The potential for caregiving to negatively impact personal wellbeing is already well documented, with the advent of Covid-19 known to have further exacerbated this. Healthcare students’ mental health was highlighted as a cause for concern pre-pandemic but the effects of disrupted education alongside the emotional impact of delivering care within health delivery systems struggling to meet Covid-19 related demands has added to these student wellbeing anxieties.
Self-care, defined as ‘a cadre of activities performed independently by an individual to promote and maintain personal well-being throughout life’ has been advocated as an important tool in enabling health professionals to deal with psychological distress. This is seen by many as invaluable if staff are to be retained within the workforce and to be able to continue to provide empathy and compassionate care, particularly so for mental health professionals. New nursing education standards (e.g. NMC, 2018) stipulate the need for resilient and robust graduates. This has led to renewed calls to embed self-care in health professional curricula.
Key actions taken
The advent of revised nursing standards (NMC, 2018), coupled with the Future Nurse agenda, has led to an increased focus on health promotion practices in Abertay University’s pre-registration mental health nursing programme. In the first term of the first year the students are asked to explore the holistic nature of health and wellbeing, the determinants and complexity of health, and consider what health and wellbeing means for them personally in the module ‘Foundational Health Studies’. Reflective practice groups are core components throughout the students’ course, both when in the classroom and in practice, and the students are taught to consider the 3Ps (Professional, Personal and Private) alongside being introduced to the concepts of Personhood. The students are also provided with guidance about self-disclosure. This has transferability in the second term of their first year (post-placement) when they study ‘Physical and Mental Health and Wellbeing’ – a module co-delivered by the Divisions of Health Sciences, and Sport and Exercise Sciences. Within the module they work on a self-care plan (a WRAP – Wellness Recovery Action Plan) which forms the basis of a unit of assessment. Students are encouraged to discuss in small groups the development of their plan as they consider healthful behaviours (and reflect on their action in practice), problem-solving strategies, behaviour change, compassion and the potential for fatigue and burnout, as well as the challenges of modelling appropriate self-care. Students are reminded of the operational boundaries and that the group purpose is educational not therapeutic.
The module is rated extremely favourably by the students with their appreciation of the support provided by both their lecturers and peers in discussion noted. There have been many positive comments affirming the utility of the WRAP in highlighting and promoting self-care.
‘….. made me realise that in order to be the best nurse I can be I need to take care of me and be happy and healthy to offer the best care and support within nursing. It has taught me that I need to allow myself time for self-care and reflection to enable my mind and body the care I need to be 100% focused. ….. I have so many commitments and always felt a huge sense of guilt about giving myself time but you have shown me that it is not only ok but it is in fact essential for my wellbeing, my family and my patients. ……..This was a module I really enjoyed and the learning will be used throughout my nursing career as well as everyday life’. (1st year, MHN student)
While this is just the first iteration of the ‘Physical and Mental Health and Wellbeing’ module the hope is that the work generated will provide the students with their own toolkit that they can continue to apply in recognition of the significance of a lifelong commitment to self-care. It is also hoped that possession of this toolkit will positively impact student perceptions of their own wellbeing as well as attendance, progression and retention statistics for the programme.