Photo Credit: https://www.usa.edu/blog/nurse-burnout/
Written by Samantha Wall, LCSW
Edited by Joe DeNoon
How can we make sure we take care of our patients without forgetting about ourselves? How can we take care of ourselves without forgetting our patients? Those are some loaded questions; it doesn’t feel like we have enough hours in the day to balance taking care of ourselves AND our patients. Many days, I am sure it feels like you have to choose one option. I cannot imagine the stress that nurses experience on a daily basis caring for people’s health. No matter the setting you work in, you are constantly having to assess when you can even use the bathroom, let alone take a break to eat food or breathe. Shannon sent me those above questions a little while ago, and I had to really think about how I wanted to approach answering them. I thought about discussing how you, as an individual, could set boundaries and increase checking in with yourself after each patient you see, but that just did not feel right. If I only focused on what you as an individual could do, it would leave out many aspects that are completely out of your control in your day. I think about how many patients your place of work has to accept each day, how many patients you are expected to meet with, as well as the attention and care required for you to give each patient. All of these things are out of your control, you cannot choose how many people are admitted that day or even how many people get hurt! This is a larger conversation than just “use this coping tool” can answer. I want to make sure it gets the consideration it deserves…
When I first saw this question, it made me think of a theory I learned about in grad school: systems theory. This theory talks about how we are all parts of different systems; we affect those systems and those systems affect us. So, I could talk about how to set work boundaries and how to integrate self care into your work day. This would be me talking about how your actions can shift the work culture around you and how you interact with the work system. With changing your actions, there can definitely be changes made. People will learn that you are setting those boundaries and that you not only prioritize your work, but you also prioritize your health to be able to provide good work. However, this type of advice leaves out the part where there are other systems affecting your work day. These systems include your coworkers, supervisors/bosses, patients, the community you live in, the country you live in, what is going on in the world. These are all different systems that affect your ability to provide your patients the best care, while also taking care of yourself.
Now, I am not saying don’t make changes to increase your self care and don’t set work boundaries! I just already talked about those changes in other blogs, so I don’t want to make it seem like the only way to fix things is by making changes to yourself and your day. The best way to make big changes is by making small changes in many different areas. This could look like setting work boundaries/increasing self care AND questioning where does the system at work need to change? Do we need to advocate for more nurses? (probably) Do we need to advocate for better mental health benefits? Do we need to change how we cover shifts that don’t have enough nurses? When you have figured out what parts of the work system need to change, the next question to ask is how can we make those changes.
There are so many areas for advocacy and so many ways to create change! It is important to keep in mind that it takes time to make these changes. While all the questions I asked above may seem impossible, it starts with asking the question and then holding that work place system accountable! It sucks too, because they benefit from you overworking yourself and staying in the pattern of “I am tired, so I don’t have the energy to set a boundary.” You are also not only advocating for your needs, but for your patients to receive the best care from nurses who are not burned out, struggling with vicarious trauma, or nurses who are running on empty because of no breaks.
The topics and questions I am bringing up in this post don’t have easy black and white answers. It is really hard to assess the systems, what needs to change, and then actually take action to change the system. Not one person is responsible for this either, it is something that takes a group of people! This blog post is meant to start the conversation, so think about the questions above or other questions this information evokes for you. How can we work together to make these bigger system changes? What do we want those changes to look like? Where can we start advocating?
System Theory Introduction: https://www.onlinemswprograms.com/social-work/theories/systems-theory-social-work/