The Hive 2018Self-care and resilience

By Dot Yam and Tiffany Baxter

A ‘call’ to nursing put you at the bedside of the patient, where you can make a difference. A commitment to self-care may well keep you from occupying a ward bed and subsequently requiring a nurse. Where it is suggested that “a good half of the art of living is resilience” (de Botton 2018), self-care underpins the ability to sustain resilience of the body, mind and spirit, form a stable platform of health and wellness and create longevity in your nursing career.

Fundamentally, “effective health care depends on self-care” (Illich 2018), meaning that if you are ill, you are in no position to help another to get well. For those of us in the caring profession, we are accustomed to putting ourselves last and yet the importance of putting ourselves first cannot be underestimated.

Having been conditioned (particularly as women) to put others first; family, friends, work, the community, our significant others etc, we are often left feeling guilty for taking even a teeny weeny little time for ourselves. Dare I mention taking a break at work? Sometimes just the thought of doing it sends us into conniptions. The only exception seems to occur mid-flight (in an emergency mind you), and in the unlikely event the oxygen pressure in the aircraft cabin decreases, where then and only then are we are instructed to put our own oxygen mask on first before assisting another. This is food for thought! My concern is that significant levels of sustained stress have become normalised and somewhat expected of us, but the consequences will feel anything but ‘normal’.

The stress response was designed by nature so we could run from rabid tigers, however, in current times our “rabid tigers” look like Facebook, work demands, social expectations to keep up with the Jones’, running a household and simply staying ahead of the mortgage, all of which hound us day in and day out. Smoking, caffeine, negative attitudes, over-exertion, lack of sleep, a lack of exercise and being overweight also contribute to our stress load. Seyle (1950), in the 1950s, clearly defined the dangers of long term and sustained levels of stress, which you see every day on the ward. Not much has changed in 70 years.

Consider these conditions, all of which are strongly linked to stress:

  • Asthma
  • Angina
  • Auto-immune diseases
  • Cancer
  • Cardiovascular disease
  • Common cold
  • Depression
  • Diabetes Type II
  • Headaches
  • Hypertension
  • Menstrual irregularities/PMT
  • Ulcerative colitis
  • Irritable bowel syndrome.

(Murray & Pizzorno, 2012)

Or perhaps you have personally experienced:

  • Feeling tired for no reason
  • Cravings for salty or sugary foods
  • Reduced concentration
  • Increased confusion/reduced memory recall
  • Insomnia
  • Increased menopausal symptoms
  • Loss of ambition or drive
  • Feeling lazy but know that you are not
  • Increased fears
  • Loss of libido and drive
  • Increased weight gain
  • Increased PMT symptoms.

(Wilson, 2015).

Oh dear! What to do?

There is only one way to eat an elephant… one bite at a time! I recommend the same for reducing your stress levels. Take it slowly, do one thing at a time and be patient with yourself.

Here are my tips to identify your stressors and some suggestions for resolution. Before you start, remind yourself that clarity precedes change.

Food
Are you loading up on coffee, chocolate, chips and stimulants? Please know that these foods are increasing the pressure on your adrenals and reducing your energy and resilience over the long term. They are like a fickle lover – whisking you off your feet one minute and dumping you the next, leaving you broken. Fresh fruits and vegetables, whole grains, good quality meat and seafood and plenty of water will reap you benefits you dream of – (increased energy, healthier bodyweight, improved moods). The Australian dietary guidelines are a great place to start for hints and tips if you are not sure. Keep it simple.

Mood
Feel down, anxious, angry, can’t get a grip on your emotions? Feeling bad is stressful and futile. I encourage you to breathe, meditate, scream underwater, go for a walk (morning sun definitely regulates your mood), engage a professional (hypnotherapy is great) and learn how to ‘calm your farm’. You are worth it and you will love who you really are.

Connection
In her research, Pinker (2017) showed the number one determinant for a long and healthy life is social connection. If you are feeling lonely, unsupported or left out, engaging in a hobby, making new friends and generally putting yourself out there is going to make a difference. Connecting with activities and people who bring you joy and make your heart sing will do you the world of good.

Tiredness
Tired really is a downer and a double-edged sword – stress fatigues you and being tired increases your stress (shift work doesn’t help). However, good sleep hygiene can help: no screens 30 minutes before bed, no stimulants, eating your evening meal three hours before bedtime, exercising regularly, healthy exposure to sunlight, meditation or mindfulness before bed (I love the Headspace app.), a cup of chamomile tea, rubbing some lavender oil on the soles of your feet as you hop in to bed may all contribute to sweet dreams.

Sickness
Sometimes we have long-term health concerns and sometimes we have acute attacks. Either way, seeking the assistance of a supportive health care practitioner to guide you in health and wellbeing is going to be priceless on your mission to reduce your stress levels and improve your overall health. Your GP, alternative health care practitioner and other specialists are part of your cheer squad. Let them help you. Remember your objective is to be beside the bedside not in it!

Back on the ward
I know it is unpopular, guilt-ridden, whispered about and frowned upon to take a break, however, word on the ward has it that your senior mentors and leaders, want you to take a break, one even suggesting you call it a self-care moment.

Hold you ground, flip open your cape, blaze your own trail, keep your chin up and live the values of self-care. You’ll love it, your world will change, and your patients will thank you.

 

References:
deBotton, A. (2018). Allain de Botton quotes. Retrieved from: https://www.goodreads.com/author/quotes/13199. Alain_de_Botton

Illich, I. (2018). Ivan Illich quotes. Retrieved from: https://www.successories.com/iquote/author/2082/ivan-illich-quotes/1

Murray, M. & Pizzorno, J. (2012). The encyclopedia of medicine (3rd ed.). New York, United States: Simon & Schuster.

Pinker, S. (2017). The secret to living longer may be your social life. [Video file]. Retrieved from: https://www.ted.com/talks/susan_pinker_the_secret_to_living_longer_may_be_your_social_life

Selye, H. (1950). Stress and the General Adaptation Syndrome. British Medical Journal, 1(4667), 1383–1392. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2038162/?page=1

Wilson, J. (2015). Adrenal fatigue. The 21st century stress syndrome. What is it and how can you recover? Petaluma, California: Smart Publications.

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