A Nurse Survivor’s Guilt and The 5 Ways to Self-Care

2020 has been traumatic and the majority of us are facing some form of survivor’s guilt.

Traumatic experiences have ranged from the chaos of the pandemic resulting in death, America’s racial prejudices and mistreatment resulting in death, personal and family stressors including separation from family members, unemployment or attempting to maintain employment while home schooling, and worries about food supply and material goods.

As a nurse, the pandemic has caused significant feelings in both myself and other nurse colleagues that I have communicated with. At first, I did not realize what the feelings that I was experiencing were; periods of tearfulness, and especially feelings of helplessness and disconnect.

As a previous NICU nurse, I was ready to spring into action when the pandemic hit. I wanted to be on the frontline saving people. I felt depleted by the quick realization that I no longer had the skills required to care for a critically ill adult patient and, had concerns about my family’s health and wellness.  I worried for my working nurse colleagues that were separated from their families, staying in hotels because the Personal Protective Equipment was not sufficient, and feared spreading COVID-19 to those they loved.

It wasn’t until I heard someone on National Public Radio mention the word Survivor’s Guilt and the associated symptoms of difficulty sleeping, loss of motivation, irritability, a sense of numbness, and thoughts about the meaning of life, that I realized that this it was what I was experiencing.

Survivor’s Guilt is considered a form of Post-Traumatic Stress Disorder.

Experiencing guilt over what I should have done and feeling remorseful that I did not do enough, are feelings that are shared by the senior nursing population. However, there are some things we can do to help ourselves through this crisis and tend to our self-care.

  1. Journaling is an important reflective process- Accept and allow the feelings to emerge, then journal about your thoughts. Even though some may think that this type of guilt is not rational, it is a recognized response to trauma.
  2. Connect with others– Share feelings with family and friends. It can be especially helpful to attend a healing circle for nurses that allows for sharing of “What is the most important thing on your mind today?”. We often find like-minded individuals have the same concerns and provide support in knowing you are not alone.
  3. Practice mindfulness– Using awareness practices, guided imagery, or meditation, allows us to dismiss the current thoughts and focus on observing our thoughts non-judgmentally from a distance. Thoughts are not all factual, they are simply events that show up in the mind and are dependent on our mood.
  4. Nutrition– It is easy to fall into poor quality nutritional habits when our daily routines are disturbed. Overall well-being requires nourishing all aspects of the whole person: Life Balance/Satisfaction; Relationships, Spiritual, Mental, Emotional, Physical/Nutrition/Exercise/ Weight; and Environmental.
  5. Exercise– Daily movement is essential especially during times of shut in. Those that walk outside and connect with nature often describe it as a spiritual reflective experience.
Executive Director of Education

Karen Avino is the Executive Director of Education for the Integrative Nurse Coach Academy and the International Nurse Coach Associationproviding online and onsite continuing education programs for nurses. As a consultant, Karen helps healthcare organizations create optimal healing environments and integrate holistic nursing into practice. Karen taught Holistic Nursing and Integrative Health for 20 years in online and on campus classes at the University of Delaware. She received the Faculty Senate Excellence in Academic Advising and Mentoring Award. She also received the Delaware Excellence in Nursing Practice Award as Nurse Educator. She has over 40 years of experience in Maternal-Child Health, Administration, Community Health, Holistic Nursing and Nurse Coach practice. She is board certified as both an Advanced Holistic Nurse and a Health & Wellness Nurse Coach. Karen is a Reiki Master, Stress Management Instructor, HeartMath, and Clinical Meditation and Imagery Practitioner. Karen is a Director-At-Large board member of the American Holistic Nurses Association and a founding leader of the Delaware Chapter (DEAHNA). She is an author and editor of Holistic Nursing: A Handbook for Practice (2016, 2021) and Core Curriculum for Holistic Nursing (2014). Karen is a Peer Reviewer for the Journal of Nursing Scholarship and Holistic Nursing Practice journals. She is an international and national speaker on holistic and integrative topics.

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