Nursing and stress
You know you're a nurse when ...
According to the National Institute for Occupational Safety and Health, studies show the following factors linked with stress: work overload; time pressure; lack of support (especially from supervisors, head nurses, and management); exposure to infectious diseases; dealing with difficult or seriously ill patients; understaffing; sleep deprivation; and lack of career development issues.
Nurses feel things. We are an empathetic bunch by nature. We know how serious it is if we make, say, a medication error, because we are handling way too many patients.
While all jobs have stress, forgetting to put fries with the order just gets you yelled at; it doesn't have the potential to kill someone — except if the Napoleon-type fast-food boss you are working for acts as if you accidentally launched a nuclear sub!
We struggle with feelings of impotence in patients we care for at the end of life and those suffering with pain we can't get pain meds in a timely manner to. We battle with conflicting emotions of “needing” to care for a larger number of frailer, more chronically ill patients while fighting anger at having to do that with less staff, or less qualified staff and always fewer resources.
And we are always aware, especially those of us in the long-term care environment, that a lawsuit is constantly looming over our heads. (Cue ambulance chasing law firm commercial; “Is your 110-year-old loved one in a nursing home? Did he or she just plum die of old age? Well, don't worry. We'll make up a reason to sue. They don't have money to fight us so we will win!”)
An article, “Hospitals explore ways to reduce nurses' stress” (Ondash, E. 2008) shows that healthcare workers have a higher rate of depression — and even more sadly, substance abuse and suicide — than other occupations. Another study (“Sicker and costlier: Healthcare utilization of U.S. hospital employees,” Thomson Reuters, 2011) shows that healthcare workers accumulate higher healthcare costs than other US workers and use more medical services.
OK, so it's clear kids: We are STRESSED!
Some suggest that since we know we will have stress, we should plan for it … that is, plan to deal with it. Authors Barron and Barron (“The creativity cure,” New York: Scribner 2012) suggest using your hands (no, not around someone's neck … stop that!) creatively as a way to decrease stress, as in a practicing a craft. Because it is calming and takes concentration, it takes your mind off of the stressful situation and creates meaningful activity with your hands. But I am not too sure we can start beading or knitting at work!
Yet, wait — as nurses, isn't that what we do all day: create meaningful activity with our hands? Our hands change the world in a positive way, every single day. What we do with our hands is meaningful and maybe if we try to concentrate on that, we can relieve the stress a bit in a world where there is so much we can't control.
We can control how we feel about the meaningful and purposeful activity we do with those loving hands. Softly touching the hand of the agitated person with dementia until she calms down, stroking the head of a dying patient and just letting her know you are there, ministering with those hands in a million ways, from treating a wound to giving a needed medication.
Being a nurse may be stressful, but remember, boy, is it something special.
Just keeping it real,
The Real Nurse Jackie is written by Jacqueline Vance, RNC, CDONA/LTC, a 2012 APEX Award of Excellence winner for Blog Writing. Vance is a real life long-term care nurse who is also the director of clinical affairs for the American Medical Directors Association. A nationally respected nurse educator and past national LTC Nurse Administrator of the Year, she also is an accomplished stand-up comedienne. She has not starred in her own national television series — yet.