First Responders First//

One Self-Reflection Exercise That Will Help To Increase Your Focus and Presence as a Nurse

Taking time each day to reflect has allowed me to be more present, and to promote my own well-being.

In March 2020, COVID-19 began to take over our lives as nursing professionals but the world around us didn’t stop. While my professional life continued to focus on the pandemic, my personal life was under strain as I received the news that my grandmother had been diagnosed with breast cancer. As an oncology nurse, I had been working at the bedside for a little over two years, but nothing seemed to prepare me for the news. Decisions now needed to be made with my grandmother in her 80s and even though I was not directly involved with the healthcare my grandmother was receiving, my familiarity with oncology/chemotherapy made it all that much more anxiety-inducing. 

So many different thoughts were continuously racing through my head as I was unable to safely see my grandmother to show my support due to COVID-19 restrictions. Many scenarios and treatment plans were being discussed amongst my family: Should my grandmother pursue chemo, immunotherapy, surgery? Or should she forego the rigorous treatments and just do symptom management? These questions plagued me, along with my mother who was directly involved in the decision making. Many times, my grandmother was forced to make these decisions without her children directly by her side as a result of the restrictions. I felt lost. Should I provide my two cents on what treatment she should pursue? Or should I remove myself from the decision-making process? All this was very stress inducing on top of the fact that there were so many moving pieces in my professional life. Each week going into work I was unsure of what kind of patients I would be caring for. Would my floor be a COVID floor this week? Would it continue to be oncology? The uncertainty seemed to be never ending and on top of the challenges I was facing at home, the burden at times felt unbearable. My initial response after being told the news of my grandmother’s diagnosis was to keep everything compartmentalized as much as possible: personal life separate from my professional work life. But as time continued, the stress from both parts of my life began to affect the other. Frankly, I was scared – unsure if I would ever be able to see my grandmother in a healthy “normal” capacity where I didn’t feel like I would be putting her at risk by giving her a simple hug. I knew I needed to find an effective and healthy way to manage all the different moving parts that were now front and center in my life. 

One day at work a few months ago, my good friend and colleague, Jill, gathered a group of us together to decompress after a taxing shift. She introduced a simple mental self check-in exercise she’s used in the past to reflect back at the end of a long day. Jill went around to each one of us and asked us to share a positive highlight from our day, a not so positive part of our day, and lastly something we could improve on – a practice she referred to as “Rose-Bud-Thorn,” which has now become my go-to self-reflection exercise.

Rose: a positive highlight or success 

Bud: area to improve on or grow from

Thorn: a challenge or not so positive highlight  

By starting to more frequently practice the Rose-Bud-Thorn exercise, I was better able to handle all the curveballs being thrown my way over this past year. I was more clearly able to notice positives in each day, no matter how small, even when days may have seemed bleak. From “today I was able to handle two very acutely ill patients and successfully place a peripheral IV” to “I ate lunch before 3pm today” to “I’ve now worked out three days in a row,” I found I was more easily able to keep things in perspective and focus on the things that were under my control to change. No day is perfect and there will always be plenty of ups and downs with one’s mental health journey, but by focusing my attention on how each day goes – the good, the bad, and everything in between – I have found it easier to appreciate the little things and not continuously bury the bad parts. Taking time each day to reflect has allowed me to be more present to my patients and to myself, and has been a great way for me to promote my own well-being during this time.

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