Shinobi:

Self-care Strategies

For Operating Theatre Nurses

 

The nursing profession has evolved from both military and monastic backgrounds to become what it is today.

 

We have inherited bullying from one, and tireless, selfless giving from the other.

 

Both are unsustainable in the long term, and both are barriers to the creation of a safety culture within the nursing profession.

 

Because of the intrinsic beliefs and values created in the evolution of our profession, nurses are poor at engaging in self-­‐care activities within work hours.

 

 

 

Instead of privileging our own wellbeing, we continually bow to workload pressures in preference to ensuring our short and long-­term physical and emotional health.

 

In this work, I have developed a simple way to effect change in both the culture and expectations of nurses with respect to self-­‐care.

 

These interventions may be of benefit for the individual, or they may be incorporated into a workplace well-­‐being programme to benefit all staff.

 

In order to consider current standards with respect to emotional support for operating theatre nurses, I looked to the 2010-­‐2011 Edition of the Australian Confederation of Operating Theatre Nurses (ACORN) Standards, in particular, Position Statement Number 5.

 

The Position Statement points to uncertainty as a major stressor within our operating theatre work environment.

 

Stressors are divided into 2 broad categories:

 

Vicarious Trauma’ And ‘Systems of Work’.

 

The ACORN standards are predominantly “debrief-­‐centric” and management focused, and are contingent on the theatre manager having both the skill to identify and the will to implement appropriate debriefing strategies.

 

Debriefing, in this sense, is a physical act, requiring the presence of the affected team, other affected persons and a suitably qualified mental health professional.

 

It also requires time and place. Given the nature of rotating rosters and the ever-­‐present onslaught of production pressure, it is not hard to see why opportunities to debrief are often missed.

 

To further dampen managerial will to provide much needed emotional support to staff, recent research has suggested that the act of ‘debriefing’ may, in some cases, be counter-productive, delaying healing rather than promoting emotional resilience.

 

The American Operating Room Nurses (AORN) Standards are almost, but not quite the same. The difference is:

 

AORN believes that self-­ awareness on the part of the nurse is a key ingredient in defence against Burnout with an insistence that Emotional Support is a SHARED Responsibility between Management and the individual.

 

Shinobi:

 

The concept of ‘Shinobi’ was born out of my OH&S & ANF Representation experiences. Shinobi is a Japanese word associated with the Ninja.

 

It means “To escape”, or “To Steal Away” .

 

In this context I am using ‘Shinobi’ to define the action:

 

‘To escape briefly (physically and metaphorically) for strategic moments in time’

 

 

 

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