Nurse, Heal Thy Spiritual Self
Last month, I shared
with you a very personal story that jump-started my quest to further understand why nurses are emotionally tired. I wanted to understand how today's environment spiritually impacts the practice of nursing. I dove into the research and literature like they were a cool pond on a hot August day. I researched with gusto, hungry for a sense of grand accomplishment. Three key tracks emerged: holistic nursing, self-care for the nurse, and an academic take on how to do a spiritual assessment. A few courageous authors spoke about the spiritual self of the nurse, but most directed it toward self-care. Self-care is important, and we will be exploring self-care in the coming month.
Spiritual resilience is what I wanted to understand: that ability to be present and mindful to those in need of care, even in the face of computers, chaos, and suffering. The American Medical Association has also identified this need for our physician colleagues and has developed learning modules to improve resilience and decrease burnout. So in my quest, I sat down with one of the top leaders working tirelessly in the field of spirituality. I asked her what she thought could be done. She replied, "One cannot be gentle with others, until one is gentle with oneself." I reflected on this comment. Nurses are trained to look for what is wrong as we stand vigilant over those entrusting us with their care. In essence, we have a very critical eye, and we use that same critical eye on ourselves and others.
As a chief nursing officer, I often would do rounding, but my rounding sometimes was in the parking garage. I found the parking garage to be a great place to just talk. I remember coming upon a nurse who looked not only exhausted but also defeated. We started talking, and she shared with me her day. She used terms expressing feelings of being a failure in nearly every other sentence. She missed a medication, she had a family that was upset, and she didn't have a patient ready for radiology. When I asked her what had happened to influence her day that way, her eyes welled up. She reflected on an elderly patient who had just lost her husband and learned that she now had cancer. The woman was alone and afraid. The nurse made the decision to be present to her patient's suffering. By doing this, she took on her own suffering of feeling like a failure for not having tasks done. She felt she let her team down. She felt that she should have been able to do it all. She was in spiritual distress.
Spiritual distress is defined as a disturbance in a person's belief system. It is an approved nursing diagnosis for patients but rarely is it discussed for nurses. Nurses, many times, feel they can do it all, and asking for help is seen as being less than adequate. We spoke about her feelings of failure. I asked her what she was going to do next time. She replied, "Try harder." Try harder would only bring on more frustration and feelings of being overwhelmed. Who knows what would stem from those feelings. The studies show that actions such as leaving the profession of nursing, impairment, disengagement, and job change are consistent with nurses who felt the way she might have felt over time.
I softly asked her if she could forgive herself. Forgiveness of self and others is a first step to being spiritually healthy and resilient. Forgiveness is a tough word and concept to bring forward in a work setting. Yet, in looking to the evidence on developing resilience, two key actions are major influencers on creating spiritual resilience: gratefulness and forgiveness.
A wise leader taught me to have a virtual tree where, at the end of my day, I could hang all of the things that I felt I did not do right throughout the day. Then the next day, I could decide if I wanted to pick up any of it or leave it there on the tree of forgiveness.
When we seek to understand forgiveness and practice it, we start to understand and appreciate the very essence of humanity before us-our own. What are you grateful for and how do you use those experiences to fill your cup?