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I M ind/Body/Spirit W e l l n e s s 101

Spiritual wellness: A journey toward wholeness By David Hrabe, PhD, RN, NC-BC; Bernadette Mazurek Melnyk, PhD, RN, APRN-CNP, FAANP, FNAP, FAAN; Susan Neale, MFA

Through spirituality, we connect with the world around us.

Editor’s note: This is the last installment in a 10-article series on wellness. You can read all o f articles in the se­ ries at americannursetoday.com/category/wellnessl01/. Thank you to the authors at The Ohio State University College o f Nursing fo r their support o f nurse wellness.

Have you ever felt like a “human doing” instead of a “human being”? As we fling ourselves from one activity to another, we sometimes find that getting beyond our list of “to do’s” and staying in touch with those aspects of our lives that mean the most to us is difficult. Re­ member that well-rounded self-care also involves spiri­ tual wellness.

W h a t is sp iritu a lity? Barbara Dossey, a pioneer in the holistic nursing move­

ment, writes that our spirituality involves a sense of connection outside ourselves and includes our values, meaning, and purpose. Your spiritual well-being isn’t what you own, your job, or even your physical health. It’s about what inspires you, what gives you hope, and what you feel strongly about. Your spirit is the seat of your deepest values and character. Whether or not you practice a religion, you can recognize that a part of you exists beyond the analytical thinking of your intel­ lect; it’s the part of you that feels, makes value judg­ ments, and ponders your connection to others, to your moral values, and to the world. For this reason, spiritu­ ality frequently is discussed in terms of a search. Spiri­ tual wellness is a continuing journey of seeking out an­ swers and connections and seeing things in new ways. It also means finding your purpose in life and staying aligned with it.

Although religion and spirituality can be connected, they’re different. A faith community or organized reli­ gion can give you an outlet for your spirituality, but religion isn’t spirituality’s only expression. Hope, love, joy, meaning, purpose, connection, appreciation of

24 American Nurse T o d a y Volume 13, Num ber 10 A m ericanN urseToday.com

Continue the journey Here are some ideas to consider as you continue your nurs­ ing journey. You’ll notice that many are connected to rec­ ommendations we’ve made for other dimensions of well­ ness. This isn’t a mistake. We’re whole human beings, and these practices support multiple dimensions.

Reconnect/reimagine your life’s purpose and passion: Set aside some time for a “retreat with yourself” to carefully consider your purpose and whether/how you’re living it out. Where do you need to make adjustments? What do you need to stop doing? What do you need to start doing? What would you do in the next 5 to 10 years if you knew that you couldn’t fail? Periodically “taking stock” is critical to staying on track.

Ramp up your positive outlook: In their work w ith peo­ ple newly diagnosed with HIV, Moskowitz and colleagues developed an intervention to improve patients’emotion­ al outlook even in the midst of a very challenging circum­ stance. The intervention involves cultivating positive emo­ tions through these daily practices:

• Recognize a positive event each day.

• Savor that event and log it in a journal or tell someone about it.

• Start a daily gratitude journal.

• List a personal strength and note how you used it.

• Set an attainable goal and note your progress.

• Report a relatively minor stress and list ways to reap­ praise the event positively.

• Recognize and practice small acts of kindness daily.

• Practice mindfulness, focusing on the here and now rather than the past or future.

Results were promising and showed that, over time, the positive effects increased. Cultivating an “attitude of grati­ tude” is cited by many spiritual leaders from multiple faith traditions as essential to their daily practice.

Consider some kind of meditative practice: Traditional forms of meditation can include prayer, chanting, or sit­ ting in stillness with a quiet mind. Some people prefer physical action that incorporates meditation, such as yoga, tai chi, gardening, or simply walking. Experiment to find what works for you.

beauty, and caring and compassion for others are asso­ ciated with spiritual well-being.

Spirituality as part of nurses’ DNA As nurses we’re fortunate that the very basis of our practice is grounded in spiritual ideals. From the be­ ginning of our education, we learn about the impor­ tance of spirituality in relation to a person’s overall health. Even our ethics emphasize the value of a spiri­

tual connection. Provision 1 of the Code of Ethics for Nurses with Interpretive Statements states, “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.” But many nurses are surprised to find that Provision 5 extends this compassion and respect to nurses them­ selves: “The nurse owes the same duties to the self as to others, including the responsibility to promote health and safety, preserve wholeness of character and in­ tegrity, maintain competence, and continue personal and professional growth.” We have a responsibility to both our patients and to ourselves to honor our spiri­ tual heritage.

Think about your job and what you do every day. When do you feel most energized? Great satisfaction can come from learning a new skill and mastering it, and of course it’s vital that you complete your many tasks efficiently and competently, but there’s more. When asked about the times they felt most energized, many nurses cite moments when they really connected with another person—family, friends, colleagues, pa­ tients. This is the “more”—when we go beyond just our needs and wants to connect beyond ourselves. Hu­ mans are wired to be in relationship with others. Spiri­ tuality is fundamental to nursing practice.

Disconnected much? Although most nurses would likely agree that spirituali­ ty is an important component in the care they provide and in their personal lives, too often the pressures of modern life interfere with what’s most important to us. Crushing workloads, family responsibilities, financial pressures, and fast-paced living create the perfect storm that makes acting on our values difficult. Many nurses suffer chronic illnesses, including depression, at a rate greater than the general population and other health professionals. In a study, Letvak and colleagues dem­ onstrated that nurses are twice as depressed as the pa­ tients they serve. A study by Melnyk and colleagues of more than 2,000 nurses across the country found more than half of the nurses reported poor mental or physi­ cal health and depression. Additionally, nurses with “…worse health were associated with 26% to 71% high­ er likelihood of having medical errors.”

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