As nurses, we care for individuals, families, and communities at times of great vulnerability. To be present in these situations is part of a divine calling. The hours are long and the work demanding. Caring for others requires courage.
Caring also comes at a cost for us. This has especially been true during the pandemic. The challenges we've faced stretched us in ways we've never before experienced. It's also provided new opportunities to learn, grow, and be cared for by others. This process also takes courage.
Nurses typically look at themselves as the ones providing care. It is often difficult to focus on self-care or to allow others to support us in our own care. But these are steps we absolutely need to take if we are to be and do our best each day. And let me clarify—being and doing our best does not equate to having everything done or denying our being tired and weary. It's not about ignoring or numbing our pain. Sometimes our best is lived by admitting that we are tired and weary.
The pandemic created an environment ripe for moral distress/moral injury as resources became strained (Maben & Bridges, 2020). Lack of personal protective equipment (PPE) and exposure to COVID patients contributed to nurses in Michigan demonstrating higher rates of depression and anxiety (Arnetz et al., 2020). Almost half of surveyed ICU nurses working in the United Kingdom met criteria for severe depression, posttraumatic stress disorder, severe anxiety, or problem drinking, with 13% reporting thoughts of self-harm or that they would be better off dead (Greenberg et al., 2021).
Workplaces can help meet basic physiological and safety needs of staff by providing places to rest, training regarding the psychological needs of patients, adequate PPE, and access to COVID testing (Maben & Bridges, 2020). Maben and Bridges (2020) suggested that care among peers, promoting team well-being, and active engagement of managers with staff also are helpful. Smaller team sessions can provide important psychological support. Resilience/resilience training, though helpful, should not be used against staff as “another stick to beat them with” (Maben & Bridges, p. 16).
This past year has been a train wreck for me: caring for my father in hospice during the last weeks of his life, the grief of packing up his home, moving my own family to another state, experiencing COVID, and advocating for my husband through the early stages of dementia have challenged my mental health. Grief leading to depression left me struggling to sleep, focus, and even laugh. Caring for myself is no longer optional. I am learning to accept where I am and to say to others I trust, “I need help.”
During my recent appointment with my nurse practitioner, she shared with me, “You care for others all day long. Please let this time we have together be an opportunity for me to care for you.” Her words gave me the courage to be open and vulnerable so we could work together on promoting my own well-being. In that same way, I encourage and invite you to let the trauma, loss, social isolation, and adverse childhood experiences articles in this issue equip you in your own journey of well-being. Elizabeth Johnston Taylor urges us in her column on self-compassion to reconsider how we perceive caring for ourselves. “Self-compassion is not about self-pity, self-esteem, or self-indulgence. Rather, it is a way of respecting who God made us to be — loving towards ourselves, so that we can be loving towards others.”
If you are uncertain where to start in caring for yourself, ask God for understanding. He knows you and I better than we know ourselves, and his prescription for us will always be just right.
Arnetz J. E., Goetz C. M., Sudan S., Arble E., Janisse J., Arnetz B. B. (2020). Personal protective equipment and mental health symptoms among nurses during the COVID-19 pandemic. Journal of Occupational and Environmental Medicine
, 62(11), 892–897. https://doi.org/10.1097/JOM.0000000000001999
Greenberg N., Weston D., Hall C., Caulfield T., Williamson V., Fong K. (2021). Mental health of staff working in intensive care during Covid-19. Occupational Medicine
, 71(2), 62–67. https://doi.org/10.1093/occmed/kqaa220
Maben J., Bridges J. (2020). COVID-19: Supporting nurses' psychological and mental health. Journal of Clinical Nursing
, 29(15-16), 2742–2750. https://doi.org/10.1111/jocn.15307