Understanding mental health nurses' lived experience of self-care at work: an interpretative phenomenological analysis

Abstract

Background: Nurses experience stress and distress at work, impacting at organisational, practice and personal levels. Self-care can support and value the integral role of nurses in quality healthcare delivery. Self-care has been identified as mitigating distress yet there are barriers evident in nurses’ ability to engage in self-care. The lesser prevalence of self-care activities noted in nurses combined with the clear benefits of self-care practices warrant a deeper study of the self-care of nurses at work. Aim: To understand mental health nurses’ lived experience of self-care at work. Method: A qualitative approach was adopted, guided by Interpretative Phenomenological Analysis (IPA). Eight participants from a homogenous background were recruited to explore their understanding of self-care. Data were collected through in-depth semi-structured interviews and analysed using IPA. Findings: Three super-ordinate themes emerged relating to how individual nurses made sense of their experience of self-care at work. The Nurse Bombarded offered insights to the physical and relational world of the nurse struggling to cope. This triggered The Search for Equilibrium. To mitigate bombardment participants made changes to their way of being, adopted self-care and relied on their trusted inner circle of colleagues for support and guidance. The Nurse Triumphing illuminated the self-regulation, psychological readiness and sense of performance of the nurses interviewed. Conclusion and Implications: Nurses’ self-care does not occur in a vacuum of personal and ethical responsibility. Participants simultaneously moved between bombardment and triumph, seeking equilibrium to reduce their sense of vulnerability. Their vulnerability was dependent on their experience of professional and team identities, collegiality and role purpose. New understandings of the barriers and challenges to practising self-care emerged, associated with choice, confidence and relationships. The findings should encourage us to look more deeply at the interchange between professional and team identities within complicated social situations, thus reducing vulnerability. Opportunities to enhance professional identity and self-care exist at educational, practice, research and policy level.