Amy Whetstone

Long shifts, heavy patient loads, and a relentless pace are common recipes for both mental and physical fatigue in nursing. In an effort to cope with increasing demands in the workplace, it is tempting to turn to unhealthy habits. These ways of coping may feel good in the short term, but don’t give us the means to build a resilient life outside of work. Effectively using days off for recovery is crucial for our well-being. Here are three unhealthy (and common) ways we cope with job stress and what to try instead. 1- Alcohol There’s nothing wrong with a glass of pinot every once in a while, but if you are viewing alcohol as the “light at the end of the tunnel” on every shift, you may be using it as a coping mechanism. A few drinks may make you feel relaxed and soften the rough edges of a hard day, but, in the long run, alcohol does little to alleviate stress and exhaustion. Although alcohol may induce sleep faster, studies have shown that it disrupts our restorative REM sleep later in the night. Alcohol is also a mild diuretic. This causes dehydration that leads to that hung-over feeling the next day. Exercise Making time for physical activity can go a long way towards stress reduction. You don’t have to run a 5K every day to get the benefits either. A 20-minute walk around your neighborhood or a short Youtube yoga video will do the trick. According to the Mayo Clinic, exercise boosts feel-good endorphins and reduces the negative effects of stress. Exercise also improves physical well-being by strengthening muscles, improving cardiovascular fitness, and heightening immunity, all of which help you better cope with stress. 2- Tuning Out I get it, you talk to people all day long at work. Whether it’s patient care, updating family members, or discussing care plans with colleagues, at the end of a shift you’ve given all you have to give and you’re all talked out. This type of one-way interaction can be emotionally exhausting and it may feel as though isolation is the best remedy. While it is tempting to lock yourself in a room with a good book on your day off, totally removing yourself from society can be counterproductive. Be Social We are designed to be social creatures. Having a strong (not necessarily large) social circle has a positive impact on our well-being. While our interactions at work tend to be outward-focused, friendships are a two-way street that allows us to be on both the giving and receiving end of support. Lunch with a friend, shopping with your favorite aunt, or a short visit with a neighbor can go a long way to restoring you psychologically. Engaging in social interaction causes a physiologic response in our bodies that helps us better deal with stress. 3- Binge-Watching The latest season of your fave show has just come out and you plan to spend your day off glued to the screen. There’s no problem with the occasional show marathon. It gives your mind an escape, a chance to focus on someone else's problems for a change (even if that someone is fictional). But if you find yourself spending every day off staring at a screen, you may need to rethink how you engage your mind in your downtime. Get a Hobby Hobbies give you a chance to learn and improve your skills at something unrelated to work. They can bolster confidence and give you a sense of accomplishment that watching 12 hours of Netflix cannot. They allow you to see yourself as more than your career. Some hobbies even open you to a new social circle and give you a connection with a group of people outside of your profession. Most importantly they give you a work-free slice of time to engage your mind in a positive way. Workplace stress is a common complaint amongst healthcare workers. It can leave you feeling tired, depressed, and downright isolated. Coping with stress is a learned skill. It involves making the right choices about how we spend our downtime. It may take some trial and error to determine which activities work best for you, but healthy coping skills can make a tremendous difference in your work-life balance. References/Resources Alcohol and a Good Night's Sleep Don't Mix Exercise and stress: Get moving to manage stress Socialization and Altruistic Acts as Stress Relief The Importance of Hobbies for Stress Relief

I’ve spent most of my career in busy Emergency Departments and Urgent Care. The fast-paced environment and high patient turnover mean I don’t get to spend much time with each patient. From triage to discharge, my job is to give compassionate care in a timely manner. But providing compassionate care and moving patients through their visits efficiently are often in conflict. We nurses use our strong clinical and time management skills to help patients; this is how nurses show care. But people often need something more than knowledge and speed to feel cared for. They need compassion that they can understand. Compassion is acknowledging others' feelings and expressing that you want to help. It is most meaningful when it is most needed. Compassion makes the biggest impact on the vulnerable, and caring for the vulnerable is where nurses excel. Here are three ways to show compassion even in a fast-paced setting: 1- Slow Your Roll Working in a high turnover environment you tend to use the same phrases over and over. Once you’ve said something 50 times in one day, you’d better believe you can say it really fast. An opening phrase of “Please confirm your name and birthdate, have a seat in the chair, and push up your sleeve so I can check your blood pressure” can easily morph into one long, fast string of demands. This leaves patients feeling rushed and overwhelmed, and makes us look impatient. Instead, at each patient interaction try to: Slow down your speech Pause between each question, statement or request Allow patients to process one piece of information at a time Each time I have a patient interaction, I consciously slow down my words and leave a pause between each sentence. Whether it’s a question, request or information about treatment or testing, pausing gives the patient time to process what I’ve said. Then I let people answer one question or follow one request at a time. 2- Face the Patient In many patient care settings, charting is done at the bedside from a computer. This means we often spend an entire patient encounter looking at a screen and not at the patient. This is especially true at triage or during the initial patient encounter when we most need to establish an environment of compassion. Not facing someone you are talking to sends a message of disinterest and leaves people feeling invisible. Ways to counteract this are to: Turn your body towards the patient Look up from the screen often Make eye contact I try to maneuver my computer so I face the patient whenever possible. If I can’t arrange to be facing the patient, I turn towards them as best I can and look up from my screen often. Sometimes when computers are mounted to a wall, having your back to a patient simply can’t be helped. In that case, I simply apologize that I can’t face them. Then, I use any time I’m in the room, but not stuck at the computer, to really face the patient and make eye contact. This shows our connection on a human level, not just a nurse-patient level. 3- Offer Reassurance In high-volume units, we often see similar patient complaints multiple times per shift, making most illnesses and injuries routine for us. But getting medical care is a new and frightening experience for many patients. People feel vulnerable in an unfamiliar environment, especially when experiencing pain or discomfort. While our experience as nurses allows us to respond to the sick or injured in a controlled way, that control may come across as nonchalance to patients. To reassure patients that we understand their concerns: Repeat back what they say Acknowledge their discomfort Express desire to help When I ask patients to list their symptoms or give me a pain scale, I let them know that I hear them by repeating back what they say, often as a clarifying question such as, “so your foot has been hurting for 3 days now?”. Then I also acknowledge how they are feeling with a simple phrase such as, “it sounds like you’re feeling pretty crummy today”. Finally, it seems obvious to us that we are here to help, but sometimes saying it out loud is comforting for many patients. Without promising to cure them of every ailment in 30 minutes, I say something like, “we’ll take good care of you today” or “this medicine should get you feeling better”. Working in a fast-paced unit is a challenging environment for nurses. Giving patients the care they need while still moving quickly requires a tricky balance of skill, efficiency, and compassion. Putting patients at ease and making them feel comfortable in an uncertain situation often goes just as far towards their healing as the medications and therapies we administer.