Nursing is a profession built on empathy, dedication, and resilience. We care about and are dedicated to both our patients and our teams. We’re also really tough. Sometimes we are too tough for our own good. What many call resilience can be a dangerous thing.

This resilience often causes us to make decisions or accept things that might not be good for us. We know that we CAN, so we think we SHOULD. We often struggle with setting healthy boundaries, not just in our careers, but in our lives. 

You see, the type of person who becomes a nurse is generally a very giving person. We have a natural tendency to want to serve others. This is a good thing. It’s part of what makes nurses so amazing. Unfortunately, it can be very difficult for us to turn this off. 

When we talk about boundaries in nursing, we often talk about the nurse-patient relationship. This is a very important boundary, but it’s not what I’m talking about. I’m talking about setting healthy boundaries in the nurse-employer relationship and even in the many different relationships with people in your lives. Yes, setting boundaries with people you care about is not only a good thing to do, it’s actually good for the relationships.

Why Boundaries Matter in Nursing

The reasons why boundaries are important in the nurse-patient relationship are well documented and, for many of us, obvious. However, the reasons why the sort of boundaries we’re talking about here matter are not really talked about so much. Here are some of the ways that these sorts of boundaries impact nurses:

MENTAL HEALTH

Many, but certainly not all, of the mental health struggles we face are a result, at least in part, of our inability to set healthy boundaries. Recently, on LinkedIn, I wrote a post talking about my own struggle with this. The weight of the many things that I had taken on seemed to come crashing down on me as I drove home from work. The result was me shaking and crying, with tightness in my chest and palpitations. My lack of boundaries had led me down a path that took me to that moment. 

I think most of us have experienced something similar. 

RELATIONAL HEALTH

As nurses, we work long hours. We work nights, weekends, and holidays. This alone can put a strain on our relationships. It becomes even worse when we fail to set healthy boundaries. Our inability to say no to extra shifts or that last-minute call-in often results in us missing more family events than we’d like to. Trust me, this has an impact on all the important relationships in our lives.

PHYSICAL HEALTH

Working 12 hours is tough. AND, how often are those 12-hour shifts actually only 12 hours? First, we have to add 30 minutes for our lunch break. Then there is time after your shift to finish charting or wrapping up other things that you may not have gotten done. Then we take and do this 3-5 times per week, sometimes even more. This WILL take a toll on your body over time. 

As you can see, failing to set boundaries can impact all of the 6 Pillars I write about in my book.

Common Boundary Challenges Nurses Face

Most of us would willingly admit that boundaries are important. Yet, many of us struggle to set them. Here are a few reasons why:

• GUILT: Many nurses feel guilty at the very idea of setting boundaries. We feel like we are letting others down.
• FEAR: This may be a fear of rejection, retaliation, or just fear of what others will think.
• PEOPLE PLEASING: Many of us struggle with this felt need to make everyone happy.
• EXAMPLES: Many of us have never seen what healthy boundaries look like.

For more, check out this article: https://www.thewomensvault.com/setting-boundaries-barriers/

Types of Boundaries Nurses Should Establish

Ok, now that we’ve established why boundaries are important. Let’s look at some types of boundaries nurses need to set:

WORK

Staffing is not your responsibility… unless you’re a manager or administrator, then it is your responsibility. But, for the rest of us, staffing is not our responsibility. Decide how much extra you will or will not work, then set that boundary. Decide what things you will or will not miss in your personal life for the sake of work.

RELATIONAL

Nursing often means missing family events, but it doesn’t have to. If you choose to stay bedside in a hospital or other 24-hour setting, great. Do what works for you and your family. Even with this, be intentional about the sort of events you will or will not miss in your personal life. Maybe you don’t make it to every practice, but when the big game comes, you need to be there. 

Being a nurse doesn’t mean you HAVE to miss events. Early in my career, when our kids were small, we would adjust our holiday celebrations to fit my work schedule. Maybe we would do Thanksgiving on Sunday, after church, instead of Thursday. Maybe we would open Christmas gifts on Christmas even, instead of Christmas morning. Maybe a birthday party would be on Saturday, instead of the actual day. You get the idea.

As my kids got older and had more events, this changed. You see, I had committed that I was going to be at ALL of my kids’ stuff. My parents, for a variety of reasons, struggled to be at my events, and I was determined not to let that happen to my kids. I was going to be there so much that it would become annoying. I told my wife that I was going to keep showing up until the kids ask me to stop. Then I was going to keep showing up, cause I’m grown and do what I want. The funny thing is, they never got annoyed with my presence, and they never asked me to stop showing up.

We are often told that “real nurses” are the ones who work bedside in the hospital. Well, that’s crap. I made the decision to seek a Monday-Friday, 8-5 type job a number of years ago so that I could always be there for my kids. The result was that the band’s trailer has almost no miles over the past seven or eight years that it wasn’t attached to my truck. There are plenty of this sort of job out there, and there is no shame in taking them.

SOCIAL

Time with friends and family is so important. It is not just fun, it’s a vital part of a self-care plan. At the same time, it can be yet another drain on you. There are times when your friends will invite you to something and you really don’t want to go. It’s ok to say no. Let me say that again, it’s ok to say no. 

You don’t have to say yes to every social event or call for help. Yes, there are for sure times when a friend calls for help and you NEED to be there for them, but when it’s not one of those moments, it’s totally ok to say no. The ones that care about you will get it. The ones who only care about what you can offer them, might get angry. 

Strategies for Setting Healthy Boundaries as a Nurse

1. Reconnect with who you are: Take time to consider who you are. Yes, nurse is a part of your identity, but I don’t think any of us would say that it is the most important part. So, take time to think about all the parts of who you are. This is one of the exercises I go through in the companion workbook to my book, The Restored Nurse.
2. Identify what matters most: Once you’ve identified who you are, take time to consider which parts of you are most important. Put those in order from most important to least. For me, my top three are: child of God, husband, father, in that order. Your list may look very different, but put the top five or so in order.
3. Name your values: Now that you’ve identified what matters most, name your values. For me, my relationships with God, my wife, and my kids are the top. This means that I have to build my life in such a way that feeds those relationships. Name your values, then write them down. Once you’ve decided what your values are, you know where your boundaries are, because it is anything that goes against those values.
4. Communicate your boundaries: This is not to say that you have to go out and make some grand statement about your boundaries, but when someone threatens your boundaries, you do need to make it clear where your boundaries are. You can do this with love and respect, but you need to do it. If someone violates a boundary that you have not communicated, that’s not on them.

Choose guilt over resentment

If I could boil this entire post into one statement, it would be something I’ve heard from my favorite podcaster many times: “Choose guilt over resentment.” Dr. John Delony says this frequently on his podcast, The Dr. John Delony Show.  

Ok, but what does this mean?

When setting boundaries, there will be times when we feel bad about enforcing them. Your manager, or your favorite coworker, calls and asks you to come in. Because you care about your team, you may be tempted to come in. You might think, “The extra money would be nice.” But then you remember that your son has a baseball game that night. If not missing your kids’ events is a boundary that you’ve set, then the obvious answer is “no”. Still, you feel guilty.

Over time, saying yes to things you don’t want to do in order to avoid feeling guilty can lead to resentment. This is what Dr. John is talking about. It’s better to feel guilty for a little while for saying no than to grow resentful of the person asking.

I get it, boundaries are hard, but they’re also vital. 

The post Nurses Give Great Care, but at What Cost? Setting Healthy Boundaries for Well-Being appeared first on Restoring Nurses.

As nurses, we see and experience things that most people run from. This may seem cliche to say these days, but it’s true. Many people outside of healthcare have no idea what it’s like to sit with a person you don’t even know, so that they don’t die alone, while a worldwide pandemic prevents their loved ones from visiting. Most people never had to witness the anguish on someone’s face as the only access they had to their dying loved one was through an iPad screen or window. This takes a very real toll on nurses and other healthcare workers.

We are very familiar with the mental and even physical effects that the stressors of nursing have on us. However, what’s often ignored is its effect on our spiritual health. There may be a variety of reasons for this. Among them is the connection that many place between spiritual health and religion. We’ll talk more about the difference between the two, but this connection often leads folks to avoid any talk of spiritual health, much to their own detriment and that of other nurses.

Ok, but what IS spiritual health? A quick Google search gives us this definition for spiritual:

“A dimension of wellness focuses on meaning, purpose, and connection, encompassing belief, values, and a sense of connection to something larger than oneself.”

Understanding Spiritual Health in Nursing

Now that we’ve identified what spirituality is, let’s talk about what it’s not. Spirituality is not equal to religion. Yes, if someone has a faith tradition, it will influence their definition of spiritual health, as well as the habits and routines that they use to nurture it. However, spiritually does not automatically mean religion. In my book, The Restored Nurse, I share some of my own spiritual journey as a Christian. Regardless of your religious background, you may find some of yourself in my story.

You can be spiritual, without being religious.

Ok, now that we’ve established that spirituality is not about religion, let’s look at how spiritual health can impact your emotional resilience and mental health. An article from Mass General Brigham hospital shows us how spiritual health can affect mental health in a variety of ways. (1)

• Purpose and Meaning: Spiritual health practices can help us to gain a sense of purpose and meaning in our lives. In a time when many people struggle with a lack of these things, this can be a powerful tool.
• Supportive Community: Many spiritual habits include spending time with people who share your beliefs and values. This provides a base for the sort of supportive community that we really all need in the difficult times of our lives.
• Hope, Self-Esteem, and Self-Worth: Spirituality, even when separate from religion, can help us to see that there is hope beyond our darkest moments. It can help us to believe in ourselves more and improve our sense that we matter.
• Tools: Spiritual practices can provide he sort of tools that we need to better care for ourselves. 

On a more clinical level, spiritual health habits have been shown to help with addiction, depression, and even lowering suicide risk by as much as 68% in women and 33% in men. (1)

Common Challenges Nursing Face in Maintaining Spiritual Health

It’s among the greatest of ironies that the very people who dedicate their lives to caring for others often ignore the very care that they, themselves, need. Mental healthcare among nurses has almost become a taboo subject, with a large stigma being attached to it. Spiritual healthcare may not have the same level of taboo or stigma, but mostly because it simply gets ignored. I’d say that stigma and lack of awareness are the start of the challenges nurses face when it comes to spiritual health.

Stress and Emotional Exhastion: Let’s be real here, nurses are TIRED. Not just a physical kind of tired that can be fixed by a good nap or a weekend of sleeping in. I’m talking about the kind of tired that you feel DEEP down inside. The kind of tired that has you driving home from work, crying in the car, for no reason, which I did recently.

The job of a nurse has always been hard, but it seems in the past few years, since COVID, it’s gotten worse. I believe that many nurses went into COVID at their limit emotionally, mentally, and spiritually, and came out of it with nothing left. This is why we saw 100,000 nurses leave during COVID and expect nearly a million more to leave by 2027. (2)

The existing emotional exhaustion, the stress that’s a natural part of the job, and the many stressors that are NOT normal are huge factors making spiritual health even harder for nurses.

Compassion Fatigue: I won’t go much into this, cause I covered this in some detail in last week’s blog post. Still, understand that it is a factor that affects spiritual health.

Time constraints and lack of self-care focus: Some time ago, I asked nurses on TikTok to identify their biggest barriers to self-care. Time was one of the top answers. We work long hours, weekends, nights, holidays, etc, 24 hours, 7 days a week, Nurses are working to care for other people. On top of that, many of us have lives outside of work, regardless of what our employers may want. This all leaves us with limited time for self-care, especially spiritual health.

Practical Strategies for Nurturing Spiritual Health

Personal reflection and mindfulness: Recently, on LinkedIn, I shared a post on mindfulness. In its most basic form, mindfulness is about understanding yourself both mentally and physically. If you’re interested in learning more about mindfulness, I’m planning a Mindfulness Workshop.

Meditation: While meditation is a common practice among a wide range of religions, it’s an amazing practice that you can benefit from, even if not religious.

Gratitude: This is another topic I discuss in The Restored Nurse. This can be a gratitude journal that you write down 3-5 things you are grateful for every day, or simply thinking about what you’re grateful for as you drive to work.

Finding meaning in your work: I recently spoke at a pinning ceremony for a nearby nursing school. One of the things I told these soon-to-be nurses was that if the work you do doesn’t mean anything to you, then it will become harder and harder to do it year after year. If you can’t find meaning in the current work you are doing, seek out work that does give you meaning.

Community: We are made for community. This can be as simple as spending time with friends or as big as religious or other gatherings with people who share your beliefs and values. You NEED those relationships. They will feed your spiritual health, but also your mental and relational health.

Prayer, music, time outside, and many other things can feed your spiritual health. If you’re not sure which practice is best for you, just start doing SOMETHING. Take the time to learn what works best for you. The truth is that even as you try some things and find that some don’t work as well as others, your spiritual health will benefit, even from this process of discovery.

Conclusion

If you get nothing else from this post, remember that you are a spiritual being, even if not a religious one. As you work to take care of all the other parts of yourself and your life, don’t ignore this one. If you do, you may make great advancements in your life, only to find that you still feel empty. That emptiness is within your spirit. Be sure to fill it.

REFERENCES

1. https://www.mcleanhospital.org/essential/spirituality
2. https://www.ncsbn.org/news/ncsbn-research-projects-significant-nursing-workforce-shortages-and-crisis

The post Spiritual Health for Nurse: Why it Matters and How to Nurture It appeared first on Restoring Nurses.