NERU Study Presentation
EXPANDING UNDERGRADUATE NURSING
STUDENTS’ KNOWLEDGE OF THEIR SELFCARE
DR. LYNN MARTIN, JANET LOVEGROVE,
LORA VANBERLO, ELISHA VAN HARTE,
VIOLA FODOR
Our Stories
Janet and Lora
CHS 719 Seminar
Strengthening ‘Self’ in a
Self-Directed Learning Curriculum
Noticing
 rising attrition and workplace absenteeism rates in nursing
 use of black humour
 unaddressed exposures to critical incidents
 Post Traumatic Stress Disorder (PTSD)
 problematic substance use
 perfectionism and burnout
PTSD Story
“I witnessed and participated in many
attempts to maintain life. I am haunted
by these disasters. I never received any
counseling, nor was there any thought
that anyone on my staff might need it.
It never occurred to me that the ‘cutting
edge’ I was so proud to be working on
would, in the end, cut me so deeply.”
PTSD in Nurses. 2005, p. 78
Noticing
Bevis and Watson (1989; 2000) state
there are rich ways of knowing, beyond
the rational and prevalent thought and
deductive reasoning of academia. Rich
ways of knowing involve intuition,
insight, imagination, and creative
problem solving, which form the
foundation of transformative thinking.
NERU Pilot Project Application, 2010
Noticing
In the views of Bevis and Watson
(1989; 2000), transformative thinking
has value because it fosters inner
resources that are essential
components to effective teaching and
learning, as well as to health-illness
outcomes.
NERU Pilot Project Application, 2010
Noticing
Elliott (1997); Witt-Sherman (2004); and Johns
(2007) support bringing transformative thinking
processes to nursing. Further support comes with
Hansen-Ketchum (2004) recommending Parse’s
(1992) Human Becoming nursing theory as a
means of illuminating meaning by finding and
being the true self. Fodor (1997) states that when
people nurture themselves in body, mind, and
spirit, they can help and heal themselves, and lead
lives of rich meaning.
NERU Pilot Project Application, 2010
Noticing
 The Canadian Nurses Association (2009) suggests
that “further research may identify interventions
that can be introduced in nursing school to address
the emotional and psychological factors that
contribute to problematic substance use as well as
information that nurses can use to develop selfawareness and resiliency.” (p.4)
Interpreting
 According to Ackley and Ludwig(2006), nurses
demonstrate a need for strengthened coping and
resiliency.
 Our research team believes that this can be
accomplished through developing self-awareness
and self-care that begins early in nursing education
and continues throughout a nurse’s entire career.
Responding
 “We
believe that before nurses can engage in a
professional caring relationship with a client, they
must learn to value and care for themselves.”
(McMaster University, 2009, p.5)
 “Nursing education institutions [need to]
incorporate information about the health, safety,
and well-being of the nurse into the core
curriculum of nursing education programs.”
(RNAO, 2008, p.26)
Responding
 CHS 719 graduate seminar with Viola Fodor as guest
speaker to explore some of the challenges in nursing
education and the need for self-care
 NERU study: Expanding Undergraduate Nursing
Students’ Knowledge of their own Self-Care
NERU Study Research Question
“Would attending a one-day workshop
help McMaster undergraduate nursing
students expand their knowledge of
how well they take care of themselves in
body, mind, and spirit?”
NERU Study Objective
A one-day self-care workshop, facilitated by
speaker, author (1997), and psychotherapist, Viola
Fodor, would encourage nursing students to assess
their levels of self-care and introduce ways that
they could improve their self-care over time.
Nursing students who nurture their self-care would
be better able to draw on their inner resources to
cope with their educational and future career
challenges.
Study Findings
Study Design with measures and participant activities
Group
Time 1
Activity
Time 2
Activity
Time 3
Activity
Time 4
Activity
Treatment
Pre-Measure
Training
Session
Post-Measure
Post-Measure
Wait List
Control
Pre-Measure
Pre-Measure
Training
Session
Post-Measure
Study Measure
SELF-CARE Pre-Test
WINTER 2011
Level of Program: ______________
Age: ______________
Gender: M
Username (first three letters of mother’s maiden name/2-digit birthday include 0 where applicable)
____________________________________________________________
Please rate your responses to the following statements
How often during a week do I take time to relax?
1
2
3
4
(Not at all)
(Sometimes)
5
6
7
(Frequently)
How often during a week do I take time to sit quietly?
1
2
3
4
5
(Not at all)
(Sometimes)
6
7
(Frequently)
How often do I take care of my body on a daily basis?
1
2
3
4
5
(Not at all)
(Sometimes)
6
7
(Frequently)
How often do I take care of my mind on a daily basis?
1
2
3
4
5
(Not at all)
(Sometimes)
6
7
(Frequently)
F
Study Findings
6
5.5
5.3
5.4
5
4.3
4.4
Ratings
4
4.2
Treatment
3
Control
2
1
0
Pre
Post 1
Post 2
Reflecting
Reflecting on the voices of student nurses
“I think if I learned earlier in my education what I
learned today, it would’ve saved me from a lot of
stress, grief, and from the pressures of nursing and
university life.”
Reflecting on the voices of student nurses
“I absolutely do not think the critical reflections are
enough because I feel ashamed/embarrassed to write
some things and sometimes I just rush in my writing
and don’t really mean what I say. I just wished my
tutor could’ve sat me down and asked me if I was
okay and how I was doing. I know that I have to be
self-directed and responsible but sometimes I need
help and it’s too much.”
Reflecting on the voices of student nurses
“There’s no point in McMaster having such a high
quality of education if the students don’t have the
supports to handle it. I don’t want to survive my
undergrad, I want to come out as a nurse that has the
skills and understanding to cope with real life career
pressures.”
Reflecting on the voices of student nurses
“I feel this should be expanded to be a 16 week
course for all nursing students.
Potential Research Question:
If the need is identified by students after
successful completion of the self-care workshop,
should this content be the basis for a compulsory
course in the undergraduate nursing program?”
Reflecting on the voices of student nurses
“Through this workshop I have realized that understanding ‘how’ to
manage stress in my life is crucial now and not later. I feel that nurses
are often forgotten about in terms our own health needs. We educate
and advocate for stress management in our patients, but we ourselves
find it difficult to manage our own stress.”
“… in order to take care of our patients, we need to take care of
ourselves.”
“The nursing program needs to instill awareness and the importance of
self-care. Nursing students need your help in finding strategies to
manage their stress and nurture their minds, spirits, and bodies and it
needs to start now.”
Level III BScN student's letter, 2011
Next Steps
 Viola Fodor will present for half the day at a faculty
development event in May 2012. She will focus on how to
incorporate the care of body, mind, and spirit into the
undergraduate nursing curriculum.
 Consider providing Viola’s program in the spring/summer
as a prerequisite to entry into the four year BScN program
at all three sites
 Consider offering booster sessions of Viola’s program
throughout each term to remind and encourage students
about their self-awareness and their self-care
 Other suggestions?
Contact Information
Janet Lovegrove, RN, BScN, MSc
lovegrje@mcmaster.ca
Viola Fodor, MEd, (C)OACCPP
violafodor@sympatico.ca
www.violafodor.com
Elisha Van Harte, MSW, RSW
elishavanharte@hotmail.com
References
Ackely, B.J. & Ladwig, G.B. (2006). Nursing Diagnosis Handbook A Guide to Planning Care (7th ed.).
Philadelphia, PA: Mosby Elservier.
Bevis, E. & Watson, J. (1989;2000). Toward a Caring Curriculum: A New Pedagogy for Nursing. Sudbury, MA:
Jones and Bartlett.
Canadian Nurses Association. (2009). Position Statement on Problematic Substance use by Nurses.
Canadian Nurses Association. (2002). Planning for the Future: Nursing Human Resources Projections.
Elliott, H. (1997) Holistic nursing and the therapeutic use of self. Complementary Therapies in Nursing and
Midwifery, 3, 81-82.
Evaluation of Oral Presentation Adapted From McMaster University (2009), Undergraduate Nursing Education:
Program Handbook 2009-2010. Hamilton, ON: McMaster University.
Fodor, V. (1997) Desperately Seeking Self: An Inner Guidebook for People with Eating Problems. Carlsbad, CA:
Gurze Books.
Hansen-Ketchum, P. (2004). Parse’s theory in practice: An interactive analysis. Journal of Holistic Nursing,
22(1), 57-72.
Johns, C. (2007). Toward easing suffering through reflection. Journal of Holistic Nursing, 25(3), 204-210.
PTSD in nurses. 2005. Advanced Journal in Nursing, 105(7), 77-78.
Registered Nurses Association of Ontario (RNAO). (2008). Healthy Work Environments Best Practice Guidelines
Workplace Health, Safety and Well-being of the Nurse.
Tanner, C. (2006). Thinking like a nurse: A research based model of clinical judgment in nursing. Journal of
Nursing Education, 45(6), 204-211.
Witt-Sherman, D. (2004). Nurses’ stress and burnout. American Journal of Nursing, 104(5), 48-56.