Why Self-Care is so important.
A personal story, please be kind.
One inevitable thing we all must address… is death. As soon as we are born, we are dying. Although part of the normal sequence of life, death encompasses grief, and grief is uncomfortable, so naturally death at times is avoided in general conversations. This can create fear surrounding the process. As Nurses’, we go through intense vigorous training and do everything possible to prevent death and clinical deterioration in our patients. And when the time comes, to facilitate a peaceful and dying process. Through when I walk onto a shift to take a person and their family through the experience (sometimes who I have never met) there is not much that can prepare me for what is coming.
I presume I am speaking on behalf of my profession when I say that if my patient is comfortable, surrounded by their loved ones, and has their wishes met, that it’s a good day. When they are cared for with dignity and respect, I have done my job and can rest my head easy at night.
But sometimes we are not so lucky. One night I found myself among my team in a horrendous prolonged arrest situation, where the patient died.
And by my definition it wasn’t dignified.
It was organised, but not peaceful. It was prolonged but not effective. We pulled in every resource and ended with a poor result for a young man. There was no way we could have prevented this situation. Though it was still one of the most unpleasant experiences of my life.
I was standing over this man when his wife walked in. The poor woman’s scream is something I can still feel.
I can only describe it as been punched in the chest, having her heart ripped out and slashed apart in front of her, and then someone stomping on the remaining pieces.
And so, resting my head at night suddenly become difficult.
Generally speaking, nurses are notoriously altruistic. They give and give and give until everybody else is accounted for, though it may come at a price. Health care workers (nurses) possess empathy, meaning we feel what our patients are feeling. We are compassionate, meaning we will habitually do whatever we can to relieve others suffering. Whether it be emotional, physical or mental.
After that experience, I had what they call a ‘normal reaction to an adverse event’ and would explain why I was no longer coping. It was also attributed to a combination of multiple deaths over a short space of time which made it so difficult for me to deal with.
The accumulated stress significantly outweighed the resilience I had at the time, and I had to ask for help. Professional help. And I am so glad I did. I found out my extremely low mood was ‘normal’ as well as the unexpected intense waves of grief which came over me, where I had no choice but to stop what I was doing, and breathe through each emotion as they eventually passed.
And for a short while, I couldn’t bear the thought of going to work ever again.
If my resilience and ability to cope was a pendulum, it did not stand a chance from the emotional stress I endured.
Motivated by my ambition to prevent my career from sabotaging my personal life, it became my mission to draw meaning and equanimity from the experience.
I have a long list of healthy coping strategies that I acquired over the years. I learnt to channel and release my anger and frustration through exercise. I learnt ways to express my feelings through creative outlets. I learnt that being kind to yourself is paramount. I sought out particular people to talk to, who could hold a conversation about life and death, and I learnt how to talk about it.
To me, ICU Nursing is like a heightened emotional profession. Along with the lows, come the highs. The ICU team work relentlessly to acquire skills and provide a service. Regardless of race, gender, sex, wealth or age everyone is equal and receives the best possible care. We not only save lives but provide comfort and reassurance that everything possible is done regardless of the outcome. And it is extremely unique in this day and age and personally satisfying.
Although that experience shook me to my core, there are many others whose suffering is relieved. I found satisfaction from slowing down and engaging more with my patients. By rushing and talking less, and listening and asking questions more. By helping them out the door and on their way again.
By practicing my self-care strategies, slowly my stress and resilience pendulum came back into balance and my ability to cope was restored. I am proud I had the courage to say I was not ok. I am even more grateful for the help and support that I received.
If I could go back now and give myself any advice it would be:
1. Check in with yourself. Ask yourself how you are feeling and how you are coping. A good measure of this is “How much do you have to give today?”
2. Create opportunities to practice mindfulness in your daily activities. This may be creating a playlist for your commute to work, taking some nice deep breaths in line at the post office. Connecting with others instead of withdrawing. And…
3. Restore your own pendulum. I learnt that nobody will even notice when you are out of balance if you hide it well and don’t speak up. It is your responsibility to show up as your best self. So practice your self-care practices not only to help yourself feel good, but so you can then go and be of best service to others.