Thursday, April 18, 2013

Today's Lightbulb Moment: Failure to Care for Oneself Is an Addiction

I just had a wonderful conversation with a fellow holistic nurse about how we nurses care for ourselves, or rather how we frequently don't. There were several great things that came out of the conversation, but this was the big lightbulb moment for me, when I realized we were using language like "hitting rock bottom" to describe what often has to happen before a person takes stock and realizes they need to take better care of themselves. 

That's the language we use to talk about addiction, be it to alcohol or other drugs, gambling, whatever. So, then, if the same process has to occur, is pouring oneself into work and tasks and such also an addiction? If it takes a dramatic bottom-hitting wake-up call, then it would seem so. It is certainly habitual behavior that has the potential to result in self-harm.


I think that another pattern that we're culturally addicted to is the all-or-nothing approach. If I do not have the space in my apartment to do a nice long yoga flow every day, then I can't do any at all. If I can't stay awake for a full self-Reiki treatment, then why bother? The answer, for me, also comes from the realm of work I've done with people in recovery, using the harm-reduction model: something is better than nothing. It's not about being perfect, it's about doing better. 

If the addiction is "putting everything else ahead of caring for myself," and the resulting harm is "reduced wellness for myself," then the goal is not "take on an impossible load of self-care practices all at once and set myself up for failure." It's "do something to care for myself, even if it doesn't measure up to some arbitrary standard of what that should look like." It's not "do an hour of yoga followed by an hour of Reiki every day." It's "do some."


Another tool that both comes from the realm of recovery and is echoed in one of the most common translations of Dr. Usui's Reiki Principles is to make a commitment to self "just for today." It's a useful tool, because truly, while what we do today can affect tomorrow, we can only act in the present moment, and it's helpful to remind ourselves of that. So just for today, I commit to doing ten minutes of yoga in the space that I have and ten minutes of Reiki before going to sleep.


Interestingly, in looking for a link to the Reiki Principles, I found this page that teaches you how to say them in Japanese. That seems like a neat practice and an intriguing one. It is also, though, in its way, a temptation. It would be very easy to derail myself onto the far more familiar task-oriented approach of learning something new, while letting the practices I already have languish for another day. That would rather defeat the point. So, just for today, I'm choosing to bookmark it as something to return to later, so that for today, I can focus on the commitments I just made to myself.


Returning to something I said in my introductory post, a theme I expect to return to from time to time, the Code of Ethics for Nurses from the American Nurses Association explicitly says that "[t]he nurse owes the same duties to self as to others (ANA, 2008, p. 55)." That includes setting realistic goals. We don't write care plan goals that say, "the client will avoid infection forever." That's not realistic or reasonable. We write goals that say, "the client will remain free from infection for one week," or maybe one month, or whatever makes sense in context. We also evaluate whether the interventions we've planned and implemented are achieving that outcome, and if not, we change them. We owe it to ourselves to do the same. Set reasonable goals and realistic plans to attain them. Evaluate whether the plans are working, and if not, change them. If they are working and higher goals become realistic, then adjust accordingly. 


In other words, we need to use the nursing process on ourselves. Assess. Diagnose. Plan. Implement. Evaluate. Lather, rinse, repeat. We use it in caring for our clients because it works. There's no reason not to use it in caring for ourselves as well.


I hadn't intended to write a blog post today, but I wanted to get some of these thoughts down while they are fresh. I suppose that makes this a form of journaling, though I tend to associate that process more with pen and paper. But whether electronically (and publicly) or more conventionally (and privately), it's about reflecting and organizing thoughts into language using some means that can be revisited later. That's also useful, just like our dreaded charting. How do you know if you are achieving the goals you have set if you don't document it somewhere? How do you hold yourself accountable? I'd been thinking about starting a paper journal for yoga, specifically, to make notes after class about things I learn and experience. Thinking about it, but I haven't done it yet. I'm not going to add that to today's commitments, though. Just reminding myself for now that it's a thing I may want to incorporate. Because first, I need to meet the goals I set for myself today.


What about you? What goals can you set for yourself today? If they turn out not to be attainable, how can you modify them to make them so?


Reference

Fowler, M. D. (2008). Guide to the code of ethics for nurses: interpretation and application. Silver Spring, MD: American Nurses Association.

Thursday, April 11, 2013

New Moon, New Blog

The new moon seems like a good time to start this blog that has been simmering in the back of my mind for a couple of weeks. Welcome to Making Time and Space.

As you can tell from the title, and if you didn't already know me, I'm a nurse. The nurse who does Busy Nurse Bento, actually, which is the reason for the URL. (That and every holistic/wellness URL I thought up was taken.) I'm also a Reiki Master-Teacher and a yoga practitioner, though I've discovered during my first two years as a nurse it is sadly easy to let these key self-care practices slide. My body recently decided to let me know what it thought about that (it was not a favorable opinion), and so I'm working to get back to a more balanced place wherein I take care of myself.

It's worth noting that doing so is part of the American Nurses Association Code of Ethics. Provision Five states, "The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth (ANA, 2008, p. 55)." If I wouldn't stand by silently and let a client drop practices that had been helping them (my patients tend to agree that my job title could easily be "professional nag") then I owe it to myself to do the same. One of the blog posts that's been simmering is an expansion on that theme, in fact.

One other thing I should probably include in this introductory post is that I'm currently in graduate school working on a Masters in Nursing degree. While the tone of this blog will (I hope!) be more conversational than academic, I will do my best to both link and formally cite anything that I reference in order to make it easier for the reader to explore it on their own. I've always been big on pointing people to things I think they may find interesting anyway, and there's nothing like grad school to make a person completely cite-happy. In that vein, let me also link to one of the best tools a fellow student shared during my first semester: the BibMe bibiography maker. It's a great time-saver, though it does leave you on your own to work out the hanging indents required by APA format, something I've not accomplished yet in html.

Whether you're a fellow nurse, a student nurse or thinking about becoming one, or just think this sounds interesting, I thank you for stopping by and invite you to leave any thoughts you wish to share in the comments area.

Reference

Fowler, M. D. (2008). Guide to the code of ethics for nurses: interpretation and application. Silver Spring, MD: American Nurses Association.