10 Experts Weigh in:

How to deal with on-the-job stress

The beginning of a new career is a very exciting time. For nurses, they’re ready to embark on a path that will involve lots of compassion, busy shifts and many interesting patients. Along with this excitement, everyone who has started down this road has also faced their share of stress that comes with this new job.

To help those who are new to nursing or a healthcare career, we’ve asked 10 experienced nurses to offer some words of wisdom. Take a look.

Identify feelings of stress

We’re all likely to undergo feelings of stress and may not know how to combat this. To start, it’s important to acknowledge that you are stressed. Then, identify what is stressing you out. Is it your schedule? Juggling your priorities? Is it your co-workers or work place?

Beth Boynton, an RN, MS, nurse consultant, teacher, author of Confident Voices: The Nurses’ Guide to Improving Communication & Creating Positive Workplaces and owner of www.confidentvoices.com and www.bethboynton.com websites, says, "Stress affects us all differently and varies over the course of a shift and throughout life.  Learn to identify, honor, and act on feelings that signal what is 'too much stress' for you.  This awareness will empower you to set-limits, ask for help, sustain a long-term rewarding career, participate in collaborative professional relationships and provide safe care."

Deal with one issue at a time

When we get stressed out, it can affect many aspects of our life: our diet, our demeanor, our sleep and our reactions to what people say. We don’t act like our best self at work, which isn’t a good thing. Rather than let stress take over our lives, take one issue at a time.

Elizabeth Hanes, an honor's graduate in nursing and author of the blog, RN2Writer.com, says, “As a new nurse, I found it helpful to take things moment-by-moment. Try to deal with one issue at a time. It can be challenging when three patients and your charge all demand your attention at the same time, but that’s where your nursing training in triage comes in handy. Prioritize these requests and then dispatch them in order. This approach really helped me tame on-the-job stress as a new nurse.”

Also, think back to what you learned in nursing school and apply it. Remember all these real-life scenarios you practiced? You most likely prioritized your tasks and then tackled your job effectively because you were organized. By doing this now, it will also alleviate the stress.

You’re not alone with the stress

Congratulations, you’ve identified that you’re stressed. Now, stop for a second and look around. Many of your nurse colleagues are also feeling this way. Reach out to others and talk about this.

Michelle Katz, MSN, LPN, healthcare advocate, and author of the new book, “Healthcare Made Easy," (available at all major bookstores and online), remembers feeling this way. She explains, “…new nurses need to know about "job stress" is everyone gets it...and that is part of the stress. It is important that as a new nurse you have a mentor i.e. situations will come up and having someone to help talk you through the situation and give you sound advice on how to handle a situation can relieve some of that stress. It is important that you do not put so much pressure on yourself and always ask questions if you do not fully understand something (that is half the battle).  No one expects a new nurse to be perfect and it is better you ask for help than make a mistake that can hurt you or worse, the patient in the end.”

Respond, don’t react

As you’re trying to deal with stress, remember to not just react to it, but embrace that it’s part of the job. This is what you signed up for and more than you know, this is also an attraction to nursing.

Kathy Quan, a 30-plus years RN and author of, The Everything New Nurse Book, and the blog, TheNursingSiteBlog.com, says, "Anything we do in life that is new will always be stressful because of all the unknowns. Tackle the big issues and let the little ones rest on the sidelines for when you have time to address them. Take a deep breath and realize that nursing is a complex profession. It's challenging both physically and emotionally, and everyone deals with that in different ways. Learn to Respond and not to React."

Develop self-care

As nurses and health care professionals, by nature you take care of other people. You’re nurturing to others and sometimes you forget about yourself. During times of stress, it’s important to also focus on yourself. Two nurses like to call this self-care and it’s vital for those in the profession.

Keith Carlson, a passionate holistic career coach, nurse entrepreneur and the author of the website, NurseKeith.com, says, “On-the-job stress for nurses is as common as stethoscopes and BP cuffs, so you need to protect yourself every day. Self-care is crucial, and nurses need to be diligent and thoughtful in terms of making sure that they develop habits that support their wellness on all levels. Exercise, good nutrition and hydration, a healthy social life, and attention to your own needs are paramount. Nursing can be very consuming, but our relationships, health, hobbies, and well-being must be maintained, or we cannot truly be fully effective as nurses.”

 

Donna Cardillo, known as the Inspiration Nurse, author of the “Dear Donna” career advice column at Nurse.com, and expert blogger at DoctorOz.com, advises, “Self-care is mandatory to balance the stress of our work. It is not ‘pampering’ or a ‘luxury’ or ‘selfish’ but rather routine maintenance for the body, mind, and spirit. It is an integral part of a nurse’s professional responsibility and practice.”

Take a deep breath

Ok, self-care may sound a little intimidating to some. So you may ask where to even begin. Start with baby steps such as just taking a deep breath. Then when you feel better, start doing more to alleviate your stress.

And at some point you will look back and realize this was all part of starting a new nursing career.

Cynthia Howard, RN, CNC, and PhD, who’s been in private practice for more than 20 years, explains, “Stress is very much a part of daily life as a nurse but overwhelm, worry and anxiety do not have to be! The more aware you are of what triggers you and then interrupt that reaction, you will build your resilience. BREATHE deep and focus on gratitude and or appreciation to stay centered in your purpose as a nurse.”

 

Carole Eldridge, DNP, RN, CNE, NEA-BC Senior Director of Post-Licensure Programs at Chamberlain College of Nursing, takes a similar approach but with an extensive a six-step process.

She begins with breathing slowly, then deeply into her abdomen for several breaths, followed by taking a drink of water.  Second, Eldridge says, “I remind myself that I am doing something important and meaningful.  This knowledge calms and energizes me.  I am proud of what I do and proud to do it well.” Third, “I rethink my priorities—is what I am rushing to do the most important thing I could be doing?  Or can it wait while I do a more important thing, which might include sitting still and just breathing for a minute?”

Fourth, Eldridge says, “I ask for help.  I say in my head or out loud, ‘Help me, please, I need help’ and for No. 5, “I remind myself that I am strong and resilient.  I have handled difficult things before, and I can handle the current challenge. This too will pass.”

And at No. 6, “I remember that how I do things is as important (or more so) than doing the things themselves.  Stress is contagious, and when I am giving off stress signals, those around me suffer. My greatest gift to others is a calm, loving spirit that accepts the reality of a difficult situation and moves gracefully through it.”

 

Brittney Wilson, The Nerdy Nurse, who has a BSN, RN (with a specialty in Clinical Informatics) and author of The Nerdy Nurse’s Guide to Technology, echoed Eldridge by saying, "This too shall pass. - When I was in nursing school I remember thinking that it was one of the most stressful times of my life. I was wrong! The first six months of my nursing career was WAY more stressful. There were so many things I didn't know and it didn't seem like I'd ever get the hang of it.

So, my advice is to simply realize that being a new nurse is hard and there's going to stress with it that you probably won't shake for a little while, but it will pass."

And remember. It gets better.

Along with moving past this bump in the road, remember it will get better. Sometimes it’s hard to see the forest for the trees but on those challenging days keep your chin up and learn your job, you’ll soon see some light.

Barb Dehn, a Women’s Health Nurse Practitioner, award-winning author, and nationally-recognized health expert and speaker, succinctly says, "3 words: It gets better. Being a nurse requires that you tap into an incredible skill set that mere mortals can only marvel at. Within you resides superb and effective communication techniques, a vast knowledge of the human body, the ability to organize chaos, split second decision making, high energy, empathy, compassion, and that’s just the tip of the iceberg…remember that the work we do is difficult on many levels, so do find ways to recharge and nurture yourself so that you can feel fulfilled and not suffer the effects of job stress."

From this team of seasoned nurses, their advice comes from experience and thoughtfulness. Now that you have these tools, here are a few next steps.

Recognize your stress

We all have patterns and different triggers that stress us out. Start paying attention to these times and write them down in a journal. Go back and start to identify these times. By doing so, you’ll be able to prepare for the stress and learn how to combat it.

Determine ways to fight it

Now that you can identify when your stress is going to build, make a plan to minimize it. We all have different coping mechanisms to do this. This could include exercise, eating a treat, getting together with friends, drinking tea or sitting in the sunshine mediating. Find out what works for you and do it next time you’re feeling stressed.

Embrace your environment

For some nurses, the stressful environment is part of the allure for this chosen career. Don’t fight it but embrace it. You may find that you perform better in this fast-paced environment by getting more things done during your shift. All of us feel better when we’re productive.

Identify what you like about nursing

You have chosen nursing for a few reasons so why not revisit these now to gain some insight about yourself. Was it the chaos, helping people, being part of healthcare or taking part in the lifestyle? These are just a few of the reasons but by acknowledging them, it will give you a chance to review and think about what you like about nursing.

You’ll feel refreshed after this exercise and may have a new appreciation for this chosen field.