PURPOSE
The purpose of this assignment is to allow the learner to demonstrate good organization, appropriate resources, and correct APA formatting for preparing a scholarly paper.
I Mind/Body/SpiritW ellness 101
Spiritual wellness: A journey toward wholeness
By David Hrabe, PhD, RN, NC-BC; Bernadette Mazurek Melnyk, PhD, RN, APRN-CNP, FAANP, FNAP, FAAN; Susan Neale, MFA
Through spirituality, we connect with the world around us.
Editor’s note: This is the last installment in a 10-article series on wellness. You can read all o f articles in the se ries at americannursetoday.com/category/wellnessl01/. Thank you to the authors at The Ohio State University College ofNursingfor their support of nurse wellness.
Have you ever felt like a “human doing” instead of a “human being”? As we fling ourselves from one activity to another, we sometimes find that getting beyond our list of “to do’s” and staying in touch with those aspects of our lives that mean the most to us is difficult. Re member that well-rounded self-care also involves spiri tual wellness.
W hat is spirituality?
Barbara Dossey, a pioneer in the holistic nursing move
ment, writes that our spirituality involves a sense of connection outside ourselves and includes our values, meaning, and purpose. Your spiritual well-being isn’t what you own, your job, or even your physical health. It’s about what inspires you, what gives you hope, and what you feel strongly about. Your spirit is the seat of your deepest values and character. Whether or not you practice a religion, you can recognize that a part of you exists beyond the analytical thinking of your intel lect; it’s the part of you that feels, makes value judg ments, and ponders your connection to others, to your moral values, and to the world. For this reason, spiritu ality frequently is discussed in terms of a search. Spiri tual wellness is a continuing journey of seeking out an swers and connections and seeing things in new ways. It also means finding your purpose in life and staying aligned with it.
Although religion and spirituality can be connected, they’re different. A faith community or organized reli gion can give you an outlet for your spirituality, but religion isn’t spirituality’s only expression. Hope, love, joy, meaning, purpose, connection, appreciation of
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Continue the journey
Here are some ideas to consider as you continue your nurs ing journey. You’ll notice that many are connected to rec ommendations we’ve made for other dimensions of well ness. This isn’t a mistake. We’re whole human beings, and these practices support multiple dimensions.
Reconnect/reimagine your life’s purpose and passion:
Set aside some time for a “retreat with yourself” to carefully consider your purpose and whether/how you’re living it out. Where do you need to make adjustments? What do you need to stop doing? What do you need to start doing? What would you do in the next 5 to 10 years if you knew that you couldn’t fail? Periodically “taking stock” is critical to staying on track.
Ramp up your positive outlook: In their work with peo ple newly diagnosed with HIV, Moskowitz and colleagues developed an intervention to improve patients’emotion al outlook even in the midst of a very challenging circum stance. The intervention involves cultivating positive emo tions through these daily practices:
tual connection. Provision 1 of the Code ofEthicsfor Nurses with Interpretive Statements states, “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.” But many nurses are surprised to find that Provision 5 extends this compassion and respect to nurses them selves: “The nurse owes the same duties to the self as to others, including the responsibility to promote health and safety, preserve wholeness of character and in tegrity, maintain competence, and continue personal and professional growth.” We have a responsibility to both our patients and to ourselves to honor our spiri tual heritage.
Think about your job and what you do every day. When do you feel most energized? Great satisfaction can come from learning a new skill and mastering it, and of course it’s vital that you complete your many tasks efficiently and competently, but there’s more. When asked about the times they felt most energized, many nurses cite moments when they really connected with another person—family, friends, colleagues, pa tients. This is the “more”—when we go beyond just our needs and wants to connect beyond ourselves. Hu mans are wired to be in relationship with others. Spiri tuality is fundamental to nursing practice.
Disconnected much?
Although most nurses would likely agree that spirituali ty is an important component in the care they provide and in their personal lives, too often the pressures of modern life interfere with what’s most important to us. Crushing workloads, family responsibilities, financial pressures, and fast-paced living create the perfect storm that makes acting on our values difficult. Many nurses suffer chronic illnesses, including depression, at a rate greater than the general population and other health professionals. In a study, Letvak and colleagues dem onstrated that nurses are twice as depressed as the pa tients they serve. A study by Melnyk and colleagues of more than 2,000 nurses across the country found more than half of the nurses reported poor mental or physi cal health and depression. Additionally, nurses with “…worse health were associated with 26% to 71% high er likelihood of having medical errors.”
Living life on purpose
In his groundbreaking work with professional ath letes, performance psychologist Jim Loehr, EdD, ar gues that being out of touch with our life’s purpose creates an extraordinary energy drain. People may run in marathons, eat the healthiest foods, and be at the top of their game professionally, but these really good things can become an end to themselves when they’re disconnected from life’s purpose. Without that connection, anything can become meaningless.
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Loehr writes: “When you find—or, more aptly, choose-—your pur pose, then you are the agent of your own happiness. You have the opportunity to harvest joy in both the pursuit and the achieve ment, the journey and the desti nation.” Our purpose, our reason for living on this planet, is at the foundation of our spiritual nature.
Joy in the journey
All of us experience tragedy, sadness, and grief; they’re part of the human condition. If you’re wondering if finding joy and peace is possible under what appear to be impossible conditions, remember this: History is re plete with ordinary humans rising to challenges of the day in extraordinary ways. They were able to unlock that part of themselves that gave them the strength and couragetocarryon.
Nurses are extraordinary—don’t lose sight of the amaz ing work you do to improve the lives and comfort of the people you touch. It’s never too late to make a positive change in your life. (See Continue thejour ney?) If you take a few small steps in the direction you want to go, you’ll be amazed at the results. ★
The authors work at The Ohio State University in Columbus. David Hrabe isassociate professor of clini calnursingandexecutivedirectorofacademicinnova tionsand partnershipsforTheOhioState University CollegeofNursing. BernadetteMazurekMelnykisthe vice president for health promotion, university chief wellness officer, dean and professor in the College of Nursing, professor of pediatrics and psychiatry in the College of Medicine, and executive director of the He lene FuldHealthTrust National InstituteforEvidence- based Practice in Nursing and Healthcare. Susan Neale
(continuedfrom page 21)
waved over the device. Patients also can show their ID card and request alternative screening.
Keeping pace with technology
The LP represents a profound change in pacemaker technology. More literature is needed to pro vide nurses with the education they need to keep up with these innovations. Currently, LPs are lim ited to right ventricular pacing; however, other implanted cardiac devices are being investigated that will work in combination with the LP for use in other areas of the heart. ★
Joyce Bulger-Noto isa nursing professional develop ment specialist at NewYork-Presbyterian Weill Cor nell Hospital in NewYork.
Selected references
Bernstein AD, Daubert JC, Fletcher RD, et al. The revised NASPE/BPEG generic code for antibradycardia, adaptive-rate, and mul
tisite pacing. Pacing Clin Electrophysiol.2002;25(2):260-4.
Crotti N. Abbott is developing a dual-cham ber leadless pacemaker. June 4, 2018. med- icaldesignandoutsourcing.com/abbott-is-de- veloping-a-dual-chamber-leadless-pacer/
Epstein AE, DiMarco JP, Ellenbogen KA, et al. ACC/AHA/HRS 2008 Guidelines for de vice-based therapy of cardiac rhythm abnor malities: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing com mittee to revise the ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices): De veloped in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. Circulation.2008;117(21):e350-408.
Leier M. Advancements in pacemaker tech nology: The leadless device. Crit Care Nurse.2017;37(2):58-65.
Medtronic. Micra MCI VR01 Clinician Manu al. manuals.medtronic.com/wcm/groups/ mdtcom_sg/@emanuals/@era/@crdm/docu- ments/documents/contrib_231758.pdf
Mond HG, Proclemer A. The 11th world sur vey of cardiac pacing and implantable car
dioverter-defibrillators: Calendar year 2009—A World Society of Arrhythmia’s project. Pacing Clin Electrophysiol. 2011;34(8):1013-27.
Reddy VY, Knops RE, SperzelJ, et al. Pennanent leadless cardiac pacing: Results of the LEADLESS trial. Circulation. 2014;129(14):1466-71.
Reynolds D, Duray GZ, Omar R, et al. A leadless intracardiac transcatheter pacing sys tem. N EnglJ Med. 20l6;374(6):533-4l.
Roberts PR, Clementy N, Al Samadi F, et al. A leadless pacemaker in the real-world set ting: The Micra Transcatheter Pacing System Post-Approval Registry. Heart Rhythm.2017;14(9):1375-9.
Udo EO, Zuithoff NP, van Hemel NM, et al. Inci dence and predictors of short- and long-term complications in pacemaker therapy: The FOL- LOWPACE study. Heart Rhythm. 2012;9(5):728-35.
United States Food and Drug Administration.
Circulatory System Devices Panel Meeting: Leadless Pacemakers. Division o f Cardiovas cular Devices Office ofDevice Evaluation, Food and Drug Administration, February 18, 2016. Executive Summary Memorandum General Issues: Leadless Pacemaker Devices.2016. fda.gov/downloads/AdvisoryCommit- tees/CommitteesMeetingMaterials/MedicalDe- vices/MedicalDevicesAdvisoryCommittee/Cir- culatorySystemDevicesPanel/UCM486733.pdf
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/yistory is replete with ordinary humans
rising to challenges of the day in extraordinary ways.
issenior writer/editor of marketing and communications in the College of Nursing.
Selected references
American Nurses Association. Codefor Nurses with Interpretive Statements.2nd ed. Silver Spring, MD: Nursebooks.org; 2015.
Dossey BM. Integrative health and wellness assessment. In: Dossey BM, Luck S, Schaub BS, eds. Nurse Coaching: IntegrativeApproachesfor Health and Well being. North Miami, FL: International Nurse Coach Association; 2015; 109-21.
Letvak S, Ruhm CJ, McCoy T. Depression in hospital-employed nurses.Clin Nurse Spec. 2012;23(3):177-82.
LoehrJ. ThePowerofStory:RewriteYourDestinyinBusinessandinLife.New York: Free Press; 2007.
Melnyk BM, Orsolini L, Tan A, et al. A national study links nurses’ physi cal and mental health to medical errors and perceived worksite wellness.
J Occup Environ Med. 2018;60(2):126-31.
Moskowitz JT, Carrico AW, Duncan LG, et al. Randomized controlled trial of a positive affect intervention for people newly diagnosed with HIV. J Consult Clin Psychol. 2017;85(5):409-23.
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