“I Pledge”
The calling of nursing requires a person to have a capacity and sense of satisfaction for healing others in the physical, emotional, and mental realms. Nurses spend their entire professions providing care to their patients and their families regularly in the happiest moments to the most exceedingly awful or alarming times of their lives. Nursing obligations can be long, distressing, emotional, and physically demanding. The requirements of the nursing career combined with the nursing shortage and longer work hours puts significantly more strain on an already at-capacity load. In spite of these demands, many nurses don’t completely value the significance of self-care and how it plays a valuable role in their practice; without appropriate care for themselves, nurses are not adept to provide the best care to their patients. Self-care is a critical component of being able to provide holistic nursing because nurses must be able to recognize that they cannot facilitate healing unless they are in the process of healing themselves,
Recent research on the effects of holistic self-care programs for nurses and nursing students demonstrates that such programs foster good health behaviors; resilience; improved nurse–patient communication, care, and satisfaction; and improved work environments, and may help sustain the nursing profession (Mariano, 2013, p. 21).
For this reason, nurses need to put forth the energy to schedule time for looking after their own needs in addition to the needs of their patients. With this in mind, I implemented an exercise program as my self-care modality for my independent study. Exercise fits into my personal value system because I realize the significance of taking care of the body; a healthy body tends to influence a healthy mindset. My personal core values are there to guide my behavior and my choices, and incorporating exercise increases self-awareness and helps clarify personal issues or stressors that occur in my life. Exercise, for me personally, makes intelligent decisions easier and guides me in deciding which decisions or emotions are negative and when to redirect my thought processes. It makes it easier to keep a balance in my life and is an integral influence on my beliefs and values. As Mahatma Gandhi said, “Your beliefs become your thoughts. Your thoughts become your words. Your words become your actions. Your actions become your habits. Your habits become your values. Your values become your destiny” (A quote by Mahatma Gandhi, 2018).
Through the span of my study, I inquired about the significance of self-care through research and how exercise can be a viable care method along with how I can utilize my self-care for my own personal and professional advancement as a future nurse. In preparation for my self-care study, I conducted a literature review of the importance of this modality in the nursing profession. The literature review validated that without appropriate self-care tactics nurses have a higher burnout rate and their feelings of fulfillment in their occupation significantly decreases. When nurses care less for themselves, they wind up feeling fatigued, overwhelmed, frustrated, and stressed. Once nurses begin to feel exhausted and overpowered with negative emotions, it begins to have a negative effect on patient care, leading to poor outcomes. Additionally, this absence of self-care incites poor physical, emotional, and mental well-being in the nursing populace. A research article on the mental health nursing profession illustrated that mental health nurses are at a substantial risk for stress-related illnesses when they lack familial and occupational support and self-care (Gibb, Cameron, Hamilton, Murphy & Naji, 2010). Gibbs, et al (2010) also discovered that mental health nurses needed help from their coworkers and managers and found that with a lack of support the nurses reported their occupation to be profoundly demanding, causing them to have elevated amounts of emotional exhaustion and stress. These mental health nurses were allowed the opportunity to meet with Occupational Health Services (OHS) as a means of additional help and a place to talk about their experiences and feelings. The greater part of the nurses who utilized the OSH service reported less stress and said they would highly recommend the program to other nurses. (Gibbs, et al, 2010). Another study focused on older nurses and their self-care strategies. Gabrielle, Jackson, & Mannix (2008) discovered that numerous seasoned nurses had spent their whole vocations putting the requirements of others before their own needs. A significant number of the nurses in this study announced having increased aches and pains associated with the normal fundamental nursing tasks. They reported chronic fatigue and the feeling that their bodies were essentially wearing out due to their selfless occupation. Huge numbers of older nurses also said they tended to disregard their own needs when working conditions were poor and that they needed to work longer hours with less staff. Furthermore revealed, were the expanded obligations and harder patient assignments due to their seniority and experience, which unfortunately contributed to additional stress. (Gabrielle, Jackson, & Mannix, 2008).
Unfortunately, numerous nurses assumed that “a selfless attitude and neglecting self-care made up a large part of a nurse’s identity” (Gabrielle, et al., 2008, p. 319). This nurse-held conviction of selflessness can have detrimental consequences, particularly when combined with the demands of the occupation. These consequences can include acute and chronic conditions or self-inflicted illnesses due to the absence of self-care. One older nurse expressed “You put yourself last…You see other nurses or patients needing…you can’t just have a break…But if you don’t look after yourself you end up sick…I ended up with a complicated UTI because I wasn’t drinking and I wasn’t going to the toilet” (Gabrielle, et al., 2008, p. 319). Tragically, this absence of self-care is normal to numerous nurses despite age and although many of the elderly nurses disregarded their own particular needs, the research outlined several tactics to incorporate self-care strategies among this particular age group of nurses. The self-care techniques included: setting time aside time for oneself, eating healthy, and regular exercise. Eating healthy is particularly critical for nurses because nurses are known to not allot time during their shifts to eat healthily of drink water. One nurse, in particular, expressed that, “…meal breaks, that’s got to be the biggest laugh out”, while another nurse said “I don’t drink water…basically, I have coffee, coffee, coffee, coffee” (Gabrielle, et al., 2008, p. 321). Subsequently, after executing self-care modalities delineated in the study, many nurses announced having diminished stress and physical ailments that accompany, as in high blood pressure, poor weight control, and decreased physical health. Nurses who engaged in daily physical exercises additionally communicated better eating and drinking tendencies:
Sara, a midwife of 44 years, had type-2 diabetes, obesity, and osteoarthritis from lack of self-care. Sara adopted a regular exercise program, changed her diet and cut back on her work hours. After making these changes she stated, “I’ve lost 36 kilos, I go to the gym, I walk, I swim. I do all the things I said I would never do, and I’m enjoying life. I didn’t enjoy life for a long, long, time” (Gabrielle, et al., 2008, p. 321).
Sara’s experience is representative of many other nurses in this study. Overall, the researchers found that nurses were measurably healthier and happier when they allotted time to care for themselves in addition to their patients.
For my self-care modality, I chose to embrace a customary exercise program. Before beginning my activity program, I did extra research on the advantages of exercise on both physical and psychological wellness. An article by Donaghy (2007), was a meta-analysis of many studies that observed the advantages of activity on emotional and mental well-being. The review outlined a few imperative advantages of exercise including stress reduction, decreased depression, enhanced general state of mind, expanded cognitive function and improved self-awareness and body perception. The examination additionally covered the more well-known physical advantages of activity, for example, hypertension, obesity, diabetes, and avoidance and/or treatment of cardiovascular disease. Further studies incorporated into this article discovered conceivable advantages of activity on drug and alcohol addiction. Another study found that in particular cases, exercise could be as viable as antidepressant medications for the treatment of depression. (Donaghy, 2007). A study by Henwood (2012) found that exercise done at work, for example, a nurse who is running around working a busy shift, did not have any of the similar beneficial outcomes on mental or physical well-being as exercise done recreationally outside of work. This finding was especially intriguing to me an understudy nurse on the grounds that many nurses I work with have detailed not recreationally exercising on the day of their twelve-hour shift. Their rationale is based on the fact that they don’t have to use a treadmill, bike, elliptical, strength machines, and so forth since they move around enough when they work.
Overall, the conclusion of my research is that exercise when done regularly outside of work has been proven to have numerous advantages on physical and mental health. For my own approach and endeavor into the self-care modality, I incorporated morning runs/walks for the entire semester. My program comprised of a daily 1.5-hour long cardiovascular aerobics and strength training every week. The program I did consisted of 3 major parts. Part one of my exercise was the treadmill, which included warming up for a mile and running in intervals of .25 a mile and resting for 0.10 in between for a total of 5. Part two consisted of strength-training, which involved seated rows, bench press, deadlifts, and squats, ending with abdominal crunches. The third and final part was a 15-minute cooldown that included walking on the treadmill and stretching. The exercise program was not as difficult to begin as I have always been an athletic person. I grew up being incredibly active my entire childhood, whether it was swimming, hiking, or riding horses. However, as my school responsibilities have increased since I began Nursing school, my free time to truly enjoy has decreased in college and I had stopped being as active or enjoying it. I no longer hike, a favorite of mine, or just the idea of finding time and motivation to go to the gym would feel stressful. However, when I began to make it a priority to wake up earlier at the beginning of this semester, I began to feel better. Initially, exercise had made me sore and I was wishing for more sleep. As I continued to rise earlier and exercise regularly, I began to love the way I felt afterward. I no longer felt sore and the drowsiness that plagued most of my mornings at school was lifted as my exercise program became more of a routine. My body, mind, and spirit would feel better capable to take on the day and whatever school work I was given. I expected to be healthier and have increased endurance, but what I did not expect was my overall sense of well-being. My sleep quality significantly improved and my mental clarity to understand what I was studying increased. My energy in the morning was most impressive along with my motivation to drive to school. My overall stress levels were lower and I also found if I exercised around examinations, I was not as anxious or nervous. My physical health has carried over into my mental health and has made it easier for me to cope with everyday stressors. The only drawback that I can say about initiating this self-care modality is that a chronic foot problem of mine became exacerbated and I had to decrease my aerobics on the treadmill as to not aggravate an already persistent pain.
To be a holistic nurse with the goal of healing a person as a whole, one must be whole first. The benefits of exercise are copious. It strengthens muscles, keeps bones strong, increases relaxation, enhances sleep and mood, and supports a strong immune system. Being a healthy nurse is imperative to being able to care for patients. If one cannot integrate exercise even in minute amounts, the health effects will eventually add up leading to negative physical and mental health for not just the nurse, but the patient as well. Watson’s theory of caring further stresses the importance of having a clear mind in holistic nursing. Two of the 10 carative factors focus on providing a healing environment and incorporating physical wellbeing in promotion of the patient’s health:
The provision for a supportive, protective and/or corrective mental, physical, socio-cultural, and spiritual environment, which Watson divides into interdependent internal and external variables, manipulated by the nurse in order to provide support and protection for the patient’s mental and physical health. The nurse must provide comfort, privacy, and safety as part of the carative factor.
Assistance with satisfying human needs based on a hierarchy of needs similar to Maslow’s. Each need is equally important for quality nursing care and the promotion of the patient’s health. In addition, all needs deserve to be valued and attended to by the nurse and patient. (Jean Watson Nursing Theory, n.d.)
Exercise can be incorporated in these carative factors since the lack of physical activity places individuals at increased risk for metabolic syndrome, high blood pressure, cardiovascular disease, type 2 diabetes, and much more. Additionally, the lack of mobility increases complications such as DVT’s, constipation, skin breakdown, and depressed mood, so it is important to incorporate activity throughout the day and make sure patients and nurses move around periodically.
Conclusively, this experience has shown me such a great amount about the significance of self-care for both my professional and personal development. The individual advantages of daily exercise as aforementioned above are numerous. Taking an hour and a half out of each day to work on myself has been astounding. It has influenced me to acknowledge the importance of taking care of myself and not dismissing my psychological and physical needs. Professionally, this experience has shown me that without satisfactory self-care, my fellow classmates and I are in danger of physical and emotional well-being consequences. Moving forward as a nurse, I will keep on caring for myself and will likewise bolster my peers and urge them to be aware of their needs. I would highly recommend to the patients under my care and to my fellow nurses the importance of daily activity as a way to enhance the self and their mental well-being. Something as straightforward as covering a meal break or a mental time-out are minute ways I can help others with self-care also. I am thankful for this experience to remind me that despite the fact that I have committed my life to looking after others, it doesn’t mean I need to disregard my own particular care. I intend to keep on exercising however much, conditions permitting, as I advance in my occupation.
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