Nurses are leaders and innovators in healthcare. Dame Maud McCarthy identified and described "shell shock" (PTSD) in WWI. Elise Sørenson, a Danish nurse, created the ostomy bag in 1954 and the crash cart was invented by nurse Anita Dorr in 1968. In recent years nurses have developed smart wound dressings with built-in biosensors that in conjunction with AI-run predictive wound healing algorithms. In fact, nurses have been problem-solving and improving healthcare delivery worldwide since the inception of the profession, almost 200 years ago.
During this time, an unseen malady has been moving through healthcare. Modern psychology and neuroscience have developed to the point that we finally possess language to describe the professional afflictions that have plagued healthcare. Words like compassion fatigue, vicarious trauma, moral injury, burnout, PTSD, substance use disorder, existential dread, etc. have entered our lexicon. These definitions of various mental, physical, emotional, and spiritual disorders have provided us with a fluency for articulating our suffering. Nurses, Doctors, allied health care professionals, firefighters, etc. need help combating these occupational insults.
I believe that nurses are the answer to this problem. Not just any nurse, but one who is an experienced caregiver trained in occupational health, psychiatric treatment modalities, mental wellness, addiction, spirituality, and community health with a strong education in management and life coaching.
This healer of the healers or Metacare Practitioner (MP) will act as a counselor of sorts for their respective institutions. They will administer measurement tools to the workforce for compassion fatigue and burnout surveillance. They will host workshops and lectures on diverse wellness modalities like breath work, mindfulness, grief navigation, conflict resolution, communication in the workplace, meditation, yoga, Qigong, forest bathing, grounding, etc. Additionally, the MP will have a seat at the table and report to the C suite regarding the state of the healers.
When at-risk providers are identified, the MP will set aside time to work with that individual one-on-one to drill down to core beliefs, initial sensitizing events, triggers, etc., and develop recovery strategies. Then, the individual will report back to their MP regularly until they return to a healthy baseline. If the plan fails to provide objective and subjective results in a mutually agreed-upon timeframe, the MP will be responsible for working with the provider's physician, psychologist, clergy, sponsor, and HR to gather more resources and care until the individual's depleted state has been reinvigorated and restored. There will be times when entire clinics, wards, units, or even hospitals are suffering and more widespread, institutional measures will be necessary to bring compassion, morale, and job satisfaction back online.
The MP role fits nicely into established nursing theory. In fact, Dorothea Orem's self-care model is a powerful philosophical gestalt to support this new field of Nursing. The theory is patient-focused and promotes agency in the process of healing. Self care as the name implies is implemented and sustained by the individual. Self-care deficits are responsible for the emotional and spiritual depletion that leads to compassion fatigue, burnout, substance use disorder, self-harm, and attrition. This is where education, MP support, and coaching can affect healing. This therapy is entirely patient-centered. Ultimately, only a properly motivated and self-actualized individual can save themselves, because these spiritual, psychological, and emotional insults are deeply personal, multifactorial, and display a wide therapeutic inter-individual variability.
In conclusion, it's clear that our schools have done a fantastic job teaching us how to care for others, but have neglected to teach us how to care for ourselves. Many times, healthcare providers lack even the language to articulate their suffering. It is time for a new leader to rise up from the ranks and be a beacon of education, hope, compassion, and love. The time is now and nurses already possess all the tools to solve this problem. We simply have to arrange the pieces of the puzzle properly. The time has come for Metacare.
