As nurses, it is inherent for us to listen to our patients’, clients’, and even our colleagues’ needs. We firmly believe that taking care of their mental health is just as important as tending to their physical health. With that being said, how do nurses take care of our own mental health?

Service-centered Profession

Nursing is both a science and an art. Nurses learn the latest and the best evidence-based science and apply them to practice. However, it is not only mechanically doing the dictates of science that matters. More importantly, it is about caring. In a nutshell, the art of nursing can be interpreted as the giving of one’s self.

As mentioned earlier, nurses are good listeners. More than listening to our patients or clients, we are keen on assessing the non-verbal nuances that come along with the spoken words. Those are primarily parts of our objective assessments. They help inform our plan of care for that particular patient.

Oftentimes, what we hear or observe is not very positive. We tend to empathize with the other person. We place ourselves in their shoes to fully immerse ourselves in their situation. Without knowing it, those experiences affect us. Sometimes, they even leave indelible marks in our own lives.

We do this daily. Without awareness on our part, some of us suddenly find ourselves at our own breaking points.

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Burnout

Time and time again nurses give above and beyond what is expected of us. Have you ever worked short but just “made do” of the resources that you had? Have you floated to another department in the middle of the shift because you are more needed there than in your unit? I have done both of those and they were not fun experiences. Sure, we may grumble about those times but we still do it.

As a profession, we collectively carry our stresses well. We are dutiful frontline soldiers who march where we can be of most help. We feel that it is our job to be “fixers.” As such, we think that being not okay, in terms of our mental health, is an unnecessary weakness. Of course, the residual stigma about mental health has an adverse effect too.

The Toll of the Pandemic

Burnout is a known fact in healthcare, not only amongst nurses. We may not publicly acknowledge it but we have suffered with it long enough. The pandemic, I sincerely think, just highlighted it for everyone else to see.

Working Short-Staffed

Working short-staffed is nothing new for nurses. However, the pandemic need, coupled with the shortage of nurses, just magnified that gap a hundred percent. Obviously, because patients were sicker, the demand for intensive care unit (ICU) nurses skyrocketed.

Despite the prevalence of floating practices to augment staffing needs, Medical-Surgical (MS) nurses cannot really step in the shoes of the ICU nurses. Even if the MS nurses were willing to help out, their responsibilities were limited to being “runner” nurses. In our organization, “runner” nurses were providing general help: finding supplies, expediting discharges by printing out discharge papers, etc.

Some nurses liked the “runner” role because they didn’t have primary responsibilities in taking care of patients. Plus, the $6 per hour extra pay didn’t hurt either. But what about during shifts when no nurses were willing to float? Those shifts then became more challenging for those working in the unit. Also, the stress levels of nurses who begrudgingly float despite their hesitance to increase exponentially.

Ever-changing Policies

Aside from working short during most shifts, the pandemic brought with it other challenges that are mentally taxing to clinicians. For one, not so much was known about the disease. This resulted in the ever-changing policies in the workplace. As an example, cloth masks were used at the start, but that was short-lived.

Another policy that changed often was the accommodation of visitors. Family members were frustrated about not being able to visit their loved ones, especially those who were dying. Oftentimes, the frontline nurses were at the receiving end of that frustration.

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The Dire Need for Personal Protective Equipment (PPE) in the Frontline

Then there was that concern about the lack of PPEs. Never have we reused our N-95 masks but we had to rethink creative ways to conserve our resources. As a nurse, one may have asked:

I am reusing my PPEs for conservation of resources, but at what expense? Can I get sick for keeping my mask on for the entire shift? How protected I really am if we are unsure of the mode of transmission of this virus?

These are just but a few questions but I am pretty sure we have asked them at one point or another. If we add up the fact that there were no “for sure” answers, then that may have also added a toll on our mental health.

Dealing with the Death and Dying Daily

Going back to the visiting policy I mentioned earlier, restrictions prohibited visitors from seeing their loved ones. As such, nurses, already busy with their own clinical responsibilities, didn’t have any choice but to provide emotional support not just to the sick and the dying but to their families as well.

Providing care for the dying is one of the most sacred parts of the nursing vocation. However, during the pandemic, that became a daily occurrence. Sadly, it quickly became the norm rather than the exemption.

I’ve had my fair share of dealing with death and dying in both my professional and personal life. I remember like it was just yesterday being a part of the team that provided cardiopulmonary resuscitation (CPR) to my mother when we rushed her to the emergency room more than 20 years ago. At that moment, I was able to draw the line between my being her daughter and being her nurse.

With that being said, even if a patient was expected to succumb to his or her health issues, it caused adverse mental and emotional effects on the part of the nurse. Now, let us place ourselves in the shoes of those ICU nurses who had to deal with this situation daily. Even the toughest nurses weren’t able to avoid being affected by this one way or the other. The question though was:

How were they able to deal with those experiences effectively?

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Taking Care of One’s Mental Health

We are great advocates of mental health for our patients’ sake. But not so much for our own. Thankfully, though, we are slowly warming up to the fact that we need to take care of our own just as much, if not more importantly, than those of the people we come in contact with.

We can only give what we have. If we are not filling ourselves up with positive things, then guess what we give out? We may not be mindful of it at times but we may sound irritated, short-fused, impatient, etc. Those are all signs that we needed to address our own mental health needs.

So what are some ways to do that?

1. Learn to say “NO!” Don’t feel guilty if you are not able to help out your unit when it is short-staffed.
2. Take breaks during your shift or after your shift. My mentor told me that if it is not a matter of life or death, it is important to take our law-protected breaks. It may not be the full 30 minutes, but use that time to either eat, mentally rest, read, or watch television in the breakroom.
3. Eat healthily, rest well, and take very good care of yourself. Do something that makes you happy: go to a yoga class, take a vacation, meditate, etc. Give yourself permission to binge on Netflix if that is your thing.
4. Set limits. Don’t bring your work home, unless your role entails 24/7 responsibilities. Even if it does, and you feel that this is affecting you negatively, reevaluate and reconsider.
5. Set realistic expectations for yourself and define that with your team, as necessary. For example, it’s your turn to float but you don’t feel comfortable taking care of a vented patient, voice that out. That will benefit not only you but the patient, too.

Significance of Having a Support System and a Supportive Work Environment

The importance of having a great support system cannot be emphasized enough. If your family is very considerate of your job as a nurse, you are blessed.

1. You are able to vent out your concerns for the day to them. Without violating patient confidentiality, you can share the highlights and the challenges of your shift. If they are in the medical field, they will understand your language. If not, they can help you look at things from a different perspective. Win-win!
2. They will be more understanding if you need to beg off from some household chores. During my difficult days, my husband usually asks me what I want to eat and he’ll cook that for me. Yes, I am lucky! That much I know.
3. They can divert your attention to other things: an A paper of your child, the first blooms of tulips in your garden, or a new trick your dog learned for the day.
4. They can verbally give you permission to “just enjoy your day off!” Sure, you don’t need to ask for that, but sometimes that verbal permission does something positive in a person’s psyche.
5. They can remind you to schedule a wellness check with your doctor. They will hold your hand through a lab test or through verbalizing your concerns to a mental health professional perhaps.

A supportive work environment also matters a lot. This means working with a great team and also in safe and supportive work culture.

1. Working as part of a team, you can collectively identify each other’s strengths and weaknesses. That helps a lot in assigning patient load, for example.
2. Importance of debriefing especially during difficult and uncommon cases: CPR or code situations, an unanticipated patient’s death, etc.
3. Availability of Zen Rooms. Some organizations have Zen rooms wherein nurses can chill during their break times. Those may have essential oils, faux candles, light dimmers, soft music, etc.
4. Mental health services. Some institutions provide employee mental health assistance. Just like any electronic health record, those services are strictly confidential. Those sessions cannot be divulged to the workplace without the employee’s expressed consent.
5. Mandatory breaks in between shifts. Organizations, for example, should not allow nurses to work for more than 16 hours in a shift or three days in a row of 12-hour shifts.

Mental Health Matters

Taking care of our mental health is of utmost importance. We should safeguard it as much as we take care of our physical health. While we have perfected being mental health advocates for our patients and clients, we should start doing the same for ourselves.

What about you? What are the ways that you address your mental health needs?