Self-care and what it means to me.

In my journey through nursing and midwifery, caring for others has been the theme of my professional life.

Having my own children saw caring for others take on a new direction; these three little humans' needs naturally came before my own.

Then came the "Sandwich generation" where I had young children and my parents' health started to decline. For six years I was carer for my mum as her dementia gradually deteriorated until her death in 2016, then carer for my dad who was lost and vulnerable after losing his wife of 60 years.

During all of these times, self-care was never particularly on my radar.

And actually it never seemed to be a need until I started to look after my mum, whilst juggling motherhood and an increasingly demanding and stressful career.

I think if your work-life is tough, but things at home are going well, it's easier to find coping mechanisms and vice versa, but when work life is difficult and home life is also taking all your reserves, then that's when trouble hits, and that's when it hit for me.

I had been caring for my mum for 6 weeks up until she died then had the worry of looking after my dad, my children were in their teens and I felt I had been neglecting them for some time, and my job was becoming steadily more and more stressful. I seemed to be giving of myself to everyone, except the one who really needed it-myself.

Things finally came to a head, and quite dramatically so, several weeks after I returned to work after my mum's death.

I was working on the high-risk antenatal/postnatal ward. I was in charge and it was a busy shift. My anxiety levels had been increasing for a few months, and this day it didn't take much to tip me into a very scary place. I remember the noise of the ward-buzzers , phones ringing, colleagues asking questions. I was about to start the afternoon drug-round when the noise became a relentless cacophony. Suddenly four different people were asking me questions all at the same time, A woman needed an urgent medical review, a doctor needed to speak to me, a newly qualified colleague was upset and needed to offload and a relative wanted to make a complaint. On top of all this I had a drugs round to do and a full ward with numerous complicated cases all of whom seemed to need my attention all at the same time.

The noise surrounding me became louder and was joined by noise in my head of disjointed thoughts, things I needed to do, things I hadn't done. I found that I couldn't think, my thoughts became jumbled like tangled wire, knotted and messy. I needed space so I handed the drugs keys to my colleague. I could barely piece my own thoughts together, never mind dish out medications to pregnant women.

My heart was racing, my breathing shallow and fast, I had a tightness in my chest that made me really believe I was having a heart attack. What I now realise was happening was my first ever panic-attack.

This experience was a wake-up call.

I took some time off and saw my GP. I started counselling which really helped-an hour a week just for me where I could talk about anything that was on my mind without worrying about being judged. I realised over time how necessary time for myself was for my mental health and so I started to include other methods. Mindfulness techniques, meditation, guided relaxation, yoga, walks out in nature, doing things which brought me joy. As time moved on self-care became part of my daily routine and giving myself this new routine led to me changing jobs and moving to a different area.

I became more aware that when I didn't look after myself first, I couldn't look after my family and the women in my care as well as I'd like to.

The saying " You can't pour from an empty vessel" is true; I had been pouring out care and not replenishing myself, leading to burnout.

In my day-to-day work I started to recognise other midwives in the same situation I had been. Women who were giving their all at work and their all at home to their families and who were struggling to keep themselves afloat. I saw low morale, stress and anxiety levels at an all-time high due to more demands with less resources.

In May 2018 I decided to go out on a limb and start a Facebook group for other midwives who felt the same as I had. I called this group "Self-care for midwives". I wanted to share some of the things I'd learned in my journey as I was sure I wasn't the only one who needed self-care.

I had no idea how this group would be received, and to my total surprise within 24 hours we had a thousand members!

Over the next three days the group multiplied to 4000 members- I was both delighted and horrified at how much this group was needed-midwives were posting stories of stress, anxiety, mental health issues, burnout and plans to leave the profession.

Now at almost 8000 members, it has evolved into a wonderful group for support, ideas, information and sharing. I have learned so much from fellow midwives all around the world. My own self-care has improved through learning from others and I have realised how necessary self-care is in this profession.

As I write this I am about to get on a plane to return to the UK after a few days away.

I am reminded of the safety talk given at the start of all flights; if the oxygen masks appear, always fit your own before fitting on anyone else that you're looking after.

After all, if you don't look after yourself, you are no use to anyone.

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