How Do You Handle Stress/Anxiety?

[franciscangypsy]

The past week or so has been really rough on my floor, between drug-seekers, codes, heavy patient loads and (personally) a horrible schedule where I didn't have 2 consecutive days off for over a week.

Thursday night, I came in to find that I was being floated to Surgical Telemetry for 4 hours and would return to my floor (Med Tele) for the rest of the night. Got all 6 of my pts set up, tucked in, and charted on for the next nurse on Surg Tele by 2300 (quickest and easiest shift beginning ever). When I arrived to my floor, I ended up getting six patients right off the bat and report on a 7th from ER before I could even take a look at any charts.

I did not get report done until about mn -- one pt was dying/confused, one a seeker, one having an allergic rxn and soaring uncontrolled SBP, and right after report, my 7th pt arrived to the floor.

Usually I deal alright with stress -- I take my deep breaths (I have a sticky on my COW that reminds me to take stop and take a deep breath and then give everything to God) and remind myself that I can only do my best and try to do what I can during the shift. I do not deal well, however, with the feeling of starting behind schedule (I've always had anxiety about being late; I usually arrive at work at least half an hour early) and I felt very much behind the eight ball this shift -- plus I was starving. I know that it was anxiety, but my chest started tightening.

It was a horrible feeling and I don't like feeling that way at work (it has only really happened one or two other times... also when I've only worked with a team for 8 hours). I've started looking at other jobs, thinking that I'd maybe like the lower pt load and more focused care of ICU, but I was wondering if anyone has any suggestion for (nonmedical) management of stress?

I don't hate my job (I've been here a 1 yr & 4 months and am feeling comfortable that I know what I'm doing) but I am emotionally & physically exhausted when I come home. Our pt load has been horrible lately and people are quitting left and right. I usually feel better after a good cry even if it does wipe me out -- and I feel like I'm unbalanced or something for crying over stupid stuff. I'm assuming it's because I'm so stressed/exhausted since I don't really have any other good reason.

How do you all handle your stress/anxiety? Prayer helps to some extent, but the chest tightness rxn to stress kind of scares me even more than occasional crying on my nights off.

Any suggestions you guys can offer would be much appreciated! :redbeathe

[Noob_to_Nursing]

Hi!

Usually when I'm REALLY stressed, I have to talk to my sister. So I think having someone to talk to...even a therapist (there's no shame in that!) would help a lot. Sometimes I get stressed because I feel alone; I feel that I'm the only one feeling lost or anxious. I'm a gamer and I also like to blow off steam by playing video games. haha My own outlet. I used to work out a lot to raise my endorphin level (when I was younger); if I get the chance, I'll do the Walk at Home DVDs by Leslie Sansone. Here's a link to one of the walks if you're interested on what it looks like: Walk at Home by Leslie Sansone | #1 Walk Fitness Program!.

Maybe a trip to the spa? A massage? A funny movie? Not to forget your troubles but to remember that life offers laughter and happiness.

I'm not a nurse...yet...but I suffered anxiety the day after experiencing an earthquake while in a windowless center room on the 52nd floor of a high rise building. I actually had to take medication there (no shame in that either but it's not a quick fix) and some therapy.

My prayers go out to you! I hope that your anxieties are lifted! :)

[pednursedeb]

You did have a really bad day and had every right to be stressed. The chest tightness worries me.

I went to a really bad code one time, teenager, she didn't make it. When I got back to my unit one of my coworkers looked at me and just said take 10 minutes, I'll cover your patients. I went and had a good cry, came back to the floor and finished my shift.

Having good coworkers helps so much. You have each others back and help each other as needed.

I don't know what your unit is like, but I worked telemetry for a good number of years then moved on to something different, still nursing.

If work is the only place you are having anxiety, you probably just need to make sure you chill out after work. If you are having it other times, like the other poster said there is no shame in medication.

Good luck. I hope your days on telemetry improve.

[KatMachine]

Hi,

Everytime I'm stressed out, I give myself a break even just a minute or two and do guided imagery. I would think of myself in a nice little cottage in the south of France, where I would have a little yard in a riot of blooming flowers and the green grass smells good under the brown moist earth. And I would be sitting infront of a quaint french window, sipping tea and watching this scene. This always makes me feel relaxed and calm.

[sandyteele]

Sounds like you had a busy day and that you were pulled in all directions. Sorry, that you felt that way. Know that we all go through these trying days as nurses. There was a time we had an ongoing nursing shortage, with stress and exhaustion being the primary reasons nurses left the profession in droves. Many nurses considered themselves "crispy" after ten years of being a nurse. Burnout is a reality for all nurses. Recently, more people are choosing the nursing profession because of the higher salaries, but the work requirements still remains the same and will only increase in the years to come. Our population of hospitalized patients are increasing because baby boomers are getting older, and they (we) are a very large population of people. The stressful conditions that caused nurses to leave did not go away, they're still there, and will only increase in the future. Will the stresses of our profession ever go away? Probably not. The one suggestion I can give you is to prioritize what you need to do first. You can only be in one place at one time. Take a deep breath, and know what you need to do next and do the task at hand with a positive attitude. Staying positive is always a good frame of mind to be in. Choose not to be stressed.

By the way, going to the ICU will not lower your stress level, you will be responsible for keeping your patients alive minute to minute. I hope your days in the future will be happier!

[canesdukegirl, BSN, RN]

Hi,

Everytime I'm stressed out, I give myself a break even just a minute or two and do guided imagery. I would think of myself in a nice little cottage in the south of France, where I would have a little yard in a riot of blooming flowers and the green grass smells good under the brown moist earth. And I would be sitting infront of a quaint french window, sipping tea and watching this scene. This always makes me feel relaxed and calm.

YES!!! Guided imagery really helps me as well. I imagine myself in a soft green meadow surrounded by puppies. I imagine everything that my senses will allow-the feel of the sun on my face, the gentle wind, the smell of puppy breath and the sounds of them playing and tugging. I am sharing a banana with those who are curious, and feel their big giant cartoon feet on my legs as they climb to get a better sniff of this fruit. I usually end up laughing at the image of this glorious scene and everything is fine for a bit.

When our patient loads are skyrocketing and we have too much on our plates at work, I MAKE myself take one day of the weekend to do NOTHING. It took a while for me to do this because I felt guilty for not doing SOMETHING productive. But if I didn't do this, I ended up feeling so much more stressed when the grind started again on Monday. Take some time for yourself. No schedule, no appointments, no to-do list. Just you, a nice soft blanket, a good book or a movie. Just chill and enjoy the day....you will feel human again.:redbeathe

[KitKat247]

I had a massive problem with anxiety earlier on this year.

I'm only in my 3rd year of studies so I'm not qualified yet, and I've always been an anxious person. Although strangely it had never affected my placements, until this year.

In all honesty I don't know what triggered it. I was two weeks into a six week placement when I stopped sleeping, I got maybe an hour a night. I would burst into tears and cry for hours when I got home and then retch before struggling to breath and like you I felt a tightness in my chest. I somehow managed to hold it together during the day, but it got to the stage I would burst into tears whenever I left the department.

I ended up going to see my GP, I didn't want to take medication because I wanted to learn to deal with it myself. Although I'm a firm believer that if medication will help you then you should take it. He passed me on to a counseller who assured me I wasn't going mad, and gave me a disc to play once a day.

The disc was pretty simple. You tense and release all your muscles, starting with your hands and then your arms, etc etc. It also taught me breathing exercises to help if I ever felt like I was losing control.

This helped enormously. And I despite the month I lost through my anxiety I passed my exams and essays. The university was really understanding and let me resit my critical care placement this summer, where I finished with an A.

My advice is find someone who you can talk too, whether it is someone you already know or through therapy. I would also recomend doing the relaxation exercises, it isn't an instant fix but it takes your mind off whatever problem you've fixated on and gives you back some control.

Whatever route you choose, I hope it works out for you :)

[Noob_to_Nursing]

Hi,

Everytime I'm stressed out, I give myself a break even just a minute or two and do guided imagery. I would think of myself in a nice little cottage in the south of France, where I would have a little yard in a riot of blooming flowers and the green grass smells good under the brown moist earth. And I would be sitting infront of a quaint french window, sipping tea and watching this scene. This always makes me feel relaxed and calm.

Wow! I've never heard of this before! I'm going to try it too!

[franciscangypsy]

Thanks everyone for the suggestions and the sympathy.

I got two nights off in a row after that night, then called off for a low census. The last night I worked after those three nights off was tons better stress-wise and load-wise. I think I partially just needed a break. Now I'm going on vacation for a week too, so I should be good as new.

I've never been very good at guided imagery, but the suggestions to take a few moments to get stress under control are well-taken. For me, prayer seems to work best, so I found some little 5-minute or less prayer books and some quotes of Mother Teresa (who definitely understood the meaning of stress in our area of work).

Thank you so much for taking the time to help!