Did you work over the holiday break?

Unlike many times in the past – this year I didn’t work a shift on Christmas Eve; or Christmas day, or even New Years. I spent this time with my family. And I turned off my electronic gadgets (well, for the most part)!

I spent quiet time reading. How refreshing it was to have no agenda, and nothing that just had to be done. The only trouble was that, somehow, this felt quite indulgent.

After all, we are trained to care for others – but perhaps not so enlightened on the art of self-care. Is it selfish? Or does genuine care for others perhaps start with yourself?

Photo: Beach Baby / Creative Commons

As a nurse, I have certainly felt the humanistic joy of sharing Christmas and other special days with patients – who often are alone and without family or friends. Of course it is important that we are there to attend not only to their clinical needs, but also the social and spiritual needs. Total pain requires total patient care – right?

Well, I’ve been thinking about the ways in which ‘total care’ might include clinicians themselves. How enlightened is it for nurses to wear the symptoms of burnout or compassion fatigue as a ‘badge of honour’? Further, if we soldier on and neglect our own needs or wellbeing, are we not then detracting from the patient care we can provide? The concept of self-care is not new to us – we lecture patients about it all the time! But as health professionals, we may not always walk our talk.

Self-care is mandated in competency standards for palliative care nurses in both Australia and New Zealand. Yet, there appears very little research into its uptake or utility. There is however, research that points to self-care being stigmatised (how dare we think of ourselves?!), and the general ill-health of nurses in Australia.

The work of French philosopher Michel Foucault alludes to the primacy of self-care; that it must necessarily precede care of others in order to support it. What will it take for us working in palliative care, to fully appreciate the simple logic – that truly holistic, and compassionate care for others, starts at home? Perhaps we need to give ourselves permission.

I recently wrote a more general editorial piece about this in the International Journal of Nursing Studies (In Press). If you find yourself asking the same questions as me – you might find it of interest.

Mills Wand and Fraser 2014_Guest Editorial