Shifting to self-care: A nurse’s guide to well-being

THIS year, the American Nurses Association (ANA) has chosen the Nurses Week (May 6-12) tagline of “Four Million Reasons to Celebrate” to be an ode to the nation’s 4 million registered nurses who daily represent the nation’s healthcare system and dedicate themselves to providing quality care all clinical settings.

According to the ANA, nurses make up the largest group of health care professionals in the nation and it’s no doubt that Filipinos make up a large number of the profession. In California alone, 20% of registered nurses are said to be Filipino.

For 17 consecutive years, nurses have been ranked as having the most honest and ethical profession as a testament to their role and impact both in and outside hospital settings.

But despite their hard work, many compromise their own personal health in doing so. It isn’t uncommon for example, to hear of nurses working over their 12-hours shifts, or keeping themselves on-call in case they’re needed in the hospital.

A 2015 report by the American Journal of Nursing pointed to a number of studies unsurprisingly showing that nurses who work extended hours of 12 or more hours in a 24-hour day or over 40 hours in a week, are less likely than the general population to have an adequate amount of quality sleep.

Lack of sleep combined with long hours shifts, the report added, has been found to be associated with health problems that not only affect performance or memory, but contribute to diseases like diabetes, obesity, and cardiovascular disease.

The ANA in 2014 made it a point to release a statement to nurses and their employers “to carefully consider the need for adequate rest and sleep when deciding whether to offer or accept work assignments, including on-call, voluntary, or mandatory overtime.”

“What I didn’t realize was that breaks are there for reason. They’re meant for us to fill up again and finish the rest of our shift with more energy and ease and less anxiety,” added Nacion-Vita. “You can’t go 100% from start to finish. It is not sustainable.”

Anita Nacion-Vita

Anita Nacion-Vita, the Filipina American registered nurse (RN) behind the new Nurses Rise wellness service, experienced the stresses of the job firsthand. As a result, she often experienced burnout syndrome, anxiety, chronic fatigue, and other symptoms of “workaholism.”

As a former night shift worker, there was also insomnia, and the regular need for caffeine, sugar, and sleeping aids. Coping with stress outside of work, there was shopping, excessive drinking, partying and TV binge-watching.

“I thought I had to have it all together all the time, which led to all the suffering I endured. I used to feel that taking breaks would cut into my time for charting and make me fall behind. There were times I took them feeling guilt and shame,” Nacion-Vita shared with the Asian Journal.

“What I didn’t realize was that breaks are there for reason. They’re meant for us to fill up again and finish the rest of our shift with more energy and ease and less anxiety,” added Nacion-Vita. “You can’t go 100% from start to finish. It is not sustainable.”

Wanting to make a change, Nacion-Vita made it a point to be an advocate for self-care for nurses. She shared with the Asian Journal some of her personal tips for finding balance and personal well-being.

Meditate

“Meditation is my number one tip. It’s free and can be done in as little as five to 15 minutes,” said Nacion-Vita.

As night shift worker especially, Nacion-Vita like many, found herself in a cycle of not getting enough rest on her days off, struggling to stay awake during the day, and relying on coffee and sleep aids just to find a rhythm.

“It made me feel like I was always in fog,” she said. “My sleep was broken up into a nap session, versus sleeping a full six to eight hours a day.”

But through meditation, she was able to get the relaxation and freedom she needed. She shared five simple steps, starting with creating a quiet environment free of distractions.

“Go to a quiet place where you are not to be disturbed for at least five minutes,” said Nacion-Vita. She added that playing instrumental spa music was one easy way to really get into the setting.

After finding a preferred environment comes body positioning: “Sit in a position power. Feet flat on the ground. Back is slightly curved, not rigid. Shoulders rolled back and relaxed. Hands with palms facing downwards to ‘ground’ your energy.”

Next comes setting your intention: “Spiritual quality such as love, kindness, it is whatever you want to focus on and receive from your meditation. Close your eyes and start to arrive and start to let go of external stimuli.”

Breath: “Allow your breath to guide you. Take an initial cleansing deep breath to start. Inhale for four seconds. Hold it at the top for four seconds and then exhale all of your breath for four seconds. Then do this sequence again with equal and even breaths for two rounds. Then do the last one just as the same as the first one. A cleansing closing breath. Take the deepest breath you have ever taken from the week and day.”

The final step is expressing gratitude: “Honor and thank yourself for showing up for yourself. Give thanks for the gifts you are receiving from meditation.”

End your meditation session by pausing and taking three more slow and deep breaths.

Exercise

Nacion-Vita also found regular exercise to be a big help in increasing her blood flow and waking up her body. One of the programs offered by Nacion-Vita’s group is a Mindfulness Running Program that includes group runs by the beach.

Being an avid runner, she picked up running to combat the fact that she was always very sleepy. She eventually set a goal to run a half marathon, and made running a part of her regular routine.

“It kept me on a good routine to move my body, which also added the benefit of getting better sleep and quick bursts of energy during my working hours,” said Nacion-Vita.

Make the most out of breaks

“Take breaks without guilt or shame,” said Nacion-Vita, adding that breaks are a great time to put in a meditation session, getting blood flowing, and just setting aside time to fully recharge.

She also recommends stepping away from the workspace and making a change of environment to help shift energy in a better direction.

“Maybe go to the courtyard if you have access to one, go for a walk, or go anywhere outside your usual setting,” said Nacion-Vita. Unable to get out? Nacion-Vita shared that just getting up and walking laps around the unit floor make a difference.

Other easy things that can be done during breaks are listening to music that uplifts and relaxes, or using essential oils.

“I can easily shift my mood from chaos to calm with essential oils,” said Nacion-Vita, who brings a small bottle with her wherever she goes. Her personal favorite that is recommended for relaxation is lavender.

Take the opportunity to recharge off duty

Perhaps more important than resting during break time is resting when off the work shift. A self-care rhythm is a great place to start, said Nacion who has a three-step “Release, Refuel, and Renew” method to clear energy and fuel back up.

Starting with the release step, the Fil-Am nurse suggests letting go of the things that no longer serve you through again, meditation, but also through things like writing and journaling, working out, or dancing and singing to move negative energy out through the body.

Next comes refueling. “Nourish yourself,” said Nacion-Vita. “Eat delicious and nutritious food that fuels your heart and soul. Keep brownies and processed foods to a minimum no matter how tempting. All in moderation. Hydrate. Take a mindful shower or bath honoring your body and what it does for you in a state of gratitude and thanksgiving.”

Finally comes the renewal step. “Once you are all filled up, you begin again. From this space you are able to go about your day and tackle the next task at hand in a harmonious way,” said Nacion. “Connect with yourself and loved ones and do something joyful and playful.”

Find a community of fellow nurses

Joining a community of like-hearted nurses that support and lift each other up is something all nurses could benefit from, according to Nacion-Vita. Unable to find a supportive community that was focused on nurses was what ultimately led her to create Nurses Rise.

Nurses Rise looks to bring balance to the healthcare paradigm through being a safe place for nurses to connect with each other and learn skills in overcoming the stresses that the nursing profession encounters. “Rise” is an acronym for “Reclaim Intuitive Strength and Empowerment.”

“The vision of Nurses Rise is to redefine that paradigm by expressing one’s unique healing potential to become an empowered healer,” said Nacion-Vita.

She hopes that by realizing the importance of self-care, nurses would be able to better show up for family and patients without having to compromise their own health and well-being. Her program includes personal one-on-one coaching, workshops, and retreats.

“Nurses are at the forefront of healing, so we must practice what we preach. We have been trained to take care of everyone else except no one has showed us how to do it for ourselves,” said Nacion-Vita. “It is our duty and responsibility to serve from our highest good.”

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