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Caregivers: The Importance of Taking Care of Our Four Selves

By Susan Edstrom, MS, BSN, RN, Consultant, Creative Health Care Management

Janet Hagberg once said “If the three elements of body, mind and spirit are in balance, they reinforce one another; if they are out of balance they multiply problems.”

I think most would agree with Janet’s statement. Still, believing this and being inundated with information on the importance of self-care doesn’t move us any closer to actually practicing it. Why is it so difficult for us to practice self-care? Care of self is far more complex than we realize. 

The first thing we have to do when thinking about self-care, is to clarify which "self" we are talking about. Following most major authors on this topic we can distinguish the body, mind, emotional, and spiritual selves. While we can distinguish between these selves, we know that they are inseparable. 

The question we must ask is: How do we care about these selves? Do we nurture, forget about, deny, or overemphasize one self or another? 

For example, do you see yourself or someone you know as fitting any of these descriptions? 

1)    A highly educated caregiver whose mental life has been developed while her/his spiritual/emotional life is undeveloped? How does that affect their presence with colleagues and patients?  

I once had a colleague who would readily quote all the latest research regarding the diagnosis and treatment for the majority of patients on our oncology unit. However, she could not handle a patient or family member’s emotions. I’d often hear her say, “But I’m just not a ‘touchy- feely’ sort of person – that’s not how I help patients.” She was unable to connect with patients and their families as people, to see beyond the diagnosis and how compassion and caring in a therapeutic relationship impacted their ability to cope and heal. 

2)    A highly devoted caregiver who extends her/his self to others yet downplays the need to care for her or his bodily health?  

As I work with caregivers around the country I routinely ask them, “How much sleep are you getting a night?” While this is not a scientific study, I’m struck by the numbers – I’d say 60-70% report routinely getting four to five hours of sleep per night. I hear things like, “I’m just one of those people who doesn’t require much sleep – I’m too busy to sleep.” The research on sleep is clear: as adults we need seven to eight hours of sleep a night. Less than that impairs our decision making, critical thinking, and ability to get along with others. 

You may be, or have met, caregivers who fit these descriptions as well: 

3)    A caregiver who lacks a sense of spiritual connectedness? How does this affect their ability to be with patients? 

4)    A caregiver whose actions are guided by his or her emotions without first pausing to think and reflect. What is the result?  

When we become aware that we are no longer caring for ourselves, most of us tend to lay the blame on having too much to do, not enough time, or that too many demands have been placed upon us (work, children, family, parents, etc.). 

Martin Helldorfer, one of the authors of Healthy Ways to Work in Health Care: A Self-Care Guide, has said, “I have come to believe that when we are not fully caring for ourselves, that it is more likely that the underlying issue is that we have failed to develop one or another of our "selves.’"

Our willingness to explore and tend to the needs of our various selves are core to our own health and our ability to care for others.  I encourage you to look back at the four examples again and identify where you may wish to spend some time reflecting further. 

Susan knows how important that commitment to caregiving is; she’s a nurse with more than 30 years of experience as a staff nurse, nurse practitioner, educator, and health care leader. She has a BSN and MS in public health from the University of Minnesota. While she’s no longer providing direct care to patients herself, her goal in her role as a consultant at Creative Health Care Management is to re-ignite a passion for caring in those who do.

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