Upgrade Your Stress Awareness to Stress-Savviness

Lane Therrell FNP, MSN, RN, NP

Becoming a stress-savvy nurse goes far beyond having an intellectual awareness that stress exists in our professional and personal lives. Being stress-savvy requires thinking about stress in productive ways, staying open to new approaches for coping with stress, and sharing what you've learned with others. This article discusses a rationale, a study, and three basic tips you can use every day, at work and at home, to improve your life by reducing stress.

Stress Management vs Stress Reduction

There's a big difference between managing stress and actually reducing it or, better yet, eliminating it from your life, according to Morton C. Orman, MD, founder of Stress Awareness Month. According to Dr. Orman, merely managing stress is not enough improve your health, because management fails to resolve the root cause of the stress. Orman bases his ideas on the notion that the concept of stress is an all-encompassing way of collectively labeling life's events or problems. From that standpoint, he concludes that successfully resolving the causative problems will effectively eliminate the stress.

Whether it is addressed via management or reduction, stress is a constant topic of conversation in the healthcare workplace, and for good reason: The healthcare professions, including nursing, have long been recognized as highly stressful occupations. While stress may sometimes seem like an over-hyped topic, it remains on corporate agendas because it has such serious health and economic consequences. According to research findings in the growing field of psychoneuroimmunology, chronic stress causes overexposure to cortisol and other stress hormones, which ultimately depletes the immune system and sets the stage for increased risk for a numerous other health problems. This in turn, leads to high staff turnover in organizations.

Study Shows Online Stress Reduction Program Works

High rates of nursing staff turnover are not only an expensive problem for healthcare organizations, but staff turnover can diminish the quality of care for patients as well. While employers recognize the need for supporting staff in the name of stress reduction, in-person trainings can sometimes be seen by employees as an additional source of stress.

A randomized controlled trial published in November 2016 by Applied Nursing Research evaluated the efficacy of a web-based stress reduction program developed by ISA Associates, Inc. called BREATHE: Stress Management Program for Nurses. The 104 nurses and nurse managers from 6 eastern U.S. hospitals who participated in the 3-month trial were divided in to control and program groups. Those in the program group experienced greater reductions in stress, as measured by the Nursing Stress Scale, than those in the control group.

The authors of the study concluded that web-based programs hold promise as a resource for providing nurses with the necessary tools for addressing work-related stress. The finding is significant because it suggests that employers can provide tools that are convenient for employees in their ultimate efforts to reduce staff turnover. By extension, reductions in staff turnover may contribute to enhanced quality of care for patients as well. This study draws attention to the continuing need for employers to support stress reduction in the workplace, and points to the myriad benefits this support can bring to individual nurses and patients, as well as to healthcare organizations as a whole.

Three Tips for Taking Action

Beyond the opinions of thought leaders, the findings of researchers, and the actions of employers, there are some practical tips individual nurses can use every day to upgrade stress awareness to stress-savviness.

#1 Recognize stress and keep it in perspective

When we unwittingly accept constant stress as normal, we set ourselves up for failure because the human body was never designed to thrive under the constant engagement of fight-or-flight physiology. By first admitting or recognizing that stress exists, and then by keeping it in perspective-- by acknowledging that it is neither good nor bad, but simply is-- we can take clear steps toward reducing its effects and its existence. It may be helpful to remember here Dr. Orman's idea that stress is just a code word for the collective accumulation of life's problems, which can make it easier to address and resolve each individual problem one at a time.

#2 Distinguish appropriate from inappropriate tools

Whether your approach to stress emphasizes management or reduction, it likely focuses on the use of tools such as assessments, tracking applications, information products, or online programs, among others. While substances such as alcohol, nicotine, sugar, and alcohol may also be classified as tools, it is important to distinguish between which tools are appropriate and which are not. Attitudes of denial, hedonistic escapism, and self-medication with addictive substances or risky behaviors not only fail to address the underlying sources of stress, but may actually create new sources of stress, and are therefore inappropriate tools.

#3 Develop, refine, and practice your preferred skills

What is your own, go-to, personal skillset for reducing stress? Every nurse should have his or her own personal set of preferred coping skills for resilience, mindset shifting, and problem-solving. While your choice of skills is guided by your personal preference, the important thing to remember is to stay aware what works for you-not every technique works for, or is enjoyable for, every individual. Once you've discovered what works for you, committing to practicing your preferred skills is key. Failure to practice equals failure to reduce the stress. While time-tested relaxation techniques such as yoga, meditation, massage, and exercise require the development and refinement of skill over time and can be extremely effective for managing the symptoms of stress if they work for you, it is important to remember that the longest lasting and most satisfying health benefits come from addressing the actual root cause of the stress. Depending on your individual needs, this is where counseling, coaching, or other means of coping and support can be infinitely useful if you determine that you do not currently have the skills to address the root cause yourself.

In conclusion, nurses who approach stress with a problem-solving mindset are stress-savvy, and as such, can enjoy improved health and quality of life.