16.6: Managing Stress and Self-Care Practices

Today’s nurse manager roles are diverse and constantly changing. Multiple priorities and complex pressures affect nearly every aspect of a manager’s day-to-day activities. Urgent and non-urgent considerations often intersect and can negatively impact the time and resources available for efficient, optimal decision making. In some instances, ambiguity and missing data can complicate decision-making processes. Priorities are sometimes set and then re-adjusted based on time-sensitive data, higher-level turbulent issues, or patient care management needs. Leading and managing in this environment is the new health care norm.

Within this chaos and non-stop change, it is critical for the nurse manager or leader to keep top of mind their primary leadership responsibility to organizations and their staff and to ensure proactive and positive oversight and safe, appropriate quality care for patients. Managers need to expect and anticipate change and be able to communicate effectively and collaborate easily with others to move health care forward. The use of complexity theory to explain and provide a framework for the ever-changing environmental priorities was discussed in Chapters 1 and 3.

There is no one best way to manage change in an organization. Pragmatic and logical thinking must be at the forefront of every consideration. Proactively supporting and promoting change is both a demanding and fatiguing task. Without careful consideration of internal strengths, self-awareness, and resilience coping mechanisms, it is easy for nurse leaders to experience negative impacts on their lives and behaviours. Sometimes the deleterious effects such as fatigue may not be realized, but may eventually lead to burnout, which may be displayed as emotional exhaustion, cynicism, and personal inefficacy (Laschinger & Fida, 2014).

Now more than ever, self-care is essential for managers and leaders as a proactive and continuing activity. Self-care always begins with strategic awareness of strengths, skills, and abilities that you as a manager or leader possess. It has been said that the best leaders do not rely on their positional power, but rather focus on their best attributes and assets to enhance and succeed at their roles (Rath & Conchie, 2009). Similarly, Gottlieb et al. (2012) discussed strengths-based leadership as a multifaceted concept involving the development of not just tangible knowledge and skills but also of an un-anxious mindset that allows individuals to utilize their best developed strengths for problem management, while focusing on development of weaker skills over time. Their theory of strengths-based leadership extends beyond self-assessment to further recognize strengths in others on a team and among those we collaborate with. Additionally, evidence related to how you as a leader think and view the world also impacts your actions and behaviours. Mindfulness and mindset of the manager are critical in navigating this complexity, as discussed in previous chapters.

Connecting to a leadership framework assists in focusing the personal growth of managers. Closely tied to the work of Rath and Conchie (2009) is the management framework of LEADS in a Caring Environment, now supported and endorsed by the Canadian College of Health Leaders. LEADS correlates to: Leading self, Engaging others, Achieving results, Developing coalitions, and transforming Systems.

Leading self as the first step in the LEADS framework highlights how essential it is for a manager or leader to consciously embark on a personal journey of self-awareness, introspection, and recognition of their skills, intuitive character strengths, and expertise. It is not an expectation for managers or leaders to be good at everything, but a strategic plan for self-care and personal journey development can begin if they are first aware of their strengths as well as weaker areas to work on.

From the Field

• Consult and complete the leadership and management competency assessment tools from the following two documents to recognize areas of management or leadership strengths, as well as those that may need attention: SRNA’s Standards and Foundation Competencies for the Practice of Registered Nurses and CNA’s Canadian Nurse Practitioner Core Competency Framework.
• Consider approaches to using emotional intelligence for decision making and for engaging others effectively (Bradberry & Greaves, 2009), and consider your strengths as part of your strengths-based leadership approach (Gottleib et al., 2012).
• Use the results of competency assessment tools to help you set goals for career and professional development learning. Stick to these goals and evaluate them regularly (Echevarria, Patterson, & Krouse, 2017).
• Be aware of physical and mental cues from your body that you may be becoming overwhelmed or need a “time-out” from complex and fast-paced environments. Negotiating for time to ponder and strategically consider options almost always leads to more successful decision making.
• Take care of your personal health by practising healthy lifestyle habits; specifically, pay attention to adequate sleep, healthy eating, exercise, and stress management activities.
• Identify a mentor—someone in a similar or higher management or leadership position who you look up to and aspire to emulate. Consult with your mentor and coordinate a relationship for feedback, advice, and support to guide your personal growth as a manager or leader over time.
• Practise good time management and resource management skills to support efficiencies and streamlined processes. Self-motivation skills and cues are important to ensure you keep on task and that you meet deadlines for reports or commitments.
• Schedule protected time in your work schedule to periodically review your strengths and approaches. Think outside the box in terms of creativity and ways to enhance your personal growth.