Page 14 Ohio Nurse March 2017 The Art of Self-Compassion Shifting the Focus from ‘Doing’ to ‘Being with’ Self-Care Self-care… healthy nurse… eat right… exercise more… drink water… sleep… reduce stress… do these words sound familiar to you? While these messages remind us of the importance of caring for self, it seems that for many of us they go unheeded in the ‘busyness’ of our daily lives. So…for just a moment…I invite you to stop, take a Deborah Shields deep breath and gently ask yourself how you are feeling on these wintry days? A bit fatigued? Rushing? Like you are ‘chasing your tail’... that if only there were 28 hours in the day you could get everything on your list accomplished? If you answered yes to any of these please do not feel alone. Stress is real, and our lives are filled with a myriad of experiences that can leave us feeling overwhelmed and scattered. Even joyous occasions can be stressful! In our quest to balance our personal and professional lives - places where we care elegantly for others - we often forget ourselves and our need for self-care. Indeed, we each deserve a moment to move inward and honor our own being. Stress is a life experience and the psychophysiological effects of chronic stress are now known to contribute to at least 80 % of chronic health care issues in the United States (Quinn, 2016). Nursing, while a wonderful profession, is stressful. Professional literature abounds with discussions of the stressors involved in caregiving and potential results of unmanaged stress such as caregiver burnout, moral distress, horizontal hostility, compassion fatigue, and decreased quality and safety (Borysenko, 2011 & WHO). How, though, does stress impact YOU? How does stress impact your ability to be present to those you serve in your practice – to be the holistic nurse, grounded in caring, that you are? Perhaps this is one of the most important questions that we ask as we reflect on our personal self-care patterns and identify strategies designed to nourish and support our whole self. The art and science of holistic nursing practice emanates from five Core Values (American Holistic Nurses Association, 2013). Core Value Five, Holistic Nurse Self-Reflection and Self-Care requires selfassessment, self-reflection and self-responsibility to adopt a lifestyle that supports all dimensions of wellbeing including physical, emotional, mental, spiritual aspects of oneself, and relationships with others and with the environment to create life balance and satisfaction. Holistic self-care... such a wonderful idea! How, though, might we take the first important step on this journey? How might we mindfully weave self-development into our life to create new patterns, shifting our focus from ‘doing’ to ‘being with’ self-care. Self-development involves developing selfawareness, self-reflection, self-responsibility and the healing consciousness required to care for others. It expands the traditional view of self-care to include development of the healing consciousness inherent to our inner being and connection to a source of wisdom greater than our personal self. Selfdevelopment, then, is synonymous with holistic self-care. The purpose of self-development is not only to adopt personal health promotion behaviors and manage stress, but also to connect us with the larger purpose of our lives. Self-development creates the space for an integration of “doing” and “being” dimensions of caring for self and other. It is a life-long commitment to yourself, inviting you to be compassionate, gentle, courageous and nonjudging of self. Getting started... that is the tough part. Let’s together explore a process of self-development that includes contemplative practice, self-reflection, selfawareness and health promoting self-care practices (Shields & Stout Shaffer, 2016). Contemplative practice is the foundation of self-development and for nurturing a deepening relationship with self. These quieting practices can help us reach our stillpoint, that place within us that is peaceful, still and safe. From this place of inner quiet, we are better able to appreciate our own innate wisdom and what is meaningful to us in our lives. What is our purpose? What do we value most? Contemplative practice is intentional, requiring choice and will; it is a discipline and, in truth, is not easy. Yet as we cultivate the discipline we become more able to relax into ourselves and, in a sense, become still in the storm of our daily lives. As we peel back the layers of our life we find joy, discomfort, ‘ahas’, challenges and so much more! It can be transformative. We remember, though, that the practice is enfolded in equanimity and compassion and we trust. Just as we do with others, we meet ourselves where we are and listen, without judging and harshness; within the stillpoint we are open to that which supports our healing and wholeness. Contemplative practices include whatever you choose that creates the space for quiet within you (e.g. prayer, meditation, drawing, singing, running, writing). There is no right or wrong practice; they are as unique as each of you. The power of the practice is your intention and your willingness to stay the course. In our busy world, it is easy to become distracted…guilty…and even give up. Remember, contemplative practice is a gentle discipline; notice when you stray a bit and return with love, not self-criticism. The sidebar is my invitation to you to share a quieting... or you might discover ideas on specific practices by visiting the Center for Contemplative Mind in Society @ http://www.contemplativemind.org/ and gazing upon the Tree of Contemplative Practice. Quieting practices allow you to engage in selfreflection, a turning inward to explore your thoughts, values, beliefs, experiences, and behaviors. Selfreflection helps you learn more about yourself, leading to enhanced understanding and selfawareness. You get to know and value the you that is YOU! Ultimately, this illuminates self-care practices /actions that best support you in your own, unique self-development. You are in a position to mobilize the resources to determine where you are on this journey and, yes, envision where you want to go! Self-Care Practices, then, emerge from your personal exploration and are designed to promote your wellbeing. As with any trip you take, preparation is key! You should be clear on your purpose, as this influences your planning - what you need, how to prepare. Next, assess where you are, set an intention and select what you want to focus on---what do you need for you? Evaluate along the way – how is your self-development journey going? What ‘course corrections’ are needed? Stepping forward mindfully helps you stay on course on this – your very own – self-development journey. There are numerous self-assessment tools available; it is important to use one that is comfortable and allows you to gently and nonjudgmentally assess where you are in this moment. As you look over your self-assessment, you will likely notice your individual patterns. Reflect upon any sensations you experience as you bring to your awareness a pattern – you might feel, for example, NOW HIRING NURSING FACULTY Ask about our sign-on bonus! 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March 2017 Ohio Nurse Page 15 vibrant, energized, uncomfortable, guilty, tired, steady, or anxious. Your awareness is so important. Remember that self-development invites you to accept yourself, to learn to embrace your patterns, and choose actions to modify or strengthen them. Pattern identification and the initiation of self-care practices is dynamic. You may choose to work on one health dimension to begin with... that is great! Your goals should be realistic in how much you can achieve; set yourself up for success! Clear specific goals with actions and mental desire/ commitment enables action (intention); it activates our will so that you choose to follow your plan. Self-care practices (actions) should be chosen mindfully and connected to your purpose. Behaviors can become patterned responses that may or may not serve your self-development over time—the key is attending mindfully to what occurs in you. Importantly, self-care practices are inclusive of your wholeness... your bodymind-spirit-social-relational self, able and willing to make informed choices. As you create your self-development plan, you might consider: Your Body Nutrition: Consider your relationship with food and the choices you make, remembering that nutrition is protection in your busy life. Movement: A joy and a challenge... how might you shake it out? Play: Remember the fun of building a snow person, rolling in the leaves, laughing from deep within. Laugh long... laugh often! Rest: Ah yes... a time of renewal. Establish a ritual before you rest – this can be whatever feels good and relaxing to you. Your Mind: We have many life roles and many role models who influence our thoughts, behaviors and values. Mental: How do you stimulate your mind... your thinking, your creativity? Create space for these activities! Emotion: Consider the effects of your emotions on your being and your life. Gently ask yourself if you can own what you are feeling - can you accept it, can you face it, can you let it go? Can you forgive ~ yourself and others? Your Spirit: Looking inward... connecting with the meaning in your life. Set aside a time each and every day for reflection and connection with your higher power. Your Relationships: As we live in the world we engage in a variety of relationships from casual to deeply intimate and each one, in its own way, is important to our self-development. How do you cultivate your relationships, keep them healthy, leave those that are not healthy? What is your relationship with the environment? Your Choices: The gift of saying yes... and no... without guilt! Conscious choosing invites us to be thoughtful and clear, which is often easier said than done. The evaluation of your self-development plan can include both short- term (immediate feelings that reinforce your specific behavior—the bubble bath was relaxing in the moment) and longer term (recognizing that my goal of deep relaxation and sleep is occurring as I take bubble baths every night). Give the plan a chance to work; you don’t lose 30 pounds in one month or run a marathon if you have not ever run a block. If, however, you find an action that is not working, revise it. Always strive to notice how you feel – what you are experiencing with your self-care actions. Mindful observation and reflection on your progress enhances your self-awareness; subsequently, you are more able to ‘self-correct’ and discern how you are progressing. As you continue, you become more and more observant and responsive to patterns; your embodied sense, felt sense, is shifting within you. Approach your self-development with an attitude of gentle discipline; if you stray from your desired plan, appreciate what that might mean and return to your path. Remember that contemplative practice is the foundation for self-development. You might benefit from the support of a family member, friend or even a coach. Importantly, recognize whether or not you may want to seek professional help if your patterns are particularly difficult to break or difficult for you to see how to approach them. Accept who you are, where you are. Shifting your focus from ‘doing’ to ‘being with’ selfcare is a rhythm, and you are invited to find yours. It is a life long journey of deep inner reflection and commitment - to you! There are ups and downs and that is ok. As Dr. Emoto shares: “If you feel lost, disappointed, hesitant, or weak, return to yourself, to who you are, here and now and when you get there, you will discover yourself, like a lotus flower in full bloom, even in a muddy pond, beautiful and strong” There are many resources available to support you. The American Nurses Association is launching Healthy Nurse Health Nation, a fabulous initiative designed to support nurse self-care and wellness. The website http://www.nursingworld.org/ MainMenuCategories/WorkplaceSafety/Healthy- Nurse is a treasure of ideas, activities and supports offered to you! The American Holistic Nurses Association http://www.ahna.org is another resource that you might find valuable. These are but two of the many tools ready and waiting for you to take the next step. May your holistic self-care journey be wondrous and may each and every step you take support the beautiful, caring, growing person that you are! References American Holistic Nurses Association & American Nurses Association. (2013). Holistic Nursing: Scope and Standards of Practice. Silver Spring, MD: Nursebooks.org, Borysenko, J. (2011). Fried: Why you burn out and how to revive (1st ed.). Carlsbad, CA: Hay House. Emoto, M. Retrieved from Goodread Quotes http:// www.goodreads.com/quotes/264350-if-youfeel-lost-disappointed-hesitant-or-weak-returnto October 28, 2014. Quote from The Hidden Messages in Water. Hillsboro, Oregon: Beyond Words Publishing, 2004 Levin, J., & Reich, J. (2013). Self-reflection. In B. Dossey and L. Keegan (Eds.), Holistic nursing: A handbook for practice, 6th ed. (pp. 247–260). Sudbury, MA: Jones & Bartlett. Quinn, J. (2016). Transpersonal human caring and healing. in C. Barrere, M.A. Blaszko Helming, D. Shields, & K. Avino (Eds). B.M. Dossey, & L. Keegan (Original Authors) Holistic nursing: A Handbook for practice, 7th ed. (pp 101 - 110). Burlington, MA: Jones & Bartlett Publishing. Shields, D. & Shields, D. (2012). The art of holistic self-care: A journey within. Ohio Nurses Review, 87(2), p 10-11. Shields, D. & Stout Shaffer, S. (2016). Selfdevelopment: The foundation of holistic care. In C. Barrere, M.A. Blaszko Helming, D. Shields, K. Avino (Eds.), B. M. Dossey and L. Keegan (Original Authors), Holistic Nursing: A handbook for practice, 7th ed. (pp. 683-702). Burlington, MA: Jones & Bartlett Learning. World Health Organization, “Millennium Developmental Goals (MDGs).” http://www.who. int/topics/millennium_development_goals/en/ Being Now, if you can, find the best way to be comfortable... in your chair or wherever you are. Settle into this place... feel supported physically, your feet grounded. Wiggle around until it feels right... pay attention to the temperature, light, sounds, aromas... all of the sensory experiences enfolding you. As you move into quiet, I invite you begin taking slow, refreshing breaths. As you breathe in, see gentle, healing energy flowing in and filling every part of you. As you breathe out, see the bumps of your day... the stressors, flowing out on the air... letting go. Notice your being beginning to relax a bit. Stay with this as long as you wish and when you feel ready, stand for a moment and stretch out all of you ... reach to the stars, bend gently... shake yourself out. Move as much as is good for you and really feel yourself letting go. When complete, notice yourself as you find your seat... continue breathing... and, with eyes open or closed, see yourself stepping out into the beautiful morning. You are greeted by a gentle warmcool air that is perfect for you. As you look around, you see the morning skies so rich, so blue. O look... there is a fluffy white cloud dancing in the breeze. The sun... so rosy gold... is easing upward and sprinkling the earth with glimmering light rays. You walk to a comfy seat awaiting you. There are lush green pines all around... You notice the quiet... it is profound, and in the distance you hear the good day welcome of the avian choir – your heart smiles. You allow yourself to sit and be... safe, peaceful, within your stillpoint. Stay in this space as long as you would like…beautiful nature is your companion. Reflect... notice... listen... .no judging. What messages/ awareness are you offered this morning? When you feel complete, allow yourself to rise and walk mindfully back to beginning... ever with your breath. Becoming more awake, it might feel nice to stretch a bit! Offer gratitude for this time of stillness that you have given yourself... and return, with ease, to your day. Deborah Shields, RN, PhD, CCRN, QTTT, AHN- BC is an Associate Professor of Nursing at Capital University in Columbus, a perioperative staff nurse at Doctors Hospital OhioHealth, and has a private practice as a Therapeutic Touch practitioner and teacher. She loves nursing and is committed to holistic nursing practice; she has, over her life, been an advocate for nurse self-care. Through the years, Deb has integrated concepts and practices of holistic self-care into her personal and professional life. As an educator, she introduces students and practicing nurses to self-care, inviting them to explore the importance of this as a holistic nurse…asking the hard question ‘How can you be present, to listen to another if you do not do this for yourself’? With Dr. Sharon Stout Shaffer, Deb developed Holistic Self-Development (Shields & Stout Shaffer, 2013), a model that weaves contemplative quieting, selfreflection, self-awareness and self-care practices that are nurturing and support growth, development and wellness.