Self-Care for Nurses

Self-Care Modalities
Support Groups

Nurses are making healthy changes, but no one can change a system alone. In addition to our endeavors to be healthier, we need to join forces in order to support each other in making healthy changes in our environments.

Napoleon Hill (1960), in his book Think and Grow Rich, left us a legacy with his explanation of a "mastermind". He explained that a mastermind group, where many minds join forces in synergistic action or mutual energy exchange, allows us to transcend the limitations of the individual mind and access the largest wisdom, what Jung called the collective unconscious.

When nurses join forces, they are able to give each other exactly what is needed for empowerment. The ingredients needed for true empowerment include skills, tools, information, and support. Nursing has long been rich in the first three, but support has been our weakest link. We can affect our entire profession by recognizing the value of joining forces and supporting each other's goals. United we thrive.

Support does not mean we have to listen sympathetically each other's stressful stories or that we should help others to the detriment of ourselves and our own personal or professional well-being. However, support might mean that we lend our wisdom, and intent, toward creating healthier environments and working conditions.

There are many ways to initiate formal or informal support groups for nurses. One of the simplest is to listen to our colleagues with an open heart. Many of us, facing challenging situations, find that we need to talk about our experiences, however painful, and to be heard and honored. The act of intentional listening can make all the difference during a difficult time, providing a fair witness to pain and thus releasing previously pent-up emotions that might have been weighing heavily upon the soul.

In addition to hearing each other, we can also offer suggestions that might empower our colleagues. Rather than giving advice, the suggestions might best center around reflective listening, where we reflect exactly what we are hearing the person say. Sometimes we can best hear our own wisdom with this approach. We might realize how we sound, and hearing our words affirmed can give impetus to healthy changes.

At times, it might be appropriate to offer suggestions. An example of this might be when Chandra, a night nurse, spends a long time complaining to you about the condition she found a client in after the evening shift. Rather than getting caught up in the politics or personality issues, you might suggest, "Have you spoken to Irma (the evening nurse) about this?" This act can remind Chandra that she needs to go directly to the source for positive action, rather than complain and talk about one person to someone else.

A support group can be a meeting between only two nurses, established purely for the purpose of support. Rather than allowing it to turn fully into a griping session, provide some intentional listening; then, at an appropriate point, offer simple suggestions by relating what has worked for you in a similar situation. consider the following situation:

Wilma spends the first 10 or 15 minutes venting, then catcher herself and realizes that she wants some help, rather than to complain. OR, after 20 minutes, Connie decides she needs to intervene to support Wilma's strength in meeting the challenge. Connie suggests, "I had a similar situation last month when working with Dr. Agrwal. Let me tell you how we resolved that. Perhaps you will get some new ideas from this story." In this manner, rather than supporting Wilma's victimized state, Connie is presenting a powerful example of how to handle a situation.

Many nurses have tried forming support groups only to find that they become gripe sessions with no relief. I might be helpful, in forming a positive group, to elect someone to monitor the energy, perhaps reflecting what has been happening and suggesting a progression toward resolution.

For example, the nurses on Unit C have agreed to meet regularly to discuss their challenges and arrive at policies they all agree with for handling situations. Mary is monopolizing the conversation, groaning about her husband and home problems. Doris, the elected group energy monitor, may step in: "Thank you for sharing what's going on with you, Mary. We will all do whatever we can to support you here. Are there any issues on Unit C we can help you with?"

Hopefully, an intervention like this is all that will be needed to redirect the group's focus. some groups have found it helpful to limit each person's time to talk so it is even for all members. Each group is a unique composition of individuals and may require special handling, but ultimately people working together discover ways that work for them, within their beliefs and framework, and eliminate things that do not work well in their experience.

A good source for information on groups is Peace and Power: Building Communities for the Future (Chinn, 1995), which was written by a group of nurses working together for an extended period. The group came up with a framework that supported each individual, allowed each person to feel safe in telling her story, and explored what a true cooperative model might look like. In the beginning of this book, one nurse explains their mission:

Swimming Upstream

We are tired to death of swimming upstream alone; we want to feel grounded, connected, to be able to touch the earth and put down roots. We are searching for simplicity and balance in our lives, for comradeship and challenge in our work and our relationships. We feel a need for hope, for possibilities in the midst of despair, for integrity and wholeness in the struggle against alienation, for stability in place of rootlessness, for nurturing and closeness based on equality and respect, not on obligation and exploitation. These needs dictate the journey that leads us to community. (Chinn, 1995, p. xu)

To create community, this group explored its purpose, collective values and beliefs, personal values, expectations, and goals. The depth of their joining is witnessed by the integrity evident in their collective writings. It is a beautiful testament to the power of nurses when they join together. Each group created will differ; some will be loosely structured around the simple purpose of sharing support, while others might be highly organized in terms of structure, purpose, and function.

What is most crucial is that each member be willing to have it be a safe place for every other member, that confidentiality and respect are provided for every member, and that each person be committed to speaking her truth with compassion and clarity. With these guidelines, a support group can be a place of tremendous growth and learning.