Nurses: To care for others, we must FIRST care for ourselves (Part One)

By Kim Richards | 04/01/2013

Health is not only to be well, but to use well every power we have.
—Florence Nightingale, 1893
Kim Richards author imageWhen I woke this morning, my mind was already racing. Anticipating extensive travel for numerous speaking engagements, my head was filled with items on a very long “to do” list: Meet multiple deadlines, return e-mails, follow up phone calls, check on this, check on that, complete household chores, get groceries, drop off dry cleaning, repair car, get dog groomed, pay bills, get hair cut and nails manicured, pack for the next business trip, perfect PowerPoint presentation. Oh, and take time to care for myself.
Whew, I’m exhausted, overwhelmed and overworked already, and it’s only 6:30 a.m!
Who hasn’t wanted to simply crawl back in bed, pull the covers up and call in “fried”? For the majority of us, that is not a realistic option, yet the urgency one feels upon waking up, already behind schedule, is an immediate energy sucker that sends cortisol surging through our bodies. This adrenal overload keeps us in a constant state of fight or flight, a dangerous state, and one to be avoided.
Without thinking twice, I put my sneakers on and, walking my effusively loving Goldens to the park where they love to play, intentionally took in the spirit-lifting ingredients that contribute to a “Rocky Mountain High”—snow-capped mountains, blue skies, lung-bursting air infused with fragrant smells and the sound of Colorado aspens blowing in the breeze. When I returned home, energized for my day, I scheduled a massage for late afternoon.
If your day had started out with a “to do” list like mine, would taking your dogs for a walk and scheduling a relaxing massage sound irresponsible and selfish to you?
A few stats
Consider the following sobering statistics reported in 2010 by the Robert Wood Johnson Foundation: 
  • Chronic diseases are responsible for 84 percent of all health care costs.
  • In 2009, 145 million people—almost half the U.S. population—had a chronic condition.
  • Approximately 67 percent of the workforce is overweight or obese and, in recent years, there has been a 36 percent hike in health care spending associated with obesity (Archer, 2012, p. 41).
No matter how the rising costs of insurance premiums are reallocated, employees and employers share a growing incentive: to improve their health to reduce their exposure to crushing medical expenses. “I call it the one-two punch of healthy living,” says Steven G. Aldana, PhD, chief executive officer of WellSteps Inc. in Salt Lake City, Utah, USA. “One: It’s your money. Two: You have every reason to improve your health. You pay for who you are, now or later.”
You see, taking “me time” is the only way I can stay steady, focused, organized and energized. My morning’s escape to the outdoors fed my soul and served as an intervention, snapping me out of the spiral of “lack.” Lack is defined in the dictionary as absence (noun) deficiency (noun) shortage (noun) and need (verb). The pace and pressure of my much-loved career can take a toll on my resilience, leaving me irritable, impatient and unattractively imploded.
Going with the flow
Over the years, I have found that solitude—in any form—is a catalyst for achieving optimal performance, enabling me to make headway on the tasks that are the most challenging. This self-care practice creates a flow for my day. It’s easy to devalue the importance of flow, or to blow it off as a luxurious diversion that maybe others can afford, but not me. For me, it’s essential. Creating a flow, a rhythm, a self-nurturing routine for my day makes me feel more empowered, invigorated and resilient, should chaos erupt. I find that, by developing and maintaining a flow, I become a better steward of the thoughts I allow to inhabit my mind.
You see, taking “me time” is the only way I can stay steady, focused, organized and energized.

My journey to becoming an integrative health coach has helped hone this self-care tool of mindfulness, which is described as a state of active, open attention on the present. When you’re mindful, you observe your thoughts and feelings from a distance, without judging them as good or bad. Through mindfulness, you learn to live in the moment and awaken to experience, instead of letting life pass you by.
Mindfulness practice, even as short as two weeks, has been shown to create changes in the brain. Rick Hanson, PhD, neuropsychologist and coauthor of Buddha’s Brain: The Practical Neuroscience of Happiness, Love, and Wisdom (2009), states: “There’s an expression in neuroscience: Neurons that fire together wire together. That means that new patterns of thought can actually change the physiology of our brains. So while we can’t ignore bad news, we can train our brains to become more alert to good information. When you notice a positive detail in yourself or someone else, or in your environment, try savoring it for at least ten seconds. Most of these observations will be as simple as ‘the sun is shining’ or ‘this coffee tastes good,’ but do this a handful of times each day, and you’ll feel an emotional shift.”
While I have found an emotional shift through solitude, spending time in nature, watching my dogs play, physical exercise, laughter and massage, these activities are but a few of the “tools” I have gathered in my personal self-care toolkit. These tools are designed to help me sustain my self-care journey, and I encourage the clients I coach to create an individualized toolkit for improving wellness. Understanding the purpose for each is key to getting started on your own self-care journey.
Time to lead by example
For nurses, who are the most influential catalysts for health care reform in America, the time to emulate wellness has never been more critical. The clear and compelling IOM report, The Future of Nursing: Leading Change, Advancing Health, has provided a golden opportunity and a unique platform for nurses to lead by example. By creating healthy habits for ourselves, we flourish as ambassadors of self-care for our patients, families, colleagues and communities.
While nurses are encouraged by leaders such as Marla Weston, PhD, RN, chief executive officer of the American Nurses Association (ANA), whose vision for ANA’s upcoming Healthy Nurse Conference: Nurses as Models of Wellness in Action is an example of walking her talk, the widespread chronic disease and unwisely tolerated poor health habits of many nurses are a “black eye” within the profession. Yet, with internal and external motivation, practical tools and sustainable support, nursing has the power to heal itself.
Using an established framework of self-care practice, here are some tools I use. As a certified integrative nurse coach, I also recommend these tools to my health-coaching clients. Perhaps, they will resonate with you.
Kim Richards, RN, INC, CYI, founder and owner of Self-Care Academy and president of Kim Richards & Associates, Inc., is a certified integrative nurse coach and yoga instructor.
Archer, S. (2012, May). Health is wealth: The rise of workplace wellness. Idea Fitness Journal. Retrieved from
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