Making self-care in healthcare #1

Written by Betty Holland, UTS Bachelor of Midwifery graduate

Coming to the end of my time as a student midwife, something I am deeply passionate about is the importance of self-care in a healthcare context. I can tell you first hand that doing a degree in nursing or midwifery is an at times very overwhelming juggling act. I can also tell you that burnout rates among nurses, midwives and doctors are at a critical point.

Constantly caring for others, all at very vulnerable times in their lives, without adequate support or self-care can result in compassion fatigue or emotional exhaustion. The cost for caring for others should never be your own physical and mental health. We know that burnout and compassion fatigue reduce concentration and communication skills and contribute to the development of mental health problems, heart disease and obesity.

Burnout syndrome is caused by emotional exhaustion that results in depersonalisation (feelings of detachment from co-workers and patients) and decreased accomplishment at work. Burnout has recently been prevalent in the media as we know that high rates carry with them significant threats to both patient safety and healthcare quality.

A survey conducted by the Sydney Morning Herald in 2016 found that 32% of 3000 surveyed Australian nurses and midwives were actively considering leaving the profession. This is especially significant as there is estimated to be a workforce shortfall of 123,000 by 2030.

Now, we know that working in hospitals can be overwhelmingly busy, stressful and intense. This, to an extent is just an aspect of working in healthcare. So what can we do to prevent ourselves, the next generation of nurses and midwives, from burning out and as a result leaving the profession? Or to prevent ourselves from doing the bare minimum, causing significant risk to patient safety and a true deficit in the holistic care being provided?

Self-care. Fill up your cup so you can continue to pour from it.

Self-care is not selfish. Actively looking after yourself and your wellbeing means you can better support those who you care for at work.

Self-care looks like 5 things for me:

1. Saying no when I need to

My friends have gotten very used to me having to rearrange plans. As much as I love dinner and drinks with my lovely friends, it is just not a good idea if I have to be up at 5am for a morning shift the next day. 8 hours of sleep is always a good idea.

2. Positive self-talk

Affirming myself is absolutely imperative. During the rockier times of placement I would think to myself, “I am calm, I am loved, I am okay”. These words remind me that this is just one time and place, there is help if I need it, and everything will work out in the end.

3. Treating myself

: Treated myself to a beautiful bag for making it through my first busy week of placement in 2018.

Sometimes after a rough day, it is okay to have a bit of ice-cream and go to bed early to watch some Netflix. Likewise, after a few night shifts, it is a bit indulgent (but also very kind to my body) to get a massage!

4. Nurturing my body

Physical and emotional health is very much linked. Even when I feel overwhelmed and exhausted, I try to prepare and plan meals ahead of time so that I eat something more nutritious than the cookies in the tearoom of the ward I’m in.

5. Ensuring I have an identity outside of the hospital

I love to watercolour and bake. I love going out to concerts, the theatre and movies. I am not just Betty, a student midwife (though it definitely feels like it sometimes, and it’s a huge part of my identity), but all of these things make up who I am. It is important I take time to do all of the things that I enjoy and that fulfil me.

Reflection on practice

When you disengage with your professional growth, you will stop improving. Throughout my training I would write a thorough reflection on each day I was on placement – the things I saw, the things I did well and things I felt I needed to improve in.

As I head into my new grad position in 2019, I have a plan at the end of a series of shifts to write down a ‘sink’ – something I didn’t do as well as I would’ve liked that week, a ‘swim’ – something I did really well that week, and a ‘seek’ – goals for the next shift or week.

This means I am aware of my practice, how I am balancing work and my life, and how I can improve, maintaining my compassion and desire to look after, to the best of my ability, all the women and babies in my care.

Recognise symptoms and seek help

Chronic exhaustion, reduced feelings of empathy, dreading work and feeling guilty, feelings of irritability or anxiety, impaired decision making, poor work-life balance, diminished sense of self and/or career fulfillment are all indicators of compassion fatigue. Definitely find someone to discuss these feelings with – student midwives, new grads and senior midwives will all relate or have experienced these at some stage! It is particularly helpful to identify someone who is able to mentor and support you through this.

There is no shame in speaking out and seeking help, for the future healthcare system fully depends on nurses and midwives like you and I, and needs us to be full of the passion and empathy that we had when we decided to pursue careers in healthcare.

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References & Resources