Looking Back

It is hard to believe it has been over a year since we first heard about a new virus that has since impacted each one of us in some form or another. As we continue to deal with what has evolved into a pandemic, the question becomes-Is this the "new normal"?

Among these unsettling times, gratitude and self-care can easily become low priorities or placed on the back burner. Prior to COVID-19, mental health disorders were not prioritized as a medical condition but rather often overshadowed by the stigma that has prevented so many from seeking services. According to the Substance Abuse and Mental Health Services Administration (2020), more than 61.2 million American adults had a mental illness and/or a substance use disorder in 2019. It is estimated that only 43% of individuals with a mental health disorder receive treatment. The Substance Abuse and Mental Health Services Administration is a public agency whose mission is to reduce the impact of substance use and mental illness within our communities.

Throughout the pandemic, increased awareness and open discussion of mental health well-being is starting to occur more frequently. In fact, multiple healthcare plans now provide coverage for telebehavioral services and provide videoconferencing platforms for providers to offer services to consumers. As rehabilitation nurses, we are familiar with the biopsychosocial approach in providing care. The interplay of physical, mental, spiritual, and emotional well-being cannot be overlooked, especially in the current overwhelming and challenging times. The correlation between healthcare crisis, an injured economy, and social and financial stressors has drastically impacted the mental health of the American society. A recent survey revealed that 40.9% of U.S. adults reported at least one adverse mental or behavioral health condition since the start of the pandemic (Czeisler et al., 2020). The online therapy company, Talkspace, has reported a 65 percent increase in clients since mid-February of last year. Text messages and transcribed therapy sessions collected anonymously by the company demonstrated that coronavirus-related anxiety dominated patients' concerns (Panchal et al., 2020). Consequently, the pandemic has caused an increased awareness of the importance of maintaining and enhancing mental well-being-not just for patients but for each one of us as individuals.

Self-Care Strategies

The pandemic has severely impacted the economy, health system, and healthcare workers across the country. The stress of the pandemic has impacted nurses on all levels. Fear, uncertainty, isolation, loss, and ambivalence are salient themes amidst concerns for exposure risk and loss endured from treating ill patients. As healthcare professionals, we are trained to nurture, care, and serve as advocates for those in need. Whether on the frontline, providing services in the community, or in an outpatient setting, nurses are a vital part of healing in society today.

Findings from an American Nurses Association survey of 32,000 nurses in March and April 2020 found that 87% of nurses feared going to work and 36% cared for COVID-19-positive patients without protective health equipment (American Nurses Association, 2020). According to a recent survey of RNs (Stokowski et al., 2020), more reported being "very" or "somewhat" burned out during the pandemic-37% as compared with 12% before the pandemic began.

As such, it is necessary that nurses exercise good self-care to help build resiliency for personal and professional health. During a recent informal survey of faculty, 76% indicated they were zoom-"fatigued," and 40% indicated they needed to work on self-care. The practice of self-care may seem like a daunting task to nurses who are busy caring for patients and family, along with juggling other responsibilities, which may include meetings, deadlines, appointments, children (and remote learning), applying for grants, everyday household chores, and even pursuing further education. What does self-care look like, and how can you build this into your daily routine?

Physical Strategies

Eat healthy, nutritionally balanced meals.

Practice yoga.

Get adequate sleep.

Stay hydrated.

Practice deep breathing.

Start an exercise regime.

Take stretch breaks in between online meetings (vs. back-to-back meetings).

For those working from an office, take a drive to break routine.

Use tinted glasses to help with eye strain and prevent headaches.

Mental Health Strategies

Relax/unwind.

Take a walk.

Read a book.

Find a hobby.

Take a break from TV and social media.

Create a bedtime routine.

Utilize aromatherapy.

Try meditation.

Explore music therapy.

Incorporate relaxation techniques throughout your workday.

Enjoy the outdoors.

Connect with others.

Consider a "virtual buddy" to connect and check in with.

Avoid social isolation.

Start each day by being grateful.

Identify three positives at the end of the day as you reflect back.

Set small goals and reward yourself.

Looking Ahead to a Brighter Future

Recently, at the end of a particularly frustrating day, during a conversation with my 8-year-old niece, I asked what she had learned in school that day. She simply said, "Gratitude, Aunt Terrie." She stated confidently that gratitude is "when you turn a negative into a positive. Here, let me give you an example" and she proceeded to share an example of gratitude. Reflecting on this conversation and the simple description of gratitude can help us realize how important it is for us as nurses to stop, reflect, and be grateful each and every day. In addition, we must incorporate self-care strategies into our daily routines to be the most helpful not only for our patients but for our families and ourselves, as well.

At the virtual ARN national education conference in October 2020, Dr. Prem Nathenson (Nathenson, 2020), Past President of ARN, provided a great analogy of self-care with respect to the flight attendant script when flying on an airplane. The instructions for using the oxygen mask are that "you have to take care of yourself first before assisting others." This analogy holds true for nurses when it comes to self-care. Take time for self-care by incorporating some of the above strategies into your daily practice and life. Be intentional in your self-care. And let us all look forward to a brighter future!

Gabrielle P. Abelard, DNP, PMHNP, PMHCNS-BC, RN

Terrie Black, DNP, MBA, CRRN, FAHA, FAAN

Clinical Assistant Professors

College of Nursing

University of Massachusetts Amherst

Amherst, MA, USA

References