As wound, ostomy, and continence (WOC) nurses, and nurses in general, we are often so busy taking care of others that sometimes we forget to take care of ourselves. A wise instructor in nursing school once told me, "If you don't take care of yourself first, you won't be able to take care of anyone else." I am often reminded of this when I travel and the flight attendant says "Please secure your own mask first!" Hearing that simple reminder will always and forever remind me to take care of myself first to best take care of others. Professional development and self-care are two very important concepts as a professional and as a healthy, well-rounded adult. I often have new nursing students ask me… what does professional development mean?

To me, it is about developing myself as a health care professional, advancing my knowledge, and growing my practice. It also means teaching and involving others and sharing my knowledge as widely as I am able. What are some ways to develop our practice? Conferences, in-services, online tutorials (webinars, self-learning activities), continuing education activities, and talking with other like-minded professionals are examples. Additionally, we can do our own research, to be sure we are practicing the most up-to-date, evidenced-based nursing care. If you don't know something, look it up! There are tons of resources out there for us, especially as nurses. WOC nurse specialists in particular have a whole team of professionals to consult with when questions arise.

4 Self-Care Strategies for the Busy Wound Nurse
 

And then there is the concept of self-care as health care professionals… pretty self-explanatory, right? Not always. Self-care isn't just making sure we are able to use the bathroom, drink water, and have somewhat of a nutritious lunch during our shift. Those things are important, but self-care goes well beyond that. Self-care is taking care of ourselves—mind, body, psychosocially; doing things we enjoy, taking time to rest, relaxing, and making our own happiness. I recently saw a great quote online… it said: "If you don’t like where you are, move. You are not a tree." – Jim Rohn. This is basically telling us that we are in charge of our own happiness. If you're in a career that you don't like or a relationship or friendship that isn't making you a better person, or if you dislike your home or your neighborhood… move on! The beauty of life, and of nursing, is that there are so many possibilities. Taking the time to be aware of our needs and to "move" when we are not feeling sustained or happy is very important.

Self-Care Assessment and Planning for Health Care Professionals

Complete your own self-care assessment by using the nursing process—it is the same concept as nursing school care plans! Follow the ADPIE nursing process:

• Assess
• Diagnose
• Plan
• Implement
• Evaluate

Part of the self-care process for nurses involves identifying our own deficits. Just as we identify problems with our patients and develop a plan of care, we need to do the same thing for ourselves. What is your own physical assessment? Signs and symptoms? Examples: stress, fatigue, muscle tightness, headaches, weight gain or loss, decreased concentration. Diagnosis? Examples: burnout, stress, anxiety. Plan: What is the best course of action for a plan? Examples include incorporating two yoga sessions into your week, adding 15 minutes of meditation three times per week, seeing a Reiki practitioner, incorporating massage into your monthly routine, doing something you enjoy—a mindless activity (movies, jogging, time with friends or family).

Implementing the Self-Care Plan

After you identify a plan, it's time to implement it. Implement your self-care plan in your daily routine, and try to make it a regular part of your routine for a week, then two weeks, three weeks, and then one month. After a month, evaluate your progress, and determine whether anything needs to be adjusted or changed. Maybe yoga isn't your thing and you prefer running… maybe you prefer quiet time reading a book versus a dinner with friends…. Whatever it is, it is your time to enjoy and focus on yourself, care, and renewal. Just as you would update the plan of care for patients, updating your own plan for wellness on a routine basis is important. Life changes, as do our needs. As things change, our wellness plan of care needs to be adjusted to reflect it. I often have to remind myself to take time for self-care.

Starting in June, I made it a point to sign up for routine yoga practice. This was difficult because I have never done it before… and, as you know, being the new kid on the block (whether it be the new nurse on the unit or the newbie in the yoga studio) is very intimidating! However, as we know with nursing and with life, the more you do something, the easier it becomes. Think about the first time you pouched a challenging fistula or watched your patient transition from being a new ostomate to going back to work, or educated a new nurse who had a "lightbulb moment" while applying a negative pressure dressing to a large wound. Simple or initial self-care tips for WOC nurses:

• Take time to go to the bathroom.
• Drink water or other fluids.
• Take breaks and lunches (this definitely prevents burnout!).
• Arrive at work a little bit before your shift starts – this helps to mentally prepare and triage patient needs.
• Get a good night's rest before your shift and prepare yourself: clothes, lunches, snacks, supplies.
• Ask for help when you need it.
• Help others, especially new nurses!

Relevance of Self-Care to Nursing

How do professional development and self-care relate to WOC nursing? They are constant reminders that we need the fuel to be able to be good at what we do. We need to practice self-care, and professional development, to be able to give the best care to our patients. By attending conferences, we acquire new knowledge. Whether it be talking to another person about a nurse-run continence clinic or hearing about how better to manage complex fistulas or high-output ostomies, there are so many take-away points that we can apply to our own practice. Take some time to listen, to stop and really pay attention, and to go both into our profession and into our life with an open heart and mind! Each person we meet has something to teach us, and this includes our patients.

Conclusion

We became WOC specialists because we wanted to help people, and we enjoying doing so. Each day we have the opportunity to touch or change a life. We are educators and role models, and we are constantly taking care of the whole patient, "not just the hole in the patient," as we've heard in prior blogs and wound care groups. There are so many reasons that it is important to care for the patient holistically rather than simply isolating and topically treating a wound. Our environment plays a huge role in our well-being, in our ability to heal, and in our overall health status. Always remember that to best care for others, we must care for ourselves first… so, please, secure your own mask first!

About the Author

Holly is a board certified gerontological nurse and advanced practice wound, ostomy, and continence nurse coordinator at The Department of Veterans Affairs Medical Center in Cleveland, Ohio. She has a passion for education, teaching, and our veterans. Holly has been practicing in WOC nursing for approximately six years. She has much experience with the long-term care population and chronic wounds as well as pressure injuries, diabetic ulcers, venous and arterial wounds, surgical wounds, radiation dermatitis, and wounds requiring advanced wound therapy for healing. Holly enjoys teaching new nurses about wound care and, most importantly, pressure injury prevention. She enjoys working with each patient to come up with an individualized plan of care based on their needs and overall medical situation. She values the importance of taking an interprofessional approach with wound care and prevention overall, and involves each member of the health care team as much as possible. She also values the significance of the support of leadership within her facility and the overall impact of great teamwork for positive outcomes.