by Kim Richards

“It is not the end of the physical body that should worry us. Rather, our concern must be to live while we are alive-to release our inner selves from the spiritual death that comes with living behind a façade designed to conform to external definitions of who and what we are.”

Elisabeth Kubler Ross

 

Fall is my favorite season. Here in Colorado, we have had an unusually hot summer and having intentionally moved from the searing deserts of Arizona to the Rocky Mountains, I was reminded why. I am invigorated by the typical daily (sometimes hourly!) weather changes of Colorado and I long for the transition to fall. The crisp freshness of cool nights and early mornings causes me to pause, reflect and breathe in life. I start to anticipate my first fall hike, a bike ride without 50 SPF and eventually a downhill powder run on my newly waxed skis. The lush flowers that used to grace my deck and patio are now withered and spent. I can relate…our 15 year old dog, Gator, was peacefully euthanized in our home yesterday.

 

Gator was a 90 pound Chesapeake Bay Retriever who never allowed his brothers, very friendly and effusively social, but forgetful of the “Retriever” part of being a Golden Retriever, to define his existence nor his life purpose…to swim and retrieve his tennis ball. It was his job, his mission and heaven help anyone or any animal that got in the line of his laser like focus. Gator was also supremely loyal to my husband and me even up until the moment he passed painlessly and effortlessly with the assistance of a Veterinary angel.

While I could write a book on lessons learned from each of my dogs, and the gut wrenching heartbreak of loss, I will take a clue from Gator and write about the power of focusing on “the ball”, living in the moment, releasing the gift of our inner selves and removing the façade of external definition. Through the twists and turns of my life, finally I am able to face the fear of sinking and do what comes naturally…swim! I have been blessed to mostly swim in a collaborative school of other likeminded “fish”, yet the occasional encounter with the deceptive allure of mermaid fish may have briefly taken my focus off the ball. No problem! That instance was erased with another throw of the ball chucker!

As Gator perfected the snowplow with abandon and would leap without fear into sometimes frozen water, breaking the ice with his powerful momentum, determination, and fueled by passion, I too have found my biggest successes occur after just “going for it”, without worrying how I am defined by others. His life was big, focused, joyous, uninhibited yet sometimes messy and just plain crappy. We always knew how he felt and he asked for what he wanted. Gator never stopped to wonder how he must have looked to his brothers, the “born to please” Golden brothers, Sammy and Valentino who are notoriously seeking approval and attention. While treasured, they are beautiful followers and even as Gator slowed and lagged behind, they understood that Gator set the tone for every walk to the park, every encounter with other dogs, and would correct every errant way of his much younger brothers.

Even as his massive body wore out, his mind and his deteriorating eyesight was still focused on the ball. He did not know that he could not run after the ball without suffering the later consequences of pain…he just ran! He did not know that a younger, more agile dog would catch his ball…he ran like he was one with the ball! He simply wanted to carry the ball and stayed the course of his passion!  Yes, others (specifically little yappy dogs) may not have approved of his assertiveness, but so what? He was the master of his destiny.

I have only known Gator for 6 of his 15 years and admit to being very intimidated by his “eye lock” on me when I invaded his space and married his Dad. After all, Valentino was a new puppy and I had only had a miniature daschund before then! In the years since, big Gator became a mama’s boy and I was smitten with the combination of his sense of enormous power, protectiveness and self control, yet childlike sweetness as he would cry like a baby when I walked in the door after trips away. Often, no words were needed to communicate. If you are a dog lover, you know the bond. It is unyielding trust. In the last few months, at 5am when I awoke to see him staring at me to help him navigate steps to go outside, he knew, without a doubt, that he would be cared for with compassion, gentleness and honor reflective of his gifts to us.

With the last hydrotherapy session, (a treadmill in a water tank!) it was painfully obvious the thrill was gone…we chose to let him swim with assistance in the big pool and even though he carried the ball in his mouth, he was struggling.  He was asking us to let him go. Swimming with a “just in case” Speedo diaper was not his idea of dignity, nor ours, and he was, for once in his life, terrified of sinking.

If you are not a pet lover, you are probably wondering why all the effort. If you are, you already understand. A life of focus on a purposeful ball, swimming freely and living fully is a worthy life. His memory lays buried within my heart.

Jump in.
Swim.
Keep your eye on the ball.
Release your gifts.
Define your own life.

by Deb Andelt
deb@experienceinmotion.net
www.experienceinmotion.net

We’re surrounded by tools designed to enable connection. Everyone seems to be plugged in, frequently 24/7, yet many people feel less connected than ever.

“The human connection is an important thing. 
It teaches me something, and is fulfilling in that respect.” ⁱ

Healthcare professionals were recently asked what creates a healing experience for staff. The key result of the research, 5 Dimensions of Self-Caring that Heal Healthcare: The foundation for an experience management strategy; is the need to shift from primarily caring for others first to caring for self first. One important ingredient of self-caring is connection.

“Healing in medicine is about relationship.
It is not about fixing something.” ⁱⁱ

Connect in all 5 dimensions of self-caring

We have experiences every moment of the day. To create meaningful connections start by identifying the moments, the experiences, when you feel connected and those times when you feel disconnected. As you become more aware of the attributes of connection that you value, you can then begin to make adjustments, create practices, which foster connection.

“I am a healer because of the way I connect with people
and how I care about people.” ⁱⁱⁱ

The respondents in the research study identified 5 dimensions of self-caring. These dimensions can guide your assessment and to help you create new practices that nurture connection.

Personal practices at home
Explore what creates connection during your time away from work. It could be gardening, reading and sharing thoughts on meaningful books or meditation. Resources abound to support you in personal practices at home. When viewed through the lens of self-caring even cleaning can be a meaningful practice.

“You need to be compassionate and connected enough to care.” ^iv

Personal practices at work
Experiment and bring some of those practices into the rhythm of the workplace. Talk with others about your passion for creating meaningful connections. Join with peers and engage in a few practices everyone wants to make part of their day. Consider starting the day with a common intention and focused breathing. Commit to a daily 20 minute walk in fresh air. While these ideas are not new, engaging in them with the intention of self-caring brings a new energy to what could otherwise be a lame pot luck or a short lived exercise program.

“You can have a healing person-to-person experience
without a beautiful building, it’s about spirit.” ^v

Interactions with others
Connect with others through the power of language. Language guides behavior. Language that fosters connection suggests, rather than commands; supports rather than pushes; encourages growth and development rather than demanding obedience. Pause before speaking and set an intention to speak in ways that encourage connection.

“You could not be all that you are without
the other person being all that they are.” ^vi

Clinical and business processes
Integrate connection into processes by making connection a key factor in assessing what works. For example, consider what a shift change process would be like when the primary goal for all is to connect. Does your current process foster connection with peers and connection with patients? What would need to be adjusted to result in greater connection? How would everyone, patients, family and staff, feel as a result?

“We have LEANed humanity out of healthcare.” ^vii

Business model
Examine what type of business model supports you to be in an optimal state of well-being and feel connected. If you’re working in an emergency room yet feel more connected spending time with patients and their families, you may enjoy being part of a long term care residence. If you gravitate to complimentary therapies yet work in a strict allopathic environment, perhaps working at a holistic clinic would be a path to connect with your soul. How and where you work should and will change over time.

“Being there for each other is most important. 
That’s the biggest piece that is missing for
people in a healthcare environment and it gets
translated to the patient.” ^viii

Commit to connect

We all have choices in our experiences, both what we enter into and how we show up “being” in the moment. New ways of “being” evolve by creating practices that support the connection we desire. We’re empowered when we consciously evaluate what we do and how we do it. Commit to connect. As each person engages in self-caring practices with the intention to connect, the result is more connection for all. That shift transforms organizations, and may even spark to transform the healthcare system as a whole.

5 Dimensions of Self-Caring that Heal Healthcare: The foundation for an experience management strategy research study is available at: www.experienceinmotion.net

Workshop: Get CEUs and create a strategy that focuses on all 5 dimensions of self-caring. Institute of Noetic Sciences, Sept. 8 – 10. Click here for details.

Please share your comments on our blog!

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ⁱ Tina Frontera, RN, Health Care Trends and Innovation Leader/Speaker/Consultant

ⁱⁱ Ruth Stanley, OSB, PharmD, MA, FASHP Holistic Services, Central Minnesota Heart Center

ⁱⁱⁱ Dawn Bazarko, MPH, RN, Sr. Vice President Center for Nursing Advancement at United Health Group

^iv Dr. Abraham Verjovsky, M.D.

^v Cindy Bultena, RN, VP of Patient Experience at Woodwinds Hospital

^vi Ruth Stanley, OSB, PharmD, MA, FASHP Holistic Services, Central Minnesota Heart Center

^vii Dr. Tim Culbert, Medical Director of Integrative Medicine at Children’s Hospital in Minneapolis, Minnesota

^viii Sue Penque, RN, MSN, Chief Nursing Officer North Memorial

by Diane Sieg RN, CYT, CSP

We all talk about self care a lot: “I need to lose weight… I need to get to the gym… I need to take care of myself!” Instead of just talking about it, or worse, feeling bad about it, I have found a much more positive and practical approach. That is to live with more intention.

What exactly do I mean by living with intention? It means remembering we are in choice, not always about what happens, but how we deal with what happens. It means choosing to be present to your partner, your finances, or what you put into your mouth. It means staying mindful of what your highest joy is and making decisions based on that joy.

It means choosing to ask for what you want.

Asking for what you want is such a simple, but difficult concept; We often don’t feel like we deserve to ask for what we want, we may not feel like we will ever get it, and many times we don’t even know what it is that we want to ask for! Here are my top five ways to help you ask for what you want to live more intentionally:

Vision.
It’s important to have a clear picture of what you want. Instead of your normal “to do” list, write down an intention as if it is already happening. Write it in the present tense such as I am feeling…  I am doing…  I am enjoying…  Then you can write down specific action steps you need to bring this affirmation to life. You can also create a vision board with appealing pictures, words, or phrases that represent your intention and display it someplace you can see every day so you can remember to ask for what you want.

Remember your core values.
Your core values are the non negotiable attributes in your life that you need to feel fulfilled. Are you living them? Do your actions, choices, or overall lifestyle reflect your core values? If you have not identified your core values, or it has been a while since you reviewed them, revisit them so that you can ask for what you want.

Enlist support.
We all can use a little help from our friends and family in asking for what we want. Be sure to communicate with them to let them know you are practicing asking for what you want to live more intentionally. You can partner up with a friend to support each other, or hire a coach or mentor to help you stay accountable to ask for what you want.

Get grounded.
Do something everyday that gets you grounded, centered, and focused on what is most important to you. My 30 Days to Grace program is a perfect 30 minute practice to help you do this. You can also choose to do any part of it, deep breathing, meditation, yoga, prayer, journaling, even for 5 minutes. We all need this time now, more than ever to be able to get and stay clear to ask for what we need.

Let go of the outcome.
Remember the power of the intention is in the asking for what you want, not the outcome of asking for what you want. So let go of the fact you may or may not get it. You could get something even bigger and better! The important thing is that you asked.

by Sharon Cox

I had just returned from doing a workshop for nurses on the importance of self care which I called, “Put on Your Own Oxygen Mask First” with the obvious message that

if we don’t take care of ourselves we will not be able to
be our best selves for those around us.

This topic took on new meaning for me that first weekend in May when Nashville and Middle Tennessee were under a slow moving storm system that created what is now being called a 700 year flood. We had 14 inches of rain that weekend and this resulted in 1400 water rescues and 13, 500 calls for assistance over three days.

By Monday morning when the rain finally stopped and aerial views of the city were shown it was clear that this was the worst thing to hit our part of the state since the Civil War. The death toll was 29 men women and children. The estimates of damage done are in the neighborhood of two billion dollars and growing. The national news has covered the losses to the Opryland Hotel and other major tourist attractions but other news events quickly took this disaster off the evening news. Meanwhile I have watched the way the people of Nashville have reached out to each other and been proud to be a part of a city that has surpassed all expectations as the recovery process has been underway. One network reporter was so impressed with the 15,000 volunteers, in a group called Hands on Nashville that he produced a special segment to applaud the people of this area for their capacity to deal with the aftermath of this disaster.

This had been quite a learning curve for someone who thought they knew something about self care and personal balance. Listening to a nurse friend of mine who had just returned from helping elderly family members who lost their home, I fully understood when she shared the fact that by the end of the day she was in tears. As she told of the endless phone calls to arrange for temporary shelter, the need to find important papers in soaked debris or just listening to the soft cries of people who had only the clothes on their back I could hear the exhaustion in her voice. She said that she had learned how important it was to ask for help and not be a “stoic, self sufficient nurse” as she put it. I could also tell that it helped her just to talk about what she had experienced so I listened.

I have a new appreciation for that adage, “one day at a time” since to do anything else in the face of such overwhelming loss is fruitless. As one friend put it,

after looking at these pictures of how those with so little lost all they had you just have to do something… and anything you do helps them and you.

Personally I found that I had to limit the time I spent looking at the images of this disaster or listening to the stories of homes and people being swept away by raging river currents.

Another nurse friend of mine related how useful it was to make lists each day and then cross some things off the list at the end of a long day. She also said that she had found that volunteering to help in cleanup efforts every other day had helped her” get enough sleep and recharge” so that she was in better shape to deal with those who could not get away from their new reality.

It will likely be a year or more before Nashville recovers from this natural disaster and I will continue to learn about persistence and patience with all that I see in this great city I call home. I will also take some lessons from this experience about

• the value of talking for those who have been traumatized
• taking one day at a time
• setting priorities and staying focused, and
• the need for time to grieve in the midst of catastrophic loss.

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I have a new appreciation for the necessity of self care and setting boundaries to keep ourselves in a good place. I have learned again how much we are all helped by random acts of kindness and focusing on the positive. It has been said that “you teach what you need to learn” and the next time I do a program on self care these lessons will be my takeaways from the Nashville flood of 2010.

Please share your comments on our blog!

Volume 4  |  Issue 4  |  April 2010

John Nelson, RN, President, Healthcare Environment
Kim Richards, RN

We were honored to have participated in the recent International Caring Conference with Dr. Jean Watson in Walnut Creek, CA. The innovative body of work surrounding the science of caring was inspiring, and meeting with those who had infused the theory into their facility was exciting. The collaboration, sharing and heartfelt “connectedness” created a rich medium to embrace the power of healing from the heart.

A recent study revealed a strong relationship between the first element of the Watson Theory, self care and compassion fatigue (r = .60, sig .05) and self care and burnout (r = .60, p. 05) (Johnson, Richards, Nelson, 2010). This finding is especially important to understand in this age of doing more with less. The importance lies within the concern for patient, staff and financial outcomes. It is reasonable to assert these findings will impact the following outcomes:

1. Patient satisfaction
2. Clinical judgment of staff (access to critical thinking parts of brain, the frontal lobes)
3. Productivity of staff
4. Sick calls
5. Overtime driven by unexpected absences (sick calls)
6. Turnover
7. Staff engagement which will potentiate effectiveness of organizational initiatives
8. Job satisfaction
9. Teamwork
10. Better clarity of self, role and mission of system
11. Higher levels of healing hormones within staff (higher levels of oxytocin, DHEA, IgA and lower cortisol).

Self Care Academy is currently working with clients to scientifically measure, at the unit level, the outcomes of self care. These data are being integrated into the body of knowledge that is growing out of the work being conducted by Healthcare Environment, www.hcenvironment.com, a company that utilizes multiple methods of statistics, mathematics, geometrics and qualitative data to understand how self care relates to caring and outcomes.

This scientific knowledge is supporting what we all know intuitively and experientially, when you feel better, you perform better. The importance of sustainable self care has never been greater!

Become part of the growing community of facilities who have made a conscious decision to make “care for self” an expectation and have invested in a sustainable program for their caregivers.

Please share your comments!

by Nancy Rollins Gantz, RN, MSN, MBA, PhD, EA-BC, MRCNA
President and Senior Consultant, CAPPS International

 

“We will be known forever by the tracks we leave.”
- American Indian Proverb

When I was in my basic three-year nursing program, the mental and physical demands spoke loudly to my soul. If I was to be a representative of the professional practice of nursing then I must be of a healthy, mindful, positive mentor through my career of good health and living. I believe that as a professional we must demonstrate, verbally and through our actions, a commitment to this philosophy. Nursing is very difficult work, both mentally and physically, and will only become increasingly demanding as health care continues to evolve, change, and transform. We as health care providers, a critical link to patients and the community, are the primary role model for demonstrating the value of healthy lifestyle practices. There has been an abundant amount of clinical research that illustrates the importance of exercise, healthy eating habits, embracing stress reducers, practice non-smoking, and engaging in mental, spiritual habits…all in the support of well health and living.

During my 30 year career, there was a period of time when I became seriously ill, unable to work and even be a mom and wife! I realized that I had become so consumed with my career and work – typical type A – that exercise and healthy eating took a back seat on the priority list. When looking back over that time period I can clearly see what led up to my illness and how I could have minimized the severity. Luckily, this was a short illness but one that had momentum affect on me. This experience showed me how delicate our bodies can be and if we do not treat them as a “temple or sanctuary of significance importance” then the consequences are poor health, lack of mobility, increased mortality, the list goes on and on.

It is very sad and concerning when I see young children and adults not caring for their body or mind. It has become much faster to go through McDonald’s than prepare a well balanced meal at home.

When life becomes overly busy and stressful, I have always kept a journal of what I eat on a daily basis. Many times when we do this our eyes are opened to just how many calories we actually feed our body and then get coupled with lack of exercise. When we eat a well balanced and nutritious diet coupled with exercise routine we can greatly reduce our chances of the most come aliments today – high blood pressure, diabetes and heart disease.

A simple guide to use which I have done for 30 plus years is:

• First thing in the morning drink 16 oz of water followed by a super lean but nutritious meal
• Mid-morning snack is usually an apple (fruit) plus 8oz of water
• Lunch is a salad that I bring from home (when working) plus 16oz of ice tea or water
• Mid-afternoon snack is cheese/crackers or granola bar plus 8oz of water
• Dinner is my lightest meal but includes all food groups. I also drink 8 oz of water. I eat not later than 6 pm and keep on a pretty good schedule in order to balance sleep, work, meals, and importantly exercise.

I am reminded of two very significant quotes.

• Ralph Waldo Emerson said “the first wealth is health” and
• Mahatma Gandhi “it is health that is real wealth and not gold and silver”.

by Jannina Sweetenham

In January I had the chance to attend a weeklong workshop which included a number of sessions delivered by Kim Richards of the Self-Care Academy, addressing self care for nurses, and I had to ask myself the question

‘to what extent do I self-care?’

The answer was complex. 

In many aspects of my life, I look after myself very well.  I have spent a lot of time focusing on my psychological and spiritual health and have developed real skill in using my consciousness, exploring awe and wonder in the universe and finding ways of allowing myself to grow, by focusing upon my psychological needs. I have created a new model for understanding self and others, thereby developing effective relationships, which will be published in the next couple of months. I spend a lot of time helping other people to develop in these areas also, through my business as a consultant and lecturer in personal effectiveness, leadership and empowerment. My clients include health care professionals and school principals and their staff.

I am personally very happy: I love the work that I do, I have a wonderful husband and our lives genuinely contain a lot of joy.  However, at 260lbs I am neither slim nor fit. I have tried just about every diet going.  If the doctor suggests I talk with a nutritionist, it’s largely a waste of time – it’s not knowledge I lack, it’s motivation. Over the years I have come to think that willpower is a con: the people who just naturally get on with things don’t need it, whilst the rest of us blame ourselves for the lack of something which isn’t real.

I now believe that life is managed through focus and self-belief –
and we can all do something about them.

The timing of the self-care workshop was auspicious: I already had the sense that this was the start of a very meaningful year for me: almost as if I am entering the next phase of my life, in which the good stuff will continue but also, new and exciting things will happen.  I resolved at the workshop,  to lose some weight, and I confided this to my ‘accountability buddy’. But it occurred to me that I’d made this resolution many times before.  I knew I wasn’t quite there yet.

As well as running my own business, I occasionally do some fundraising for the charity, Marie Curie Cancer Care, which is very close to my heart since I worked for them full time earlier in my career. The charity has many facets: research into cancer and palliative care, education and in-patient care but it also enables terminally ill individuals to receive expert nursing care in their own homes, a service highly valued by patients and their families.  A few weeks after the self care workshop, the new brochures for fundraising activities organised for the next year arrived.  In it was a trek in Nepal, walking in the foothills of the Annapurna mountains.

I have always wanted to go to Nepal, to experience the spiritual ambience of the country as well as the marvellous scenery.  I knew this was my focus. And so, I’m signed up: I have created a plan of diet and walking for the next twelve months so that on January 20^th 2011, I, along with about 20 other people (including my fantastic step daughter, Hannah) will set off on this life-changing trek.

Part of keeping focus on this goal, has been to make it public.  I have never before told anyone exactly how much I weigh: I certainly would never have put it in writing to be published. But this is the beginning of a new phase in my life, one in which …

I truly engage with all aspects of self-care.

My journey has begun.