Expert Advice for Nurses’ Mental Health and Self-Care
Reviewed by Abbie Jacobs, RN, BSN
As a nurse, you dedicate your life and work to caring for others, but too often, you might forget to care for yourself along the way. You take pride in carrying the burden without complaint, but the intense stresses of the job make it even more important to step back and make sure your own needs are being met. Here at BestNursingDegree.com, we know that the best nurses are those who value and prioritize their own well-being—and that doing so is a selfless act.
We talked to some leading experts and nurses who walk every day in your shoes and came up with some tips to help you nurture your mind, body, and career.
How Nurses Can Maintain Mental Health
You might think mental wellness is a luxury that you, as a nurse, don’t have time to indulge in. After all, the job is among the most demanding on earth. The truth, however, is that when it comes to mental health, a little can go a long way.
Develop a healthy grieving process
Dr. Wayne M. Sotile is the founder of the Sotile Center for Resilience and the Center for Physician Resilience in Davidson, North Carolina. He’s the author or co-author of nine books, including “Thriving in Healthcare: A Positive Approach to Reclaim Balance and Avoid Burnout in Your Busy Life,” which was co-written with Dr. Gary R. Simonds.
He believes that managing the grief that is intrinsic to the field of nursing is one of the most essential aspects of caregiver wellness and that one of the best ways to manage it is to view each loss as an opportunity to reflect, develop new skills, and better relationships.
“Almost every negative occurrence in our days comes with opportunities to learn, to grow, to improve our performance, to develop stronger relationships with our patients and coworkers,” Sotile says. “[Nurses] who see them as opportunities to improve and grow will improve and grow. Every terrible thing that befalls a patient is a reminder of just how lucky we are, how nothing should be taken for granted, and how it is most worthwhile to not only count our blessings but to savor them and celebrate them.”
Don’t forget to laugh
According to DailyNurse, nurses who can find levity in times of stress “are more emotionally flexible, and can bend without breaking amidst the difficult situations.” The phrase “laughter is the best medicine” is a cliché for good reason. Study after study has shown that laughter can increase happiness, relieve pain, and even boost physical immunity.
Find and create downtime
Dr. Gary R. Simonds is a clinical and academic neurosurgeon and a university professor who recently retired as the chief of neurosurgery and residency program director at Carilion Clinic-Virginia Tech Carilion School of Medicine. He co-authored Thriving in Healthcare with Dr. Sotile and is considered an expert in work/life balance for health professionals.
“Nurses give everything of themselves to their patients,” he says. “They forget, however, to leave a little of their concern and compassion for themselves. The problem is, the more they neglect themselves, the less effective they become in caring for others.”
One of the keys, he believes, is recharging by building downtime into your schedule—both at work and at home.
“Take short sanity breaks multiple times through your day,” he says. “Moments of calm, positive interaction, light, fresh air, connection, meditation, and escape. Plan a vacation, even if it’s nine months away. Call a long-lost friend. Make a date to hang out with close relationships—and don’t talk about work. Start or rekindle a hobby. Get out to a play or musical event.”
Nursing is a stressful job. That can’t be avoided, but it can be managed. Although it’s not easy to do, Dr. Simonds suggests that as a nurse, you should focus on the good instead of the bad.
“We tend to recount the horrors of our days with our coworkers on breaks or if we get together out of work,” he says. “Try instead to recall and recount the good stuff—the happy moments, the pleasant surprises, the funny, joyful interactions, the precious patients.”
If you can bring this mindset home with you, you’ll fare even better.
“We wake up in the middle of the night and tend to ruminate on something that has gone poorly—a mistake, a bad interaction, a patient’s illness turning sour—and we run over it again and again,” Simonds says. “Next time this happens, replay the day and recall the bright spots, the highlights of the day.”
Disconnect and do something face-to-face on days off
Kristen Snider is a forensic nurse working in a Virginia emergency department, providing care to survivals of sexual assault and domestic violence. She also serves on the board of directors for the Virginia chapter of the International Association of Forensic Nurses.
“Disconnecting and having face-to-face time can be the most important thing you do for your mental health,” she says. “Social media often turns into an echo chamber that emphasizes the stressful, negative parts of nursing and causes you to lose sight of why nursing is such a special profession. Not doing things you enjoy will quickly lead to fatigue and burnout.”
Snider acknowledges that the “organized chaos” of nursing can be exciting and exhilarating, but without a way to organize your workflow, you may not be at your best.
“Many nurses use individualized forms that keep each patient’s information right at their fingertips,” she says. “You can keep track of whatever is important in your specialty, from diagnoses to IV lines to lab values. Using a systematic approach will also allow for an easy handoff report at the end of the shift— something your colleagues will appreciate.”
But the importance of staying organized doesn’t stop at the workplace.
“Staying organized at home will also help decrease stress levels because you won’t be as frazzled while you’re at work,” Snider says.
Prioritize your sleep schedule
There’s a common misconception among healthcare professionals that working while you’re sleep deprived is somehow noble or stoic. The truth is, it’s a terrible idea both for you and your patients. According to the National Institutes of Health, there’s a direct connection between sufficient, quality sleep and healthy brain function, physical health, emotional well-being, and, most critically for nurses and those in their care, daytime safety, and performance.
The advice of Doctors Sotile and Simonds is all about making small, doable changes. They recommend setting a goal to get to bed 30 minutes earlier every night for a month. The next month, move it up another 30 minutes and continue until you’re getting a full, uninterrupted seven to eight hours of sleep per night.
Cat Golden, BSN, is a pediatric nurse, formerly at Children’s Hospital Colorado and now at Children’s Hospital of Michigan. She founded Nine Lives Health and Mind, an online community for nurses and the home of the #NursesInspireNurses movement, which includes regular coffee meetups for nurses seeking stronger work/life balances. She believes that counseling can be one of the most important things for you to make time for as a busy nurse. And help might be right there at your workplace.
“Many hospital systems actually have programs to assist nurses in paying for therapy,” says Golden, who took advantage of one such program early in her career when she was going through a difficult time. She compares nurses to campfires that provide light, warmth, comfort, and cooked food.
“What happens if we don’t stoke the flame or feed the fire? The fire goes out,” she says. “It’s the same with us as human beings first, nurses second. If we don’t nurture ourselves—and therapy is one example of this—we will burn out.”
Focusing on Nurses’ Physical Well-Being
Because of the stress of your job and the fact that a nurse’s workplace can be especially hazardous, you have to pay extra-close attention to your physical health.
Be fanatical about hand-washing
According to the Centers for Disease Control (CDC), healthcare providers wash and sanitize their hands about half as often as they should, which could be up to 100 times per 12-hour shift. Hand hygiene is the best way to prevent the spread of infection, both to yourself and to your patients. This includes using hand sanitizer to supplement—but never to replace—a strict hand-washing regimen. Visit the CDC’s “Clean Hands Count for Healthcare” campaign for more information.
Dehydration can lead to dizziness, headaches, constipation, and an inability to concentrate. Getting enough to drink, on the other hand, can boost your energy, mood, and concentration. Although 64 ounces, or eight full glasses of water, a day is the historical norm, nurses might need more because of the physical and mental rigors of the job. Drinking during breaks is seldom enough. Healthy Nurse Healthy Nation offers tips, including timing water breaks to coincide with patient turnings and chewing on ice as you work.
Download a fitness app
You might consider investing in a wearable fitness device or downloading a free health-related app like Google Fit to tracks your steps, calories, and other vitals. Many Americans may encounter health problems due to a sedentary lifestyle. This is rarely the case with nurses, but counting steps is not the only benefit of a fitness app. You can use one to get an overall picture of your daily health, including your sleeping habits, eating patterns, and sedentary periods.
Eat well whenever you can
The connection between diet and wellness is well documented, but eating healthy is one of the many things you might frequently sacrifice to the altar of your work. Doctors Sotile and Simonds recommend shopping once a week for healthy snacks, like nuts and fruit, and bringing them to work to avoid vending machine fare. They also ask nurses to cut down to three sodas a week—then two, then one—by opting instead for sparkling water or diluted fruit juice. You might also use your limited home-cooking time to cook large batches of healthy food, divide it into portion containers, and freeze them for easy access.
Wear a mask during peak flu season
The CDC recommends healthcare professionals wear surgical masks when within six feet of a confirmed or suspected flu patient. The truth, however, is that it might be wise to wear one all the time during peak flu season, as carriers—both patients and coworkers—can be contagious before they show symptoms.
Take your vitamins
According to Harvard Medical School, there’s little scientific evidence to prove or disprove the effectiveness of vitamins. Reliable studies that do exist, however, show that taking a multivitamin can be effective in promoting health among populations who aren’t getting sufficient vitamins through their diet, which is so often the case with nurses.
Squeeze in energizing workouts
It’s likely that the last thing you want to do after a long, hard shift is to work out—but that might just be the best way to boost your energy levels. Keep in mind, also, that micro-workouts during shifts can have the same effect on your energy levels. Doctors Sotile and Simonds recommend committing to 15-minute “bursts of exercise” during breaks a few times a week.
Personal and Professional Development for Nurses
Just keeping up with the demands of the day-to-day job is a challenge for nurses, but they can and should make sure they’re nurturing their lives and careers along the way.
Find a mentor
Golden founded the Leap Land Live mentorship program, which helps nurses find routine and stability in their work and lives through the all-important mentor/mentee relationship.
“I always tell my mentees, ‘Don’t take advice from someone you wouldn’t trade places with,’” she says. “This is always my filter for finding a mentor. People aren’t perfect and there are no magic pills, but you should at least feel confident that you would trade places with your mentor. You want to be where they’re going.”
If you do seek out a mentor, take the time to earn the relationship.
“Learning and knowledge are great, but the real lessons come when you take action,” Golden says. “If you don’t have time to implement and ask questions, it’s going to be hard to get the full value of what a good mentor has to offer.”
Periodically earning continuing education credits is mandatory for many nurses in order to keep their licenses in good standing, but ongoing learning doesn’t have to be a chore. You can prevent intellectual and career stagnancy by leaning on resources—including webinars, peer-to-peer networking opportunities, industry publications, and research—offered by organizations like the American Nurses Association, Medical Library Association, and Learning Nurse.
Slow down—don’t rush your care or day
Dr. Simonds acknowledges that opportunities for sanctioned breaks are often limited. You can slow your day down, however, by seeking out what he calls “humanity breaks.”
“Chat with an interesting patient about their interests, about your interests,” he says. “Find a quiet corner of a ward and sit, close your eyes, think of a favorite activity, think of a favorite place and go there for a minute, play a favorite song in your head. Or, take a peek at photos of your family. Or, find a window with a pleasant view and simply shut your mind off and take it in. If you have a few minutes of freedom, step outside, no matter the weather, and take in the fresh air. Find a colleague and discuss something—anything—unrelated to work.”
And when you do get an actual break, make it a real one.
“If you have a sanctioned break for a meal, don’t throw it down and fret about what you haven’t accomplished yet in your day,” Simonds says. “Sit, relax, breathe, enjoy your food, eat slowly, think about good things in your life and/or work. If you take a coffee break, take a coffee break—sit, savor the taste, defocus from the events of the day and enjoy that coffee.”
Address conflicts immediately
The nature and intensity of nursing make conflict inevitable, both with coworkers and patients.
“We have a caregiver’s heart,” Golden says. “This can make handling conflict very difficult. After working with hundreds of nurses I have found that a majority of nurses hesitate to speak up for themselves or say things that would make someone else uncomfortable. In order to be successful in the profession, we must speak up for ourselves and handle any conflicts immediately.”
Among her conflict-resolution tips, she says to:
- Always come from a place of understanding, not a know-it-all mentality.
- Find a common denominator, such as: “I know we both want what’s best for the patient. I would like to proceed this way…”
- Ask questions. Your conflict could simply be a result of a misunderstanding. For example: “I had a question about the last thing you said, do you mind providing some clarification?”
- Remember that high-stress environments can make it easy for people to say things they don’t mean. Ask if you can help or if someone is having a bad day and try not to take things personally.
Learn to leave work at work
For Snider, leaving the stress of work at work is one of the job’s most difficult—and most important—challenges.
“Nurses see people at their best and their worst and we experience things most people don’t understand,” she says. “If you take that home with you it will seep into all aspects of your life.”
She recommends “debriefing” before leaving work.
“Talking through a situation that was stressful, sad, or frustrating with people who also experienced it can be validating and help you process the events.”
Avoid constantly checking your work email at home, reading nothing but educational materials, or answering the phone whenever work calls.
“Setting healthy boundaries between work and home is necessary and not something to feel bad about,” Snider says.
Remember your purpose of being a nurse and your purpose in life
In their book, Doctors Solite and Simonds remind nurses to begin each day by thinking about the meaning of their work.
“So many people seek some sort of meaning and purpose in their lives,” Sotile says. “Nursing provides it hourly. Every interaction with a patient provides an opportunity to do good, to soothe, to comfort, to be compassionate, to care, to be a shining light, to create a sense of safety, to be a hero. We can do this to the point of not noticing, remembering, and celebrating all the good things that are happening around us. Patients are improving, diseases are being cured, pain is being alleviated, and sorrow is being soothed.”
As Sotile explains it, “Few people have the opportunity that a nurse has when they lay their head on their pillow at night to smile and know that they did good work, meaningful work, joyful and caring work; that their work helped others, that their work inspired others, that they will be remembered forever for what they did.”
Nurture non-work relationships
Throughout his career, Simonds has noticed a disturbing trend of nurses neglecting non-work relationships.
“Uniformly, people in nursing narrow down their scope of close relationships over time,” he says. “They are too busy, or too tired, or too stressed to make the effort when they get home from their draining days. This is poison. Close, trusting, open relationships with friends and/or family members is a tonic, a sounding board, an escape hatch for and from the stressors of the job. It is critical to sustain important relationships, nourish them, enjoy them, and savor them. Rather than draining energy from you, these relationships will recharge your batteries, fill you with coping energy, excite you, thrill you, and make you feel more alive.”
BestNursingDegree.com knows and understands the unique struggles and challenges that you face in the nursing profession. Care for yourself as you care for others, and remember that you can’t be the best caregiver if you’re not your best self. You matter too.