INTRODUCTION:

Nursing is a highly stressful profession. Unresolved and/ or ill-managed stress can be a threat to the health and wellbeing of nurses, their ability to think critically, and job performance creating uncharacteristic errors¹. Stress can also lead to errors in the workplace, burnout, and nurses leaving the profession^2,3,4. Nurses have been reported to have higher rates of depressive symptoms and a greater risk of suicide than the general population^5,6. Consistently engaging in self-care activities can help improve mental and physical health and thereby reduce the negative effects of stress. However, nurses, despite having the knowledge and skills of self-care may not be engaging in health-promoting self-care activities^4,7.

Goals of Self-Care:

Self-care comprises of any activity that one consistently engages in, to reach optimal physical and mental health, reduce stress, maintain and enhance one’s long-term health and well-being.

The goals of self-care include

· To find a state of optimal mental and physical health,

· Reducing stress and meeting emotional needs,

· Maintaining one's relationships

· Finding a balance between one's personal and academic or professional life.⁸

Self-care is not and should not be considered a selfish act. Individuals who do not take care of their own emotional and physical needs before caring for others may experience a decline in their own emotional or physical state. It is only if they have met their own needs that they are better equipped to assist others in meeting their needs.^9,10

Importance of Self-Care:

The practice of self-care is unfortunately often neglected by nursing professionals. Nurses are trained to care for others and many times they continue to do so at the cost of their own well-being. Long, irregular shifts with a heavy workload and high-pressure work environment, the hallmarks of the nursing profession, can take a toll on the nurses’ well-being. However, attending to one’s physical and emotional needs could help mitigate the consequences of these issues. Long hours, work overload, and shift work associated with nursing practice can be stressful and contribute to job dissatisfaction, burnout, and health consequences such as obesity and sleep disturbances¹¹.

People who practice self-care are better equipped to care for others. Taking time out for self-care and self-nurture must be embraced by nurses to have good health and prolong their career in nursing. Self-care training in nurses was found to decrease stress, both emotional and physical, and increase caring efficacy¹²Self-care behaviours may also help mental health professionals and other health care providers avoid compassion fatigue, which can often result from work in a high-stress or traumatic environment and may lead to self-doubt, self-blame, and ethical or legal complications.¹³

Nurses are considered as role models of health by the general public as well as the nurses themselves¹⁴ Studies indicate that the perceived health status of the health personnel influences a patient’s perception of health advice received from them; nurses agree that patients are likely to heed the advice of healthcare professionals who themselves adhere to healthy behaviours^14,15. Therefore adhering to self-care behaviours may not only be important for the nurses but their patients as well.

Barriers to Self-Care Activities

1. Personal factors

· No time or “overwork,”

· Lack of motivation and self-efficacy

· Fatigue and/or lack of sleep leave the nurses with no energy or motivation to engage in self-care activities.

· Outside commitments such as family/household responsibilities, school, and community activities.

· Feeling guilty about spending time or money on self-care activities or regarding self-care as selfish.

· Lack of planning for self-care.

· Lack of self-worth can contribute to undermining self-care as an important priority.

2. Environmental factors:

· An unhealthy food culture:

· Lack of availability of fresh and or healthy food options in the workplace settings

· Lack of adequate facilities/resources such as gymnasiums and wellness centres.

3. Organizational factors such:

· Long work hours and shift work

· No protected time for breaks/ meals

· Workplace culture is not conducive to self-care. In some workplaces, there is a stigma associated with self-care making it difficult to engage in self-care activities without feeling judged.

· Taking work home as per workplace culture or expectations interferes with self-care activities ^16,17,18,19.

Self-Care Enablers:

1. Recognizing the importance of self-care

2. Positive workplace cultures supportive of self-care; normalization of self-care in the workplace with leadership from the top-down effecting positive change towards a culture more supportive of self-care.

3. Leadership and positive role models; nurses voiced that they ate healthier when nurse managers modelled this behaviour.

4. Self-awareness of one’s own needs.

5. Gratitude and taking a positive perspective even in the face of negative circumstances;

6. Self-compassion: Self-compassion is described as being warm and understanding towards ourselves and consists of three elements: self-kindness, common humanity, and mindfulness.

7. Authenticity and courage: being authentically human in acknowledging one’s own vulnerability; having the courage to challenge stigma or be assertive in saying ‘no’, when acquiescing to additional workload may compromise one’s own wellbeing;

8. Availability of working part-time as an option.^17,18

Self-Care Activities:

1. Self-compassion. The practice of self-compassion entails self-kindness, which is the ability to be gentle and understanding with ourselves; common humanity- recognizing our failings and suffering as part of the human experience and mindfulness -the ability to have an awareness of feelings you are experiencing without avoiding them or over-identifying with them¹⁷. Individuals who practice self-compassion have lower anxiety and depression levels and employ more adaptive coping strategies than their less self-compassionate peers ²⁰; self-compassion and concern for others were associated with reduced levels of burnout^17,21.

2. Mindfulness: Mindfulness is being aware of the moment, where we are, and what we are doing without being overwhelmed or actively reacting to what is happening around us; experiencing feelings without judgment or applying meaning¹⁷. Studies have supported the effectiveness of mindfulness-based interventions in reducing occupational stress, burnout, anxiety, and depression, as well as in improving self-compassion and the spiritual well-being of caregivers. Significant improvements were found in two of three burnout components (emotional exhaustion and personal accomplishment), anxiety, stress, two emotional regulation competencies, and joy at work^22,23. Results indicated that nurses in the intervention reported significant decreases in compassion fatigue, burnout, stress, experiential avoidance, and increased satisfaction with life, mindfulness, and self-compassion¹³.

3. General self-care activities:

In addition to the practice of self-compassion and mindfulness, other general self-care activities that can be done to promote one’s well-being including

· Regular exercise: It is recommended that adults get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity, or a combination of both, spread throughout the week.

· Eating regular, healthy meals; limiting the intake of caffeinated beverages.

· Regular and adequate sleep: Sleep hygiene practices; reducing blue light exposure from your phone or computer before bedtime to ensure quality sleep.

· Grooming and attending to one’s basic daily needs.

· Relaxation activities: One can explore relaxation and wellness programs or apps. Some relaxation activities include muscle relaxation, breathing exercises such as square breathing, 4-7-8 breathing technique.

· Set goals and prioritize what must get done first and what can wait. Focus on what you have been able to accomplish rather than tasks that you were unable to complete.

· Practice gratitude; maintain a gratitude journal, be specific as you remind yourself daily of what you are grateful for.

· Staying connected to friends or family members who can provide emotional support and practical help.²⁴

CONCLUSION:

The importance of self-care in nurses who work in a highly stressful environment cannot be overemphasized. To increase the longevity of nurses in the profession and the overall well-being of nurses, self-care activities must be encouraged among the nursing professionals and consistently practiced.

REFERENCES:

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Received on 02.03.2022 Modified on 17.03.2022

Asian J. Nursing Education and Research. 2022; 12(2):251-253.

DOI: 10.52711/2349-2996.2022.00054