Courageous Well-Being for Nurses
Strategies for Renewal
Donna A. Gaffney
Nicole C. Foster
Johns Hopkins University Press
September 5, 2023
ABOUT THE BOOKThe pandemic was not the sole cause of the healthcare catastrophe sweeping the globe in 2019. It did, however, serve as a lens to see the problems that had been there all along. Nurses expressed anger, frustration and fear in a growing chorus of voices. With their own health at risk, they found ways to heal themselves and each other. Co-authors Donna Gaffney and Nicole Foster invited nurses from across the globe to tell their powerful stories. Drawing from an international body of research and scholarship in psychology, mindfulness, nursing, medicine, the arts and social sciences, Courageous Well-Being for Nurses, Strategies for Renewal builds each chapter around the nurses’ narratives. The result is a unique perspective on individual and collective well-being that extends far beyond more traditional approaches of self-care.
Evidence-based studies comprise the foundation of this book and include Carol Ryff’s model of psychological well-being, the work of Jon Kabat-Zinn, Dzung Vo, Cynda Rushton, Christina Maslach, Klimecki & Singer, Bessel van der Kolk, James Pennebaker, Louise DeSalvo, and many more. Explored are strategies and practices focusing on self-compassion and mindfulness; the latest findings in eating, sleeping and exercising well; science-based practices for alleviating stress through nature; the benefits of professional support; and the profound healing effects of advocacy and activism on health and well-being. The arts and creativity are celebrated as indispensable wellsprings of respite and joy, with poems, photographs, song lyrics, and illustrations of personal and professional challenges as well as celebrations of growth. A shared responsibility of confronting the tumultuous healthcare environment is emphasized—especially the burnout, vicarious trauma, grief, and moral distress left in its wake.
The essence of courage is the ability to pursue goals or a purpose, despite risk or fear. Courageous Well-Being for Nurses, Strategies for Renewal leads the reader on the ultimate journey to well-being – one that is essential, inclusive, deep-rooted, individual, and above all, courageous. Nurses, students and educators will embrace this book, as will all professionals in healthcare, and the families and friends who love and care for them.
TABLE OF CONTENTSPrologue
Introduction
Chapter 1. Becoming Self-Compassionate
Chapter 2. Managing Stress
Chapter 3. Exploring Mindfulness and Meditation
Chapter 4. Sleeping Well
Chapter 5. Nourishing Well
Chapter 6. Implementing Daily Movement and Exercise
Chapter 7. Embracing Nature and the Outdoors
Chapter 8. Finding Sanctuary in Words, Images, and Sounds
Chapter 9. Seeking Empowerment through Advocacy and Activism
Chapter 10. Navigating the Challenges of the Health Care Landscape
Chapter 11. Continuing the Journey of Transformation and Healing
Afterword
Acknowledgments
Resources
Glossary
Index
IN THEIR OWN WORDSWhat kept me going, despite the devastation and incomprehensible conditions, was the resilience, strength, gratitude, hope, and spiritual grace of the people of Haiti. It was evident with each patient encounter, and again each evening when the haunting sound of 30,000 voices from the tent city below would join together in prayer and song.
Donna Barry, APN, FN-CSA, Nurse Practitioner,
Beaufort, South Carolina, United States
Little did I realize that a small but bold step by me would sow the seeds for the first-of-its-kind nurse-thoracic surgeon cadre in India. I dream of a day where nurses will become the voices of the medical profession!
Neha Tiwari, RN, Chest Surgery Nurse Coordinator,
Institute of Chest Surgery and Lung Care Foundation,
Medanta–The Medicity, Gurugram, India
Someone asked me if anything surprised me about my experience and practice during this time. I felt it grounded everything I know about life, nursing, and leadership. When you lead with kindness, thoughtfulness, and love, it will always steer you right. This is who I am as a nurse. There were a lot more just like me doing the same thing.
I did not feel brave. I did not feel like a hero. I felt like a nurse.
Kevin T. Moore, BSN, RN, COVID Unit,
New York City, United States
“There’s no crying in nursing, there’s no crying in nursing, THERE IS NO CRYING IN NURSING!!!” I repeated this altered version of Tom Hanks’ words as the tears continued to roll down my face. The room was loud and cold, I was in COVID-Cove, the neuro ICU turned COVID ICU. We had two COVID ICUs in our hospital and for 60 hours a week I floated between them. Ms. Johnson was not my first COVID patient, and she would not be my last, but she was the first one I shed tears with.
Felicia Permenter, BSN, RN, NBC-HWC, Traveling Nurse Intensive Care Unit
Brooklyn, New York, United States
While mountain biking through the Welsh woodland on my daily commute to clock in for the 7am shift, I found perspective in the timelessness of nature. Scheduling was tight on these commutes, and the clock-in machine was taunting me at the top of the hill … but I would try to stop momentarily in one of these secluded spaces, take my helmet off, breathe deeply, watch, smell, listen. A moment of mindfulness.
Ed Lord, MSc, PhD, RMN, Lecturer in Mental Health Nursing
Swansea University, Swansea, Wales, United Kingdom
We kept saying to each other that we felt so burnt out, but we weren’t doing anything about it… I decided I didn’t want to feel like this anymore and emailed a therapist. I cried nonstop throughout that first phone call, and then she told me about self-compassion. I might get a poster of Kristin Neff to put on my wall; I am a huge fan. Just the thought of being kind to myself helps.
Maryrose Huryk, MSN, RN, CNL, Medical-Surgical Telemetry / COVID Unit,
Livingston, New Jersey, United States
As nurses, we must recognize the power of our voices … Most everything you’ll do as a nurse, from the treatments you administer, to how long a patient can stay in your unit, to how much you’re getting paid, to the kind of PPE you have access to, involves political decision-making. As nurses, we can more effectively advocate for ourselves, our patients and our communities when we understand how policy decisions shape the care we deliver. We must dare to provide health care for all.
Congresswoman Lauren Underwood, 14th Congressional District, Illinois. University of Michigan School of Nursing Commencement, Ann Arbor, Michigan, United States
“I hope my photos will take you on your own reflective journey of the extraordinary life experience we have all shared throughout this pandemic. For me, making photographs has been very therapeutic. I would have never thought of merging my creativity with my nursing work. I always kept nursing separate, but this time I needed my photography more than ever to get me through the times I was experiencing.”
Hannah Grace Deller, Photographer (www.hgdart.com) and Nurse, Paediatric Matron
Children’s Ward Became Adult COVID Unit and Adult ICU, London, United Kingdom
“In 2016, I experienced breast cancer and went through treatment. In 2021, I unfortunately had a recurrence of the same cancer in my lymph nodes. It pained me to share the news and take a leave of absence from the job that I truly cared about. I felt a sense of guilt and frustration about it, but there was a bigger lesson to discover, and it looped me back to the wonderful songs we created [during the pandemic]. Surely they would not expire over time. They would go on to become even more meaningful and teach me more about the “calling to care” for myself, my fellow colleagues, and humanity in general.”
Megan Palmer, RN, Palliative Care/ Hospice Nurse, and Singer-songwriter
Nashville, Tennessee, United States
PRAISE FOR
COURAGEOUS WELL-BEING FOR NURSES: STRATEGIES FOR RENEWAL“This book is like an amulet for nurses – to protect and ground, to avoid burnout.”
- Clodagh Connaughton, RN, Founder of Nurse-A-Tree, Cork, Ireland
“We say it over and over again that nurses can't care for others if they don't care for themselves. Offering nurses tried and proven ways of doing the self-care they need is another matter altogether. This book does just that and I have no doubt will be the go-to book for nurses and those who train them for many years to come.”
- Michael Rosen, poet, broadcaster and author of Many Different Kinds of Love: A Story of Life, Death and the NHS, United Kingdom
“Courageous Well-Being for Nurses is a must-read for all nurses across practice, education, and policy settings. This groundbreaking book captures the extraordinary courage, commitment, leadership, and sacrifices made by nurses during the SARS-CoV-2 pandemic. These compelling stories are masterfully interwoven with evidence-based wellness strategies and essential resources for all nurses.”
- Dr. Ann Marie Mauro, Joan Hansen Grabe Dean of the School of Nursing, Hunter College, New York City
“These pages powerfully illuminate how self-reflection, storytelling, the latest science, learning activities and collective action can support nurses to rebuild and grow from even the most difficult circumstances. An urgent call to action, this wayfinding both requires and builds courage, without hiding from the hard truths of nursing work.”
- Dr. Sonya L. Jakubec, Mount Royal University, Calgary, Alberta, Canada
"I would recommend this book to all my nursing colleagues and students. I always emphasize how important it is to take care of your own well-being when you are caring for others. This book has a wealth of resources, practices, and suggestions all in one place that can really aid student nurses to build a practice before they even fully enter the profession."
- Elmarie Botha, DNP, RN, Samuel Merritt University, Oakland, California
“Donna Gaffney and Nicole Foster have curated first-hand reflections from nurses in the trenches of COVID. Courageous Well-Being provides actionable steps to counter-balance the extraordinary pressures nurses found themselves mired in during the global pandemic. Nurses have reclaimed their power through the devastation of COVID. This book celebrates nursing's renewal.”
- Robin Cogan, RN, MS, Rutgers School of Nursing - Camden, and blogger, “The Relentless School Nurse”
BACKGROUNDBased on my work with nurses coping with work-related stress and trauma, throughout my career and this recent healthcare crisis, I decided that it was time to write a book for nurses. Along with my co-author Nicole Foster, we are honored to bring Courageous Well-Being for Nurses: Strategies for Renewal to nurses everywhere.
