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From the ER to the pediatric unit to the plastic surgery consultation, nurses everywhere know how to take care of their patients. But too often, nurses neglect to take care of their own health.

It’s all too easy to ignore the indications, according to Kate Woeber, midwife specialty coordinator for Emory University’s Nell Hodgson Woodruff School of Nursing. “We’re used to focusing our attention on the health of other people instead of on our own,” she says. “Since nursing care is holistic, and especially when so many of our patients lack a strong community of support, this means that adequately addressing each person’s needs is going to take considerable time and energy.”

That tunnel vision has unfortunately resulted in nurses being natural candidates for poor health. According to a 2017 Ball State University study of 120 nurses in the Midwest, nurses tend to develop poor health habits in response to stress on the job. A whopping 92% of the nurses participating in the research reported moderate to high stress levels. They also admitted to a slew of poor health habits, from binge drinking (22%) to not getting enough sleep (78%) to not exercising regularly (69%) to not eating enough servings of fruit and vegetables per day (63%.) Of course, knowing that the job is harming your health does little to help a nurse form better habits.

What will? Woeber recommends starting by making a point of noticing the symptoms that indicate caregivers aren't taking care of themselves. Here are five:

Your pain levels are soaring

OK, maybe it’s too much to expect a nurse to apply the PQRST method to her own pain symptoms. But physical aches are one of the top indicators that you’re neglecting your health. “Maybe what was a new ache, pain or other symptom has become a chronic one, or a worsening one, because we haven’t taken the time to see our own provider,” Woeber suggests.

You’ve gained weight

This is not a beauty contest or shaming game, and there’s certainly no reason to start weighing yourself several times per day. But signs that you’ve gained a few pounds might also be telling you to pay more attention to self care. If your scrubs are getting a bit tight or you’re noticing an extra chin in your selfies, it may be time to examine your diet, work-life balance and exercise habits.

You can’t sleep

This is another rich irony when you work as a nurse. You encourage patients to get the recommended seven-plus hours each night, and, of course, you’re really tired because you work 12-hour shifts. And yet, there you are, staring at the ceiling, willing sleep to come before the alarm rings in a couple of hours.

You’re irritable and angry

“Sometimes instead of physical symptoms, we experience symptoms of compassion fatigue or burnout, which is what happens to empathetic people who don’t take enough breaks from situations that are emotionally intense and challenging,” Woeber notes. “A nurse will know she (or he) has compassion fatigue or burnout if she finds that she’s chronically feeling exhausted, overwhelmed, withdrawn, irritable or angry.”

You can’t focus

So every now and then you forget your clipboard or a change of clothes — that’s natural. But if a nurse “realizes she’s having trouble focusing or getting things done, even everyday tasks that aren’t normally that challenging,” it’s time to examine your health.

Of course, getting your health back on track involves far more than just noticing your health is suffering. But you have to start somewhere.

“If you recognize these symptoms and signs, it’s time to change gears,” Woeber said. “Take some time away, and add in some activities that provide balance. That may be exercise, hobbies, healthy eating, mindfulness. And most importantly, realize that it’s time to make a visit to our own provider, who can provide a reality check about our health status and some encouragement for a jump start on better balance.”

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