How do you handle the stress?

Ruby Vee, BSN · Apr 4, 2017

Stress management isn't anything we ever discussed in my BSN program, although that was decades ago. I remember my instructors telling us, in essence, to just suck it up. Nursing is tough. Get tougher.

Nursing students study the sciences: anatomy, physiology, chemistry, microbiology, pharmacology, nutrition (at the molecular level), psychology. They also study statistics, medication calculations, arithmetic for adding up I & O, etc. Many nursing students enter the program because they believe they have a calling to help sick people without understanding the very real science and math they must master. If you read some of the nursing student threads, you'll find many from students who feel that their calling and compassion should matter more than grades in math and science.

Stressors in nursing are many and varied. I enjoyed the flexible scheduling while others complain that they hate the hours. The responsibility of being "the nurse" can be crushing for some, while others will shine. The workload is heavy, the patients less respectful and less grateful than they were in generations past and the customer service model places "patient satisfaction" above "patient safety" which seems crazy. Unfortunately, many in upper management do not seem to grasp the difference between patient satisfaction (getting that chocolate ice cream that isn't too cold immediately when you ask for it) and patient safety (since you weigh 500 pounds and your blood sugar is also 500, perhaps you should forgo the chocolate ice cream and visit with a dietician about a healthier diet.) New nurses come into the field with very little idea of how workplace relationships work and many of them seem to be looking for bullying in every interaction with their new colleagues. There's a skill to giving negative feedback that most seem to lack; but there's a skill to receiving it as well and most not only lack that skill but seem to believe that they shouldn't HAVE to have skill in receiving feedback because the onus is on the other person to preserve your ego and avoid hurting your feelings.

Passing the NCLEX (so stressful for some that there's a whole forum on the subject) just gives you a license to learn. New grads have so much to learn -- and most of them don't even know what they don't know. It takes two years to be competent as a nurse, and all too many leave before that can happen.

As an experienced nurse and a preceptor, the constant turnover of new staff is stressful and disheartening.

Journalling and exercise are both effective means of stress management. Self care is very important. Take a bath, listen to music, lie in bed and read trashy novels . . . whatever it takes to take care of you.

As far as stress being useful . . . the new nurse who scares me spitless is the new nurse who IS NOT afraid of making a mistake because she things she's too smart to make a mistake. The new nurse who is afraid of making a mistake is a safer nurse.

LopSided · Apr 4, 2017

Thanks for your response Ruby Vee.

I think staff turnover is one of the key reasons educators are looking at including stress-management programmes in the curriculum. Some of the more effective programmes were offered in addition to the students' current workload, so not everyone wished to attend as it would take up more time in an already busy schedule. The skills were generally effective and useful in the long-term so it was a case of short term strain for a long term gain.â€ The example you give on self-careâ€ highlights the fact that we all have our own methods of stress relief (some with extended health benefits outside of stress relief itself, e.g. exercise and relaxation). So perhaps an effective stress management programme may be less about offering a standard X amount of lessons for X amount of weeks as an extra course/unit/module; but more about learning new techniques (e.g. deep breathing, cognitive restructuring) that can be taught briefly but reinforced regularly within normal contact hours; in addition to encouraging students to maintain their preferred (healthy) methods of self-care regularly. One barrier to effective stress management may be the number and variety of different stressors experienced on the job each day, as each may require a different coping strategy; and sometimes things come up that we aren't prepared or trained for.

I suppose the challenge of being short-staffed is having the time and resources to facilitate support measures that will reduce the turnover that leads to being short-staffed.

When I was speaking with some nursing students here recently, they thought it was strange to suggest stress can actually be positive, but your point about the fear of making mistakes is a perfect example. Most people would worry about making mistakes, but its how each person perceives this and responds. One's fear may lead to serious anxiety, while another's may result in extra care and vigilance.