Self-care strategies for health care professionals
Identifying the tell-tale signs of burnout
Health & Safety Issues for Nurses: Who is taking care of our care providers?

Working in a stressful environment can take its toll on your health if you are not in the habit of caring about your health and well-being or exercising self-care strategies. In order to rise to the challenge of a busy work schedule and prevent burnout there are a number of actions you can take.

• Try to embrace challenges and opportunities for growth—this may assist in increasing your interest in your role and providing you with the variety necessary for mental stimulation.
• Take good physical and emotional care of yourself
• Create/maintain fulfilling and supportive professional and personalrelationships
• Seek activities that refresh and rejuvenate your physical and emotional energy
• Practice acts of kindness and forgiveness with yourself and others.

In order to keep your energy levels high and take care of your body and mind, it is important that you try to ensure a nutritional diet, regular exercise and seek out opportunities to have fun and stimulate your brain.

Nutritional Diet
Do you have a nutritional diet? Not sure? The following questions may assist you in determining just how healthy your diet is.

• Do you make sure you eat within an hour of getting out of bed?
• Do you seem to rush your meals?
• Do you make sure you eat every 3-4 hours during a 12 hour shift?
• How nutritional are your food choices?
• Do you snack, overeat or binge?
• How many times a day do you eat?
• When did you last prepare a meal for yourself?
• Do you eat whatever is most readily available or do you plan meals ahead of time?
• When did you last take the time to sit down at the table and eat?
• When did you last eat food without multitasking (i.e. attending to other tasks whilst you eat)?

If you think you could improve your nutrition you may need to re-educate yourself about portions and serving sizes and the nutritional content of foods. Further information can be found on the following sites:
http://www.heartfoundation.org.au
http://betterhealth.voc.gov.au

As a general rule, limiting red meat and adding fish to your diet is advisable. Using good fats, such as monounsaturated fats and omega 3 is also recommended. If you are eating a range of ‘colourful’ foods, chances are you are increasing the likelihood of a nutritious diet.

Exercise
A healthy body relies on building your flexibility and balance, increasing your strength and muscle tone and building cardiovascular health. To do this, it is recommended that you exercise for 60 minutes three or more times a week. Dancing, walking, cycling, running, swimming and climbing stairs are activities you might like to consider. The following techniques may help you to add some
exercise back into your life:

• Increase the distance you need to walk by parking further away
• Wear a pedometer and aim to do 10 000 steps a day
• Take your children and/or dog out for a daily walk
• Don’t use the lift, rather, take the stairs
• Take time out to stretch for a few minutes at regular times throughout the day (especially if spending long periods of time in front of the computer.)

Remember, if you are trying to make changes to your behaviour, set yourself realistic, achievable goals that are specific so that you can measure your success. For example: I will walk for half an hour after work on Monday, Wednesday and Friday. You might like to be even more specific. Decide on a walking route and invite a friend to join you. The attainment of this goal will spur you on to make more changes to you lifestyle and help increase your health and well-being.

Have fun and stimulate your brain
Laughter is increasingly cited as a method for improving health. This doesn’t mean you have to attend laughter classes, rather spend quality time with your family and friends and try to make the time to have fun.

Keeping your mind active is also important, and many of these strategies also ensure that you are having time out from your duties and responsibilities to pursue leisure and enjoy the rich experiences available to us:

• Read a variety of books
• Mentally challenging games such as a crossword or sudoku
• Freshen up your senses:
  - Take trip to the gallery/museum
  - Have a walk around some gardens, or explore a place you have never been
  - Listening to some different music
  - Try new foods
  

References
Graner, B. (2007). Self-Care Strategies for Nurses. The Prairie Rose, 76(1), 14- 16.
Graner, B. (2007). Self-Care Strategies for Nurses Part II. The Prairie Rose, 76 (3), 13-15.
Stop Burnout—Before It Stops Your Employees’, (2002). HRFocus, 79(2), 3-4.

Burnout is emotional physical and mental exhaustion that is caused by excessive and prolonged stress or demanding work. People suffering from burnout are likely to experience a gradual loss of interest in their daily tasks, a reduction in their energy levels and productivity, and feelings of detachment, dissatisfaction and cynicism (Maslach, 2007). These experiences ultimately take their toll on an their energy levels and productivity, and feelings of detachment, dissatisfaction and cynicism (Maslach, 2007). These experiences ultimately take their toll on an individual’s health and wellbeing. It is therefore of great importance to be able to recognise the early signs of burnout.
Burnout is often the result of high levels of stress experienced over a long period of time.

Therefore, if you are able to recognise the symptoms of stress and implement appropriate stress-management techniques, you are able to reduce or minimise the stress you experience as well as increasing the likelihood of avoiding burnout.

This being said, there are a number of differences between stress and burnout; they are not one and the same. It can be easy to detect the signs of stress, but it is not always easy to detect burnout. Therefore, it is important to take note of other’s feedback and comments, particularly where they relate to your attitudes and behaviours.

The first thing to note is that some people are more susceptible to burnout. Risk factors include:

• Spending your working life attending to the need of others, especially when it puts you in frequent contact with sadness or tragedy
• Unrealistic work goals
• Trying to be, or being expected to be, too many things to too many people
• Work that causes you to violate your personal values
• Boredom—work that never changes or doesn’t provide you with new challenges
• Feeling trapped in your job
• A lack of reasonable balance between your work and personal life.

As a health care professional, spending your life looking after others’ needs, you are at a greater risk of developing burnout and should take care to monitor your attitudes, feelings and behaviours to ensure detection of excess stress and the early signs of burnout.

Indicators of burnout
Common indicators of burnout include the following:

• Feeling that every day at work is a bad day
• Feeling like you are wasting your energy caring about work
• Feeling like you spend most of your day completing tasks that you find boring or unpleasant
• Feeling like you cannot do anything to make a difference in your workplace
• No longer feeling a sense of satisfaction from your achievements
• Feeling more irritable, cynical or critical.

What can you do to prevent or deal with burnout?
If you identified with some of the above indicators of burnout, you may be wondering where to from here. Self-care strategies can be helpful in preventing burnout or getting back on track when you identify symptoms of emotional exhaustion, hopelessness or reduced motivation. These strategies are highlighted in the Self-care strategies for health care workers section in Latest Features. improve those aspects of your work which are causing you difficulty. Consider the following:

• Clarify your job description (this may assist in removing some of the tasks you have been doing that are not part of your job description and have been creating excessive demands on you.)
• Requesting a transfer to another department
• Asking for new duties or seeking opportunities to learn and apply new skills
• Taking some well-earned time off.

References
Follow These Tips to Prevent Professional Burnout’, (2007). ONS Connect, 22 (4), 26.
‘Job Burnout: Know the Signs and Symptoms
Maslach, C. (2003). Job Burnout: New Directions in Research and Intervention.
Current Directions in Psychological Science, 12(5), 189-192.
‘Preventing Burnout
‘Stop Burnout—Before It Stops Your Employees’, (2002). HRFocus, 79(2), 3-4

Nurses are the backbone of our healthcare industry and play an integral role in the maintenance of an efficient and high-quality healthcare system. However, as with all industries, there are numerous industry-specific risks and hazards associated with the nursing industry.

Issues prevalent in the nursing industry

Bullying
Bullying can manifest itself in many forms and often involves intimidation tactics, heavy workload, discrimination, exclusion, and threats. Bullying can have an adverse impact on the health, safety and wellbeing of nurses, and also has repercussions for patients under the nurses care.

Stress
Nursing is a high stress job, particularly with the current shortages leading to understaffing and low patient to nurse ratios. It is important to identify symptoms of stress and to develop plans to counter-act its harmful effects.

Nurse Safety
The safety of nurses is a very serious issue, particularly for nurses on night shift where staff numbers are often low, and security can take up to 30 minutes to respond to calls of duress.

Nurse Health
The workplace environment and working conditions of nurses can adversely impact the health and wellbeing of nurses, unless effectively managed. Health concerns associated with the nursing industry include back and leg pain, foot problems, unhealthy eating, sleeping problems, and mental heath concerns. The impact of bullying stress, and poor safety and health not only seriously impact nurses, they also pose potential risks to patients and can be detrimental to the effectiveness and productivity of the organisation.

To adequately deal with these issues it is important to:

• Design and communicate direct policies and procedures that specifically address these issues
• Create a company culture that values and supports the heath, safety and wellbeing of nurses
• Be aware of the various heath and safety risks and incorporate workplace practices that minimise this risk
• Research – conduct surveys to find out what is really impacting upon your nurses
• Recruitment and selection – conduct thorough assessments of potential employees and hire ‘safety aware’ nurses that are more likely to adhere to safety and health regulations
• Training – implement training programs to enable nurses to effectively deal with these issues.

References
www.nswnurses.asn.au/topics