Self-Care
for Nurses
Self-Care Modalities
Imagery
Imagery is a nursing tool that has been steadily growing in popularity over the past decade (Achterberg, Dossey, & Kolkmeier, 1994; Shames, 1996). It involves the use of internal pictures, sounds, or sensations to evoke our personal healing responses.
As defined in dictionaries, an image is a mental picture, or representation of something, that can be either real or imagined. We experience emotional and physiological responses to images. We might also think of images as a thought with a sensation attached. Not everyone sees visual pictures in the mind’s eye, but most people have sensory responses to external symbols.
Consider, for example, the image of a rose. As you read the word rose, you may begin to make some mental associations, such as a color, a shape, a smell, a bush on which a rose grows. To continue, you may recall the last time you held a rose in your hand, the person who gave it to you, or feeling the prick of a rose thorn. Now, if we ask you to imagine a lemon, a very tart, juicy lemon, you may begin to salivate. Your response is not to an actual piece of fruit but simply to the thought and sensation attached to the word.
Images are extremely powerful and can be used to evoke a wealth of internal experiences, including a sense of health and well-being. When working with our clients, we can help them to feel more relaxed by speaking softly and encouraging them to picture a scene that is peaceful. They might envision themselves lounging comfortably in a favorite place, by the ocean or in a special setting where they would like to be. It does not matter that they are actually in a treatment facility. At that moment, they have actually traveled to a different, more healing place. When we are using such therapeutic imagery, we are helping clients to direct their minds toward a beneficial outcome, rather than repeating patterns of anxiety.
The following exercises are suggestions for self-care of the nurse using imagery. As you read them, allow yourself to take time to step into each experience as fully as possible and begin to experience the benefits of imagery for well-being.
EXERCISES The Release Balloon Sitting comfortably in a quiet place, allow yourself to release the breath, letting all the stress and tension of the day flow out as you exhale. Do this several times to further unburden yourself. Imagine a pile forming in front of you of specific issues that bother you. Make a symbol of something that is especially annoying to you (e.g., an imposing stack of papers to symbolize paperwork). Let the pile attract many issues like a magnet. Put the pile into the basket of a big, colorful hot air balloon. When the basket is full, gradually untie the lines that hold the balloon. Watch it rise. Drift above the treetops—above the clouds—until it is out of sight. Take several deep breaths and feel lighter and freer. The Safe Place Sitting comfortably in a quiet place, think of the most peaceful place in which you have ever been. It may be a picture that you have seen or a place that you remember. After selecting the site, allow your imagery to develop. See the colors of this safe place. See the surroundings. Hear the sounds associated with this special place. Smell the air of this place. Feel the safety and comfort. If someone is with you, hear the person’s soothing words or feel the person’s breath. Let your whole body sense the peace of this place. Enjoy the full experience of this safe haven. Gently, come back to full awareness, feeling refreshed and renewed, knowing that you can return to this sensation any time that you choose. The Image of Health and Wholeness Sitting comfortably in a quiet place, release the breath and note areas of discomfort in your body. Image a screen in front of you that shows your body to you with exact detail of the uncomfortable, stressed areas. You may note that the areas that are stressed are tighter and darker, while the healthy areas are warmer and brighter. Gradually, let each area of grayness fill in with a healing color, or sunlight, gently washing away the distress as you breathe into each area. See the whole body filled with light, warmed by your loving breath, filling with health and wholeness. Now, embrace the picture, let it become a part of you. Experience your whole being filling with light and caring. Breathe fully and deeply before moving forward to your next task. |
With these understandings, we can proceed to a brief exploration of how imagery can be incorporated into work settings. The following excerpt shows how a moment with imagery promoted a priceless experience of healing:
Dying Peacefully
A nurse was working with an agitated dying client who had always wanted to go to Europe. It was apparent that the wish would never be fulfilled. The nurse took ten minutes of relaxation with the client, mentally escorting him to a quiet place where he felt comfortable and had no pain. The nurse gently guided the client by asking questions such as “Where would you like to go?”; “What would you like to do?”; and “How does that feel?” When she looked over, the client was crying and said he really felt that he had gone to Europe, and that it was wonderful. Within two days, the client died peacefully.
(Shames, 1996, p. 98)
We see imagery as an easily used, effective tool that can be applied any time, any place. It involves the ability of the nurse to assist the client in imagining something more pleasant than the current dilemma. It can allow the client who is upset or in pain an opportunity to escape, perhaps only for a few moments, from his disturbing reality. This brief respite may be all that is needed for the client to become more relaxed or for the person to reconnect to his internal resources, making better decisions for self-healing.
Active use of the imagination, however, may not always be appropriate with psychiatric clients. There are times that using the mind to escape is not appropriate, for instance, when working with psychotic people who cannot distinguish between reality and fantasy. In these instances, the nurse must help the client to relax and “escape” within the parameters of the existing environment, perhaps by focusing on something pleasant in the room, such as a picture or a vase of flowers.
Nurses who use imagery in their daily lives often attest to being more focused, present, and powerful in their interactions. Whereas many other modalities require larger blocks of time, imagery can be amazingly effective in a minute time span. The nurse can go into a laundry room and calm herself by envisioning a peaceful scene, then step out and move into the client environment with a positive outlook. It has often been said that the mind is the builder and the physical a result. If this is so, then it is important for us to use the mind to build healthier, happier surroundings, one thought at a time.
While imagery may not always be the best tool for psychiatric clients, it is certainly always an appropriate and helpful tool for the psychiatric nurse. Our clients may be emotionally unstable or mentally confused, but we can influence their care through our own focused presence.