The Importance of Self-Care for Nurses

The global COVID-19 pandemic brought into sharp focus the vital role nurses play in our health care system and the challenges of their job. Due to staffing shortages, long working hours, shift rotations, changing work protocols and technology, and the physical and emotional demands of the job, nurses are at very high risk for burnout.

Constant attention by a good nurse may be just as important as a major operation by a surgeon.

Dag Hammarskjöld, former Secretary-General of the United Nations (1953-1961)

There are many ways the Canadian health care system can support nurses, but the nature of the job will always be stressful. Thus, useful support strategies should include ways in which nurses can take care of themselves right from the start of their careers.

With that goal in mind, researcher Dr. Catherine Aquino-Russell, faculty member at the University of New Brunswick’s School of Nursing, designed a qualitative research project with UNB nursing students and faculty to see if the Transcendental Meditation technique could help develop inner strength, resilience, empowerment and the ability to cope with stress. She partnered with the Canadian Women’s Wellness Initiative to fund the study.

The nursing program offered by UNB is an Advanced Standing Program (ASP), meaning the program is a compressed and accelerated Bachelor of Nursing (BN) degree. It was designed for students holding another degree or university credit hours prior to entering the program in order to complete the BN degree within two eleven-month terms. As the program involves a great deal of time in practice settings where students learn in hospital, community, or clinics, these nurses are on the job, albeit, as students who are learning.

““The [educated] nurse has become one of the great blessings of humanity, taking a place beside the physician and the priest.”

—Dr. William Osler, Canadian physician and founder of Johns Hopkins University

Faculty members report that ASP nursing students and instructors often experience high levels of stress, due to the rigorous academic demands of the program and the pressures of their professional and personal lives. This stress can negatively impact their overall well-being, impacting their ability to perform well, as caring nurses, in the program and their future careers.

Aquino-Russell collaborated with researchers Khaldoun M. Aldiabat, now at Cape Breton University, Sydney, NS, to implement the project, and with Enam Alsrayheen, Nova Scotia Health Authority, to write about the research study with both nursing students and their instructors. The qualitative study looked at the themes that surfaced when nursing students and their instructors practiced the Transcendental Meditation technique. Aquino-Russell knew that TM has been shown to reduce stress and improve overall health and well-being in a wide variety of populations, but she wanted to look specifically at the effect of TM on nursing students. (Click here for a short bibliography to TM research)

After learning to practice TM at the beginning of the academic year, participants wrote monthly journal entries describing what it was like for them to practise TM while being engaged in their teaching-learning journey. At the end of the 11-month academic year, the researchers analyzed the students’ and instructors’ journal entries to find the important themes revealed in their writing. The results of their study were published in June in the American Journal of Qualitative Research[i]

The themes that emerged included:

  • Enhanced vitality, sleep, insight, and performance;
  • Decrease in stress, replaced with calming tranquillity;
  • Enhanced relationships, with inner peace and more confidence;
  • Gratitude and positive views for the future;
  • Feelings of empowerment, productivity, and receptivity to change of perspectives;
  • Enhanced insight of self, more compassion for, and presence with, others.

In their own words

Here are some of the comments students made regarding their practice of TM:

The benefits of this meditation practice far exceeded my expectations. I assumed I would feel calmer, maybe more focused or well rested. While those things did occur, they were the result of something greater. I found that through taking the time to sit alone in silence with myself, I was able to get to truly know myself in a way that I wasn’t aware I hadn’t.

____________________________

The benefits of this meditation practice far exceeded my expectations…. Through this greater understanding of self, I began to feel confident and comfortable enough to deepen my connection with others. I also began to see myself in everyone, the things I loved, and even the things I dislike, … which enabled me to experience a greater appreciation for them. I started to see life through a different lens.

____________________________

I began to experience gratitude in ways I could have never imagined. Instead of viewing experiences as something I “had to do”, I began to see them as opportunities that I was fortunate to be blessed with. As I developed a greater sense of inner security, external factors were less daunting. The sense of worry about the future and of the unknown that I was once so familiar with was replaced with a sense of trust.

____________________________

I have already found that my TM practice has benefitted me in several ways. Most notably, I have found that I have more productive time in the evenings. Previously, after busy/long days I would often collapse on the couch after my son was settled in bed, too exhausted even to get myself to bed, let alone accomplish any additional evening tasks. After my early evening practice, even though I initially feel groggy for a short time, I find that I am much more alert and clear-headed throughout the evening.

____________________________

A feeling of calm is easier to access…I have become less reactionary. I can step back and not feel the need to react right away. I have a calmness that allows me to think before reacting. This has enhanced my patience with and reflection on life’s challenges. 

 

Conclusions

The researchers concluded that:

The descriptions of experiences of students and instructors in practicing TM twice every day indicate that TM did have an impact on them positively in managing their stress, influencing their well-being, and enhancing their productivity and relationships with others.

Further, the researchers stated:

We believe that if there is the desire for nurses to truly care for others in their professional practice environments, we, in nursing educational programs, must let go of our past perspectives, which include putting others first and ourselves last. We must recognize the importance of not only teaching skills and tasks for performing nursing and medical care, but also including stress-reduction techniques for nursing students and instructors in order to ensure that they take care of themselves…. Our mission in nursing is to care for others; we must realize that one cannot give from an empty cup. TM is a strategy which quantitatively and qualitatively has proven to be helpful for nurses, nursing students, and nursing instructors, so that they may help themselves.


*Aquino-Russell, C., Khaldoun, & K. M., Alsrayheen, E. Experiences of Advanced Standing Program Nursing Students and Instructors Practicing Transcendental Meditation. American Journal of Qualitative Research Volume 7 Issue 3

https://www.ajqr.org/article/experiences-of-advanced-standing-program-nursing-students-and-instructors-practicing-transcendental-13239