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Quality Patient Care Starts with Enlightened Self Care

Self-care

Caring for others comes more naturally to healthcare practitioners than caring for themselves. That’s why in recent years systematic self-care programs have become an intrinsic part of quality patient care.

In a high-stakes, high-tech, high-cost profession practiced within a highly regulated and tightly monitored work environment, job stressors can take a toll. Even on the most dedicated and compassionate healthcare provider. Finding work/life balance has never been more challenging – or critical to the well-being of patients and workers. Despite a greater awareness of the need for self-care, recent studies show that nearly half of physicians are experiencing burnout.1 And nurses and other care team members are in the same rocky boat when it comes to work stress.2

Self Care Education

Two new programs shed light on the need for self-care and provide direction for those organizations seeking to implement strategies in the healthcare workplace.

Seven Steps to Well-being for Healthcare Organizations

In May 2019, The American Physician Alliance and American Hospital Association introduced a new publication that offers perspective and practical organizational recommendations on self-care.

According to the Well-Being Playbook: A Guide for Health System Leaders, “Hospital and health system leadership must believe in the importance of clinician well-being and commit to making it a strategic imperative.”3

The playbook recommends seven steps to accomplish these goals.3

  1. Create Infrastructure for Well-Being. This starts at the top with CEO or CMO.

  2. Engage Your Team. Participation is needed from every department and at evert patient touchpoint.

  3. Measure Well-Being. Surveys are needed at least annually to gauge progress.

  4. Design Interventions. Quality improvements are needed in six key areas: input, recognition, quality, efficiency, resiliency, and community.

  5. Implement Pilots. Build buy-in to gain momentum for the larger wellness program.

  6. Evaluate Impact. Evaluate progress through outcome metrics.

  7. Create a Sustainable Culture. Celebrate wins and provide frequent updates to the team.

Learning to Support Nursing Self Care

Nurses are on the front lines of caregiving, where compassion is in almost constant demand. No wonder burnout has become so pervasive within the nursing profession.

To raise awareness of and provide coping strategies for organizations and individuals, new self-care education was presented at the 2019 AORN Surgical Conference and Expo in April.4 The program, entitled Finding Harmony by Practicing Self Care, provides nursing participants with continuing education credits. It was sponsored by Pfielder Enterprises and funded by Owens & Minor Halyard, Inc.

While specifically designed for the high-stress environment of perioperative nursing, the program offers solutions applicable to all nurses.

The goals of the program are5:

  • Identify stressors typically experienced

  • Explain the implications of stress

  • Describe self-care opportunities

  • Discuss resources available to build self-care skills

“When we’re under stress, we just don’t take the time for self-care,” says Kathleen Stoessel, MS, BSN, RN. “Self-care should be part and parcel of protecting your own health – both physical and mental – so you can help others with theirs,” adds Stoessel, who presented the training for Halyard at the AORN event.

Types of Stress

A recent study by Natalie Johnson6 breaks down stress into three types: Normal, Training and Excessive. She suggests that these first two can actually promote resilience and personal growth, while the latter can lead to negative effects that self-care programs strive to address.

The challenges of the perioperative care setting are present across many medical specialties, including:

  • Acute patients, high risk

  • Critical care environment

  • Generational differences

  • Stress from uncivility and bullying

  • Pressures for productivity and high volume

When self-care isn’t emphasized at the system level, negative effects can permeate the healthcare workplace, building on the stresses individuals experience and creating ineffective and unpleasant collaboration. When individual and collective stress leads to ineffective collaboration in perioperative care, patient errors are also more likely to occur.7,8

Four key stress-reduction strategies

Here are a few simple ways to start reducing your stress:

  1. Practice micro-recovery – select tasks like deep breathing that take only a minute or two to implement while working. 6

  2. Get moving and eat healthy – follow the American Heart Association’s recommendation of 150-minutes of moderate exercise per week.9

  3. Play outside-- take a moment to breathe in fresh air.10

  4. Stay social – strong relationships can buffer stress.10

In addition, personal safety and protection should also be an emphasis of any self-care program -- from handling sharps and lasers to using the appropriate personal protective equipment.

Finally, nurses (and others) should realize that “balance” fluctuates and finding and maintaining “harmony” is an ongoing task requiring flexibility. That starts with self-reflection to understand one’s excessive stressors and then implementing specific strategies that work for them. Here are some of the many resources available to help:


REFERENCES:

  1. Medscape National Physician Burnout, Depression and Suicide Report 2019, p 2. https://www.medscape.com/slideshow/2019-lifestyle-burnout-depression-6011056?faf=1#1
  2. Brown S, Whichello R, Price S ,) The Impact of Resiliency on Nurse Burnout: An Integrative Literature Review. MedSurg Nursing; Pitman Vol. 27, Iss. 6. (Nov/Dec 2018): 349 https://search.proquest.com/openview/230ba7e00a6e816d1361c3665365baae/1?cbl=30764&pq-origsite=gscholar
  3. American Hospital Association.(2019) Well-Being Playbook: A Guide for Hospital and Health System Leaders, May 2019. https://www.aha.org/system/files/media/file/2019/05/plf-well-being-playbook.pdf
  4. Stoessel, K Finding Harmony by Practicing Self Care, Continuing Education seminar, 2019 AORN Conference and Expo
  5. Ibid.
  6. Johnson, N. “Make Your Stress Benefit You” Periop Today Newsletter, Nov. 14, 2018. https://www.aorn.org/about-aorn/aorn-newsroom/periop-today-newsletter/2018/2018-articles/make-your-stress-benefit-you?utm_source=Email&utm_medium=Newsletter&utm_content=11_14_18&utm _campaign=Periop_Today/. Original article not currently available to the public online.
  7. Gollwitzer PM, Doris Mayer D, Frick C, Oettingen G. Promoting the self-regulation of stress in healthcare providers: An internet-based intervention front. Psychol. 15 June 2018 DOI: 10.3389/fpsyg.2018.00838. file:///C:/Users/mcboy/Downloads/Promoting_the_Self-Regulation_of_Stress_in_Health_.pdf
  8. Brennan PA, Mitchell DA, Holmes S, Plint S, Parry D. Good people who try their best can have problems: recognition of human factors and how to minimize error. Br J Oral Maxillofac Surg. 2016;54(1):3-7.
  9. American Heart Association. How to Help Prevent Heart Disease at Any Age. https://www.heart.org/en/healthy-living/healthy-lifestyle/how-to-help-prevent-heart-disease-at-any-age Accessed February 5, 2019
  10. Grohol JM. Be Like Nature: Bend and Be Resilient, https://psychcentral.com/blog/be-like-nature-bend-be-resilient/. Accessed February 5, 2019.