Nurse, Heal Yourself

What the Profession Requires

Nursing has taken me across nearly the entire human lifespan.

I have cared for adults approaching a century of life, recovering from fractures, surgery, blood loss, illness, and the accumulated vulnerabilities of aging. I have also cared for infants born around 24 weeks’ gestation, arriving months before their bodies were ready for the outside world.

Their clinical needs could hardly be more different. Yet the foundations of their care are familiar: breathing, nourishment, sleep, warmth, protection, pain relief, human connection, and someone who can recognize when something is changing and respond.

Nurses spend their careers learning to meet these needs, often within a profession that makes meeting their own remarkably difficult.¹

Long shifts become longer. Many nurses work nights; others rotate between days and nights, repeatedly asking their bodies to adjust to a changing schedule.²

Sleep becomes something negotiated rather than expected. Understanding sleep physiology does not, by itself, guarantee adequate sleep or protect a nurse from the effects of rotating shifts.² Meals, water, and even trips to the bathroom may have to wait until the work permits them.³

The work also brings exposure to infectious disease, needles, bodily fluids, unpredictable emergencies, and the possibility of violence.⁴

COVID-19 did not create the physical vulnerability of healthcare work. It brought that vulnerability into sharper public view.

The Weight You Cannot Measure

Then there is the burden you cannot weigh.

Sometimes a nurse must recognize the narrowing window in which another human being can still be saved.

A nurse may be the first to notice deterioration, question an order, identify an error, challenge an assumption, summon a team, or begin resuscitation. Sometimes the responsibility is to keep asking an uncomfortable question because the clinical picture still does not make sense.⁵

An incorrect order does not become correct because someone with greater institutional authority wrote it. A deteriorating patient cannot wait for an organizational chart to determine whose concern deserves attention.

Nurses learn to carry enormous responsibility while working with incomplete authority.

They may also encounter conditions that healthcare institutions are less comfortable discussing: bullying, harassment, discrimination, threats, and violence.^{1, 6}

I know what it is to enter a hospital prepared to care for other human beings and discover that I must also consider whether I am safe among the people working beside me.

That changes a person.

When the environment itself becomes a source of harm, the question is no longer simply whether a nurse knows how to care for others. It is whether the profession knows how to care for its own.

And Then We Prescribe Resilience

Resilience matters. So do sleep, movement, nutrition, friendship, therapy, boundaries, prayer, reflection, and time away from work. These are meaningful ways of caring for ourselves.

But resilience takes on a different meaning when institutions use it to make individuals responsible for enduring conditions those institutions have a duty to address.¹

Mindfulness cannot substitute for safe staffing. Sleep hygiene cannot substitute for adequate opportunities to rest. Resilience training cannot substitute for preventing workplace violence.^{1, 2, 6}

The problem is not necessarily that a nurse has forgotten how to practice self-care. Sometimes the nurse understands exactly what is happening and has little power to change it.

Nursing Has a Philosophy

That distinction matters because nursing is more than the competent performance of clinical tasks. Nursing is a discipline.

It has its own body of knowledge and enduring questions. What is health? What does it mean to care? How does an environment support or undermine healing? How does illness change a person’s relationship with the body, family, community, identity, or future? What do we owe one another in moments of vulnerability?

Generations of nursing scholars have approached these questions from different directions.

Florence Nightingale emphasized the relationship between health and environment.⁷ Dorothea Orem examined self-care and the nursing support people need when they cannot meet their own care needs.⁸ Sister Callista Roy developed a model centered on adaptation.⁹ Jean Watson placed human caring and relationships at the center of her work.¹⁰

Their theories are distinct, and no single theory explains the whole of nursing. Together, however, they offer a broad understanding of what it means to care for a human being.

The body matters. So do the conditions in which a person lives.

Environment matters. Relationships matter. Culture, meaning, and dignity matter.

Yet applying that understanding to nurses themselves can expose a contradiction in healthcare.

If environment affects health, the nurse’s working environment matters. If relationships affect health, the relationships surrounding the nurse matter.

Sleep, nutrition, safety, belonging, and human connection do not become less important when the person who needs them puts on a hospital identification badge.

A discipline committed to understanding the whole person must be willing to apply that same understanding to the people who practice it.

Physician, Heal Yourself

An ancient phrase has stayed with me as I think about this.

In the Gospel of Luke, Jesus recalls a proverb:

“Physician, heal yourself!”

Luke 4:23, NIV¹¹

Later, as Jesus hangs on the cross, those mocking him point to the people he saved and challenge him to save himself (Luke 23:35).¹²

These passages have their own contexts and theological meanings. But as a nurse, I hear an echo of an expectation I recognize: if you can help others, you should be able to spare yourself.

The Christian story makes room for a more difficult reality.

Jesus heals, and Jesus suffers. Jesus consoles, and Jesus weeps. Jesus gives, and Jesus grows tired.^{12, 13, 14}

He attends to sickness, hunger, exclusion, grief, and human dignity. He enters into the suffering of others while experiencing suffering himself.

For me, that image carries particular meaning. I recognize the tension between the care a person can offer and the pain that person may still carry.

The ability to care does not abolish the need for care.

A physician may become a patient. A nurse may need another nurse. A therapist may need someone who listens. Those who accompany others through suffering may need someone willing to accompany them.

So I hear “Nurse, heal yourself” differently now.

I hear an invitation to recognize that I, too, am worthy of the care I offer others. That includes the choices I make for myself, the support I accept from others, and the conditions I should be able to expect where I work.

Nurses have responsibilities toward their own well-being. Colleagues, leaders, and institutions have responsibilities toward nurses. Healing needs room to happen, and creating that room is shared work.^{1, 6}

If I could answer the ancient challenge in the language of nursing, I would answer it this way: