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NERU Study Presentation. Expanding Undergraduate nursing students’ knowledge of their self- care Dr. Lynn martin, janet lovegrove, lora Vanberlo, elisha van harte, viola fodor. Our Stories. Janet and Lora. CHS 719 Seminar. Strengthening ‘Self’ in a Self-Directed Learning Curriculum.
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NERU Study Presentation Expanding Undergraduate nursing students’ knowledge of their self- care Dr. Lynn martin, janet lovegrove, lora Vanberlo, elisha van harte, viola fodor
Our Stories Janet and Lora
CHS 719 Seminar Strengthening ‘Self’ in a Self-Directed Learning Curriculum
Noticing • rising attrition and workplace absenteeism rates in nursing • use of black humour • unaddressed exposures to critical incidents • Post Traumatic Stress Disorder (PTSD) • problematic substance use • perfectionism and burnout
PTSD Story “I witnessed and participated in many attempts to maintain life. I am haunted by these disasters. I never received any counseling, nor was there any thought that anyone on my staff might need it. It never occurred to me that the ‘cutting edge’ I was so proud to be working on would, in the end, cut me so deeply.” PTSD in Nurses. 2005, p. 78
Noticing Bevis and Watson (1989; 2000) state there are rich ways of knowing, beyond the rational and prevalent thought and deductive reasoning of academia. Rich ways of knowing involve intuition, insight, imagination, and creative problem solving, which form the foundation of transformative thinking. NERU Pilot Project Application, 2010
Noticing In the views of Bevis and Watson (1989; 2000), transformative thinking has value because it fosters inner resources that are essential components to effective teaching and learning, as well as to health-illness outcomes. NERU Pilot Project Application, 2010
Noticing Elliott (1997); Witt-Sherman (2004); and Johns (2007) support bringing transformative thinking processes to nursing. Further support comes with Hansen-Ketchum (2004) recommending Parse’s (1992) Human Becoming nursing theory as a means of illuminating meaning by finding and being the true self. Fodor (1997) states that when people nurture themselves in body, mind, and spirit, they can help and heal themselves, and lead lives of rich meaning. NERU Pilot Project Application, 2010
Noticing • The Canadian Nurses Association (2009) suggests that “further research may identify interventions that can be introduced in nursing school to address the emotional and psychological factors that contribute to problematic substance use as well as information that nurses can use to develop self-awareness and resiliency.” (p.4)
Interpreting • According to Ackley and Ludwig(2006), nurses demonstrate a need for strengthened coping and resiliency. • Our research team believes that this can be accomplished through developing self-awareness and self-care that begins early in nursing education and continues throughout a nurse’s entire career.
Responding • “We believe that before nurses can engage in a professional caring relationship with a client, they must learn to value and care for themselves.” (McMaster University, 2009, p.5) • “Nursing education institutions [need to] incorporate information about the health, safety, and well-being of the nurse into the core curriculum of nursing education programs.” (RNAO, 2008, p.26)
Responding • CHS 719 graduate seminar with Viola Fodor as guest speaker to explore some of the challenges in nursing education and the need for self-care • NERU study: Expanding Undergraduate Nursing Students’ Knowledge of their own Self-Care
NERU Study Research Question “Would attending a one-day workshop help McMaster undergraduate nursing students expand their knowledge of how well they take care of themselves in body, mind, and spirit?”
NERU Study Objective A one-day self-care workshop, facilitated by speaker, author (1997), and psychotherapist, Viola Fodor, would encourage nursing students to assess their levels of self-care and introduce ways that they could improve their self-care over time. Nursing students who nurture their self-care would be better able to draw on their inner resources to cope with their educational and future career challenges.
Study Findings Study Design with measures and participant activities
Study Measure SELF-CARE Pre-Test WINTER 2011 Level of Program: ______________ Age: ______________ Gender: M F Username (first three letters of mother’s maiden name/2-digit birthday include 0 where applicable) ____________________________________________________________ Please rate your responses to the following statements How often during a week do I take time to relax? 1 2 3 4 5 6 7 (Not at all) (Sometimes) (Frequently) How often during a week do I take time to sit quietly? 1 2 3 4 5 6 7 (Not at all) (Sometimes) (Frequently) How often do I take care of my body on a daily basis? 1 2 3 4 5 6 7 (Not at all) (Sometimes) (Frequently) How often do I take care of my mind on a daily basis? 1 2 3 4 5 6 7 (Not at all) (Sometimes) (Frequently)
Reflecting on the voices of student nurses “I think if I learned earlier in my education what I learned today, it would’ve saved me from a lot of stress, grief, and from the pressures of nursing and university life.”
Reflecting on the voices of student nurses “I absolutely do not think the critical reflections are enough because I feel ashamed/embarrassed to write some things and sometimes I just rush in my writing and don’t really mean what I say. I just wished my tutor could’ve sat me down and asked me if I was okay and how I was doing. I know that I have to be self-directed and responsible but sometimes I need help and it’s too much.”
Reflecting on the voices of student nurses “There’s no point in McMaster having such a high quality of education if the students don’t have the supports to handle it. I don’t want to survive my undergrad, I want to come out as a nurse that has the skills and understanding to cope with real life career pressures.”
Reflecting on the voices of student nurses “I feel this should be expanded to be a 16 week course for all nursing students. Potential Research Question: If the need is identified by students after successful completion of the self-care workshop, should this content be the basis for a compulsory course in the undergraduate nursing program?”
Reflecting on the voices of student nurses “Through this workshop I have realized that understanding ‘how’ to manage stress in my life is crucial now and not later. I feel that nurses are often forgotten about in terms our own health needs. We educate and advocate for stress management in our patients, but we ourselves find it difficult to manage our own stress.” “… in order to take care of our patients, we need to take care of ourselves.” “The nursing program needs to instill awareness and the importance of self-care. Nursing students need your help in finding strategies to manage their stress and nurture their minds, spirits, and bodies and it needs to start now.” Level III BScN student's letter, 2011
Next Steps • Viola Fodor will present for half the day at a faculty development event in May 2012. She will focus on how to incorporate the care of body, mind, and spirit into the undergraduate nursing curriculum. • Consider providing Viola’s program in the spring/summer as a prerequisite to entry into the four year BScN program at all three sites • Consider offering booster sessions of Viola’s program throughout each term to remind and encourage students about their self-awareness and their self-care • Other suggestions?
Contact Information Janet Lovegrove, RN, BScN, MSc lovegrje@mcmaster.ca Viola Fodor, MEd, (C)OACCPP violafodor@sympatico.cawww.violafodor.com Elisha Van Harte, MSW, RSW elishavanharte@hotmail.com
References Ackely, B.J. & Ladwig, G.B. (2006). Nursing Diagnosis Handbook A Guide to Planning Care (7th ed.). Philadelphia, PA: Mosby Elservier. Bevis, E. & Watson, J. (1989;2000). Toward a Caring Curriculum: A New Pedagogy for Nursing. Sudbury, MA: Jones and Bartlett. Canadian Nurses Association. (2009). Position Statement on Problematic Substance use by Nurses. Canadian Nurses Association. (2002). Planning for the Future: Nursing Human Resources Projections. Elliott, H. (1997) Holistic nursing and the therapeutic use of self. Complementary Therapies in Nursing and Midwifery, 3, 81-82. Evaluation of Oral Presentation Adapted From McMaster University (2009), Undergraduate Nursing Education: Program Handbook 2009-2010. Hamilton, ON: McMaster University. Fodor, V. (1997) Desperately Seeking Self: An Inner Guidebook for People with Eating Problems. Carlsbad, CA: Gurze Books. Hansen-Ketchum, P. (2004). Parse’s theory in practice: An interactive analysis. Journal of Holistic Nursing, 22(1), 57-72. Johns, C. (2007). Toward easing suffering through reflection. Journal of Holistic Nursing, 25(3), 204-210. PTSD in nurses. 2005. Advanced Journal in Nursing, 105(7), 77-78. Registered Nurses Association of Ontario (RNAO). (2008). Healthy Work Environments Best Practice Guidelines Workplace Health, Safety and Well-being of the Nurse. Tanner, C. (2006). Thinking like a nurse: A research based model of clinical judgment in nursing. Journal of Nursing Education, 45(6), 204-211. Witt-Sherman, D. (2004). Nurses’ stress and burnout. American Journal of Nursing, 104(5), 48-56.
