This Thanksgiving, in nurse lounges across the United States, makeshift buffet tables will be filled with an array of delicious food and beverages to mark one of America’s most beloved holidays—second only to the Fourth of July. Between caring for patients, nurses will dash off to get a bolus bite in the festive, yet subdued, atmosphere just steps away from the Omnicell. In the unionized hospital where I worked, holiday time off was granted by seniority. Being third from the bottom of the list, I spent most Thanksgivings and other major holidays working during my nearly 2-decade tenure as a staff nurse. Once, a patient walking down the corridor caught a whiff of our Thanksgiving celebration (likely from the smell of homemade adobo drifting out of our windowless lounge) and asked if he could have some. I ended up sneaking him a plate, filled with a blend of ethnic dishes—minus the traditional turkey—that are now a hallmark of American holiday gatherings. And boy did he thank me!
I imagine patients have been thanking caregivers since the dawn of nursing as we know it. At the peak of the pandemic, the world heard the sound of gratitude. Ordinary citizens became quasi bellringers, not only to cheer the essential workers, but also to amplify our collective heartbeat of survival. Whoever started the 7:00 pm banging of the pots and pans ritual, I want to thank them. This year, I went to watch the New York City marathon for the first time. Along the route, the crowds rang bells, clapped and hooted, hoisted placards with uplifting messages, and called out encouraging phrases to boost the spirits of tired and sweaty runners. I thought, wouldn’t it be nice if once a year, at a designated time during nurse’s week, people would make some joyful noise to help recharge the spiritual batteries of nurses in this marathon called patient care.
Dear (insert name here)
Around Thanksgiving, I bring blank thank-you cards to class and distribute them to my students. I ask them to take 5 minutes to handwrite a thank-you note—not the emoji-laden kind, but a brief letter in full sentences—to someone who has made a meaningful difference in their lives. I encourage them to hand-deliver the card, snail mail it, or leave it somewhere the recipient will find it. To avoid any perception of self-interest, I clarify that they can’t write the note to me. It’s heartwarming to watch some students hand their thank-you card to a nearby classmate, frequently with a heartfelt hug. This small exercise reminds me that gratitude often begins with the people closest to us, those we might sometimes take for granted.
Research on the impact of thank-you notes shows that people underestimate how meaningful their gesture will be to the recipient, assuming it won’t have much effect. However, recipients report high levels of happiness upon receiving these notes. Expressing gratitude is a mindset and a choice, and whether handwritten or emailed, a thank-you letter brings positive benefits, including higher reports of happiness, to both the sender and the recipient. In my office, I keep a tray filled with thank-you notes from students that I’ve received over nearly 3 decades as a nursing faculty member. Many of my colleagues have similar displays in their own offices. For me, these handwritten expressions of gratitude are the permanent records of moments and mementos of transformative encounters I’m eternally grateful for.
When and how to practice giving thanks
The internet abounds with practical advice on how to practice gratitude. I particularly like the list of questions to generate gratitude. Here I’ll share some of my almost daily habits. I call my 12-minute, cell phone–free walk from my apartment to the office my “gratitude walk.” During this time, I mentally recite at least five things I’m thankful for (expressing gratitude in clusters is shown to have a greater positive impact) as I stroll or sometimes sprint to work. Waiting at traffic lights becomes an opportunity to pause and flex those gratitude muscles, which can weaken amidst life’s daily grind. And thank goodness for traffic lights! Can you imagine New York City without them?
Just as with giving feedback, being specific when expressing gratitude enhances the experience and amplifies positive emotions. So, I want to take a moment to thank you (the reader) for sticking with me this far into the essay. Last month, I thanked the nurse who administered my flu shot by saying, “Thank you so much for the painless injection!” She responded enthusiastically, “Thank you for saying that!” Expressing gratitude fosters an environment where prosocial behaviors thrive, supporting human flourishing.
Most nights, instead of counting sheep, I count the people who have made my day better. I do this simply because expressing gratitude before bed feels right. But, for those who appreciate a scientific perspective, a study has shown that people who feel grateful tend to sleep better and longer, fall asleep faster, and feel less tired during the day. This link between gratitude and good sleep happens because grateful people have more positive thoughts and fewer negative ones before going to bed.
Appreciate yourself
A recent New York Times article, How to Like Yourself More, extols the virtue of self-appreciation, a practice that shares the same DNA as giving thanks to others. The author describes a self-appreciation practice that involves focusing on oneself, not as the opposite of gratitude but as a variation of it. It’s about showing gratitude toward oneself, which might initially feel self-centered, but over time, feels natural and grounding. This message resonates strongly for nurses. Stripped of self-compassion, nurses expose themselves too readily to burnout. The Code of Ethics for Nurses with Interpretive Statements reminds us that nurses have a moral obligation to honor their own dignity and worth. I think an authentic daily practice of self-appreciation is the antidote to conceit and self-absorption; it’s the muted incantation to raise the caring spirit that nurses have been recognized to be truly deserving.
Fidelindo Lim, DNP, CCRN, FAAN is a Clinical Associate Professor at New York University Meyers College of Nursing.
