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Table 5 Theme 3: Barriers and enablers to self-care practice

From: Exploring the meaning and practice of self-care among palliative care nurses and doctors: a qualitative study

Cathi There’s too many patients and you can’t get enough done… busyness contributes to poor self-care because you actually don’t stop to go ‘How has this affected me? What can I do? What do I need to make me ‘okay’ about it?’
Patrick There is an expectation that people won’t take holidays, but how are people supposed to recharge so they can keep working?
Scott There’s this… culture sometimes where you just sort of ‘soldier on’ and do what’s expected – take work home.
Merilyn It just follows you home and it can really impact on your home life and your health, because you’re just… stressing about things
Gordon The biggest hindrance to self-care is organisational culture.
Larissa There’s a big culture shift that needs to ha in order for people to be able to look after themselves properly.
Winston There is still a lot of stigma around having feelings or accepting feeling or being vulnerable… we do see confronting things but there is still that superhero, you know, not letting it affect you.
Peggie People are considered to be selfish if they do something for themselves… you know, if you take a day off because you’re on a mental health day people think ‘Oh, she’s so selfish because she’s let her team down’
Prudence Lack of self-worth and self-value is a bit of an issue… I can see that in how my colleagues - how people treat themselves, and that’s not a judgment - it’s an observation coming from someone doing pretty much the same kind of thing.
Sandra Self-care always get shoved down to the bottom… that self-worth thing of… you know, something else always being much more important.
Philis I certainly used to be quite critical about myself… which isn’t a particularly helpful thing to do really… [most of us] just beat ourselves up emotionally and physically… and then eventually work out why you can’t keep doing that for the rest of your life.
Carmel Self-care goes down the toilet when it’s random… there’s no effective random self-care.
Peggie I’m very conscious of [self-care] because I’ve been a in bad spot before with palliative care… I really didn’t cope very well, so I’m [now] highly vigilant about self-care.
Gordon I was ‘young and bullet-proof’… and I found [that] to be a fairly unpleasant experience; ‘young and bullet-proof’ didn’t work very well. But it took me about seven years to work that out, and I became significantly burnt out… So, having burnt out… taken time off, and readjusted… I’m now very conscious of how important self-care is.
Abbie When I do [prioritise self-care] I’m calm and I’m more compassionate.
Winston Preventative maintenance… Yeah, well it is [like having a regular check-up and a tune-up]
Reece I have written self-care plans for myself… but I don’t approach that in a sense of, you know, at six months – ‘now I need to redo my self-care plan’. An ongoing planning process is the critical element rather than just the piece of paper.
Carmel Leadership. It’s got to come from the top. You can’t have someone at the top who thinks that people who need to go for counselling are ‘poor little things’. Seriously, it’s not going to work
Kaleb Having a reasonable degree of self-awareness is hugely important [for effective self-care], particularly in our line of work.
Cathi Finding the positive in situations… also taking account of things that have negatively impacted me [but still finding] something positive.
Doreen …intentionally choose how I want to be each morning, and how I want to leave work, and respond to events; having a mindset of gratitude.
Reece Practising self-compassion is a really important enabler – without that I’m not really sure how authentic my self-care would be.
Gordon Being realistic about your limitations is central to self-care… self-care involves being honest about a whole host of things, and it’s primarily being honest with yourself - and being prepared to take that up with other people where you need to - but it’s about being honest with yourself in relation to your limitations.
Lucas Contemplating my own mortality is very important in terms of self-care. I have to have confronted that; there but for the Grace of God go I… and this could be me [dying]… Really puts things into perspective and helps you to live and enjoy your life to the full.