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Prioritizing Self-Care of Nurses

      Nursing is a stressful and often physically and mentally demanding profession that attracts individuals who are willing to put others before self every day in their jobs. Nurses frequently experience long working hours, understaffing, insufficient resources, and other work-related circumstances that contribute to burnout, job dissatisfaction, and numerous health related consequences including mental distress, fatigue, obesity, and sleep disturbances (Buss, 2012;
      • Ross A.
      • Bevans M.
      • Brooks A.T.
      • Gibbons S.
      • Wallen G.R.
      Nurses and health-promoting behaviors: Knowledge may not translate into self-care.
      ,
      • Ross A.
      • Touchton-Leonard K.
      • Perez A.
      • Webrlen L.
      • Kazmi N.
      • Gibbons S.
      Factors that influence health-promoting self-care of registered nurses: Barriers and facilitators.
      ;
      • Linton M.
      • Koonmen J.
      Self-care as an ethical obligation for nurses.
      ). All of this is leading to a great exodus of nurses from our profession. According to the World Health Organization (WHO), the shortage of nurses is reaching a crisis state and by 2030 there will be a global shortage of roughly 18 million health care workers worldwide (

      WHO (2022). WHO guideline on self-care interventions for health and well-being, 2022 revision. https://www.who.int/publications/i/item/9789240052192

      ).
      Unfortunately, while nurses are knowledgeable about the importance of their own health promotion activities such as regular exercise, healthy eating, maintaining healthy relationships, stress management, and adequate sleep, they do not regularly translate this into their own self-care behaviors (
      • Ross A.
      • Bevans M.
      • Brooks A.T.
      • Gibbons S.
      • Wallen G.R.
      Nurses and health-promoting behaviors: Knowledge may not translate into self-care.
      ;
      • Ross A.
      • Touchton-Leonard K.
      • Perez A.
      • Webrlen L.
      • Kazmi N.
      • Gibbons S.
      Factors that influence health-promoting self-care of registered nurses: Barriers and facilitators.
      ). Given this situation, it is essential that immediate steps be taken to improve nurses’ physical, mental and spiritual well-being.
      An essential first step is for nurses to look at the ANA's Healthy Nurse, Healthy Nation (HNHN) program which is completely free to any nurse in the world (https://www.nursingworld.org/practice-policy/hnhn/). Included in this program is their HealthyNurse® survey which provides a quick snapshot of any nurse's self-care status. The Healthy Nation program also provides numerous web-based resources to inspire action, connect nurses with one another, encourage health competition to achieve physical activity, rest, nutrition, quality of life, and safety goals. One of its most significant features is its focus on nurses’ mental health, which has become critical in our practice (2021). In the August 2021 HNHN survey, findings revealed that only 34% of nurses are emotionally healthy with even greater numbers among emergency room, critical care and younger nurses. Among its numerous holistic self-care materials, HNHN offers multiple resources such as mental health webinars, blogs, informational presentations, and a suicide prevention website (
      HNHN
      We are in this together: Year four highlights 2020-2021.
      ).
      Equally important is a need to concentrate on safer, more respectful, and more encouraging work environments. Unfortunately, nurses are often exposed to workplace aggression including incivility, bullying, and other negative behaviors that affect their work lives and contribute heavily to burnout and job dissatisfaction (
      • Combrinck Y.
      • Van Wyk N.C.
      • Mogale R.S.
      Preserving nurses’ professional dignity: Six evidence-based strategies.
      ;
      • Arnetz J.
      • Neufcourt L.
      • Sudan S.
      • Arnetz B.
      • Maiti T.
      • Viens F.
      Nurse-Reported Bullying and Documented Adverse Patient Events.
      ; Anusie et al., 2020;
      • Anusiewicz C.V.
      • Ivankova N.V.
      • Swiger P.A.
      • Gillespie G.L.
      • Li P.
      • Patrician P.A.
      How does workplace bullying influence nurses’ abilities to provide patient care? A nurse perspective.
      ). A key factor is a lack of respect from colleagues, managers, directors, and health care administrators.
      • Leape L.
      • Shore M.
      • Dienstag
      • Mayer R.
      • Edgman-Levitan S.
      • Meyer G.
      • Healy G
      A culture of respect, Part 1: Nature and causes of disrespectful behavior by physicians.
      writes “disrespect …inhibits collegiality and cooperation essential to teamwork, cuts off communication, undermines morale, and inhibits compliance with and implementation of new practices” with nurses and students particularly at risk (p.845). Ted James, from the Harvard Medical School, further posits that “respect is an essential component of a high-performance organization. It helps to create a healthy environment in which patients feel cared for as individuals, and members of health care teams are engaged, collaborative and committed to service” (2018, p. 1). He further states “within a culture of respect, people perform better, are more innovative and display greater resilience” (, p. 1). Unfortunately, there is much to do in improving our work environments to foster a culture of respect (
      • Nouri A.
      • Samagoo A.
      • Jouybari L.
      • Talegahani F.
      Challenges of respect as promoting healthy work environment in nursing: A qualitative study.
      ). Examples of how to establish and maintain respect are nurses having opportunities to participate in decision making, having regular instances to address their problems and concerns in a timely manner, having a supportive environment that includes effective and open communication, constructive feedback, being helpful to nurses in stressful situations, and affirming their value to the organization.
      Nurses continue to play an essential role in health care around the world. It is important that we collectively promote and sustain self-care behaviors of all nurses while working hard to create work environments that are both respectful and supportive.

      References

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        How does workplace bullying influence nurses’ abilities to provide patient care? A nurse perspective.
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        Preserving nurses’ professional dignity: Six evidence-based strategies.
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        We are in this together: Year four highlights 2020-2021.
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        Setting the Stage: Why Health Care Needs a Culture of Respect. Trends in Medicine.
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      1. WHO (2022). WHO guideline on self-care interventions for health and well-being, 2022 revision. https://www.who.int/publications/i/item/9789240052192