(Self) Care-Plan

Ah, care-plans. If those two words don't trigger a visceral reaction for you, then you've clearly never been to nursing school. 

The more times I wrote those dreadful 8 to 14 page assignments on a patient, the more I realized I'd been creating and valuing modified care-plans for a few years now. But, these informal care plans aren't for patients; they're (self) care-plans that I apply to my own life, and they utilize three sections similar to the assignments I wrote in nursing school. With only 9 weeks of experience in the Pediatric ICU, I've already gotten a realistic glimpse of what comes along with pediatric and/or critical care nursing: trauma, death, sickness, grief, and loss. 

With this being the specialty I intend to enter, it's becoming more necessary than ever for me to practice self-care, not only for myself, but also for my future patients. 

Right now, I'm still new to the field, and I don't yet feel as if I'm becoming broken down by it. But, I know that if I don't start upping my self-care game now, nursing (and life in general) can throw some heavy obstacles at me; and if I don't get a handle on them from the start, they have the full potential to break me down and harden me up. 

Through my (self) care-plans, I am able to find more answers, truths, solutions, and peace that help me become a better person and a better nurse. 

ASSESSMENT FINDINGS 

(I take a brutally honest look at myself and acknowledge what I'm doing well, and what I'm doing...well, not so well. My clinical instructor this quarter gave an amazing talk about self-care vs. self-pampering and highlighted the key difference between the two: true self-awareness. So, my acknowledgement of my successes and shortcomings have served me as the first step to identifying areas most needing self-love and attention.)

• Successful
• Communicating to others and myself what I feel and need
• Finding different ways to express my emotions and goals
• Balancing work and play
• Stepping out of my comfort zone
• Doing what brings me joy despite how I think others will view it
• Needs Improvement
• Moodiness & sensitivity
• Snapping at others when feeling impatient or frustrated
• Always feeling there is more I can/should do to be a better daughter, better friend, better girlfriend, better sister, better nurse, better student, better person, better practicer of mindfulness, better runner, better cook, better writer, better storyteller, better crafter, better better better better better.
• Balancing gratitude and guilt

MEDICATIONS 

(I've been on and off antidepressants since I was 17 years old. Sometimes exercise, a good support system, honest communication, enough sleep, and all the candlelit baths and essential oils in the world can't win the battle against mental health. That's okay. It's been a long journey, but I no longer feel immense shame in relying on medication and/or therapy from time to time. They've been necessary tools that allow me to get to a place to practice the self-love I need).

• Escitalopram (Zoloft)
• Class: Selective Serotonin Reuptake Inhibitor
• Indication: anxiety, mild depression
• Side effects: lethargy, weight gain
• Alprazolam (Xanax) PRN
• Class: Benzodiazepine 
• Indication: Anxiety attacks, panic attacks
• Side effects: sedation

NURSING DIAGNOSES

• Low Self Esteem r/t entering a new career AEB passive aggressively requesting reassurance outside the hospital & self-blame/criticism

• Interventions:
• Praise myself when I do or say something I would praise someone else for doing or saying
• Forgive myself when I do not accomplish everything I set goals to accomplish
• Choose only 1-2 area(s) for improvement for the extended future. There are not enough hours in the week to constantly try to work full time (without getting paid), complete homework and projects, get 8 hours of sleep/night, call my grandma more often, grocery shop and meal prep healthy meals, read more novels, balance spending time with my boyfriend and friends and family, do cardio 3-5 times per week, do yoga and strength training, journal, follow politics and current events, find a hobby, start a blog, explore LA, be available for my loved ones at any hour they need me, apply for jobs, plan awesome birthday parties, and stay sane. So why do I put so much pressure on myself and feel like a failure if I'm not succeeding on all of these fronts simultaneously? 
• See it as a success if I can kick a** in only one or two of these areas 
• Move on to 1-2 new area(s) once I've spent a long time dedicated to improving and kicking a** in the others

• Mild depression r/t isolation during days off, constant exposure to death and dying, & genetic predisposition to mental health issues AEB decreased energy level, decreased desire to spend time being social, inability to shake a general feeling of sadness, & fleeting feelings of worthlessness

• Interventions:
• Identify who in my life makes me feel supported, loved, and not-judged. Pursue time with those people. Quietly pull away from (but don't burn bridges with) those who don't. 
• Allow myself to feel sadness. Recognize and intervene when the sadness becomes a burden. 
• Look for the beauty, the positive, the attitude for gratitude in every sad event
• Continue current medication regimen 
• Journal or blog it out

• Fatigue r/t being on my feet with a smile on my face for 12 hours straight AEB people stating "you look tired" or "are you wearing any makeup?", falling asleep within 30 minutes of getting home from a shift, red eyes, & headaches

• Interventions:
• Charging my phone away from my bed overnight so I don't get tempted to scroll through social media as I try to fall asleep
• Trying to have a regular sleep schedule 
• Relaxation/self-pampering techniques: 
• Baths, face masks, candles
• Cozying up and watching a good TV show/movie or reading a book
• Meditation, deep breathing 
• Getting a massage
• Going for a 20 minute walk listening to instrumental music

So, there you have it. This is what the ever-changing (self) care-plan of a new nurse with an ongoing history of mental health struggles looks like. Self-assessments and tailored interventions are what help me persevere. I won't lie...they take a lot of effort, and I am not always successful in following through with them. But, if I surrendered to every doubtful thought, every stigmatized shame, or every hurtful interaction, I'd still be a scared young girl filled with self-hate, confusion, and hopelessness. I want to live up to my full potential, and I can't do that if I let those demons consume me.