Leaders Need to Walk the Talk When It Comes to Self-Care, Too

September 17, 2019 by Joni Watson DNP, MBA, RN, OCN®

How are you taking care of yourself? It’s a question I’ve asked many team members, including leaders I have had the privilege of serving, over the course of my career.

I’ve even added this question into certain candidate interviews to assess resiliency in individuals. And of course I ask it of myself often. That’s because it is my professional responsibility to ensure I am caring for myself (https://www.nursingworld.org/practice-policy/hnhn). Provision 5 of the Code of Ethics for Nurses (https://www.nursingworld.org/coe-view-only) says, “The nurse owes the same duties to self as to others, including the responsibility to promote health and safety.” 

What Research Tells Us

The evidence specific to nurse leaders’ self-care is sparse, but the body of knowledge for nursing self-care and burnout prevention is growing. Mindfulness-based stress reduction (https://doi.org/10.1097/01.NURSE.0000558105.96903.af), which is a combination of interventions such as nonjudgmental presence and awareness of in-the-moment stressors, emotions, and body language; breathing; and simple yoga techniques, has shown benefits. Practices linked to developing resiliency (https://doi.org/10.1097/NAQ.0000000000000101) such as intentionality, accountability, maintaining positivity, and reflection are also evidence-based interventions (https://doi.org/10.1097/NAQ.0000000000000087) for nurse leaders.   

How to Practice

Here are some of the ways I have cultivated self-care for my nurse leader soul.

Remember gratitude: I began keeping a gratitude journal in high school. Early on, it was a physical journal for myself in which I chronicled the five things I was grateful for that day. The year before my wedding, I wrote gratitude journals to both of my parents, expressing one thing I was thankful for about them each day, and I gifted this to them before I walked down the aisle. 

Gratitude is a part of who I am, and it helps reframe my focus. I carry thank-you notes with me every day, I plan time each week to write thank-you notes to patients or team members, and I build in gratitude practices for my teams like “hearty thanks” in February and “thankful trees” in November. During pharmacy or lab appreciation week, I have thank-you notes team members can grab and send to those departments. I smile every time I write a note of thanks, which feels good. If I’m stressed, I pause and write someone a thank-you note; it absolutely changes my mood.  

Reflect on your practice: I spend a good amount of time reflecting, and I thank my BSN program at the University of Texas at Arlington for including reflective journaling in almost every class. It taught me to reflect on my clinical experiences and critically think through my emotions and responses. 

I still journal my negative experiences to this day. Sometimes they’re just scribbles, phrases, and short descriptions of scenarios with how I felt and what I did—and what I wished I didn’t do—and strategies to help with that in the future. I’ve journaled less over time as I’ve implemented strategies and learned my emotional triggers. Reflection also helps me identify what spurs joy in me throughout the work day and what drains my soul at work.  

Build joy into your work and life: It’s not always possible to love literally everything about work, but I do believe work can be full of soul-refreshing moments. Only through reflection and knowing yourself can you identify the pieces of work that bring you joy. Throughout the day, write down when you are happiest at work. And then do more of that. 

For example, I love rounding on team members and talking with them one-on-one. I love recognizing great work. I build time in my work week to do those things, and it refreshes my soul. At home, I love staying inside, reading, and writing, so I am intentional in doing those things as often as possible. 

Respect your boundaries: I love people, but I am an introvert; I need time alone to recharge so I can love the people around me. I am comfortable alone, and I know that if I don’t get time by myself, I will not feel refreshed. I also am still practicing staying off the “road to Abilene,” a business metaphor for when people do things they don’t really want to do. Yes, I compromise with my family and friends, but if I need time to care for myself, I might decline the plans you propose. You might do the same to me. And that’s okay. 

Ensuring we care for ourselves as nurse leaders while we have the privilege of caring for the people who care for our patients is vital. We must role model the way for our frontline nurse leaders, letting the evidence guide us and continuing to research interventions specific to nurse leaders. 


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