Following your Path

From our readers: The art of self-disclosure

The art of self-disclosure

One aspect of the “art” of nursing is appropriate self-disclosure. Nurses and other healthcare providers often have an opportunity to share information about their own health to help a patient or family, or even a peer. For example, a nurse who takes niacin to lower cholesterol and raise high density lipoproteins (HDLs) may have found that taking the niacin with applesauce helps to prevent the flushing sensation that often accompanies taking this drug. After I shared the hint about applesauce and niacin in a speech at a national nursing conference, a nurse told me that she had found eating five Triscuit brand crackers helped her. When self-disclosing, a nurse can say, “These strategies helped me, and may help you.” They may or may not help the patient, but trying them will also not harm the patient.

Sharing experiences

Nurses can also share more personal information, as long as the revelations are meant to be helpful. For example, research has shown that just one or two counseling sessions can be helpful to people who are having trouble coping with or adapting to a new disability, and nurses can recommend that patients and their families obtain counseling. Counseling may also be helpful to people who want to make life changes, or are in the midst of family crises, or wanting to learn healthier ways to respond to stressful situations. If a nurse has undergone counseling and believes a patient, or family, or peer is open to counseling, then sharing the view that counseling has been helpful is appropriate, and may bring hope. The nurse can say, “I have had times in my life when counseling has helped me. It might help you. If you want more information about counselors where you live, I will be glad to find information for you.” Unfortunately, appropriate self-disclosure is seldom discussed in the nursing literature, and even more rarely studied, except for the work of Ashmore and Banks who studied self-disclosure in nursing students.

I believe it is appropriate for me to disclose that I have been helped by counseling at different times in my life. I have also taken anti-depressant medications for situational depression. Because of the counseling and the medication, I made some needed changes in my behavior. The colleagues I teach with, my students, and my family were all happy that I took the medication and went to counseling. If you are having problems that you would like help with, counseling may help you.

I also have another problem. At times, I am a binge drinker, consuming five or more drinks on one occasion. Recently, at a nursing conference, I drank too much every evening. After I got home, my counselor insisted I go to an Alcoholics Anonymous (AA) meeting, and I did. By going to AA meetings, taking my anti-depressant, and going to counseling, I achieved a first for me; I did not take a drink for over a month. This was probably the first time I had gone without a drink for a month since I was 18. I am now 58.

Drug and alcohol abuse are common problems for nurses and for our patients. We need to have frequent and open discussions with patients and peers about alcohol and drug abuse. We need to help our patients and our peers go to alcohol and drug treatment programs and to counseling. We also need to tell the families of our patients and peers about Al-Anon and other programs for the families of alcohol and drug abusers. Just as one or two counseling sessions may help, one or two AA or other 12 step programs meetings may also help.

Although AA discourages public disclosure of personal stories, I believe by sharing mine, others will be helped and feel supported. When I made these disclosures in the keynote speech at the national rehabilitation nurses conference, there was spontaneous applause as I told the attendees I had gone to AA, and that I was going to be “grateful” rather than have a drink. A nurse whose son is an alcoholic came up to me later and told me her son was now 3 days sober. That day was his birthday. She said, “Don, you are a birthday gift to me.” Another nurse told me, “I have been going to Al-Anon for years. My brother is an alcoholic in recovery.” She wished me the best with my sobriety and told me how much she liked my speech. Another nurse told me, “get past the word ‘alcohol’ – both AA and Al-Anon are ‘life skills’ programs.” She agreed that we need both AA and Al-Anon programs in our hospitals.


Bringing hope to others

My hope in writing this article is that nurses will learn from my self-disclosure, and by disclosing to other nurses and patients, will bring new hope to our peers, our patients and their families.

Donald Kautz teaches at a school of nursing and frequently talks and writes about inspiring hope in our patients, their families, and ourselves. The author gratefully acknowledges the editorial assistance of Elizabeth Tornquist with this manuscript.

From our readers gives nurses the opportunity to share experiences that would be helpful to their nurse colleagues. Because of this format, the stories have been minimally edited. If you would like to submit an article for From our readers, click here.

Selected references

Ashmore R, Banks D. Mental health nursing. Self-disclosure in adult and mental health nursing students. Br J Nurs, 2002;11:172-7.

Ashmore R, Banks D. Patterns of self-disclosure among mental health nursing students. Nurse Educ Today, 2001;21:48-57.

Dunn D. Substance abuse among nurses-Defining the issue. AORN J,2005;82:573-596.

Kautz DD, Van Horn ER. Promoting family integrity to inspire hope in rehab patients: Strategies to provide evidence-based care. Rehabil Nurse,2009;34:168-173.

Kautz DD. Inspiring hope in our rehabilitation patients, their families and ourselves. Rehabil Nurse,2008;33:148-153,177.

Van Horn, E.R. and Kautz, D.D. Promotion of family integrity in the acute care setting. DCCN,2007;26:101-107.

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