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Life-Saving Rituals for Nurses

It's October, and Americans are up to our eyeballs in fall rituals like back-to-school shopping, pumpkin spice lattes, homecoming games, thanksgiving gatherings, and chili cook-offs. Why do we do this? For many, participating in these rituals elicits a sense of comfort, care, and connectedness as life gets busy and the northern hemisphere begins to cool.

The term ritual evokes an array of feelings and opinions. This is especially true for healthcare professionals with our unparalleled passion for ideas like time management, patient-centered care, and evidence-based practices. Don't get me wrong, those professional approaches are vital and central to saving lives but, at times, can limit wholistic healing for both patients and their caregivers.

At CODE YOU, we define ritual as the use of routines to evoke a particular feeling or state of being. If only briefly, a ritual can open the space to acknowledge and incorporate the reality that something has changed.

Most of us love the feeling that a tasty fall beverage offers, but why, you ask, does this matter to nursing practice?

1. Rituals Offer Space for Healing

Rituals can be crucial in healing, particularly in coping with grief and loss. They provide a structured way for individuals and communities to acknowledge and process their emotions. In her book Bearing the Unbearable, Joanne Cacciatore offers the idea that ritual is vital to healing. She says, "RITUAL SERVES TO HONOR the contents of our hearts, both the love and pain. Every society has rituals associated with death and grief…. Emotional expression revives a sense of control, helps us feel meaning, and underpins communal structures within which we are better able to cope with our losses."

When we in nursing centralize the values of time management and patient-centeredness, there is rarely time to engage in a ritual that honors our sense of grief. For example, it is not uncommon for a post-partum nurse to support a family during a fetal demise with only time to wash their hands before entering another patient's room filled with balloons to take celebratory pictures of their newly expanded family. A ritual such as mindful handwashing could help.

2. Rituals Reduce Anxiety

Rituals, when done with intention, have been shown to reduce anxiety. A 2005 study published by Science Direct found that singing a fun song like "Don't Stop Believing" before a stressful event helped "reduce anxiety, lower elevated heart rates, and improve performance – provided they are imbued with symbolic meaning." This is often seen in sports, where athletes have pre-game rituals that help them focus and perform better.

There are days when we enter our healthcare setting and intuit something is wrong. With this felt knowledge, we immediately experience a tightening in our chest, and our blood pressure elevates. Our bodies move into fight, flight, or freeze. A start of workday practice offers us space to regulate our bodies, reduce anxiety, and improve our performance.

3. Rituals Restore Our Sense of Power and Control

Studies have shown that intentional routines can make individuals feel more in control and less helpless. This can be particularly valuable in high-stress professions like healthcare, where a sense of control can reduce burnout and improve overall well-being.

One of the most challenging aspects of the COVID-19 pandemic was healthcare professionals feeling powerless in the face of a deadly virus that seemed to break all the rules for treating respiratory disease. Feeling a sense of hopelessness in the early days of the pandemic led many care providers to experience despair, moral injury, compassion fatigue, and burnout. We should remember that engaging in intentional routines is a powerful tool to reduce nurses' pain in profound distress.

4. Rituals Enhance Connection

Rituals create a sense of belonging and connectedness. They remind us that we are part of a larger community and serve to strengthen social bonds, whether in healthcare or any other context. "Rituals afford us a sense of belonging," writes Dr. Abigail Brenner in Psychology Today. 'When we engage in the ritual process,' she notes, 'we are, in essence, connected to "original time." Rituals awaken that which is eternal within us and show us how our individual lives are part of a much grander design.'

Are you feeling overwhelmed with the idea that on top of everything else on your to-do list, you now need to think up and begin practicing daily rituals? Rest assured, there is no need to create new tasks in the name of "ritual." Most of us follow daily routines – get out of bed, let the dog out, drink coffee, pack lunch, and drive to work. Most of the time, this is a somewhat mindless process; however, these simple things can begin to offer ritual healing with the slightest movement toward intention. For example, as you let the dog out, you could take it as a moment to greet the day. The first sip of coffee can invite you to gratitude. While making lunch, one can practice self-care in food choices. One might also use the drive to work for meditation or prayer. In her book Calling the Circle, Christina Baldwin offers this daily prayer:

"May all that I do today contribute to the healing of the world, and may my heart be open enough to allow the world to contribute to my healing."

In the same way, our workplace routines can become healing rituals for ourselves and our healthcare co-workers. Consider a few times in your workday that you could engage in a ritual intention.

Infusing daily routines with intention and mindfulness will create transformative rituals. In doing this, even mundane tasks can become sources of personal growth, reflection, and healing.

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