chaos around them. If a patient experiences stress, a professional’s quiet reassurance about a pending event can lower the stress level. Along with a gentle touch and a soft, modulated tone, explaining what will happen and what patients can do to maintain self-control may be a professional’s best approach.17


Inhale-exhale


Breathing techniques can reduce the deleterious effects of stress. One such technique is to take a slow, deep breath to “exhale out worries” and “inhale peaceful thoughts.” The resulting calmness allows the healthcare professional to stabilize and serves as a grounding rod for the patient and family. Another breathing tech- nique is for the professional to mirror the patient’s respirations and then slow down gradually. The patient’s breathing will slow down, as well, and when the breathing slows, the patient is calmer. Healthcare professionals who remain calm have learned to


modify their own stress responses and have found adaptation models that keep their bodies from stress overload. One approach is to go to a quiet place four times a day for five minutes each time. While in that quiet place, focus on counting the breath as it goes in (1) and out (2), “1 … 2 … 1 … 2 … ” or repeat the words “in … out … in … out … ” for five minutes. The mind’s awareness moves to the present, leaving thoughts of the future and past aside. The body resets itself to a lower level of action preparation. As this rhythmic breath awareness and control becomes routine, the professional can add what is known as a body scan, moving conscious awareness to parts of the body, starting at the feet and contracting muscles during inspiration and consciously relaxing them on expiration. The scan then moves up from the feet, placing awareness on various muscles, group by group, until the whole body has felt contraction and relaxation.15


For years, stress management courses have taught


this basic pattern of conscious breathing and body scanning, modified in many subtle ways. It may be the best work break a healthcare professional can take. When taking a break from stress, consider the hurricane as a


model. Many healthcare professionals face daily “mini-hurricanes” at work. Constant pressure comes from many quarters, such as high-acuity patients, provider demands, administrative expecta- tions and personal issues that cannot be set aside. A hurricane has something to teach us. In the center of the destructive wind and rain, there is an eye. Within that eye is calmness and peace. Within that eye, we may think the chaos is over, except we know that on the other side winds will blow strongly again. A healthcare professional can retreat into the eye of the personal “hurricane” and take five minutes to de-stress before re-entering the storm with a renewed sense of calmness and tranquility. The basic art of breath control, with its focus on breathing


and muscle relaxation, has roots in many cultures. Yoga uses breathing and muscle relaxation. Meditation practices of many religions focus on the breath, and offer “timeout” methods that reduce stress and improve well-being. Meditation has been found to be a benefit in decreasing the stress response. In a review of eight studies using meditation practices to decrease work-related stress among nurses, it was determined that slowing thoughts, focusing and spiritual attention were effective in significantly decreasing stress levels.


2016 • Visit us at NURSE.com 27


Greg Smith, 50, is a family nurse practitioner in a rap- id-paced community health center who sees 24 to 26 patients a day. Many have chronic pain and seek help through drugs to alleviate that pain. Greg uses consulta- tive resources when possible to check out his diagnoses and treatment plans. He has expertise in several areas, and his previous work as an ED RN prepared him to handle stress and make quick decisions. Recently, Greg has cut his hours from four 10-hour days to four 9-hour days. He now has two days on, one day off, two more on days and a two-day weekend off. He makes sure he exercises three to five times a week. He has taken vacations with his wife. Greg also uses a breathing technique several times during the day: He takes a slow deep breath and “exhales out worries and inhales peaceful thoughts.” The resulting calmness stabilizes him, allowing him to be a grounding rod for patients and their families.


1. Greg demonstrates the ability to: a. Ignore stressful situations b.Work until he is burned out c. Use food to handle his stress d. Manage stress in positive ways


2. When Greg uses breathing techniques, he is: a. Producing calmness


b. Catching his breath after rushing to a patient’s room


c. Practicing a body scan d. Trying to clear his throat


3. Exercise (as noted in this vignette) is useful for: a. Losing weight b. Building strong muscles c. Improving virility d. Reducing stress


4. One of the best ways to handle stress is: a. Keep your thoughts to yourself. b. Ignore the issues and they will go away. c. Complain about it daily.


d. Talk it over with a colleague and strategize ways to reduce it.


Answers


1. D — Greg controls stress by rearranging his schedule to give space in between long hours. He exercises to lower cortisol and adrenaline levels, and takes vacations when needed.


2. A — Breathing techniques can reduce the deleterious effects of stress and promote calmness.


3. D — Exercise is an excellent stress-reduction technique outside the hospital.


4. D — Chronic complaining does nothing but perpetuate the issue. Strategizing new ways to overcome or change responses to stress leads to positive outcomes.


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42