Expert: This National Nurses Day, ‘Self-care Is Not a Nicety, It's a Necessity’ for Nurses

Today is National Nurses Day, so Bernadette Melnyk, PhD, the chief wellness officer and dean of the College of Nursing at Ohio State University, joined Contemporary Clinic to discuss the results of a recent study she was the lead author on which shone some light on the extent to which alarmingly high levels of stress, depressive symptoms, and anxiety have been affecting critical care nurses nationwide, even before the COVID-19 pandemic began.

Alana Hippensteele: So, Dr. Melnyk, what were some of the findings from the study you recently published, and why might critical care nurses be experiencing such high levels of stress, depressive symptoms, and anxiety?

Bernadette Melnyk: Our study findings showed very high rates of depressive symptoms affecting 40% of the sample, and this was a random sample of critical care nurses throughout the United States. So, we can generalize those findings to all critical care nurses in the American Association of Critical Care Nurses.

We also found a little over 50% of these nurses met the cutoff for clinical anxiety on the valid and reliable screen that we used. But very importantly, we found that the poorer the physical and mental health of these nurses, the more medical errors they made over the last 5 years, and that's very sad.

I don't want that to put a poor light on critical care nurses because they're fabulous, but it gets back to the issue of: If we don't support our clinicians’ health and well-being, it is going to affect health care quality and safety.

Alana Hippensteele: Absolutely, yeah. How are these mental health concerns affecting nurses ability to also provide patient care, as well as other medical services?

Bernadette Melnyk: Well, I think any time any person experiences stress, depression, or anxiety to the point that it's going to interfere with concentration, judgment, or functioning, it will affect the quality and safety of care.

These are wonderful, caring, well-meaning nurses, but the level of burnout, depression, even suicide, in nurses is higher than the general population. So, health care systems really need to invest in fixing system problems that we know are the root cause of burnout, depression, and anxiety, as well as offer great screening programs and wellness evidence-based programs to protect oneself against these mental health issues.

It's just so critical. We know what works, we just got to translate it much quicker into the real world.

Alana Hippensteele: Right, right. How have these mental health concerns specifically impacted critical care nurses during the COVID-19 pandemic?

Bernadette Melnyk: They definitely have skyrocketed even further. Think about being a critical care nurse taking care of very, very sick people whose family members could not come in and be with them.

So those nurses had to be the primary support for dying people. That adds to the already stressed-out situation that they're functioning in. I think we're going to see an aftermath of skyrocketing rates of post-traumatic stress disorder and chronic grief reactions as we pull out of this.

Alana Hippensteele: Yeah. What are some ways nurses can approach an awareness of their experience of these mental health concerns?

Bernadette Melnyk: I think for one we've got to just become self-aware and honest with ourselves, and if any clinician is experiencing burnout, depression, or anxiety to the point where it's interfering with their concentration or functioning, they've got to get help.

It is not selfish to take good self-care. It's truly necessary to be able to take great care of others.

Alana Hippensteele: Yeah, and what has been the impact of programs like the Stress, Trauma and Resilience (STAR) Program or the Buckeye Paws program for critical care nurses?

Bernadette Melnyk: At Ohio State, we have such a fabulous menu of options to help all of our clinicians, faculty, staff, and students. Buckeye Paws is our pet therapy program, and honestly you should see the faces and the stress melt off of clinicians when those trained dogs step up on the unit.

We also have this other STAR programming for both patients as well as our own clinicians who are experiencing issues with stress and trauma. We offer evidence-based mindfulness programs and cognitive behavior skills building programs that we now work to decrease depression, anxiety, and stress.

Alana Hippensteele: Yeah, that is excellent, that is excellent. Why is it important for all medical health professionals or medical professionals to focus on continuing to care for themselves while caring for their patients?

Bernadette Melnyk: As clinicians, we cannot pour from empty cups. When we get on an airplane and the oxygen mass drop, we're told to put them on ourselves first before we can be effective in helping others.

Again, oftentimes clinicians want to help everybody else, but they often don't focus on their self-care. Self-care is not a nicety, it's a necessity. We have got to take a little bit of time—I call them micro-recovery breaks—during the day to focus on effective strategies that'll decrease our stress and improve our mood.

Alana Hippensteele: Yeah absolutely. What is the value of nurses in health care today?

Bernadette Melnyk: Nurses are at the bedside of patients 24/7. They are there to make observations, to pick up early complications, and to nurture the emotions and spirit of patients who are often seriously ill. They are such a valuable piece of our workforce.

Alana Hippensteele: Absolutely, absolutely. Is there anything you would like nurses to know on this National Nurses Day?

Bernadette Melnyk: I'm going to give all of our nurses a dose of vitamin G for gratitude. People honestly underestimate the power of practicing daily gratitude. If we get up every morning and just think about a few things and people we're grateful for and then do it again when we go to bed at night, it will so decrease our stress, decrease blood pressure, improve our mood.

So, I’m going to give all nurses out there a dose of vitamin G today, and just thank you, thank you so much for everything you do every day to transform health and improve lives. You are greatly appreciated.

Alana Hippensteele: Thank you so much for taking the time to speak with me today, Dr. Melnyk, and for sharing these important words on this National Nurses Day.

Bernadette Melnyk: Great, thank you for covering it.