Self Care for Nurses and Mental Health in Nursing

Written by Sasha Blakeley

Nursing can be a very stressful profession. It requires a high level of compassion and empathy in difficult situations, not to mention long hours, frequent night shifts, or the risk of contracting contagious diseases. Some nurses might find that the challenges of the job begin to harm their mental health. This experience is common, and it can be very distressing.

According to a 2022 study on mental health in nursing published by the Elsevier Public Health Emergency Collection, 44.6% of nurses surveyed reported experiencing moderate to severe depression, while 31.1% reported moderate to severe anxiety. Finding the appropriate resources to care for one's mental health is an important process. One of the best ways for nurses to manage their mental health is by practicing good self-care. Read on to learn more about why self-care is important, what it looks like on a practical level, and how to customize self-care systems.

Stress and Burnout in Nurses

Many nurses experience high levels of stress; some manage that stress with little need for outside help, while others find that their stress impacts their ability to do their jobs well or negatively impacts other aspects of their lives. When nurses experience unmanageable stress levels, they can end up in dangerous or even life-threatening situations. These include situations that are dangerous to medical professionals and situations that are dangerous for patients.

One result of ongoing stress can be burnout. Burnout is a term denoting intense emotional exhaustion and is extremely common in the nursing profession. According to a 2021 study conducted by Nursing CE Central, a shocking 95% of all nurses surveyed reported feeling burnt out, either at the time of the survey or some point in the last three years. That means almost everyone who chooses to become a nurse is likely to experience these stressors at some point.

For some, burnout marks the end of a nursing career, while others find ways to cope and ultimately recover. With the current global need for nurses increasing continually, nurse retention is a critical issue. While self-care is not the entirety of the solution to nurse burnout, it can go a long way in helping nurses sustain their emotional well-being while working.

The Impact of the Pandemic on Nurse Mental Health

The Covid-19 pandemic has impacted everyone, but few groups of people have been as severely and immediately affected as nurses. Unsurprisingly, the statistics on nurse mental health listed above are strongly influenced by the pandemic, which pushed many hospitals and clinics to a breaking point. Many healthcare facilities were overwhelmed and unable to care for all patients who needed help. Nurses, especially but not exclusively emergency room nurses, were on the front lines of that influx. Many nurses ended up leaving their jobs during the pandemic because the strain was simply too great. Self-care for nurses during the pandemic was difficult, as almost everyone was simply running to keep up. Nurses reported issues like:

  • Unmanageably long work hours
  • Severe lack of PPE,
  • Fearing for their own health because of extended exposure to Covid-19

Although Covid-19 remains a serious threat, infection levels have dropped in the United States and many other parts of the world. Most hospitals now have systems in place to adequately quarantine and treat new cases. Although nursing remains stressful, it currently seems unlikely that things will be as challenging as they were in the first two years of the pandemic. Nonetheless, the scars on nurses' mental health remain. Those who have remained in the profession may find themselves more prone to stress than they once were, and those who are just coming into the workforce might find that they are working under systems that have not been in place for long. Prioritizing initiatives to improve nurse mental health is more important than ever to ensure a smooth return to a more normal healthcare situation.

The Risks of Poor Mental Health

As noted above, poor mental health can have serious risks. Nurses who are under a lot of stress, experiencing depression and anxiety, or not properly caring for themselves are more likely to make serious mistakes than they might if they were feeling well. Those mistakes can be dangerous to patients; for instance, if a distracted nurse were to give a patient the wrong dose of medication.

These mistakes can also be dangerous for nurses; an exhausted nurse who has to drive home may be more likely to get into a car accident than one who is better rested. There are also long-term impacts of stress on the body, like a heightened risk of heart attack, high blood pressure, and stroke. People who deal with long-term stress might also have sleep problems or issues with memory and concentration.

Maintaining Good Mental Health

For nurses, the stresses of the job are a given. What matters is how nurses manage that stress during and outside of work hours. Although work stress can sometimes seem insurmountable, implementing positive self-care practices can make a big difference to a nurse's quality of life and ability to balance work with personal time. Before taking a look at these tips in more detail, it is helpful to examine exactly what self-care is, dispelling some myths about this useful tool and looking into the ways that self-care really can make a difference in people's everyday lives. While self-care is important for everyone, it may be an especially critical consideration for nurses and others with high-stress jobs.

What Is Self-Care?

The term ''self-care'' can actually refer to many different behaviors and activities. Broadly speaking, self-care is what it sounds like: taking care of oneself. But what exactly that care entails can vary significantly from person to person depending on their personal needs and circumstances. Self-care has been widely discussed in online spaces, sometimes in reductive terms.

Many people are familiar with exhortations to run a bubble bath or unplug from social media for a few hours, and it is certainly true that these can be aspects of self-care. However, the concept can actually be applied in many other circumstances, some of them intensely practical in a more challenging way to romanticize. For some people, self-care might mean having a quiet evening, cooking a healthy meal, and journaling. For others, it might involve deep-cleaning the apartment, asking friends and family to help with childcare, and putting systems in place that will make life easier in the long run.

The Importance of Self Care

Self-care is important for many reasons. First, every person deserves and requires adequate care to survive and thrive, which is something that nurses are well aware of. Self-care can help reduce stress and make the impacts of anxiety and depression more manageable, leading to both short-term relief and long-term health benefits, like lowered blood pressure and a more positive self-image. People who practice good self-care may also be more likely to succeed in their careers, as they will be better equipped to do a good job and less likely to let important tasks slip through the cracks. Self-care can improve both mental and physical health, though it is most commonly associated with mental health. Mental health conditions like anxiety and depression come with serious risks if not managed properly, and self-care is a crucial part of that management process.

Self-Care Tips for Nurses

Understanding the importance of self-care is one thing, but actually finding actionable suggestions and implementing them is another. Many people know they should take better care of themselves, but the demands of life and work can make the task of putting systems in place seem overwhelming. Self-care has many dimensions, including:

  • Physical
  • Emotional
  • Professional
  • Spiritual

The following suggestions are intended to be specific starting points that nurses can work on one at a time, picking and choosing which are most important and effective for their current situation.

Get Enough Rest and Food

The National Sleep Foundation recommends that adults between the ages of 18 and 64 should aim for between 7 and 9 hours of sleep each night. Getting enough sleep, especially having a regular sleep/wake cycle, is crucial for good emotional management, integration of new learning, and physical health. For those who experience mood disorders like depression and anxiety, a regular sleep schedule is considered a base treatment. Because of how nurses' shifts are set up, many nurses struggle to maintain a regular sleep schedule or get enough sleep, often contributing to greater stress. While maintaining the same 24-hour sleep/wake cycle each day is very difficult for most nurses, prioritizing sleep whenever possible is a good way to promote wellness. Nurses should plan ahead to figure out when they will be sleeping and should plan personal time around sleep whenever possible.

Another aspect of physical self-care is nutrition. Eating enough food is crucial for nurses, who need to maintain high energy levels during work hours. Eating nutritious food is also important to support one's health, ensuring the body and brain have all the fuel and nutrients they need to function well. It may be helpful for nurses to make a meal plan, subscribe to a meal delivery service, or plan grocery trips carefully to ensure they always have access to good-quality food while working and at home. Keeping a supply of high-energy snacks like protein bars on hand can also be helpful as a way to maintain energy at work. Steady, varied nutrition is a good way to support mental and physical health.

Take Time to Switch Off

The importance of establishing and maintaining a good work-life balance has been at the forefront of a lot of popular discussions in recent years. While creating this balance is good for all workers, it is particularly helpful for high-stress careers like nursing. Outside of work hours, it is very important to find time to switch off. That means not thinking about work and living in the moment. For some, that might mean setting aside time to focus on specific activities, either alone or with loved ones, during which time they do not speak about or worry about work or having at least one day off per week without checking in with work colleagues. Taking time away from work, both physically and mentally, can help people reset, allowing them to feel more refreshed when going back to work. For many people, even a few hours without work stress can make their careers much easier to manage.

Develop a Strong Support Network

Most self-care tips emphasize the ''self'' aspect, but the truth is that humans are social creatures. Connecting with and relying on each other is a fundamental need that can be easily overlooked. One way to prioritize self-care is to develop a strong support network to rely on. This network can include friends, family members, neighbors, or a partner. Ideally, it should consist of multiple people and should be based on mutual care. Support networks are important when it comes to emotional regulation; spending time with friends and partners can help individuals work through their emotional experiences, disengage from work stress, and form close bonds. Support can also be practical, giving nurses people to reach out to for help, like picking up children from school, coordinating grocery store runs, or even planning holidays.

For those who live with partners or roommates, support can also take place at the household level. It may be helpful to talk about how to split household chores in a way that is fair but also supports the member of the relationship who is working longer more demanding hours. Having these discussions and laying out an agreement that works for everyone can be challenging, but the outcomes are often positive. For those who are not used to asking for help, the process of learning how to express one's needs can take time. Practicing talking about one's difficulties and needs with a trusted friend or partner is a good place to start.

For those preparing to become nurses, you can find NCLEX exam resources and support to help you on your way to becoming a licensed nurse.

Connect with Spirituality

Spirituality is one facet of self-care, though that term should be applied in the broadest sense. Essentially, connecting with spirituality is a way to ground oneself, let go of stressors, and maintain a sense of purpose. Many people find meditation to be a helpful tool, both for its potential spiritual benefits and its anti-anxiety effects. Mindfulness is another more secular tool that falls under spiritual self-care, reducing the need to get caught up in the future and the past and bringing individuals back into the present. For those who do have a religious faith, that faith can be an important element of self-care. Spending time in prayer or reading religious texts can help people connect to meaning, reduce their stress, and feel more secure.

Consider Therapy

Self-care sometimes means recognizing a need for more help than people can provide for themselves, even with the support of friends and family. Attending therapy can be a great way for people to work through challenging emotions and experiences. It is one of the most widely recognized treatments for clinical anxiety and depression, but a diagnosis is by no means a prerequisite for attending. Therapists can provide an unbiased, confidential space to talk about the stresses of work. They can give nurses further resources to use in times of greater stress and can teach effective coping mechanisms. For those who have busy schedules, even one session every week or two weeks can make a difference when it comes to maintaining mental health over time.

Create a Peaceful Environment

When people are not at work, they typically spend most of their time at home. That means the home can contribute a great deal to a person's mindset and mental health. Working a long shift and then coming home to an apartment where the dishes have not been done can be immensely demoralizing and have a compounding effect on stresses that already exist. Although the process of making a comfortable home environment and keeping it tidy is easier said than done, it is a good goal to work toward. That might mean taking some time to redecorate, setting a chore schedule and sticking with it, or finding ways to reduce the work involved in keeping things clean. Doing a little bit of cleaning work often instead of letting it pile up and doing it all at once can be much easier to manage, even if it is occasionally frustrating. Having a private space to unwind is also a good option for many people, especially if they live with other people.

The Limitations of Self-Care

While self-care can have a profound impact on people's ability to cope with stressful work situations and self-care practices are crucial for avoiding burnout for many nurses in an especially high-stress profession, it should also be recognized that self-care is not the solution to all problems facing nurses right now. It is just one piece of a much larger puzzle. Many hospitals and clinics are still understaffed or have insufficient funding and resources. Nurses still run the risk of contracting infectious diseases at work and still have to deal with challenging patient interactions regularly. Self-care can help ease some of these problems, but not all of them. That does not mean all hope is lost, but it does mean that nurses should not feel discouraged if their best efforts at self-care are still not enough to help them avoid burning out. The limitations of self-care simply point to the importance of other initiatives to improve nurses' working conditions, which usually involve the collective effort of many people working together. Self-care is only as powerful as the collective care that it inspires and assists.

Frequently Asked Questions

  • Why is mental health important for a nurse?

    Mental health is important for nurses because nursing is a high-stress job that can lead to burnout. Monitoring one's mental health and practicing good self-care can help nurses function better at work, providing better care for both patients and themselves.

Expert Answers to Common Questions about self-care tips for nurses' mental health

  • What are some ways aspiring nurses can find support and community among their peers and other nurses?
  • What is one piece of advice you wish you had when you were working to become a nurse?
  • What is the most rewarding thing about being a nurse?
  • What tips can you share to help students prep for and pass their nursing exams?

You can read their biographies and answers below:

  • Expert contributor image

    Cristine Hampe

    Administrator

    I started my healthcare career in US Navy in the 80s as a Hospital Corpsman Surgical Technician. After leaving the Navy I worked as an OB Technician, then received my LPN, followed by my ADN, and then my BSN. I worked as a pediatric home health nurse for 15 years and pediatric surgical nurse for 4 years. In 2010 I started teaching in a PN program and then became the Administrator of the program after completing my MSN a few years ago. The PN program that I am the administrator of is the same PN program I graduated from almost 20 years ago.

    • What are some ways aspiring nurses can find support and community among their peers and other nurses?

      Nurses are being valued now more then ever before. Joining nursing social media sites and nursing organizations will help keep nurses connected to their profession and other nurses.

    • What is one piece of advice you wish you had when you were working to become a nurse?

      Do not give up on your goals in life, no matter what may be thrown at you, you can do it.

    • What is the most rewarding thing about being a nurse?

      The most rewarding part of being a nurse is helping others.

    • What tips can you share to help students prep for and pass their nursing exams?

      Know the "WHY". When doing practice questions, read the rationales. Rationales will teach you why certain answers are wrong and why certain answers are right. You can not memorize, reading the rationales will help you learn.

  • Expert contributor image

    Melissa Davis

    Instructor in Nursing

    I have been a registered nurse for over 42 years and continue to have an active practice in community health. I have taught nursing at all undergraduate levels since 2011 and have a master's degree in nursing education as well as a doctorate from Yale University. Research interests include the nursing role, metacognition for nursing students, and nursing medication errors.

    • What are some ways aspiring nurses can find support and community among their peers and other nurses?

      Study with your peers and teach them the concepts you are required to master (use your learning objectives to find out what those concepts are). Talk about the difficulty you're experiencing with your peers and other nurses. Only nurses and nursing students will understand what a gargantuan task it is to learn this profession.

    • What is one piece of advice you wish you had when you were working to become a nurse?

      Be patient. It will take years, even decades, to understand the complexity of the nursing role, so it's not easy to learn and even if you are currently successful, there are concepts to learn which you probably haven't thought of yet. Lean on the experts around you.

    • What is the most rewarding thing about being a nurse?

      Seeing others grow in health, wellbeing, and knowledge.

    • What tips can you share to help students prep for and pass their nursing exams?

      If you struggle with exams, seek the help of a skillful tutor to help you master the unique way nurses need to learn and think. Memorization of ideas will no longer work for you, even if you've been a 'A' student in other coursework. Learn to take your thinking up Bloom's Taxonomy and anticipate likely questions related to your assigned reading. You will likely not be successful, and will not be a safe practitioner, if you decline to read. That's only the beginning of then comprehending, applying, and analyzing client data to make safe determinations about clients in the moment. Another helpful idea is to really understand the nursing role, or you won't know what to learn. Nurses are collaborative to, not subsidiary to, medicine. That means we have our own body of knowledge and use it to give providers feedback on their plan of care and how it is or isn't working. That's a huge responsibility which requires an analytical understanding of clients and all aspects of their care, including the psychosocial. You will be tested on all those things!