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Self-management = a balanced life

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By: By B. Suzy Diggle-Fox, PhD, ANP, GNP, B-C, and Lisa Sparacino, PhD, RN, CNE, CHSE

Follow this formula for success.

Takeaways:

• Self-management coupled with a wellness approach can mitigate the stress associated with nursing and improve individual nurse health.
• Procrastination is a common barrier to self-management, resulting in negative effects on overall health.
• Knowing what causes you to procrastinate will help you recognize the behavior and work to correct it.

Editor’s note: This is a web exclusive article for the June 2021 issue of American Nurse Journal

Nurses focus so much on caring for others that they frequently overlook taking care of themselves. They constantly chase time and never catch up, leaving them physically and emotionally drained, which can perpetuate body aches, back pain, moodiness, anxiety, depression, irritability, sleep disturbances, work errors, and memory loss. The end result can be exhaustion and burnout.

Put off procrastination

Procrastination is a common barrier to self-management. It can have adverse effects on overall health, especially if you need to make a lifestyle change regarding diet, exercise, or sleep habits. The number of people who admit to procrastinating is significant. A 2020 study by Litvinova and colleagues noted that 95% of students said they were procrastinators. Procrastinators tend to work the same number of hours as others, but they focus solely on completing urgent tasks, rather than important ones (those that will make a bigger long-term difference).

Knowing what causes you to procrastinate will help you recognize the behavior and work to correct it. Are you a passive procrastinator (you put off tasks because you have difficulty making decisions and then taking action) or an active procrastinator (you put off tasks because you work best under pressure)? Other types of procrastinators include perfectionists, dreamers, defiers, worriers, crisis-makers, and overdoers. (See Procrastinator types.)

Procrastinator types

Understanding why you procrastinate can help you overcome the tendency. Do you fall into any of these categories?

  • Perfectionists delay tasks because they’re afraid of not doing them perfectly.
  • Dreamers have difficulty zeroing in on the details.
  • Defiers don’t like being told what to do.
  • Worriers are afraid of change or the unknown.
  • Crisis-makers prefer working under pressure.
  • Overdoers take on too many tasks and then have little time to complete them.

Source: Cherry 2020

You can overcome procrastination with behavior modification. Consider these suggestions.

  1. Recognize what you’re delaying and why. For example, maybe you hate going for a yearly mammogram because you fear bad news.
  2. Make an intention plan to prevent putting things off. Consider the reasons why you would put them off and give yourself a better reason for completing the task now. Using the mammogram example: “I won’t put off my yearly mammogram because early diagnosis has a better treatment outcome.”
  3. Start your day by dividing it into steps. Make a schedule for what needs to be done ensuring you add time for self-care.
  4. Remove or decrease distractions. For example, if you need quiet to complete documentation, wear earplugs or move to a quiet place (as long as another staff member is monitoring alarms).
  5. Try a reward and penalty method. For example, if an important task is completed, join staff members after shift to socialize; if it’s not completed, you can’t join them. 

Owens documented that individuals who have a plan are almost eight times less likely to procrastinate. Owens also found that once people start on their postponed task, anxiety decreases. Creating a plan begins with developing your self-management skills.

Develop self-management skills

Preparation and organization will help you facilitate professional and personal self-management.

  • For 1 to 2 weeks, document all your activities and the time it takes to complete each. Once you have that information, you’ll be better able to plan your daily tasks, assigning a time frame for each.
  • Develop clear, measurable short- and long-term goals that correlate with your professional and personal activities.
  • Determine your most and least productive times.
  • Make and prioritize a daily to-do list, concentrating on results, such as safe, evidenced-based patient care. (See Care priorities.)

Care priorities

Plan your workday based on patient care priorities.

  • Immediate. For example, airway disturbance, hemorrhaging, or loss of consciousness.
  • As soon as possible. For example, administering medication for a moderately high fever.
  • Routine. For example, administering tube feedings.
  • Comfort care. For example, holding a patient’s hand while they cry.
  • Learn to delegate, especially time-consuming tasks. For example, when patients need help eating, delegate this to unlicensed assistive personnel. Use hospital resources such as physical therapy and wound care teams.
  • Understand that it’s acceptable to say “no.” Know your limitations, and don’t feel obligated to say “yes” to everyone.
  • Manage technology and don’t let social media rule your personal and professional life. For example, limit the number of times you access your phone and email throughout the day.
  • Use active listening skills to help improve communication.
  • Rethink your attitude toward tasks you don’t enjoy. For example, if you delay brushing your teeth, think how good it feels to have a clean fresh mouth and how important it is to good health.
  • If possible, try to complete the most difficult tasks first.
  • Allow ample time to complete tasks, and take advantage of unexpected free time to accomplish necessary duties.

Initially, addressing self-management issues may cause additional stress, but this can be managed with stress reduction techniques such as relaxation imagery, mindfulness, meditation, yoga, and focused deep breathing. Talking to a friend, counselor, or other healthcare provider also can help reduce stress.

Other self-care activities that can contribute to stress reduction and better overall health include regular exercise, healthy meals, and adequate sleep. And don’t forget to carve out time with family and friends and for participation in community activities. When you’re at work, take breaks so you can relax and restore yourself to provide excellent care for the next patient.

Make yourself a priority

When you have the tools in place to balance your life and improve your self-management skills, staying motivated will become easier. Studies show that individuals with good self-management skills experience less depression, stress, anxiety, anger, and alcohol and drug dependency. In addition, these skills can increase productivity, which may help you move up the work ladder and achieve your personal and professional goals.

Becoming a good self-manager requires change, which may be challenging, but you’ll need to embrace it by being persistent, flexible, and patient. All nurses must gain perspective and set boundaries so their lives are balanced and productive. If self-management isn’t a priority, eventually the ability to care for others will become impossible.

B. Suzy Diggle-Fox is an assistant professor at the University of North Carolina at Wilmington. Lisa Sparacino is an assistant professor and chair of the nursing department at the New York Institute of Technology Old Westbury.

References

Cherry K. What is procrastination? Verywell Mind. 2020. verywellmind.com/the -psychology-of-procrastination-2795944

Cramm JM, Nieboer AP. Self-management abilities, physical health and depressive symptoms among patients with cardiovascular diseases, chronic obstructive pulmonary disease, and diabetes. Patient Educ Couns. 2012;87( 3):411-5. doi:10.1016/j.pec.2011.12.006

Elite Learning. Ten steps to better time management. April 2, 2012. elitecme.com/resource-center/respiratory-care-sleep-medicine/ten-steps-to-better-time-management 

Ferguson J. Procrastination, a modern-day plague. Corporate Wellness. January 29, 2014. corporatewellnessmagazine.com/article/procrastination-a-modern-day-plague

Institute for Healthcare Improvement. Changes for improvement. ihi.org/resources/Pages/Changes/default.aspx

Litvinova A, Kokurin A, Ekimova V, Koteneva A, Pozdnyakov V. Procrastination as a threat to the psychological security of the educational environment. Behav Sci. 2019;10(1):1. doi:10.3390/bs10010001

McKinney KC, Hillebrand K. A careful balancing act. Am J Health Syst Pharm. 2015;72(23 suppl 3):S168-70. doi:10.2146/sp150026

Owens SG, Bowman CG, Dill CA. Overcoming procrastination: The effect of implementation intentions. J Appl Soc Psychol. 2008;38(2):366-84. doi:10.1111/j.1559-1816.2007.00309.x

Preville P. Work-Life Balance. A Handbook for Professors. 2015. tophat.com/teaching-resources/ebooks-and-guides/guide-work-life-balance-handbook-professors

Reese S. 12 smart time management tips for doctors. Medscape Bus Med. April 27, 2016. medscape.com/viewarticle/860328

Stanford Medicine. Seven time management tips for happier (and healthier) days. October 4, 2017. scopeblog.stanford.edu/2017/10/04/seven-time-management-tips-for-happier-and-healthier-days

Steptoe A, Kivimäki M. Stress and cardiovascular disease: An update on current knowledge. Annu Rev Public Health. 2013;34:337-54. doi:10.1146/annurev-publhealth-031912-114452

Wolters CA, Won S, Hussain M. Examining the relations of time management and procrastination within a model of self-regulated learning. Metacogn Learn. 2017;12:381-99. doi:10.1007/s11409-017-9174-1

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