Caring for the caretaker: a nursing process approach.

Problem: Nurses begin their careers infused with a passion for making a difference in the lives of their patients. However, patients' needs and the demands made on their time can cause nurses to become desensitized to their own needs. The resulting dissonance between values and actions increases stress levels, which, if left unchecked, lead to burnout and compassion fatigue. Method: The nursing process is a dynamic and efficient problem-solving technique used by nurses in their approach to caring for their patients. This approach can help nurses who are experiencing stress and burnout to define their core values, develop goals, implement a plan of action, and realign their focus. Reflection and journaling bring insight and understanding to the process and promote growth. Outcomes: This process develops a stronger sense of self that leads to a solid foundation from which to act. The individual makes mindful choices from an integrated state based on positive goals. This leads to a sense of well-being and balance, which can decrease stress and promote satisfaction and a return of passion for our profession. As new nurses, we enter our profession with enthusiasm and the desire to make a difference for our patients. However, the cumulative effects of stress cause many nurses to lose their passion. It is the nature of nurses to respond to the needs of others before their own, but habitually putting off our own needs can cause us to become desensitized to them. Over time, we feel less vital and less energetic. Eventually, nothing satisfies us; and finally, we burn out. When our needs are pushed aside, so are desires, dreams, aspirations, and our selves. "Expert at caring for others, nurses are novices at caring for themselves, as reflected in the high rate of burnout that are endemic to nursing" (Hernandez, 2009, p. 129). One factor that differentiates nursing care from other disciplines is our use of the nursing process. Practiced throughout nursing school, it becomes so ingrained in our thinking that we use it automatically. However, this dynamic and efficient problem-solving technique need not be reserved only for patients; it can be a way for nurses to approach problems in our lives as well. By following the steps of the nursing process with flexibility, curiosity, and critical thinking, we can map out a plan of care for ourselves to return balance, enthusiasm, and satisfaction to our careers. ASSESSMENT The first step begins with self-assessment. Self-care is personal; no one else can tell you what you need to do for yourself. Some will advocate therapies such as yoga, aromatherapy, and/or meditation. These are certainly helpful adjunct therapies. However, we cannot improve the stress in our lives until we face the sources and cultivate new responses. Sources of stress can be internal or external. Reconnect with yourself through reflection. Give a name to your desires. Look at your dreams; it is possible to make them happen. Journaling works well to organize your thoughts and feelings. Use it to increase awareness of individual preferences, emotions, spiritual needs, and growth. If you find you are stuck, Kathleen Heinrich (2008) describes a free-write exercise in her book, A Nurse's Guide to Presenting and Publishing, that can help you get started. Specify a certain length of time between 1-2 minutes, put pen to paper, and let your thoughts flow without editing. Have a specific question in mind, and keep your pen moving, even if it starts with doodling (pp. 9-10). Define your core values. It is important to operate from these values-otherwise we experience dissonance or dis-integration. This dis-integration can be a strong source of moral distress. When you function from your values and beliefs, you feel on track and you respect yourself. The value of self-respect may be something we take for granted (Dillon, 2009). However, whether we respect ourselves determines how we live our lives. …