What is Self-Care?

Photo by Photoholgic (@photoholgic) via Unsplash

Ah self-care....one of the most overused and under-defined phrases in “wellness” culture! I’m know I’m not the only registered nurse that cringes when I see how wellness “influencers”, coaches, and other health-adjacent individuals present the concept of self-care. If your idea of self-care is subscription boxes of beauty products, manicures, and juice “cleanses”, please read on!! There’s a lot for us to unpack.

In this blog post, I'd like to take you on a brief "tour" of self-care from a nurse's perspective, along with the attributes of self-care as I define them in my professional practice. As a side note, other professions may have their own definition of self-care; this is how I define it as a RN.

Let's start in 1949 (yes, really) with a nurse named Dorothea Orem. Between 1949 and 1956, Orem developed the Self-Care Framework as a way to enlarge and deepen the meaning of nursing practice. At the time, the practice of the nursing profession wasn’t well-defined. Orem developed her framework of self-care as a way to clarify the unique attributes of the nursing profession. In other words, Orem’s framework clarified the unique role of the nurse, and distinguished nursing professionals from other health care providers.

What is Self-Care?

Self-care are the behaviors and activities of daily living that adults perform to care for themselves in service of maintaining their life and health (as well as the responsibility to do the same for persons socially dependent on them). The role of the registered nurse in self-care is to provide assistance to persons in order to meet their daily needs. It’s less about "doing for" and more about helping someone to be able to care for themselves.

There are eight universal self-care attributes that are common to all human beings during all stages of the life cycle. Orem used the phrase “maintenance of” to illustrate the importance of continuing to attend to activities of daily living which support and preserve life and health (no “one and done” here- these are ongoing needs!).

#1- Maintenance of sufficient intake of air- this includes unlabored and unrestricted breathing to meet the needs of our heart and lungs. There are many factors that prevent sufficient intake of air and impede lung gas exchange including lung infections, environmental pollutants (e.g., smog), pre-existing conditions (e.g., asthma), among other things.

#2- Maintenance of sufficient intake of water/fluids- to support the body’s fluid balance, blood volume, and electrolytes levels. Dehydration and over-hydration can be detrimental to life and health. Each person has unique hydration needs that vary depending on external temperature, activity level, kidney function, medications they take, and other factors.

#3- Maintenance of sufficient intake of food (in the form of both macro and micronutrients)- this means an adequate amount of energy (in the form of calories), consistently (day-to-day) for the body to perform its life-sustaining functions. I would add that a sufficient intake of food goes beyond “enough” energy to include sufficient satisfaction from food and eating. Unfortunately, “diet culture” and weight stigma have impeded our ability to honor our body’s needs by promoting disordered rules and beliefs about food. This has led to confusion, increased the rates of eating disorders, and normalized disordered eating at a societal level. If you remember one thing from this post it is that you deserve to eat, you need to eat, and you have full permission to eat.

#4- Provision of care for bladder and bowel elimination- this means attending to your need to empty your bladder and bowel on a regular basis, and performing hygiene as needed. Think of this as a way of checking in with yourself every few hours. You might be surprised to learn that meeting elimination needs can be incredibly complex depending on someone’s occupation, where they live, their access to restrooms, pre-existing health conditions (e.g., being diagnosed with IBS or a prostate issue), food/fluid patterns, among many other things.

#5- Maintenance of a balance between activity and rest (activity is inclusive of all things we do like work, chores, leisure, movement, etc.)- this involves not just adequate sleep, but rest time away from activity in order to allow the body structures to recover and repair. Consider other types of rest outside of physical rest- for example, mental rest (e.g., time away from stressors/work).

#6- Maintenance of a balance between solitude and social interaction-Most of us fall somewhere between extrovert and introvert. No matter, balancing times of quiet reflection with meaningful social interactions are an important part of overall well-being. Of course, having access to solitude and a supportive social network is often a privilege! Even moments of quiet and brief social connection can be energizing and restorative.

#7- Prevention of hazards to human life, functioning, and well-being- While there is no such thing as 100% prevention from hazards to human life, functioning, and well-being, there are steps that we can take to reduce harm (and attempt to prevent fatalities). While many hazards to human life exist on a societal level (e.g., natural disasters, lack of access to health care, identity theft, and many, many more hazards), there are things we can do as individuals to reduce our risk for harm. For example, wearing seatbelts during transportation, electing to stay home from work if you were exposed to COVID, and so on.

#8- Promotion of human functioning and development- this last attribute refers to all the things we do to grow, function, and thrive as individuals across the lifespan. This can include many things (e.g., participation in hobbies, seeking out psychotherapy, learning a new skill) and simultaneously be hindered by many factors (e.g., trauma, loss, etc.).

When I say "self-care" this is what I'm talking about- the foundation of basic care of our human self. It's amazing how these attributes stand the test of time. I bet that you never thought that things like wearing a seatbelt, answering “the call of nature”, and learning a new skill as self-care; I hope you’ve now been able to expand your definition!!

Some closing thoughts- each and every one of us has different self-care needs depending on our age, life circumstances, health status, and season of life. Performing self-care isn’t an obligation, and you have the autonomy to decide what needs you prioritize day-to-day.