Nursing Self-Care: Current Evidence and Implementation Strategies for Improving Patient Outcomes and Nurse Well-Being

The American Nurses Association (ANA) defines a healthy nurse as actively focusing on creating and maintaining a balance of physical, intellectual, emotional, social, spiritual, personal, and professional well-being (Healthy Nurse, Healthy Nation, 2016). While this recommendation may appear simple, the complexity and difficulty of implementing self-care behaviors into a nurse’s professional and personal environment is challenging. Poor self-care is a prevalent issue in healthcare (Levtak, 2013). The purpose of this project is to explore the current literature on nursing self-care and its’ impact on patient safety, satisfaction, and nurse well-being. Strategies for cultivating self-care behaviors throughout ones’ nursing career, and integrating self-care at the unit, and more broadly, promoting a culture within hospitals, which foster staff self-care, will have the greatest impact on patient outcomes, as measured by pre and post intervention patient and staff questionnaires.

A lack of self-care contributes to increased stress, which negatively impacts patient care in a multitude of ways. The 2011 ANA Health and Safety Survey found that the top health and safety concern among nurses is the acute and chronic effects of stress and overwork. (ANA Health and Safety Survey, 2016). Nurses who work with pain or depression reported more medication errors, patient falls and provided a lower quality of care (Levtak, Ruhm, & Gupta, 2014), however, frequent self-care behavior can facilitate stress reduction. A literature review by Letvak (2013) showed 18 studies on improving nurse health. On-site wellness programs, offering Tai-Chi, fitness classes, ergonomic training programs, message, CBT programs, and grief debriefing, significantly improved nurse health. Additionally, hospitals and nursing managers who promote self-care behaviors for staff, as a means of personal empowerment, report fewer falls and nurse-assessed risks (Purdy et al., 2010). These findings support the need for evidence-based interventions to foster self-care.

Self-care is a skill which must be introduced early, and cultivated throughout one's’ nursing career. Nursing curriculum should include self-care coursework. Once in the workforce, nurses need the continued support of nursing managers and hospital administrators to ensure self-care is incorporated into the working environment. Adequate staffing, support programs, activities providing opportunities for self-care, and a culture which values wellness are presented in detail. This project will aide in increasing self-care behaviors, and ultimately provide the highest level of care and satisfaction for patients.