WORKBOOK for Self-Care for New and Student Nurses

• Self-care is not selfish. Nurses should be entitled, in fact expected, to care for themselves with the same creativity and compassion that they use to care for others.
• Nurses don't flourish simply by fostering the well-being of others. The nursing profession is inherently meaningful in that we care for patients and families during their most vulnerable moments. But meaningful work has its limits. A major thread throughout this book is that we don't want to be "the naked person offering someone their coat."
• Self-care is about the mind as much as it is about the body.
• Self-care is a lifelong practice, and it is best to begin the practice early, before facing the stressors of a hospital or other clinical setting. In general, student nurses face significantly more stress than their peers, increasing the importance and value of self-care practices during nursing school.
• Individual self-care practices do not let organizations off the hook. The importance of a healthy work environment cannot be overstated, and in this book, we offer help in selecting a healthy workplace and encourage readers to advocate for themselves and others.

Building a Self-Care Tool Kit

This workbook will provide opportunities for you, the student nurse or new graduate nurse, to explore self-care behaviors that will help you deal with the big and small stressors you will encounter in your life or that you are encountering now. Our hope for you is that you will wholeheartedly "jump in" and explore both the practices outlined in this book and others that you encounter in this journey. Self-care has become an exciting field of study and practice, especially during the time of COVID-19 and other stressors that affect those of us who work in healthcare. There are so many resources to explore, and we have designed this workbook to encourage you to take advantage of as many of them as you can. We encourage you to build your own self-care tool kit. Just like a carpentry tool kit or any tool kit, it will contain important items to help you be the best nurse (or carpenter) possible. The tools are essential to getting the job done. This self-care tool kit, instead of hammers, screw drivers, and tape measures, will be a collection of a strategies, behaviors, and mindsets that will help you flourish in nursing.

To that end, we hope that you will try many of the practices shared here. Some will resonate with you immediately. Some will fit your lifestyle. Some will need modifying to suit your preferences. (Don't like writing down a gratitude list with paper and pen? Take photographs or use social media instead.) Some will just be completely wrong for you. Some might be intriguing to you, but maybe you'll decide to hold off and try them again in a few months or years. Explore practices on your own. If you are in a classroom or group setting, take advantage of your collective wisdom, and share

your explorations with each other.

We cannot emphasize this enough: These practices take practice! So much of self-care is mental work, even more than the physical work of caring for your body. Our human brains are blessed with neuroplasticity, or the capacity to change. Just as you can build muscle tissue and train yourself in a

physical skill such as bowling, roller skating, or playing the tuba, you can train your brain to react in new ways to stress and the challenges of your chosen profession.

When you have completed the readings in the textbook and the exercises in this workbook, we anticipate that you will have your own collection of self-care tools that you can practice regularly and rely on when you face challenges in your career and life. This self-care tool kit will help you build resilience to overcome a range of adversities, from daily annoyances, to ongoing stressors, to sudden loss or change.

Dorrie K. Fontaine, PhD, RN, FAAN (she/her), 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 spring 2009 retreat at Upaya Zen Center in Santa Fe 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 (he/him), 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. During his time in New York City, 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 (she/her), 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, 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.