Importance of self care in nursing

[Tenebrae, BSN, RN]

Reflection

Before I progress in this reflection I need to acknowledge that I made a medication error by giving medication that impacts on a patient's cardiac rate control to a patient who had no clinical need for it. This had the potential to have a disastrous outcome for the patient including postural hypotension and fatal bradycardia.

This incident has got me thinking about the role of grief and stress and how it impacts on our ability to function safely and effectively as registered nurses. Over the last several years I have been dealing with the impact of two terminal illness diagnosis of close family members, my mother (who had small cell lung cancer) and my brother in law (who had pancreatic cancer). Working in primary health and elder care I have had the opportunity to see how a terminal illness impacts on members of the family, however it was not until my mum and brother in law were diagnosed that I fully began to experience the stress that causes. Despite the terminal diagnosis, life still continues on, other family members still have to continue working at jobs as well as supporting the family member through palliative treatment and care.

My brother in law died 15^th January 2018. At the same time my mother was dramatically deteriorating as well, the cancer was slowly robbing her of physical function and taking large portions of her personality. Living with her up until four weeks before she died, affected me a lot. After working a full day I found I was coming home and having to be on constant alert in case she fell and hurt herself, trying to find foods to encourage her to eat and ensure that her symptoms were being adequately managed.

When mum died I expected to feel primarily relieved. I under estimated the impact of grief and how it impacts a person's ability to function in a day to day context and within the work environment. As nurses we tell our patients and their families about the importance of self-care and how it is critical that they 'look after themselves'. Yet often we fail to take our own advice. I felt that by getting back into work it would help me get back to normality and start the process of moving on from the death of my mum and my brother in law. I now realise that I would have been better to take some more time and to get my health issues under control before coming back to work.

This medication error has really bought home to me several things. How if a nurse fails to look after themselves it can bring their stress into the work place. Which in turn can impact on how the nurse does their job and could result in errors that may result in serious harm to the patient. Also grief at the loss of a family member or in my case several family members whether expected or whether the end to a long illness also has the potential for the nurse to bring more stress into the work place which in turn can result in an error such as the one I committed where medications that could have had a huge impact on the patients well being were given to the wrong patient.

As a result of this error I realised my grief wasn't as dealt with or wrapped up in a nice package as I hoped. To ensure my grief did not impact on my work or put another patient at risk at the recommendation of the palliative clinical nurse specialist I decided to take a few days off as I was not up to working and to try and get my head on straight to ensure another mistake like the one concerning Mr X did not occur again.

[Have Nurse, ADN, RN]

My heart goes out to you, My Colleague. As nurses, we seem to never get out of "care mode", even during the most trying times. You are in my prayers. May the Lord comfort you and give you strength. Please remember to eat and drink well? Scented candles, soft music, rest......

[nurse awake]

Thumbs up for you for being truthful. May this Lord comfort you and give you strength to carry on in life.

[Tenebrae, BSN, RN]

It was an interesting experience writing this reflection because I expected it went in such a different direction that I had been expected. I thought I would write about my medication error, what I did wrong and what I had learned from it, and it was such a light bulb moment. Realising that if I dont take the time to care for myself and my needs I'm absolutely no use to my patients.

I think as nurses we are awesome at caring for our patients, often not so good caring for ourselves.

To me good patient care and nurse self care arent the antithesis of each other they go hand in hand