Nurses’ Self-Care as Part of an Organizational Vision for Patient Safety

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ContemporaryBalletLeapThe Joint Commission has been advocating for assertiveness training for nurses since the turn of the century when speaking up about concerns and psychological safety became spotlight issues for patient safety.   What ‘we’ didn’t do, IMHO is ensure that training, role-modeling, and organizational support include being assertive for one’s self as well as one’s patients!  After all, self-care requires self-awareness, self-respect, asking for help, setting limits AND Click To Tweetit is not a huge leap to see how these same elements are important for patient safety.

This one statement; “Can you get Mrs. Jones pain medication, I’m having problems with Mr. Smith’s blood transfusion and haven’t had lunch” demonstrates all of them.  Or this; “I need a few minutes to collect myself after that patient’s boyfriend threatened me” or  this probably controversial one; “I’m too tired to work overtime safely.”

Maybe there are leaders who worry that nurses saying “No” to overtime or taking on additional patients when already overwhelmed will create an avalanche of nurse limit-setting that will lead to staffing troubles or raise issues about workplace violence and the need for addressing security.  And yes, some nurse colleagues will complain that nurses who set limits don’t have the kind of work ethic necessary to be a ‘good nurse’ or think that because they worked overtime or took on more patients despite feeling overwhelmed so should others.

These are problems or concerns that should be addressed and effective communication and leadership are will help provide clear expectations,  address patterns of behavior, and validate nurses who have perhaps sacrificed their own health chronically and suffer from burnout.  (If you a nurse leader who is reluctant to address any of these issues because of communication or culture issues email me, and I’ll give you a really good deal on some quick, short-term coaching to help!)

For healthcare organizations that have a vision/mission statement something like this:

Safe, compassionate care is our primary goal.  

The following language might be helpful in promoting self-care for staff:

ABC hospital expects each staff member to speak up about ideas, barriers, and concerns you have in meeting this goal.  This includes taking care of yourself so that you are rested, alert, and in good physical, emotional, and spiritual health when you come to work and letting your manager know how we can help!

Along with ideas and action steps like these (and all sorts of co-creative ones that you will come up with):

– Quarterly workshops on self-care techniques like mindfulness,  Reiki, resilience,  or yoga.  There are plenty of nurse leaders who will come and share expertise on these topics e.g. Elizabeth Scala,  Cynthia Howard, and Annette Tersigni.   (If you offer self-care services for healthcare professionals please feel free to post a link in the comment section!)

– Leadership training that focuses on helping managers coach staff to set limits, ask for help, delegate, and respect each others’ limits. This online course I teach for Pedagogy Online Learning Systems can help leaders and staff with these skills, includes 2 CEUs and is only $20!

– Find out what ideas your Employee Assistant Program (EAP) or Risk Management resources have on preventing and treating burnout!

– Maybe some of your staff are learning and/or practicing a new physical activity they’d be willing to lead!  Walking as a group could become a once-a-month activity that the organization could promote in a newsletter and some healthy beverages.  Maybe the local health food store would like to help with a basket of goodies that could be part of a raffle involving regular participants.  Robert Woods Johnson Foundation is promoting a “Culture of Health” and there are endless possibilities for bridging staff with community efforts as we begin to focus on the value self-care!

– Try out a medical improv session with me or Stephanie Frederick for fun, team-building, and soft skill development! 

– Encourage staff to plan a fun and affordable vacation by passing along this post by Nurse Entrepreneur Marsha Ann Battee!  (a Greek Island on $30/day anyone?)  Or maybe even contact her and see if she’ll come and speak to your staff about the topic!

– Print out and post or email any of the articles on this months blog carnival to share with your staff because they are ALL about Self-care!

blog carnivalNurses have long been associated with and focused on preventative health measures and now we have many role models to focus on our own health too.  Organizations can be part of the new wave!  Please feel free to share your current efforts and new ideas here!

This post is part of a Blog Carnival on the topic, Self-care for Nurses!

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19 Responses to Nurses’ Self-Care as Part of an Organizational Vision for Patient Safety

  1. Jackie Levin says:

    Hi Beth, Excellent post! Thanks. I also took at look at your improv video. Seeing/hearing “yes, but..” and “yes, and…” played out got a real visceral response from me. Well done. I’m both a Nurse Coach and a Patient Advocate at my hospital and see everyday how stress impacts how people listen and speak, causing so much more unnecessary suffering. I’m on a personal mission to #end-stress in health care.

    I appreciate your invitation to share what I’m offering. It’s a 7-week online program called Room to Breathe: Rewiring for Ease. The tagline is “Sweet Relief from the Frazzle.” You and others can check it out here.

    Thanks again, for your great work.

  2. allewellyn says:

    great examples Beth….thanks for sharing.

  3. Beth. I absolutely agree with you.
    Nurses need to be more assertive and confident enough to say No without feeling they will be penalized. Overwork only takes away balance from nurses. Great post!

  4. John Keith says:

    Beth, awesome post! As a healthcare worker I think we are sometimes afraid to speak up about our concerns. No one wants to stand out or not be seen as a team player. Nurses are way too often expected to do their jobs in conditions that are unsafe to their patients and themselves. Thank you for such a great post.

    • Beth_Boynton_RN_MS says:

      Thanks, John. I hear you and so agree. Fear of repercussions or lack of response to concerns over time are both key reasons that nurses might hold back. Leaders need to be training in listening and being responsive to nurses speaking up. Without this, we’re missing a crucial puzzle piece in solving communication, human factors, and leadership issues. I bet you’d like this piece:

      If we look deep enough we can see how the very nature of this rule can be blaming and promote a toxic culture. YIKES!

  5. Gregmercer601 says:

    Great ideas, thanks! I’ve found that JCAHO mandates interventions to address even trivial risks rather freely. That they only suggest an intervention suggests to me that it’s a low priority fo them, and/or that client hospitals resist the idea strenously.

    • Beth_Boynton_RN_MS says:

      Yeah, I hear you, Greg. A suggestion without clear expectations and consequences may have little impact unless an organization truly wants to be supportive. That’s one of the things I think is hopeful in Magnet Hospitals although I don’t have first hand experience.

  6. Kelly Payne says:

    Beth thanks! I love the idea of Leadership training that focuses on helping managers coach staff to set limits, ask for help, delegate, and respect each others’ limits. I will pass this on to my leadership team.

  7. eileen spillane says:

    Beth, great post. I really appreciate the specific examples you provided. It is helpful for nurses to remember that JCAHO actually supports nurses in this way.

    • Beth_Boynton_RN_MS says:

      I agree, Eileen. Now if we can get them to understand how complicated assertiveness is and how vital it is to promote nurses to be assertive for themselves and each other, (I need more training and practice in this procedure”, “Please stop talking about Mary behind her back”, respectively) in addition to patients we will make huge strides in patient safety, patient experience, and job satisfaction.

  8. Elizabeth Scala says:

    Great examples of how to phrase the statements. I find that when we clearly articulate our needs, we increase our chances to really be heard. I went to a training this past weekend and one of the speakers presented on difficult conversations and how to frame questions before we ask. Similar to your examples above, it was all about clarity. Great post. And thanks for the shout-out and recommendation to check out my meditation audios!

    • Beth_Boynton_RN_MS says:

      Thanks, Elizabeth and great point. When we speak up respectfully and clearly we are helping others learn to listen, just as when we listen respectfully we are teaching others to be assertive!

  9. Donna Carol Maheady says:

    So many great ideas Beth!
    I would add… if you have a massage therapy program in your area….invite massage students to give nurses neck massages at work.
    When a group of new nursing students arrive, ask them if they have any talents (pilates instructors, massage therapists, yoga instructors; or students who love to cook or play an instrument). Invite nursing students to share their gifts and talents….What a great way to say….”students matter”…and benefit nursing staff ….win-win!

    • Beth_Boynton_RN_MS says:

      What great suggestions, Donna! Think about the rippling effects of helping each other and being encouraged to share a talent/practice that you love doing! I love it! Everyone wins!

  10. What an insightful and generous post Beth!!! Great action steps that are all realistic. I’m grateful to state that our YogaNursing protocol for self-care for nurses is now being implemented at the Mayo Clinic in their nurse wellness initiative in a one year program with a study attached, plus major nursing colleges are offering our weekend trainings as continuing ed for seasoned nurses, who also get 10 CEs tied into the self-care. As you say, our self-care impacts patient outcomes and satisfaction, so more and more organizations are bringing self care into the workplace.

    • Beth_Boynton_RN_MS says:

      I am very excited about your progressive and effective work, Annette. Truly important pioneering steps! How exciting to the Mayo Clinic implementing YogaNursing!

      Congratulations and best of luck with your programming!

      I see much valuable learning for me in my efforts to promote ‘Medical Improv’ and will be taking a closer look at your materials and story soon.

  11. Pingback: Nurse Blog Carnival Self Care for Nurses - Marsha Battee

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