Do any of you remember summer car trips as a child, headed for a vacation adventure – or maybe to visit family? After all the hurry and excitement of packing and getting everyone in the car, you settle into your spot in the back seat and begin to look out the window. It’s not long before you are restless and bored, shifting uncomfortably in your little spot. You find yourself asking Mom, “are we there yet?”
The first time you ask Mom that question she answers patiently, suggesting you find something to do to help pass the time. However, by the tenth time of hearing the same question from you in less than an hour, you hear a different tone and message from Mom. It’s more like, “will you please be patient! No, we are not there yet!” You let out a long sigh and settle back into your spot looking out the window at very boring landscape when suddenly Dad says, “hey, anyone want to play Padiddle?” Though you had no idea what that was, Dad led the way and soon everyone in the car was looking for a car with a burned out headlight. Within a few seconds you find yourself laughing, eagerly looking out the window, gone the boredom and restlessness of the previous hour.
Likewise, have you ever anticipated an upsetting encounter with a supervisor, physician, or colleague but instead of irritation or anger, the response is warm and pleasant? And so it is – the power of distraction, engagement toward a common goal, or kindness and emotional warmth to change the mood and calm anxiety.
Sources of Stress
The angst felt among nurses at the present time is palpable. Nurses carried the ball during the initial viral outbreak. Many continue to bear very heavy workloads, significant COVID exposure risk due to lack of adequate PPE (personal protective equipment), and now the threat of furloughs and layoffs. Many fear they will tread the deep waters of despair and overwhelming anxiety to the point of hopelessness and helplessness. The question of the hour for nursing is, “how are we going to survive?” The answer lies within knowing how to manage your stress as a nurse. Our nursing curriculum helps you find a pathway of resilience through challenging times.
Let’s face it. Beginning in the early days of pre-licensure education, nursing students are oriented to the rigor, accountability, and self-sacrifice of nursing life. Nurses deal with overwhelming stress. Nurses somehow “come up through the ranks” ignoring whatever internal prompts arise to warn of imminent stress overload, failing to recognize early signs of unhealthy stress, and take appropriate steps to intervene. In fact, self-sacrifice and holding one’s bladder for the maximum amount of time possible have become a badge of honor for nursing students, and unfortunately, for many nurses. Without self-awareness, effective self-care skills, and balance in life, nurses can get into an entrenched, unhealthy pattern of stressed-out living which resists change. Like a hamster on a wheel, nurses can go round and round but get nowhere, eventually exhausted and not able to go on.
To my fellow battle-weary nurses, I offer you hope, a pathway out of the abyss, away from hopelessness, powerlessness, and despair. We as nurses can acquire the skills necessary to prevent stress overload, to prevent the type and level of stress that destroys quality of life and has the potential to end life prematurely, to avoid chronic dis-stress (distress). Simply stated, instead of distress, think de-stress.
Getting “off the distress wheel” must begin with the identification of the sources of stress. Where do you experience the stress most? Is it troubled thoughts, tight muscles in the neck and shoulders, sadness, a feeling of uneasiness, unsettled stomach? Or is it something more, such as nausea or diarrhea, more than a few sleepless nights (or days), anxiety or panic attacks, or thoughts of ending it all? Sometimes scheduling an appointment with a primary care provider is a good place to start so a medical issue can be ruled out. Or speaking with a therapist. This could be helpful – or essential if thoughts if self-harm occur. A therapist can offer support and insight. It is important to slow down and deepen self-awareness and reflection. There is a place for emotional and supportive care from others, including colleagues, friends, or a family member. Finding someone to talk with whose clarity of perspective is valued, and who will be honest about what they see going on, can be difficult for those in a profession which values self-sacrifice in tough times. All of these could be helpful – and so important at this time. The level of distress among our ranks must be addressed – and now.
Personalize Stress Management
Beyond ensuring enough sleep and good nutrition, the type of self-care sufficient to mediate the current level of high stress generated among nurses must be skillful, deliberate, and consistent. It is crucial to have a personalized Nurse’s Guide to De-Stressing in order to help manage stress. The toolkit must fit the nurse - individually. Therefore, it must be developed by the individual nurse. To begin, think of the tools ordinarily found in a toolkit purchased at a local hardware store. Most likely you would find a hammer, nails, saw, various wrenches, plyers, a screwdriver or two, a flashlight, a box cutter, and maybe a level. Each tool has a specific use toward one end, to build or repair something. The tools fit the purpose and outcome of use.
Are you already thinking about your personalized toolkit? What type of thoughts, activities, people are needed in your life to help you manage stress more effectively? It is generally helpful to first identify what you do and do not have control over in your life. This will begin the process of self-awareness, a necessary first step in stress management. The next step is to identify and evaluate expectations to determine if they are realistic or in need of revision. This step might require feedback from others who know you. Some unrealistic expectations are that everyone should accept us and care about us, nothing should ever break down, we should always be successful at everything we do. We may not realize such false expectations are within us until we have a period of self-reflection.
Strategies to Manage Stress
Identifying negative thought patterns prior to getting all the facts (jumping to conclusions), overgeneralizing, seeing only the negative, or emotional reasoning (making assumptions based on emotion) all lead to unwarranted misery. Such negative thought patterns develop under periods of chronic stress, especially in childhood. A great way to begin lessening stress is to identify and eliminate these faulty patterns of thinking. It is helpful to re-work unrealistic expectations and eliminate negative thought patterns. Chronic stress adversely affects the body, not just our thought processes. Physical activity such as walking, running, workouts, housework (believe it or not!), can be outlets to release built up tension or negative emotion. Additionally, learning body stress release techniques can be enormously beneficial for stress management. Three of these techniques are the tense-relax muscle exercise, guided imagery, and relaxation breathing. I suggest you set aside a regular time period of 15-20 minutes for body work, preferably daily, and set the stage with maybe a warm bath, aromatherapy, lit fragrance candles, and/or music. The relaxation breathing and/or tense-relax muscle exercise can be done in a few minutes if short on time. There may be times the pent-up negative emotion is so intense or overwhelming that “talking it out” with someone, or writing out thoughts and feelings “free-style” until experiencing a release, could be helpful.
An effective Nurse’s Guide to De-Stressing should include self-reflection and care, along with individuals (and/or pets) who can provide comfort, touch, and TLC, those who give energy and life, not drain it away. Close your eyes. Allow a moment to reflect on who in your life could inspire, soothe, or comfort you? I hope you have someone in mind. My question is – do you have a personal De-Stress Toolkit to prevent distress? If not, what will be your first step forward to help you manage stress as a nurse?
Our nursing faculty at Ottawa University understands and cares about the stress our future nurses experience. We encourage activities to mitigate stress and foster success. Read more about the Ottawa University RN to BSN program today, and discover the wonderful opportunities that await you in the nursing and health care fields.
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