BY DEFINITION SELF-CARE is when we perform a deliberate action in accommodation to our mental, emotional and physical health. In theory, it’s a relatively simple concept but one that can be easily neglected, especially in the context of the patient experience. Safiya Daley, faculty member at Loma Linda University School of Nursing says, “When I was a psychiatric nurse at an in-patient psychiatric hospital one of the first things I learned in practice was that when there is a presence of mental health issues one of the first things that is compromised is an individual’s self-care.”
While self-care concerns everything from sleep patterns to diet to interpersonal relationships, the crux of the issue here became highlighted to Daley in observation of a patient’s hair care needs; specifically a patient of color who didn’t have the appropriate hair products for treating thicker, matted hair. “I was working with a 7 year-old girl, her hair was very matted. You can tell she was embarrassed by her appearance. So I gave her the bag of toiletries which was protocol for each patient and it had a fine tooth comb. She takes it with her but then I meet her the next day and found that she had an incident the night before where she escalated due to emotional stress and anxiety. She didn’t like how her hair looked and it was making her anxious because she had to be around others the next day. The fine tooth comb was not going to work with her type of hair.”
As Safiya further assessed the patient she discovered that she simply wasn’t equipped with the products needed to manage her hair appropriately and feel confident and comfortable with herself, which is vital in the psychiatric patient setting. “This difficulty was causing prolonged self-care time, frustration and embarrassment within our patient. [This patient] did not want to participate in group therapy or even leave her room because she were embarrassed with the state of her hair. After purchasing a wide tooth comb and leave-in conditioner and showing one of my patients how to style her hair, she felt confident to leave her room and participate in group therapy. This scenario is one of many and it has motivated me to become a patient advocate for this cause.”
As a graduate student in the LLUSN Psychiatric Nurse Practitioner program, Daley found immediate inspiration in this cause to build her graduate research project around and work towards an applicable solution to this dilemma. “My ultimate goal is to completely fund a pilot project that would place these wide tooth combs and conditioners on a wider selection of patient units and have more research stem from that. I would like to explore how it affects patient satisfaction, nursing satisfaction in regards to work load; to see how it would affect the budget and finances of operating a unit.”
The project is still in development but the objective is clear: what is the cost vs. benefit of proper self-care accommodations to psychiatric patients of color as well as other patients from various backgrounds whose hair needs are not met with fine tooth combs.
She recalls another scenario that reinforced the stakes at hand when it comes to self-care specifically in the case of hair care. “[One patient] had been in rehab for 6 months. She had lost most of the function in her legs; she was bed ridden. While everyone was focused on getting her up and walking, her head had been on a pillow this whole time with no attention or care. Her hair was completely matted and ended up needing to be cut off. Th is was such a point of pride for her, she said it was more traumatizing than losing the function in her legs. Some might say, ‘But she can walk now. She has her legs working.’ But to her, she didn’t feel like herself. Losing her hair was significant. That resonated with me. It was telling.”
Daley recognizes that while the healthcare climate is plagued with countless issues on the operational side, further assessment of matters like this which may be perceived as minute can stimulate exponential progress in the area of patient satisfaction. “I want
this to be a catalyst for further discussion on patient self-care. I think its important to ask why we employ certain protocols and how we can adjust them to meet the broadest range of needs when it comes to our patient landscape.”
With the initial steps of funding and planning underway, Daley plans to implement the study in the year ahead and have the project completed by the end of her doctoral program with measured data to support the numerous individual cases she has already encountered. “When self-care is the obstacle that is holding these patients back from thriving and feeling better, it is usually a fundamental need. When your mind is in a better state, your body is going to follow.”