HOSPICE NURSES1
Self-Care for Hospice Nurses
Susena Araisa
California State University, Stanislaus
Self-Care for Hospice Nurses
One of the most rewarding responsibilities is nursing is being involved with patients during their most vulnerable moments. In the case of hospice, the job becomes more of a challenge as the nurse is aware that the care of plan for the patient is no longer a cure, but comfort and quality of life. During these vulnerable moments hospice nurses become the eyes and ears for these patients in an effort to assist them in coming into terms with their life legacy. While the job brings many rewards to the nurse, the stress involved can trigger and evoke emotions which could have long term consequences. Many nurses experience a burnout, which if not treated, could interfere with a clear view of the patient’sneeds (Jones, 2008). Having a self-care plan for nurses is a tool necessary to keep them emotionally and physically healthy to better enhance the end of life experience for the patients.
The Common Misconception About the Hospice Career
Thinking about death triggers different emotions in people. Most people think ofdeath as part of the circle of life in which they will end up in a comfortable bed, free of pain, surrounded with their loved ones, as they close their eyes and never wake up again. The reality of the story is that some patients will face death with not one person by their side, with a history of abuse by their grandson, or in a comma with no way of communicating their final wishes (Jones, 2008). This is when the job of a hospice nurse becomes more of a challenge. Many emotions can be evoked when the ideal way of death is far from reality. Given the scope and demanding job of hospice work, self-care becomes pivotal for the nurses. Taking the appropriate measures to avoid burnout is essential for the nurses to remain effective and able to provide the best care as the end of life approaches for these patients (Jones, 2008).
The Nurse Self-Care Plan
Many nurses decide to follow their calling and work at hospice facilities without having a self-care plan to combat the many challenges that accompany the job. According to Jones (2008) the challenges of hospice work makes self-care necessary for the nurse to endure at their job and to ensure that the best care is being provided to the patient. Multiple factors need to be part of the nurse self-care plan to address the physical, emotional, relational, and spiritual strengths and challenges which will serve as a guide to prevent burnout and to sustain motivation (Jones, 2008).
Physical Self-Care
The physical component of self-care focuses on the nurse’s overall health. Healthy eating habits and stress relief promotion are part of this criteria. With stress negatively affecting the nurse overall health, it is important for the nurse to incorporate ways of coping with stressful situations. Some ways of coping with stress include: listening to music, learning simple breathing techniques, massage, exercise, yoga or mediation (Jones, 2008). Stress at a hospice facility is not only the cause of the high demanding job but of outside sources that are out of the nurses’ control such as the patient’s family. In some cases, as evidenced by the student nurse, the patients family is in denial or angry of the status of the patient and they take out their frustration on the nurse. Some families have a misconception of what hospice encompasses and believe their loved ones are getting treatment when in reality they are there only for comfort. These common misconception increase anxiety and add stress to the nurse’s role therefore it is important to counteract physical stress.
Emotional Self-Care
Another component that needs to be included as part of the self-care for nurses is emotional self-care. Nurses need to be aware of their own emotions which can easily bedisturbed without proper coping skills. If a lack of emotional coping skills exist that could lead to exhaustion which is linked to burnout (Tunnah, Jones, & Johnstone, 2012). Being emotionally intelligent helps to facilitate the process of grief by maximizing energizing emotions and understanding that death is part of the cycle of life that is inevitable (Melvin, 2012). The first step necessary for the nurse to take is to have emotional awareness and to be able to recognize that self-care in this area is necessary to help their emotions come back to a homeostasis level. This is not to say that nurses don’t ever cry, feel sad, or have self-doubt, on the contrary, these are common feeling experienced by most nursing professionals. The problem is when these feelings get out of control and affect the nurse’s life. For instance, some nurses present signs of depression and insomnia which could be the cause of poor emotional coping skills. Besides understanding their emotions other ways to cope with emotions include: talking with co-workers about feelings, allowing time to grieve, engaging in pleasurable activities, daily release ritual to let go of emotions at work, writing thoughts down, prayer, or even crying (Jones, 2008).
Relational Self-Care
Having a strong support system as a hospice nurse becomes a key factor necessary for self-care. It is often difficult to deal with a death of a patient who has been in the nurse’s care for months and sometimes that meaningful support at home becomes essential. However, it is important to recognize that increased irritability, distance, or dependence can accompany the loss of a loved one and these actions can affect the relationships at home (Melvin, 2012). A helpful tool is recognizing when these actions are overextending and stopping them before it’s too late. Some ways of keeping relationships healthy is setting limits, learning how to express and resolve conflict, and remaining focused on solutions without personalizing (Jones, 2008).
Mother Teresa once said that burnout is always hunger, and the hunger is for love (Jones, 2008). In many cases nurse’s burnout is associated with the caregivers desire to feel loved and needed by someone. The nurses will go out of their way to comfort the patient even if it involves doing things outside of work. Part of the nurse’s job is to recognize when these extra assignments lead to physical, mental and emotional exhaustion. As a nurse, it is important to understand that professional’s self-care is the vehicle for serving clients. Having a self-care plan will help nurses provide safe, quality care as the end of life approaches for the hospice patient.
Reference
Jones, S. (2008). A delicate balance: Self-care for the hospice professional. Aging Well, 1(2), 38.
Melvin,C. (2012). Professional compassion fatigue: What is the true cost of nurses caring for the
dying?. International Journal of Palliative Nursing, 18(12), 606-611.
Tunnah, K., Jones, A., & Johnstone, R. (2012). Stress in hospice at home nurses: A qualitative
study of their experiences of their work and wellbeing. International Journal OfPallative Nursing, 18, 283-289.