Health and Wellness

Stress busters and sanity savers

Your shift just started, and already you have too much to do in too little time. Your heart rate rises and your mood falls. You ask yourself, “How can I make it through the next 8 hours without imploding?”
To survive some shifts unscathed, you need a toolbox of stress-reducing strategies you can dip into from time to time. But first, let’s get clear on one point: Healthcare facilities can’t expect nurses to work in impossibly stressful situations day in and day out. If your employer isn’t actively working to reduce stress in your workplace, it’s time to find out why.
Now let’s get back to you.

The crush of complexity compression
Like most nurses, you’re probably caring for sicker patients at a quicker pace. At the same time, you’re being pulled away from the bedside by mounds of paperwork and other tasks. These dueling responsibilities create what’s called complexity compression, in which you’re forced to take on additional, unexpected responsibilities while juggling your normal duties—all in a tighter time frame.
For many, the stress triggers an unrelenting adren­aline surge, setting off a slew of physical and emotional symptoms. The upshot: Your body is primed for either fight or flight, threatened by the woolly mammoth disguised as your next 8 hours.
As you get ready to jump into the fray, you prioritize what needs to be done, decide what must be done and what won’t get done, and delegate tasks. But what about the emotional and physical toll the shift will take on you?

Immediate stress slayers
If you smell something burning and it’s you, chances are you’re experiencing an array of stress symptoms. These symptoms may hitch a ride home with you and show up in your personal life.
When you’re stressed, you may see stress-reduction techniques as one more thing you don’t have time for. But if your body’s stamping its feet in protest, you need to subdue the stress before your body sends even stronger signals—in the form of illness. For starters, remember that you’re not perfect or invincible. Appreciate that you’re doing the best you can in a difficult situation.
Here are some short-term techniques to help you make it through the day—or night:
• Take a deep breath. Stress makes breathing shallow. To deepen it, place the palm of your hand on your belly, and inhale slowly and deeply so you can feel your belly expand. Then exhale slowly and completely. Repeat p.r.n.
• Listen to music. Keep a compact disc or MP3 player at the nurses’ station, with soothing music that help decrease stress. Classical music that keeps a metronome rhythm of about 60 to 70 beats per minute is ideal. This tempo helps decrease your heart rate and lifts your mood—and may work on those around you as well.
• Tighten and relax your muscles. Progressively tighten your shoulder muscles and then release the tension. Next move on to your arms. If time allows, work all the way down to your toes. You’ll feel some tension fall away.
• Change your scenery. Only have 5 minutes to spare? Use it to decrease stress by taking a quick walk—even if it’s just to peek out a lobby window.
• Decrease caffeine intake. Resist the urge to fuel up with a java jolt. You’ve got enough adrenaline surging as it is. Instead, try green tea or chamo­mile tea.
• Laugh. It’s not easy to laugh when you’re stressed, but laughing is a great tension reliever because it reduces stress hormones.Long-term strategies
While long-term strategies probably won’t help you get through the next 8 to 12 hours, they can shore up your defenses for the future. Start by assessing the balance between your personal and professional lives. If work stress is depleting your energy and your personal life is crammed with carpooling, housecleaning, and laundry, you’re already operating at an energy deficit. Burnout isn’t pending; it’s underway.
Use these long-term strategies to help regain control:
• Assess and evaluate your work environment. What aspects of your workplace do you have some control over? Can you think of a way to make these flow more efficiently and easily? Take a good look at your workday; if necessary, talk to your nurse manager about ways to make it run more smoothly for you, your colleagues, and patients.
• Practice saying no. If you often say “yes” to overtime even when your body’s screaming “no,” firm up your boundaries. Practice a response to requests on your time, such as “I’d love to help out, but I’ve got a commitment I can’t break.” Don’t explain; just repeat this response p.r.n.
• Watch your words. Use language that supports rather than demoralizes you. Replace “I’ll never get this done” with “I know I’ll get through this with flying colors.” As your language goes, so goes your mood. (See Out-of the-box stress squelchers.)
• Make a play date. Play isn’t just for kids. Schedule enjoyable activities at least twice a week. Meet a friend for coffee, take a belly-dancing class, get a massage, or read in a quiet corner of your local library.
• Delegate. Assign some household chores to your children. This will teach them skills, give them some independence, and give you a break. If you can afford it, hire someone to clean the house.
• Exercise. Join a gym, swim at your local YMCA, or walk with a neighbor. Physical exercise makes you healthier and burns away tension. Aim for 40 to 60 minutes at least five times a week.
• Build a support group. Make time for friends. Develop a support group of nursing colleagues—those who will watch each other’s backs and work together to get everyone through a challenging shift.
You know you’re worth it
Results from the Nurses’ Health Study show that workplace stress can damage your health and well-being as surely as smoking or a sedentary lifestyle. And the damage is cumulative. You deserve better than that.
Pick the stress-busting methods that work for you, and use them whenever you recognize the symptoms of stress. Your health and well-being are riding on it.
Selected references
Borgatti J. Frazzled, Fried…Finished? A Guide to Help Nurses Find Balance. Borgatti Communications; 2004. Available at: www.joanborgatti.com and www.booklocker.com.
Cummins H. Nurses cope with increasing job pressures. Minneapolis Star Tribune. December 17, 2006. http://nursesrev.advocateoffice.com/vertical/Sites/%7B41671038-B8D0-4277-90A9-50B10F730CBD%7D/uploads/%7B090FF510-6058-45AB-8DFF-3139500878A8%7D.PDF. Accessed December 11, 2007.
How can I deal with stress at work? http://www.webmd.com/mental-health/features/work-it-out-work-stress#1. Accessed December 11, 2007.
Murray R. Managing your stress: a guide for nurses. Royal College of Nursing. www.rcn.org.uk/__data/assets/pdf_file/0008/78515/001484.pdf. Accessed December 11, 2007.

Joan C. Borgatti is the owner of Borgatti Communications in Wellesley, Massachusetts, which provides writing, editing, and coaching services. Her website is www.joanborgatti.com.


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