How to carry yourself under high stress?

dazyRN · Oct 28, 2010

Nursing is a very stressful career. I was a victim of high stress when I began my career in the 1990's. I have decided that I am only one person and can only do one thing at a time. Your co-workers have to pitch in and help sometimes. Also, the nurse has to have a routine that you stick to during your shift. If distractions occur, and they always do, talk to who ever you need to talk to then refocus on you daily routine during your shift. I come in in the mornings, get my coffee, sit down and get report, visit with my co-workers for a few minutes, then go to each of my patient's rooms to check on them. If they are ok then I will go to the pyxis to get their morning medications. Then one by one I go to the room, assess my patient, and give them their medication. Then its on the the next room. After wards I sit down and chart my assessments. But getting on a routine and sticking with it helps. Yes there will be interruptions and something totally unexpected will happen but as soon as the crises past get right back in to your same routine. And practice smiling and be pleasant and friendly. Then your coworkers wont mind helping you if needed.

roser13, ASN, RN · Oct 28, 2010

Your post could have been written about me. I did not realize I was vulnerable to such feelings of stress until I became a nurse. What's worse, my face apparently betrays every little feeling that crosses my mind, leading everyone to think I'm mad, about to cry, or worse.

While personally working on dealing with my stress levels, I have found it helpful to try to make a little fun of myself, to try to defuse my stressed-out appearance. If someone says "are you OK? What's wrong?" I try to make a joke about how my face always looks like this and don't worry, I'm fine. It's kind of like the boy who cried wolf....if I always look completely stressed out, even when I don't need help, everyone will get used to me looking like that. When I really am underwater and could use some help, no one would think to offer because that's just how I look!

Davey Do · Oct 28, 2010

winter_green:

Identifying that stress is having a profound effect on your life is the first step in the problem-solving process.

You've identified the problem. Now to do something about it.

DazyRN gave you a personal technique which works. A systematic approach is always good approach.

Each individual must find their own way.

Stress is like any other damaging force- it has to be reckoned with by a continuous program of growth. And a program is utilized every moment of every day in every situation. It consists of adopting principles, beliefs, and methods of behavior.

To be at peace with oneself; to be at peace with how oneself behaves and reacts to any given situation is true happiness.

There are all sorts of systems of beliefs out there and all sorts of people who want to show you the way. It's up to you which system of belief you are comfortable with and can adhere to.

That's the second step in the problem-solving process: Gather data.

Try on all those shoes and see which one fits. That's the third step.

Choosing the best answer is the fourth, and final, step in the problem-solving process. Make your choice and follow the tenets of your beliefs with great abandon.

I assumed you wanted a strong answer for your poignant question.

Otherwise, you could just say to yourself, "In a hundred years from now, who'll know the difference?"

The best to you in your quest for the correct answer to your query.

Dave

SlightlyMental_RN · Oct 28, 2010

When I'm under a lot of stress, I tend to become very focused, and honestly, I think that's okay. However, I never lose my appreciation for the absurd or my ability to laugh at myself. (Warped sense of humor--that's me!) As for how I cope, I am a big believer in being organized. I like to get up a little earlier and not start my workday with my running around like a crazy person at home. Also, I use a time grid that I made up specifically for my specialty/workplace to keep myself on track. Ask for help when you need it, and force yourself to ask co-workers if they need a hand--then, when you're fried, they will be more likely to help out. Additionally, I think it helps, too, to use therapeutic communication and touch on your co-workers. Too often, we forget to nurture ourselves and the people we work with, and we end up feeling lost and isolated. :redbeathe

bropolka56 · Oct 28, 2010

Nursing = Stress. I find that being as organized as I can be and following my own designed routine for the day is what works best for me. When the overwhelmed feelings arrive, I am known for calling a "time out" in the nurse's station and having everyone present, stop and do some quick deep breathing before we start back in again. This has been useful for calming the place down and allowing everyone to have a quick laugh before returning to the task at hand. Note: If all else fails, I'm also known for handing out chocolate!!

skittlebear · Oct 28, 2010

You have received great replies here. I just wanted to a few of my personal experiences and possible coping mechanisms for you:

I, too, did not know I was capable of such intense feelings of stress until I entered the nursing profession. You suddenly have new immense responsibilities!

One of my new co-workers once asked me, "How do you stay calm all the time?" Boy, if they knew how I was really feeling inside. My heart rate stays over 100 while at work, I get sweaty palms, and have severe anxiety (I had a little before...but much, much more so after becoming a nurse). I looked at her simply and stated, "Things aren't always what they appear to be". I explained to her that I too, have anxiety but I've gotten very good at hiding it. Under a stressful situation, I remind myself to stay calm because who will care for the patient if I am panicking? I've learned to "fake" being calm because no one wants a nurse to walk in their room and look frazzled. Even if that's how I feel on the inside, I don't let it show on the outside. I have a smile on my face and take silent deep breaths. I FOCUS on what's in front of me. That does seem to help take some of the anxiety away because my anxiety isn't my main focus anymore. It's still there, but it takes a back seat. I keep silently telling myself, "I am a good nurse, I am a good nurse." I know this sounds silly but it does work...CONFIDENCE.

I also read in a magazine once that counting backwards in 3's from 100 would help relieve some anxiety...because you are focusing on something that will take your mind elsewhere and your anxiety will take a back seat to that. It works! So, when I'm not having to actually critically think, I will count backwards from a hundred in my mind, "100, 97, 94..."and so on.

I have found ways to cope with my stress while on the job. I now have to figure out ways to cope with stress off the job. Good luck to you. As you gain experience, you will start feeling less and less stressed. If your like me, the stress doesn't ever really go away. You just have to find different coping mechanisms.

HopeItWorksDNP · Oct 28, 2010

Working in the ER, I instruct the new grads: "You've always seen worse." No matter how bad the patient it, you cannot show it to the patient. Your job is to remain calm so the patient remains calm. When I started, I tried to keep a smile on my face in the patient's room even if it was fake so the patient would not know how nervous I was. Eventually, it stopped being fake. It comes with experience and time. Don't be too hard on yourself.

Forever Sunshine, ASN, RN · Oct 28, 2010

Nursing = Stress. I find that being as organized as I can be and following my own designed routine for the day is what works best for me. When the overwhelmed feelings arrive, I am known for calling a "time out" in the nurse's station and having everyone present, stop and do some quick deep breathing before we start back in again. This has been useful for calming the place down and allowing everyone to have a quick laugh before returning to the task at hand. Note: If all else fails, I'm also known for handing out chocolate!!

In LTC the nurses station is the most stressful place. lol Especially at 3pm shift change. Everyone is yelling, and arguing and talking and phones are ringing and call lights are going off. This noise and action stresses out the dementia patients so then they start getting restless and yell and get up out of their chairs. So we are yelling at them and each other and ourselves.

The first two hours of one night at work were just so stressful, I went into the O2 room(which is a dark, locked closet) and just cried for a minute. I felt so much better after that and more in control the rest of the shift.

After we have our state visit I'll hide a bag of chocolate bars for those stressful nights(or any night with nothing to eat lol).

Ruby Vee, BSN · Oct 28, 2010

i am realizing that i am the kind of person who does not deal with stress well. when under stress, i find myself, really serious, forget to have humor or smile, and sometimes feel the pressure and perhaps can be a little hesistant to help others or take on other things if needed. i don't mean to be like that, but the feeling of stress can be overwhelming and it can over take me.
my question is, how can i still carry myself well with a good personality even with high stress??? i don't want to look overwhelmed all the time, or frazzled. how do you deal with stress?? how do you still maintain yourself and openess?

i used to just freeze when the stress got bad enough. my patient went into vt, i froze for what seemed like forever before i remembered what i needed to do and then did it. my patient vomited blood, i'd just stand there like a fencepost before i'd realize that it was on me to do something about it. then i got an evaluation -- the evaluator complimented me on my ability to keep cool in an emergency. (keep cool? i was frozen solid!) but it occurred to me that people thought i was calm in an emergency and over time, i became calm.

nursing is one of those jobs where you have to do the work of two people and smile while you're doing it. no one expects the housekeeper to smile while she's cleaning projectile vomit off the bathroom walls, or the truck driver to grin while he's sitting in traffic. it ought to be enough that we just do our jobs and do them well and not have to smile while we're so busy and so stressed we cannot think straight.

anyway, here's my advice:

fake it 'til you make it.

eat well, exercise, have projects, hobbies and friends outside of work and get plenty of sleep. but if you behave as if you're not stressed, the stress ebbs.

Orange Tree · Oct 28, 2010

When I'm stressed out, I start feeling self doubt and my thoughts become very focused on ME. It happens to the point that I hear people talking to me, but I'm not really listening to what they're saying.....I'm too preoccupied with my own feelings and racing thoughts. Soooo, my strategy is to tell the little voice inside my head to "shut up" and try my best to rejoin the circus around me. Then I cry, eat chocolate and put things into perspective when I get home.

I also try to jump in and help coworkers when I see that they're stressed and having trouble coping....even

if I'm quite busy, myself. And lately, it seems that they've been more than willing to jump in and help me in the same way. That takes a huge amount of stress of of me. :heartbeat

mastover · Oct 28, 2010

stress is a crippling things if you dont get a handle on it! I have to stay organized and focused! and dont be afraid to ask for help! theres no shame in that!