What it is: Self-care is a range of knowledge, skills, and attitudes that health care professionals can use for themself or to support others to maintain mental and physical wellbeing.
Why it matters: Grief over the death of clients is not unusual and may contribute to stress or burnout. Factors unique to palliative care include:
- accumulated losses
- emotionally-charged care
- sustained and exclusive focus on terminal illness and care
- acknowledging and living with grief
- loss within your own personal life.
Nurses, including those who care for only a few palliative care clients, may experience:
- difficulty shifting from curative mode to a palliative and supportive role, accepting death as an inevitable and appropriate outcome
- guilt, if perceiving that a diagnosis was missed or delayed
- stress, if unable to relieve difficult symptoms or intense distress in the patient or their family
- difficulty in handling their own mortality.
What I need to know: Self-care can include self-reflection and self-awareness, identification and prevention of burnout, appropriate professional boundaries, and grief and bereavement support.
Being part of a team that provides the opportunity for support, reflection and debriefing is beneficial. This may be particularly helpful in developing realistic expectations of the degree of support that can be provided to dying patients. A team may be your work colleagues or a network of people outside of work.
Actions
Acknowledge your grief and recognise that it is a normal reaction to loss.
Talk to your supervisor and colleagues about what you are experiencing and request their help or support from a professional counsellor if needed.
Develop your self-awareness by reflecting on how you care for yourself. Consider:
- Physical: am I getting enough sleep, exercise, and healthy food?
- Psychological: am I doing enough to keep myself mentally stimulated?
- Social: do I get enough time for my relationships?
- Emotional: What am I doing to process my emotions?
- Spiritual: what questions do I ask myself about life and my experience?
Reflective practice includes a conscious look at emotions, experiences, actions, and responses, and using that information to understand our responses.
Look out for signs that demonstrate a person is not coping such as:
- physical and emotional exhaustion
- poor sleep
- headaches
- negativity and cynicism
- lack of enjoyment
- not working effectively
- absenteeism
- use of drugs or alcohol as ways of coping.