Self-Care for New and Student Nurses

Awarded second place in the 2021 AJN Book of the Year Awards in Professional Development!

Self-care. Well-being. Resilience. Happiness. Self-compassion.

These are among today's self-help buzzwords. There are countless books, articles, and podcasts on these topics, and many of them are essential resources for anyone seeking solid footing in the world today. Self-care remains an imperative for nurses and other healthcare professionals as burnout, high attrition rates, emotional fatigue, and moral distress loom large over us, especially in the age of COVID-19. The people who so compassionately care for others are in dire need of care themselves.

Self-care practices are important because we need you.

We need all the gifts that you bring to the nursing profession. Your future patients need you. Your future colleagues need you. We need you to become the best nurse you can possibly be so that you can support other young nurses as they, too, enter this profession. Nursing will afford you daily interactions that will change the lives of your patients, strengthen the resolve of your colleagues, and ripple beyond your immediate circle to surprising places. The gifts that you bring are beyond measure.

Imagine for a moment a patient who is a young mother. Perhaps she is facing her health challenges while trying to be strong for her children and partner. The kindness, wisdom, and support that you bring to your interactions with her will have a downstream impact on her children and family. Even her children's children. Think about yourself or your nursing school peers who, when asked why they wanted to become a nurse, tell a story about growing up and seeing a nurse who cared for them or a loved one during a health crisis. So many nurses are nurses because they experienced the compassion of someone like you when they were in need. These nurses' compassion may have started you on your own journey to nursing, even though they may never know the impact they had on you. That is one of the superpowers of nursing: the impact you have on others. You will matter in ways big and small, in ways that the universe may never even be able to reveal to you.

But here is the hard, honest truth: while you have chosen one of the most noble professions, you have also chosen one of the most difficult. In your career, you will face challenges big and small, whether it is a problematic coworker, the death of a favorite patient, or a global pandemic. You will have bad days or weeks when you ask yourself why you didn't choose a less demanding path in life. You will experience exhaustion, frustration, and grief. You will balance not only your nursing responsibilities, but also your commitments to your family and community. But as you question your life choices and wonder how you can take one more step forward, that voice inside you will whisper, "You are a nurse."

Our goal in writing this book is that you never have to betray that voice. No matter what comes your way, you will have the strength, skills, and resilience to keep moving forward. But let us be clear: we do not want you to move forward at the expense of yourself or your well-being. We want you to move forward with wisdom and clarity of purpose by using every resource you can muster. We hope that what is contained in this book will become a valuable resource throughout the early years of your career, and even beyond.

We welcome you on this journey, and we hope you welcome the opportunity to explore the concept of self-care, what it means, what works best for you, and how it can help you flourish in good times and help you grow in difficult ones. We are especially grateful, and humbled, that we can do it with you.

Dorrie K. Fontaine, PhD, RN, FAAN, is the Dean Emerita at the University of Virginia (UVA) School of Nursing, where she served as dean for 11 years until 2019. A champion of creating healthy work environments in clinical and academic settings, she is a past president of the American Association of Critical-Care Nurses (AACN). In 2009 she created the Compassionate Care Initiative at UVA, which has grown to be a guiding force in transforming the culture of the school with a focus on fostering human flourishing and resilience for students, faculty, and staff. A noted author of critical-care texts, a leadership book, and multiple papers and presentations on creating healthy work environments through compassionate care, Fontaine credits a retreat at Upaya Zen Center, Santa Fe in Spring 2009 with the Abbot, Roshi Joan Halifax for setting her on the path of mindfulness, meditation, and a renewed focus on self-care. She attended Villanova University and the University of Maryland, and she received her PhD from The Catholic University of America. Her four-decade career of teaching and academic leadership includes the University of Maryland, Georgetown University, and the University of California, San Francisco (UCSF). Fontaine lives in Washington, D.C. and the Blue Ridge Mountains of Virginia with her husband Barry.

Tim Cunningham, DrPH, MSN, RN, FAAN, began his professional career as a performing artist and clown. As a clown, he worked for two organizations that changed his life. The first, The Big Apple Circus, employed him to perform as a clown doctor at Boston Children's Hospital, Yale New Haven Children's Hospital, and Hasbro Children's Hospital. Concurrently, he volunteered for Clowns without Borders (CWB) performing in various refugee camps, war zones, and other global zones of crisis. He later served as Executive Director of CWB. It was in pediatric hospitals and refugee camps where he witnessed and began to learn about the true meaning of resilience and self-care. This performance work inspired him to pursue a career in nursing, and he completed a second-degree nursing program at the University of Virginia. Cunningham became an emergency trauma nurse and worked clinically in Charlottesville, Virginia, Washington, D.C., and New York City. It was during his time in New York City that he completed his doctoral degree in public health at the Mailman School of Public Health, Columbia University. Cunningham is the former Director of the Compassionate Care Initiative at the University of Virginia, where he had the opportunity to work closely with Drs. Fontaine and May as this book came to fruition. He currently lives in Atlanta, Georgia, and serves as the Vice President of Practice and Innovation at Emory Healthcare, where he also holds a joint appointment as an Adjunct Assistant Professor at the Nell Hodgson Woodruff School of Nursing at Emory University. Cunningham began his academic journey receiving his BA in English from the College of William and Mary in 2000. For self-care, he is an avid runner and wanna-be gardener. He also loves any chance he can get to swim in the ocean or meditate as the sun rises.

Natalie May, PhD, recently transitioned to the University of Virginia (UVA) School of Nursing after 30 years as Associate Professor of Research in the Division of General Medicine in the UVA School of Medicine. She is a founding member of the UVA Center for Appreciative Practice. Certified as an Appreciative Inquiry facilitator and lead author of Appreciative Inquiry in Healthcare, she enjoys developing appreciative inquiry projects and teaching appreciative practice workshops at her home institution and beyond. May is an experienced qualitative researcher, and she has extensive grant writing, program and curriculum development, and program evaluation experience. Her current research projects include the Mattering in Medicine study and the Medical Subspecialties HOME Team Program for high utilizer patients. She was also an investigator for the Wisdom in Medicine Project: Mapping the Path Through Adversity to Wisdom, a study funded by the John Templeton Foundation. She is coauthor of Choosing Wisdom: The Path Through Adversity and coproducer of a PBS film, Choosing Wisdom. She has codeveloped and implemented an innovative curriculum for medical students, The Phronesis Project, designed to foster wisdom in young physicians and has implemented a similar program, Wisdom in Nursing, in the UVA School of Nursing. May earned a BA in economics and urban studies from Wellesley College, an MA in creative writing from Boston University, and her PhD in educational research from the University of Virginia Curry School of Education. She lives in Richmond, Virginia, with her husband Jim. Her most consistent and effective self-care practices are modern quilting and walking near water, especially the James River and the ocean at the Outer Banks, North Carolina.