Nurture

Self Care at School:

119 Ways That School Nurses Nurture Themselves On the Job

School nursing is a wonderful role and many of us cannot imagine doing anything else. Yet there are stresses that go with the role. Isolated from peers and other adults, we spend our days meeting the diverse needs of students, staff and parents, always available and always in demand. We are often without back-ups to cover breaks, and subs for covering sick days, so we often make do without either. In a role that is enormously responsive, we seek also to be proactive, juggling the expectations of others against our professional expectations of ourselves, only too aware that our roles are often misunderstood. We provide nursing expertise and compassionate care to the populations we serve, populations that are often larger than anyone can possibly serve well, yet we do our best anyway. Unlike in other nursing specialties, we find that we must be good at everything, for the breadth of the role is greater than most, encompassing many nursing specialties as well as education.

The potential for caregiver burnout is obvious in acute care nursing, but often less obvious in our specialty. Many others see only the flip sideautonomy, a great schedule, health promotion, a well-population, and solo health expert status. These are all true enough, but as any school nurse will tell you, there are stresses unique to the school nurse role, and the potential for caregiver burnout are very real and can take their toll.

As we return to the New Year after winter break, refreshed and filled with renewed enthusiasm, how will we nurture ourselves at work ? Recently, I asked my web page readers to share how they do this, and responses poured in. Some were common, some were quite unique and a few are too funny not to share. I share them here, not verbatim but summarized and grouped, with my thanks to everyone who responded for inspiring me and the hopes that they will also inspire all of you!

Make Your Space Comfortable, Practical and Beautiful

Play music or nature sounds in your office that soothes you, uplifts you or energizes you.

Decorate your work space with beautiful art, posters, quotes, murals, wall hangings, wreaths, mobiles, table top fountains, a small pillow for your chair, curtains, fresh flowers, wind chimes, sun catchers, fish tanks, quilts, terrariums and plants. Bring in seasonal items that change through the year.

Winter over a few of your porch plants if you have a window. A pink geranium blooming in February is a lovely sight.

Although most of your office is public space, create an area around your desk that is your own oasis and where children and other adults are not allowed to go. Personalize this space for yourself.

Tuck a nice folding tray table out of the way. When you are having your lunch, open it by your desk, cover it with a pretty placemat and enjoy the interlude without having to eat off your desk.

Personalize your office with pictures of family, pets and friends.

Get a really good desk chair, even if you have to buy it yourself. You deserve an ergonomically healthy work station.

Every school year, add one item to the "clinic supply" requisition list that would be considered a luxury, but which makes your job easier or more pleasant.

Instead of a bunch of out-dated stuff on your bulletin board by your desk, reserve it for cards, poems, quotes and pictures. Let it be your meditation board instead.

Remove one of your drop ceiling tiles, put a picture or a poster on it, and then put it back. These are great for putting over the cots, creating a teachable moment for kids who are lying down.

Keep a private stash of comforts and treats for yourself or to share with a colleague; chocolate, tea, bottled water, herbal teas and soup.

Put up "wall words" in the clinic. They are rub on words that can be ordered in different scripts and sizes with over a thousand different quotes. Choose inspirational quotes. The quotes reaffirm the importance of kindness, character, etc. and during a stressful day will help to refocus and remember why you are there.

Put up wall paper borders or Wallies to color your space cheerful.

If you can, create a small space in your office with a home-like feel, perhaps two real chairs, a table and lamp and a plant or silk floral piece. Move to this space to talk with parents, staff or kids when you can. Do not always talk to others from behind your desk.

If you are lucky enough to have a window, open it at least once a day, year round, and let some fresh air in.

In the winter, keep a beautiful pottery container in your office in an out-of-the-way place, a bowl or a pitcher. Each day, fill it with water. Our schools are dry and the evaporation through the day will add a bit of much-needed humidity. Be sure to wash it out at least weekly and change the water daily.

A small microwave, a coffee pot and a stash of disposable plates and utensils will make meals and snacks possible and healthful.

Always eat lunch, even if you have to put the kids in the room on hold and just chat and visit with them while you do.

Get a desk lamp and turn off the overhead lights once in a while. This changes the atmosphere and gives your eyes a break from the bright lights.

Provide yourself with the little extras that your school may not purchase: post its, note paper, pretty desk blotters, good scissors, a rolodex, your favorite pens, disks, a nice mouse pad, desk accessories, stickers and notebooks.

A small bag or a drawer for personal items such as lip stick, deodorant, powder, lotion, and toothbrush and toothpaste make it easier to refresh yourself.

Healthy Pleasures

Drink water throughout the day. Consider getting a commercial bottled water dispenser, a filtered water container for your refrigerator, or bring your own bottles from home.

If you can leave your office during lunch time, take a walk, go for a jog or at the very least, stand or sit outdoors in the sunshine for a few minutes. Offer to do occasional recess duties for the fresh air and Vitamin D.

Keep a "funny board" where you can post cartoons and jokes.

Some school nurses are collectors and many bring that piece of themselves to work. Angels, frogs, cats and even skunks grace school nurse offices and remind the school nurse and the kids that the nurse is a multi-faceted person.

Have you ever heard of Walter? One school nurse shared that he is a big hit in her high school. It is a book based on a true story. The book tells of Walter, a dog adopted from the pound who has a problem with flatulence. After various cures are tried, including low-gas doggie biscuits, the family's father declares that Walter has to go back to the pound the next morning. How does Walter escape his fate? Check out the book and find out.

Deliver meds and forms yourself, go get kids you need to see. In other words, get out and about, create opportunities to walk and move, don't stay hidden in your office or velcroed to your chair.

Keep yogurt, sparkling water and fruit for yourself in your refrigerator.

Maintain a TLC file where you keep notes and cards of appreciation from students, staff and parents. Look at that file at least once a week and especially when you are feeling down.

Smile and don't take yourself too seriously!

Clean the telephone and keyboard, the sink, the counters!

Close the door and take ten minutes on the cot yourself, it is a nice way to drop out for a few minutes.

Wear pants and comfortable shoes!

Occasionally eat in the cafeteria at a lunch table with the kids. Just be chatty and sociable instead of "The Nurse."

Take three 10-minute exercise breaks a day. Stairs are made for this, but who says you cannot keep a set of free weights or a jump rope in your office?

Call your husband or another loved one for a quick hello each day.

Take your vitamins, take a Zinc and Vitamin C supplement in the winter, stay hydrated. You can do all of these things at work if you want, keep them in your desk drawer and take them with your morning cup of tea.

Enjoy the kids when you can: teach a class, run a group, read a story, play a game.

Hang up art work the children give to you.

Keep a Touchstone on your desk. This can be anythinga real stone from a special place, a crystal, a small figurine. Associate this Touchstone with whatever works for you; letting go of stress, saying a prayer, taking a deep breath, unclenching your jaw. Hold it for a moment whenever you need to center yourself.

Feeling crabby? Close the door, turn off the lights, and hang a sign that says what time you will be back.

Go to the nearest stair way. Go up. Go down. Do it a couple of times. Feel those muscles work! Feel your heart pump! Feel the oxygen in your brain! It feels really good and you will leave a lot of tension there.

Order lunch to be delivered to you once in a while.

Aromatherapy in your desk area can be quite nice. To avoid allergic reactions among the students, use "naturals" like an orange pierced with cloves.

Take a deep breath now and then!

During your break, read a novel or magazine, play computer Solitaire, surf the net, eat an indulgent snack like an ice cream bar or visit the staff member who keeps chocolate on hand.

Get a massage or a facial once a month. This is called Caring for the Caregiver.

Join a weight loss group if you are stressed or dragged down by being overweight. You will feel better, have more energy and be the embodiment of what we try to teach our students.

Go to an exercise class on your way home. You would be amazed how differently the world looks after an hour of aerobics, jazzercise, or kick boxing. It's a great way to transition to home.

Get to know the kids; their backgrounds, their issues. Take a holistic view of them for this helps you not too see the neediest ones as Frequent Fliers, problem kids, or complainers, but as children in need of adult nurturing.

Surprise everyone once in a while, and show your funny side. Wear a funny hat, sing a funny song, wear a tee shirt or sweat shirt with a health message on it.

Create your very own school shirts that identify you as the school nurse, and be sure to include your favorite sayings on them. Would anybody notice if the back of your sweatshirt had the words, " Did you eat a healthy breakfast today?"

If you start to feel way behind and overwhelmed, stop and organize and clean. By creating some order and getting rid of clutter you regain a sense of being in control.

Take workshops and seminar days to get new ideas and information and to renew or add to your sense of mastery. The day out of school helps too!

Interpersonal Support

Connect with teachers, guidance or other school nurses regularly to talk, vent or problem solve together. Do not remain isolated.

There are positive people in the school and there are negative people. Do not associate with, reinforce or encourage the complainer or naysayer, because these are the people who drag morale down. Be one of the positive voices!

If you can leave for lunch, meet up with other school nurses once a week and eat together.

Stay connected to the community in which you work. Send notes of appreciation to the docs and their staff nurses who work together with you "out there", write letters to the editor to acknowledge support around the holidays, stop by your local fire department with some goodies and a note or thanks for their ambulance responses to your school, serve as a resource to community health, public health and other organizations that share your concern for children.

Every school nurse should be on her school Sunshine Committee. If there isn't one, she should start one. This keeps you ever in touch with the people and times that are sad or glad, and helps keep you in touch and involved with staff.

Attend PTO/PTA meetings as a way to meet and talk with parents. Don't let your phone calls about a sick child be your only contact with them.

Nurture work friendships. Eat lunch with a colleague if possible, walk with others after school (start a walking club) socialize when you can, participate in the school events, organize small fun events for staff who share your interests.

Do not under-estimate the importance of professional affiliations in your regional, state and national school nurse organizations. A united voice, common interests and connection to the bigger picture serve us well.

Treat each child the way you would want someone to treat your own child or grandchild. This helps in being patient and positive and seeing beyond behaviors that can be frustrating at times.

Take a few minutes to read the School Nurse Listserv and respond to someone else's dilemma.

Organize an occasional pot luck supper for staff and focus the hour following on something funa paperback book swap, a craft lesson, a scarf-tying lesson, a color consultation, a Scrabble or Bunco Tournamrnt. . Remember, teaching is stressful too, and whenever you nurture the staff, everyone benefits.

Seek out mentors and "sisters" who are also school nurses. Sometimes this person might be a formal leader in your district or someone you connect with from elsewhere. Keep in touch and keep tabs on one another. Affirm and inspire each other whenever you can.

Read Gerri Harvey's School Nurse web page (http://www.snp.homestead.com) for inspiration and new ideas and don't miss any of her newsletters!

Maintain email and telephone connections with other school nurses in your district. Touch base with one another and be supportive colleagues to one another. Meet to talk, share and vent, but don't let these meetings become nothing more than gripe sessions. Use them to affirm and energize one another. Make it a rule to bring at least one good thing to each meeting a tip, a story, a good form, a new resource, a funny.

Arrive a few minutes early every day and use that time to plan. Establish one or two priorities for the day.

At the end of the day, spend a few minutes reflecting. This is a good way to be sure that your practice reflects your philosophy, priorities and goals.

Make a To Do List and prioritize it every day. Validate yourself for what you did accomplish instead of berating myself for what doesn't get done.

Make a set of door signs and use them. (See Gerri's door signs) . Slip them into clear plastic sleeves or laminate them and change them around as needed)

Have a plan for the school year, for each month, for the week and for the day. This helps you to be proactive as well as reactive.

Create a clinic schedule so that you have time for screenings and paper work. Don't ask if it's OK, just do it, because who could possibly say that you can't? It is OK to have times that are designated Emergencies Only or "Red, White and Blue" only. Red equals blood, White equals faint or vomiting, Blue equals breathing problems.

Give appointments to kids who show up during non-urgent time that you have designated for something else. This meets the need while also reinforcing what is urgent and what is not. Don't feel guilty for doing this! Ours is an "instant gratification" society, but the reality is, not every problem needs a medical expert and not every problem is an emergency.

Set up a Try Three Things Rule for kids to begin teaching them ways to promote their own comfort and solve their own problems. Got a belly ache? You cannot come to the nurse until you have tried the following: 1. Used the bathroom 2. Eaten a non-junk food snack 3. Had 2 glasses of water. In other words, gas pains, bathroom needs, thirst, and hunger are things kids can solve without a nurse. This can work for other discomforts too. This is not about discouraging kids from seeking help, this is about teaching them self-care and prevention.

When illnesses are high, forget doing it all, and revert to triage and treat mode.

If you feel chronically behind, designate one day a week to work late to catch up. Bring a special snack or even your supper and experience your office in a quiet, uninterrupted way. Take pleasure in being able to focus on one task at a time!

Leave on time at least a couple of times a week and don't bring work home.

Schedule things in your personal life that nurture you when not at worka family fun night, an evening out with friends, time to read and play, exercise, massages. It's easy to find that all you do is work, eat and sleep, and spend your time off cleaning, doing errands or rushing from here to there. Balance is the key. Work to live, not the other way around. School nursing is only one aspect of who you are.

Give yourself permission to take a Coast Day once a week. This is a day in which you do nothing except see whatever walks through the doorno screening, no reports, no projects, no being super productive. Just see the kids, talk to the kids, enjoy the kids, and nurture the kids. A good day to take a Coast Day is on a Monday.

At least three times a day, turn off your light, hang the appropriate sign, lock the door and take a walk. By the time they are ready to put out an APB, you will be back, refreshed and energized. Use this same strategy for bathroom breaks, walkabouts, and to stand outdoors in the sunshine.

Start your day with a personal prayer or affirmation.

Eat a morning snack and then take your lunch break after all the students and staffs have taken theirs. With only an hour or two left of the school day, you will be less likely to get interrupted, you will get a chance to de-stress and regroup, and you won't arrive home stressed and starved yourself.

Be sure every teacher has a supply of band aides and give them "permission" to hand them out for hangnails, paper cuts and minor boo boos.

See Your Role Through New Eyes

Encourage and help kids to plan their own health goals.

See the joy that comes with the school nurse role. The children are blessings to us. Stop and listen. Hear their laughter. Hug a small child. Watch them run. Enjoy their silliness. Be grateful for your job and do not miss an opportunity to take pleasure in helping children to grow.

Teach health classes as often as you can.

Think of your job as a ministry or mission in life.

Reject slogans that trivialize or sexualize nurses, such as "Nurses call the shots!" or "Nurses do it better." We need new ones. See Gerri's suggestions elsewhere in this newsletter.

Maximize on School Nurse Day! It is not just a day to wait for others to recognize you with flowers and cards, it is a chance to promote your role, educate others about what you do, and express your positive thoughts about the importance of your role and your appreciation for having this job.

Learn to say "No" gracefully, knowing that by doing this, you can say "Yes" to something else you want to do. "Thank you so much for asking me to do this, I appreciate your confidence in me, but 1. my plate is full right now and I know I don't have time to give what that deserves 2. I have to decline right now."

Take on at least one other unrelated role in the school. Work on the yearbook, coach a team.

Re-read Gerri Harvey's Seven Habits of Highly Effective School Nurses posted on her web page. It helps to re-energize and refocus.

Do what you do with an attitude of love. Remember, school nursing is the means you have chosen to contribute to our society and to a better world. It will matter in some small way long after you are gone. Remember that you are touching the future.

Further your education. Professionals within education and nursing today go beyond entry level credentials. Remember that education, degrees and certification are important currencies within education and that is where you work.

Frame and hang your credentials on your office walls.

Think about summerit will be here before you know it and it is definitely one of the perks of this job!

Reach out to student nurses through their schools. You will not only be promoting future nurses, but also future school nurses. At the same time, the experience they are getting with you extends what you can accomplish in your school, so you both win!

Keep your role within professional parameters remembering that you are not the school "Mommy" there to take care of every little thing, every little hurt, every little problem. Don't describe yourself as the school Mommy or present yourself as one. Remember, you are an expert resource and part of your role is to foster self-responsibility. Never allow anyone to think that the nurse could be replaced by any well-qualified mother, for that mistake has been made by more than one former school nurse.

Review and remember the Theory of the Five Balls; it helps you to keep your perspective. It's at the end of this newsletter.

Find some small way to celebrate things with kids; birthdays, lost teeth, first periods.

Keep books and art supplies on hand so that kids who are waiting for parents or spending some observation time with you will have something to do. Give out stickers.

Think of all the students in the school as your own, because in some ways, for a time, they ARE!

Keep a copy of The Four Agreements where you can see it; in your planner, on your desk, framed on the wall. It's at the end of this newsletter.

Create and write your own health newsletter once a month. It will give you a wonderful feeling of accomplishment and demonstrate your professionalism and expertise to staff and parents.

Consider this: you are an adult spending your day immersed in a world of children, just like Wendy in Peter Pan! You have snow days and holidays and school vacations off. You live a child's schedule, but you get paid for it!

Accept the fact that you are ONE HUMAN BEING.you cannot perform superhuman feats and no one expects you to. Give it your best and end each day knowing that you did. Don't focus on what you didn't accomplish; focus on what you DID accomplish.

Accept that you will NEVER be all caught up, there will always be someone transferring in or out. Your desk will never be cleaned off; your filing will never be all done. Take away the mental stress of being a perfectionist.

Seek out collaborative activities with teachers. Volunteer to help them with relevant projects. Don't be an invisible school nurse.

Create wellness moments for the staff: organize an after school yoga class for staff or bring in a lunch time chair massage therapist. It doesn't cost as much as you might think.

Right after school, instead of always working alone in your office, wander around. Touch base with teachers, drop in on basketball or play practice, say hello to the subs, chat with the secretaries and custodians. Fifteen minutes a day of doing this can pay big dividends, no only for you, but also for them.

Create a special bond with your Special Ed teacher and students. Visit their classrooms or visit the kindergarten. They need you more than most and their needs are often unique.

Remind yourself that good nursing is only possible if you first take good care of yourself. Martyrdom and self-sacrifice lead to burnout.

It is easy to see just the problems and the neediness when these are the focus of your days, so be sure to take note both to yourself and in conversations with others of the majority of students who are healthy, active and well-nurtured and well cared for by their families.

Go on a daily Walkabout. Use this time to say hello or to make Wuzzy letter deliveries.

Focus on indulging the attention needs of one Frequent Flyer every day. You never know what a difference real, appropriate attention will make.

Remind yourself of all the reasons you wanted this job in the first place.

Remind myself that the issues that stress us seem to be universal, no matter what country you are from.

When things seem crazy, just think that one ice pack, one hug, one tear, one band aide, one conversation with a 1st grader that lasted long enough to make the child forget why he/she came into the nurse's office made a difference in a child's life and for that brief moment you made that child feel special. THAT is what makes it all worthwhile!

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The Theory of the Five Balls.

This was presented by James Patterson in his book Suzanne's Diary for Nicholas, an outstanding book. Patterson says we have five balls to juggle in life. Four of the five are glass balls and will shatter if dropped. The 5th ball is a rubber one, and it will bounce back if dropped.

You may have guessed that the last one, job, is the rubber one.

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The Four Agreements

(From the book by the same name.)

BE IMPECCABLE WITH YOUR WORD

Speak with integrity. Say only what you mean. Avoid using the words to speak against yourself or to gossip about others. Use the power of your word in the direction of truth and love.

DON'T TAKE ANYTHING PERSONALLY

Nothing others do is because of you. What others say and do is a projection of their own reality. When you are immune to the opinions and actions of others, you won't be the victim of needless conflict

DON'T MAKE ASSUMPTIONS

Find the courage to ask questions and to express what you really want. Communicate with others as clearly as you can to avoid misunderstandings, sadness and drama. With just this one agreement, you can completely transform your life

Your best is going to change from moment to moment; it will be different when you are healthy as opposed to sick. Under any circumstance, simply do your best, and you will avoid self-judgment and regret.