Nursing is an incredibly stressful career. From the moment nursing students start their education program when they retire, they face difficult situations and stressors on a daily basis. In fact, stress and burnout affect 10-70% of nurses. Sources of stress can be the patients and cases they observe, time constraints to get work done, conflict with leadership or co-workers, or a feeling of lack of control in their work environment. Stress can lead to fatigue, exhaustion, and detachment from their work which may lead to patient safety concerns. Therefore, successful management of stress is essential to the well-being of not only the nurse but patients as well.

So how do nurses manage high levels of stress and the accompanying emotions? Below are ways nurses can help deal with (sometimes) overwhelming stress and prevent burnout.

Talk About It

It's easy for nurses to finish a shift, come home, and just want to zone out in front of the TV or computer. However, the stresses don't go away. Challenging events and situations may replay when the nurse is trying to sleep, and when the next shift rolls around, the stressor is still there. After a long and harried shift, it may help to talk about it. Sometimes it's difficult with a friend or spouse who is not in healthcare. However, the point of talking things out is to get it out, not necessarily to find a solution. Talking about stressors helps to recognize them – which, later on, can help address and hopefully resolve them.

Talking about stressors also helps the nurse identify what the actual issues are. For example, a nurse may have a tough day because staffing has been poor. In speaking about it later, he or she may discover that the extra work isn't necessarily the problem, it's that the manager isn't hearing the nurse's concerns about patient safety. To resolve the issue, the nurse would need to address the communication between the staff and the manager.

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Recruit Support

Nursing co-workers are a tight-knit family. They are down in the trenches with one another and for this reason, talking about work-related stressors with another is extremely valuable. Basically, they can all relate. Having a therapeutic vent session is extremely helpful not just to get concerns out in the open, but to share ideas on how to improve things. Sometimes it helps to arrange a gathering outside of work. Night-shift workers can meet for breakfast, and day workers can have a late lunch or dinner. By removing the group from the environmental source of stress (work), nurses can be more candid in verbalizing their concerns.

Exercise

Let's face it, the last thing a nurse on the verge of burnout and at the end of a 12-hour shift wants to do is exercise (although kudos to those who do). However, exercise has been proven as an effective stress reducer. Exercise helps reduce adrenaline and cortisol as well as boost endorphins. It also helps boost energy, so nurses aren't so exhausted at the end of their shift.

The question of when and how much can be answered easily. Whenever a nurse can exercise and however much they are able to be better than nothing. Counting running around at work as exercise is probably not sufficient; it helps to go somewhere else and do something different. Listening to music while exercising is extremely helpful in reducing stress as well. Squeezing in a form of exercise before or after work or on a nurse's day off will have long-lasting physical as well as mental health benefits. The bottom line is you must exercise to keep your immune system healthy

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Find a Hobby

Finding a hobby is another great way to reduce stress. It gives nurses something else to focus on, and it's something that they enjoy. Hobbies make people feel good and sometimes provide a feeling of pride and accomplishment. Hobbies don't need to be time-consuming; it could include reading, knitting, working on an art project, even exercise (which is a double-whammy when it comes to stress reduction). The possibilities for hobbies are endless and have enormous health benefits as well.

Breathe Deeply

Many people eschew the notion that deep breathing helps to reduce stress. Nurses, especially, should take notice, as there is a scientific basis on this method of stress relief. According to stress.org, deep breathing helps to bring oxygen to the brain and stimulates the parasympathetic nervous system which helps to reduce stress. Heart rate and blood pressure decrease and muscles relax.

Deep breathing is a quick and easy way to reduce stress; it can even be done at work in the midst of chaos. Slipping away to the break or supply room for a minute or two can help. At home, deep breathing in the form of yoga or meditation is a more in-depth method for stress relief. Yoga is especially focused on breathing patterns so practitioners can become aware of the mind-body relationship.

Seek Help

For some, the stress is too much to handle independently using the techniques listed above (and more). Nurses need to know that it's okay to seek professional help when necessary. When stressors at work become unbearable to the point that it manifests into physical symptoms, if interpersonal relationships are strained, or if work performance suffers and patient safety is at risk, nurses should seek professional help immediately. Many organizations offer some type of assistance program for staff, but there are also resources out in the community. Nurses should definitely know that caregiver stress is rampant and taking the first step to getting help is paramount to their well-being.

Nurses often care for others without stopping to care for themselves. This culture needs to shift. After all, how can one effectively care for others when their own mental health is suffering? It's easy for nurses to experience "compassion fatigue" as compassion is engrained in their DNA. However, staying in touch with one's own feelings and emotions and recognizing stress and the effect it has on one's life will help nurses maintain a long and healthy career.

Amanda Bucceri Androus, RN, BSN
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