hopes that it will get better without us taking on more of an active role to ensure that it happens.
The goal of my research was to evaluate how the patient-provider relationship impacts the patient’s decision to access health services. Through my quantitative research, I wanted to delve into the rationale that African American patients have about how they make the decision about when they will visit the doctor. African American cultural norms, in addition to the historical aspects of discrimination coupled with provider biases, create a divide that can become evident during the patient’s visit. African Americans often feel as if they are not heard or a priority when they make medical visits. Chronic diseases and conditions often necessitate the need for medical visits as it pertains to African Americans, so African Americans between the ages of 40 and 65 were the target population that was studied. After reviewing the demographics within Shelby County, Tennessee, it was determined that the sample could be identified after evaluating the community right within my reach. It is apparent through observation as a former practicing certified pharmacy technician that African Americans are subjected to health disparities at an alarming rate. Those racial health disparities are prevalent because of the effects of the patient-provider relationship, limited access to health care resources, and health outcomes that are less than ideal.
A group of 56 participants were gathered through the help of alumni chapters of African American sororities and fraternities located throughout the greater Memphis area. All of the participants that were used to complete the analysis lived within Shelby County, had health insurance, had an English speaking primary care physician, and were African American. The findings evaluated the interactions that occur during the medical visits. The goal was to possibly uncover why African Americans do not go to the doctor in hopes of explaining why there is a prevalence of chronic diseases within that population. The findings did indicate that there is a significant relationship between the patient-provider relationship and the behaviors of the provider. Additionally, the behavior of the provider does contribute to the African American patient’s decision to seek health care services.
The participants that were evaluated stated that gender and assumptions that the provider makes about their education level and income did play a factor in how the provider interacted with them during the medical visit. The behavior that the staff exhibits during the medical visits of African American patients does impact the decision that is made to seek services, and the way that African American patients are made to feel during the medical visit does impact their decision to seek follow-up care and even their willingness to comply with medication compliance. It is important for the African American patient to be understood and treated with compassion, care, and concern. The historical component of the racial tension that African Americans have dealt with makes it pertinent for health care providers to treat the patient’s concerns as a priority.
In summary, there is a direct correlation between the relationship that the patient has with their provider and how the behavior of the provider is perceived during the interaction. It is important that African American patients receive ongoing education regarding the importance of seeking timely and routine health care. Providers need to be cognizant of how their mannerisms and responses affects their African American patients. African Americans do not consistently go to the doctor, which is evident by the staggering statistics of preventable and treatable conditions and diseases that plague that community. The goal for both parties within the relationship is to realize that it is impacted by both the actions and reactions of both sides.
Acknowledgment. The author would like to thank Cheryl Beers-Cullen, DHA, MPA, BSN, RN, CALA and Manoj Sharma, MBBS, PhD, MCHES for their contribution and mentorship.
