BLOG: To Care for Others, Nurses Must First Care for Themselves

The following is a blog by Janie Heath, dean of the University of Kentucky College of Nursing; Connie Jennings, director of the UK HealthCare Integrative Medicine and Health Clinic; and Colleen Swartz, chief nurse executive/chief administrative officer for UK HealthCare.

Stress and the intense pressure of finishing a degree have driven promising students away from the nursing profession. For others committed to a career caring for the sick and injured, unmanaged stress, anxiety and depression have resulted in the tragedy of suicide.

Across the nation, we are experiencing a shortage of nurses. While some choose to leave the career to preserve their psychological well-being, others succumb to the psychological distress that comes with a demanding and psychologically distressing career.

The problem pervades every level of the nursing profession – from the students struggling to matriculate through a rigorous academic program to the seasoned professionals who witness heartbreak on a daily basis. To take care of the most vulnerable in our society, we must first attend to our own mental and emotional well-being.

In our colleges and universities, we are seeing more nursing students enter programs of study on more mental health medications than ever before. Nursing students, as well as other health professionals, are destined for stress.

Whether in the classroom, in simulated labs, in health care settings where they will one day be employed or in the heat of studying for licensure board exams, we hear about these silent sufferers from faculty members, friends and colleagues at universities across the nation. This calls attention to the need for the nursing profession to take collective action against mental illness.

National research polls only corroborate the consequences of neglecting our mental and emotional well-being. While Gallup Polls consistently rate nursing as the “most trusted” profession, that trust comes at the cost of a vulnerability to stress, burnout and depression. At 4.2 million strong, the nursing profession is the largest health care workforce.

But across the nation, the nursing profession is experiencing an 8 percent vacancy in registered nursing positions and 16 percent turnover rate in registered nurses. In Kentucky, the rates are even higher.

This year the National Academies of Medicine (NAM) released a call to action to the nursing profession to break the silence about struggles with stress, anxiety, addiction and suicide.

At the University of Kentucky College of Nursing, we are making the mental health of our most precious resource — our people — as the top priority. We are initiating such programs as the Cultivating Practices for Resiliency (CPR) Room in the UK College of Nursing where faculty, staff and students can attend activities for self-stewardship and renewal of their mind and body.

In addition, we are renovating a 2,400 square-foot facility for the UK HealthCare Integrative Medicine and Health Clinic, which will provide restorative services for employees and patients on site.

Instead of waiting to get home to de-stress, our facilities provide outlets for healing and mental wellness throughout the workday.

For nurses who struggle with mental health and addiction disorders, recovery programs available through the Kentucky State Board of Nursing offer support and second chances for nurses to re-enter the nursing workforce.

The message is clear: if our national health care system is defined by sicker, older, more complicated cases, nurses must build resiliency through self-care. We must incorporate venues in the workplace that invite employees to practice skills that reduce burnout and build resiliency.

Moral distress and mental health suffering can be countered through preventive measures:

• Engage in mindful practices. Learning skills to pay attention to the present moment without judgment and in service of self-understanding and wisdom.
• Engage with moral ethics. Learning skills to build confidence in one’s ability to establish or re-establish a moral value or standard and preserve integrity.
• Engage with moral courage. Learning skills to stay emotionally balanced, to befriend fear or uncertainty, and to stand up for individual/collective values and principles.
• Engage with self-stewardship. Learning skills to know oneself and compassionately respond to individual/collective limits and choose healthy and wholesome behaviors.

If you are a nursing or health profession student or nursing professional in the midst of a struggle, please know your colleagues want to listen, care for you and get you the help you need. You are surrounded by the most caring professionals in the health system – there is no shame or fault in letting someone know what’s really going on. 

Pain and suffering are a part of our lives. However, if we put hope in the middle of it to promote moral resilience and ethical practice in stressful learning and working environments, we might be able to prevent tragedy. With the proper tools, nurses, who epitomize caring for others, will lead the health care industry toward a place where caring for each other is the first step in healing.