Monday, July 11, 2022

Doing Your Inner Work as a Nurse

Nurses spend a great deal of time providing care for others, and even in non-clinical roles they carry many psychoemotional weights on their shoulders. Nurses give physical care (including that which is immediately life-saving), compassionate connection, and spiritual succor, often in the form of motivational conversation and nurse-to-patient teaching.

What is a powerful way for us nurses to empower and elevate our understanding of human behavior, the human condition, and the nature of suffering? By assiduously doing our own inner work throughout a long lifetime of giving, loving, and feeling.

a clear mind

Understanding the Self and Understanding Others

We nurses can more truly understand the suffering and challenges of our patients when we're more fully in touch with ourselves. Self-reflection and inner work can open us to deeper empathy and compassion through connection with our own humanity, and the humanity of others.

Being in touch with our own inner journey can empower us to reach more deeply within ourselves for that which can build bridges to the inner journey of the suffering patient. We all walk through this life with psychological shadows, buried pain, and subterranean memories -- bringing some of this to the surface for healing can lighten our load and allow us to be more present for both ourselves and others.

Janna Thomason, The Enneagram Nurse, helps nurses and others to understand themselves more deeply through the use of the Enneagram, a powerful tool for self-exploration. 

How a nurse gets to a place of inner knowing, personal healing, and deeper relatedness to others is individual, and myriad powerful tools abound for the courageous exploration of the self.

Psychotherapy and Counseling: Rejecting the Stigma

I'm admittedly a very biased fan of psychotherapy and counseling. I have no reservations about sharing publicly that I've been in some form of counseling off and on since I was 22 years old, and I wouldn't trade that time in therapy for the world.

Having an unbiased third party who can walk with you through the challenging passages of life is an invaluable experience.

Whether it's the deaths of loved ones, uncertainty about the direction of one's life, parenting and relationships, issues around career and professional direction, or clinical depression and other manifestations of spiritual and psychological distress, psychotherapy can be a significantly useful tool in unpacking the excess baggage and moving forward somewhat less encumbered, especially in the overwhelming complexity of the 21st century.

Both mental illness and its treatment have been stigmatized for decades, and the stranglehold of judgment and stigma have slowly released as depression and other maladies of the heart and spirit have become mainstays of our wider cultural conversation. The stigma assuredly remains in some cultures, but the normalization of mental health care continues.

Some sources estimate that 15 million Americans are impacted by depression. Not all seek treatment, often due to either fear of being stigmatized or lack of access to care. Current conversations about access to addiction treatment related to the opioid crisis is front page news, thus 21st-century society is becoming acutely aware of how lack of treatment for mental health issues has wide-ranging repercussions.

Nurses are witness to enormous amounts of trauma and suffering, and we can only imagine how many nurses carry burdens of depression, anxiety, and post-traumatic stress in response to the challenges of their work. After all, nurses are themselves a microcosm of the macrocosm.

A nurse colleague of mine once quoted a statistic that more than 50 percent of nurses are the first-born children of alcoholics. While I can't corroborate that figure, her assertion makes sense -- nurses want to save others from their suffering, just as many adult children of alcoholics are the anchors of their families when the addicted parent is missing in action.

Scrubbing the Floor of the Psyche

Inner work comes in many guises. Some pursue psychotherapy, others seek transcendence in dance, music, and artistic expression. My friend and nurse colleague Caroline Cardenas teaches nurses and others how hoop-dancing and body play can promote the unleashing of joy and inner freedom; in fact, she wrote her master's thesis on the use of hula hooping in combating and preventing burnout in nurses and is now working on her dissertation for a PhD in Somatic Psychology on the science of play in relation to compassion fatigue. So many inner demons can be vanquished at the hands of creativity and play.

Still others engage in spiritual practices, including shamanism, yoga, spiritual workshops and retreats, sweat lodges and vision quests, meditation, and other pursuits that were once relegated to the fringe. People I personally know seek inner wisdom and expansive experience through vehicles like ayuhuasca, peyote, psilocybin mushrooms, sweat lodge ceremonies, or communing with indigenous tribes deep in Central and South America.

One may see the use of mind-expanding substances as escapist crutches, yet current research shows that psychedelic-assisted psychotherapy is very useful in treatment-resistant depression (TRD) and PTSD, and cannabis and CBD show promise with symptoms of PTSD and anxiety. As counterintuitive as it may seem, the use of mind-altering substances for the treatment of Alzheimers also apparently has potential currently being explored.

Nurses must find the avenues that work for them when it comes to self-care and the promotion of personal mental and spiritual wellness. I, myself, continue to do my own inner work, a seemingly never-ending process, even now in my early 50s. I assert that I have a long way to go and many dark, cobwebbed corners of my psyche to scrub. As Saul Bellow's beloved character Herzog once said in the novel of the same name: "On the knees of your soul? Might as well be useful and scrub the floor." I assume I'll be scrubbing for years to come.

Pushing Back and Climbing Up

Nurses are fierce caregivers and defenders of the wellness of others. We're renown for burning ourselves out in service to our patients, and I'm no exception. Back in the day, I deeply wounded myself psychically while caring for underserved inner city communities. At that time, my exasperated wife had to literally force me to quit that job and radically change my life in order to save myself from myself (and from my ever needy patients).

Wellness can be an uphill climb when we're wired to be selfless caregivers. There are certain types of personalities drawn to nursing and medicine, and the assembly line nature of many healthcare environments do nothing to promote staff wellness. Chronic understaffing, mandatory overtime, high nurse-patient ratios, and workplaces lacking even the most basic civility and kindness all take their individual and collective toll.

Whether you dance with Peruvian shamans, walk dogs at the shelter, take ayahuasca, or go to psychotherapy, the goal is essentially the same. We all seek personal peace of mind in a troubled -- and troubling -- world.

We need to push back against the rigors of nursing and the ways in which a career in healthcare erodes our ability to be healthy and balanced. We must climb upwards and reach the places where the emotional air is clear, the clouds of burnout have dissipated, and the sunshine of self-awareness glows brightly and cheerfully under the dome of a protective yet expansive sky.

We nurses all deserve a healed mind and healthy body. Our hearts deserve to feel peace, and our psyches need not suffer from overpowering depression, compassion fatigue, and burnout.

Doing your inner work as a nurse is a call to action in relation to the self. We must each choose a personal path of inner wellness because we want it. And when you know that you want it, you can then choose to do everything in your power to manifest that wellness in whatever way serves you most powerfully.

Keith Carlson, RN, BSN, NC-BC, is a Board Certified Nurse Coach offering holistic career development for nurses and healthcare professionals. All things Nurse Keith can be found at

Keith is the host of The Nurse Keith Show, his solo podcast focused on career advice and inspiration for nurses. From 2012 until its sunset in 2017, Keith co-hosted RNFMRadio, a groundbreaking nursing podcast.

A widely published nurse writer, Keith is the author of Savvy Networking For Nurses: Getting Connected and Staying Connected in the 21st Century and Aspire to be Inspired: Creating a Nursing Career That Matters. He has contributed chapters to a number of books related to the  nursing profession. written for,, MultiBriefs News Service, LPNtoBSNOnline, StaffGarden, AusMed, American Sentinel University,, Diabetes Lifestyle, the ANA blog,, American Nurse Today, Working Nurse Magazine, and other online and print publications.

Mr. Carlson brings a plethora of experience as a nurse thought leader, keynote speaker, online nurse personality, social media influencer, podcaster, holistic career coach, writer, and well-known nurse entrepreneur. 

Living in beautiful Santa Fe, New Mexico, Keith shares a magical life with his partner, Shada McKenzie, a gifted, empathic, and highly skilled traditional astrologer and reader of the tarot. 

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