Dr. El

“How’s it going?” I asked Larry, one of the maintenance workers I chatted with from time to time. He didn’t have his usual smile and his wrist was in a brace from a repetitive stress injury.

“I’m tired,” he replied. “I’m real tired. I was supposed to be off today but Jules called in sick and we were already short one guy. Tomorrow will make seven days of work in a row.”

“You’ve got to take care of yourself,” I encouraged him.

“I know,” he said, “but they needed me.”

A few months after my encounter with Larry, I noticed that an excellent nurse had “lost her shine.” I stopped by her med cart to see why.

“My sister’s very sick,” Shirley told me, becoming tearful. “She lives in Haiti and I’m worried about her.”

“Oh no! Do you have any vacation time? Can you go see her?”

“I do, but I don’t know if the director of nursing will sign off on it. I guess I could try.”

I followed up with her the next week as if she’d been one of my patients.

“No,” Shirley said as I approached the nursing station, “I didn’t put in for the vacation time.”

She’d lost weight since the prior week and her expression had become grim. I regularly observed her completing paperwork and tending to the residents an hour after her shift was over.

“Let’s do it now,” I insisted. I stood at the desk while Shirley filled in the form requesting time off the following month. That weekend she had a heart attack.

I’ve met many Larrys and Shirleys over the years. If asked, they’ll work the extra shift because they’re the type of people who don’t like to say no. While it’s tempting for organizations to meet staffing needs with someone who always says yes, good managers recognize that such requests can push employees to the brink. Encouraging employees to engage in ongoing self-care and to recognize when they need to “refill the well” can reduce their chances of burnout and illness, leading to better workers, improved care and fewer missed shifts overall.

Self-care for healthcare workers is, according to one research paper, “a proactive and holistic approach to promoting personal health and well-being to support professional care of others.” Team-care — a concept I learned while researching this article — refers to coworkers supporting and encouraging the self-care efforts of their teammates.

When I asked after the well-being of Larry and Shirley, I was engaging in team-care. While I often informally check in with my coworkers, team-care is much more effective if it’s a consistent, leader-supported element of workplace culture.

There are many ways in which individuals can engage in self-care and be supported by facilities and coworkers in their efforts. These include:

  • Enjoying regular meal breaks rather than eating at one’s desk
  • Using vacation days for recreation purposes
  • Taking sick leave when ill
  • Participating in mindfulness exercises like meditation or, as is done in some religiously affiliated nursing homes, team prayer to be of service before morning report
  • Providing respectful, confidential clinical supervision
  • Engaging in informal debriefing by trusted colleagues, such as expressing condolences to direct care workers who may be affected by the death of a resident
  • Allowing for a reasonable display of emotion in the clinical setting
  • Employing humor and laughter
  • Maintaining a separation between work and home by engaging in practices like listening to music during a commute, completing paperwork before leaving the facility, or showering when arriving home to literally wash off the day
  • Checking in with colleagues to encourage self-care as I did with Larry and Shirley
  • Creating facility-supported self-care programs such as providing paid two weeks off to do something memorable for workers who reach an employment milestone (for example, 15 years with the company)

Self-care is an ongoing process requiring continual monitoring. Right after I wrote the sentence about setting boundaries between work and home, I went online to check the census so I’d know what faced me on the job the next day. On the other hand, I wrote this piece during my travels to meet an old friend for a “girls” weekend midway between our homes on opposite coasts. I engaged in team-care by telling some of my coworkers about my trip with the hope that it inspires them to do something fun, special and rejuvenating.

Whether or not we work in a setting that actively encourages self-care, we can each take the initiative to attend to our own needs and to encourage and cheer on our colleagues in their efforts to maintain their wellbeing. The old saying, “You can’t draw from an empty well,” is particularly apt for those who work in healthcare.

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is the Gold Medalist in the Blog-How To/Tips/Service category of the American Society of Business Publication Editors Midwest Regional competition. A speaker and consultant with over 20 years of experience as a psychologist in long-term care, she maintains her own award-winning website at MyBetterNursingHome.com.