Strategies in Self-Care for Healthcare in the 21st Century


Working in a stressful environment is commonplace for many in the world. But in healthcare the stressful conditions and stress of the job has become unbearable for many including nurses, doctors, social workers, pharmacists, occupational therapists, respiratory therapists, physiotherapists, clinical instructor, nursing professors and student nurses. The demands of our jobs with its shifting priorities have changed in the 21st century of healthcare delivery. As a result, our stresses have increased tremendously impacting our mental, emotional, and physical health, our relationships with family and friends and in some cases with devastating consequences. So how can we manage the stresses of our environment? What are the actionable strategies in managing our stress, burnout, a toxic work environment, depression, anxiety, exhaustion from long hours and shift work and the list goes on? How can our leaders be authentic, caring, better empathetic leaders in leading, managing issues and authentically support their employees to decrease the stresses recognized by experts as a fast growing epidemic?

The nation’s Institute for Healthcare Improvement (IHI) is concerned and encourages better leadership behaviors to include treating employees with respect. This, according to the Harvard Business school experts “has a powerful effect on employees’ health, happiness, and engagement” more-so than any other leadership behaviors (November 8, 2017). The concept is supported by the nurse theorist Watson’s (2005) evidence-based theory of human caring, transpersonal caring. The theory lays the foundation for and provides a conceptual framework to guide nurses and other caregivers on how to treat each other, how to provide caring and compassionate therapeutic care to our patients. As human beings, when we are shown caring, kindness, respect and understanding it makes us feel good on the inside and out. Our brain responds by producing the feel-good hormones that fosters the positive happy feeling. Essentially, when we feel appreciated our behavioral response (good feelings) has a direct impact on performance which in turn leads to better patient care and treatment, better outcomes.

It makes sense that as healthcare leaders we should role model caring, respectful, supportive behaviors in an authentic manner to our frontline caregivers; strategies that supports “civility” and a healthy work environment, the (IHI, 2017) ultimate goal to “finding joy in our work.” Since 2017, the IHI in its recognition of this “epidemic” has partnered with experts to provide online training webinars on strategies and solutions to “turn burnout into engagement,” with a focus on self-care, patient safety, and quality of care, to better assist nurses and healthcare providers in their professional and personal lives.

The World Health Organization (WHO) is concerned with the health and welfare of global populations and encourages healthcare providers to work collaboratively for solutions to improve the lives of populations around the world most especially, the underserved. But, the WHO also recognizes the stresses of nurses and healthcare providers and is concerned about its direct impact on populations’ healthcare thereby urging us to decrease our mental stress. According to the WHO “good mental health enables people to realize their potential, cope with the normal stresses of life, work productively, and contribute to their communities” (September, 2017). The WHO cites a negative work environment including “commonly reported” bullying and harassment in the workplace is detrimental to our health and well-being, identified as having an economic impact estimated as $1 trillion US per year (September, 2017). Added to the stresses are gun violence in the USA, the frequency of mass shootings that has become a part of our daily lives, the occurrences has a direct negative impact on healthcare providers. People regardless of social or professional status, education or experiences are suffering silently, many with poor coping skills and in a system severely lacking in mental healthcare/support. Nurses are not immune either, to what is happening around us.

The nature of a nurse’s job is difficult as it is; consider the other compounding factors including poor staffing, constant interruptions, alarm fatigue, poorly functioning biomedical and computer equipment, toxic cultures, and unhealthy work environment, not to mention the expectations related to patient satisfaction scores. The American Nurses Association (ANA, 2013) in a supportive stance has been urging nurses to take care of themselves recognizing that mental health is just as important as physical health and both are essential to providing the best possible safe compassionate care to our patients. This requires finding strategies to decrease our stresses including eating healthy nutritious foods, and exercising, the same advice we give to our patients on a daily basis.

While many stakeholders are collaborating with various experts to find solutions to equitable care, decrease the rising costs of healthcare, pharmacare, and improve quality and outcomes we must shift our focus from just raising awareness of the stresses. The problems have been identified now the time has come for us to take ownership, take action, and commit to working on ourselves. It is a change in individual behaviors that will help us to manage our stresses and improve our overall health. This conference is aimed at providing evidence-based strategies, collaborative action-plans to empower us to make the necessary changes to manage the stresses, protect our health and well-being.Changing the existing culture is key in transformative care, improving healthcare for patients, communities, and populations. Change starts with ME. Self-care is healthcare…by Dr. Reezena H. Malaska, DNP, MSN, RN, CCRN


American Nurses Association (ANA), (2013). A Healthy Nurse: Better Self Care, Better Patient Care. Retrieved from

Horton-Deutsch, S., Sherwood, G.D. (2016). Reflective Practice: Transforming Education and Improving Outcomes, 2e. Sigma Theta Tau International. 9781945157134

Institute for Healthcare Improvement, (IHI), (2017). Turn burnout into engagement. Retrieved from

The Schwartz Center for Compassionate Care (2015). Building compassion into the bottom line:

The role of compassionate care and the patient experience in 35 U.S. hospitals and health systems. Retrieved from

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