Nurses work as superheroes every day, and the high-performance demands of this profession can lead to side effects such as exhaustion, anxiety, and constant stress. However, as leaders in health care, nurses can choose the way they approach their roles and thrive.
Below are nine strategies that can help nurses manage stress and stay positive all year long.
1. Make Self-Care a Priority
Nurses are inclined to focus on the needs of others. However, the American Nurses Association explains, “Self-care is imperative to personal health and professional growth, serving as sustenance to continue to care for others.” Nurses should make a point to squeeze in at least one self-care activity that makes them happy every day, such as drinking a hot cup of tea or taking a bubble bath.
2. Spend Time With Positive People
When work life feels hopeless, nurses can benefit from reaching out to others to gain some positive energy. Increasing social contact and venting to a good listener are great ways to relieve stress and calm anxious nerves. Sharing work concerns, problems, or thoughts with loved ones can also help build trust and strengthen these relationships.
3. Set Aside Relaxation Time
Practicing daily relaxation techniques, such as prayer, meditation, yoga, or deep breathing, can help nurses achieve a state of restfulness. However, it takes daily practice to reap the full benefits. Getting into a habit of engaging in regular relaxation time can lead to improvements in overall health and happiness. These beginner-friendly guided meditations only take five minutes a day.
4. Begin the Day With Positive Self-Talk
Daily positive affirmations, also known as self-talk, can have a significant influence on how we react to our environment, jobs, and other people. Making a habit of this can help increase self-esteem and reduce feelings of anxiety and depression. For instance, write a positive affirmation and keep it handy at work to refer to when starting to feel overwhelmed.
5. Keep a Consistent Exercise Routine
Regular exercise is an excellent way to manage nursing stress and work burnout. As the Centers for Disease Control and Prevention points out, at least 30 minutes of daily physical activity helps to improve mental health, cognitive function, and quality of sleep, as well as decreases depression and the risk of many cardiac diseases.
6. Just Say No to Extra Shifts
Nurses are often eager to assist when someone asks for help. However, working longer hours and agreeing to take on more shifts than necessary can lead to burnout and even compromise patients’ safety. On the other hand, saying no to extra work means saying yes to more meaningful things in life. This could mean more quality time with family, outdoor nature hikes, or starting a new hobby. Plus, when we achieve a better work-life balance, we become more effective as nurses.
7. Take a Break from Social Media and News
When away from work, set a time each day to completely disconnect from social media, technical gadgets, and the news. Aim to also turn off cell phones, put away the laptop, and stop checking email. Instead, try spending some time outdoors, breathing in fresh air while doing something physically active and enjoyable.
8. Aim for 8 Hours of Sleep
Getting enough sleep every day is paramount—particularly for nurses. An article from health.gov discusses several benefits of sleep. This includes an elevated mood, reduced feelings of stress, improved cognitive function, and better maintenance of a healthy weight. Therefore, it’s important to make time for a few calming activities to help unwind after a stressful day.
9. Start a Gratitude Journal
Writing about what we’re thankful for can encourage feelings of optimism and boost overall well-being. Gratitude journaling works by adjusting our focus, and changing how we perceive situations over time. This type of writing allows us to see more of the world around us, deepening our appreciation for the things and experiences we have.
Conclusion
Stress and overwhelm are an inevitable part of every nurse’s life. However, developing healthy habits and coping strategies can help reduce feelings of burnout and boost resilience. Try to implement a few of these actionable steps every week to maintain a better work-life balance and improve overall health.
Nurses in the United States are facing unprecedented hardships that increase the risk that they will experience burnout. Health care workers, especially nurses, often experience high levels of stress due to the long hours they put in and the sheer number of patients that they interact with.
Avoiding burnout is necessary for a long career in nursing and it is important that nurses do their research when it comes to methods for preventing burnout. While there is a pharmaceutical answer in the use of antidepressants, this method merely treats the symptoms that can lead to burnout. For many nurses, the answer lies in a more natural path that will give them the tools they need to combat burnout holistically.
Building Resiliency
Health care workers have been shown to be particularly susceptible to experiencing burnout due to the fact that they are expected to perform patient care with consistent and constant empathy and patience. This can lead to emotional exhaustion which, coupled with the physical exhaustion that comes with working in the medical field, eventually morphs into what we know as burnout. Naturally, the stresses of this line of work can lead to fatigue that impacts motivation in the workplace and a misplaced sense of failure.
One of the best tools available to nurses in the fight against burnout is the development and strengthening of resiliency skills. When nurses possess a solid foundation of resiliency skills they are better equipped to bounce back from a particularly intense shift more easily and are able to maintain their ability to work effectively. Taking breaks during shifts, scheduling time to hang out with coworkers outside of work, and learning how to say no to taking extra shifts if they need breaks are all ways to increase resiliency.
The prevalence of burnout and resiliency’s effectiveness in combating it has led to the development of nurse resilience programs designed to arm nurses with the proper tools before they begin their careers. Through cognitive-behavioral training, stress inoculation therapy, and various other methods, nurse resilience programs are effective in preparing nurses for what lies ahead of them in their career and can be invaluable in the fight against burnout.
Taking Care of Mental Health
Another natural proven method for nurses avoiding burnout is simply taking care of their own mental health and well-being. While it might seem like obvious advice, for those working in high-stress environments like health care can find it far too easy to forget to take care of themselves. Self-care is vital for nurses who want to dodge burnout, and even something as simple as keeping a journal to acknowledge positive things that happen in life can be enough to stymie burnout.
Many nurses suffering from burnout experience feelings of inadequacy, low self-worth, and depression. It is important that nurses recognize that these feelings, while they can be intense, do not represent the reality of the situation and do not reflect their actual performance or capabilities either at work or life in general. Quieting that negative inner-voice is an effective way for nurses experiencing burnout to boost their self-esteem and sense of self-worth.
Learning how to practice mindfulness meditation is another excellent natural way to look after one’s own mental health in even the most stressful of situations. Mindfulness meditation has a whole host of benefits from helping to increase attention and concentration to improving practitioners’ heart rates and blood pressure, all of which can help to manage stress and fight off burnout. While there are plenty of books on the subject, there are also a multitude of free resources available online that are secular, simple, and can get a struggling nurse on the right track.
Looking Towards Nature
Should building resiliency skills and working on maintaining good mental health fail to do the trick, spending time in the great outdoors has also been proven to help prevent occupational burnout. Engaging in physical exercise outdoors helps to reduce fatigue and improve overall cognitive function and can result in a marked reduction in tension, depression, and anger. While nurses do indeed have wildly busy schedules, making an effort to set aside time for themselves in the outdoors can yield incredibly positive results for them.
If a nurse finds themselves unable to break away from the concrete jungle, there are still ways in which stress can be reduced naturally without going outside. Taking the time to unplug from technology frequently can reduce stress and allow for moments of silent self-reflection untainted by the constant and looming force of the internet and social media.
Finally, nurses that are looking for a way to combat burnout but are wary of getting a pharmaceutical prescription to manage its symptoms can always turn to mother nature. Cannabidiol, or CBD, is a compound found in cannabis that has no deleterious or psychoactive effects and is becoming a popular stress-reduction tool for many. While the science regarding CBD is still in its infancy, there is a huge amount of anecdotal evidence that points to the compound being an effective treatment for stress and a host of other symptoms and disorders.
At the end of the day, nurses and health care practitioners are some of the most important people in a functioning society. It is vital that they receive all possible help when fighting against burnout, whether that comes in the form of resilience training, mindfulness practices, or spending time with mother nature.
Nurses need to be prepared for every eventuality in patient care: they welcome life into the world, and hold patients’ hands as their lives come to an end. The core job duties are physically, emotionally, and spiritually taxing — and sometimes dangerous — so it’s no surprise that nurses experience burnout at an alarming rate.
In fact, the National Nursing Engagement Report for 2019 found that 15.6% of all nurses were feeling burned out at the time of reporting, with 41% of nurses who reported themselves as feeling unengaged also reporting feeling burned out. But many nurses also know they can’t leave — or even take time off — because the nursing shortage is so critical that every hour counts.
We’ve written before about how to combat nurse burnout, but it’s just as important to recognize the dangerous signs of burnout when it starts.
What Are the Signs of Burnout?
Between the long hours, the demands of the job, and just being human, most nurses will experience either the signs of burnout or full Burnout Syndrome (BOS) at some point during their careers. As the National Nursing Engagement Report showed, even fully-engaged nurses report these symptoms. The first step to combating BOS is to recognize the symptoms.
Perhaps the first sign and highest predictor of burnout is emotional exhaustion. Nurses know what it’s like to be tired, but emotional exhaustion leaves you feeling completely drained as a result of the stress of your job. In addition to feeling fatigued in every way, people who are emotionally exhausted often feel like they’ve lost control of their lives — they often report feeling trapped in their situation, whether it’s at work or in an outside relationship.
Another sign of burnout is depersonalization. When you become so exhausted that you have to detach from your surroundings to survive, then you are burnt out. Your outlook may be negative or even calloused, and it can express itself in unprofessional comments directed at colleagues, feeling nothing when a patient dies, or even blaming patients for their problems.
The final major predictor of burnout is a reduced feeling of personal accomplishment. You may not feel that you’re a good nurse or that you make any difference at all in patients’ lives. Nurses working in high-intensity settings, like the ICU or emergency room, may experience this more often as they receive a greater proportion of cases where little can be done for the patient.
Why Burnout is Dangerous for Nurses and Patients
Burnout is more than having a bad day; it’s an impaired outlook on nursing and life in general. Experiencing burnout doesn’t mean you don’t love your job, nor does it mean that you aren’t good at what you do. In fact, this reality makes it even more difficult for nurses who experience burnout because leaving is just another impossible choice.
At the same time, burnout is as dangerous for nurses as it is for their patients. A nurse in the throes of BOS is both less likely to have life satisfaction and more likely to provide a poorer standard of patient care. In a study published in Research in Nursing & Health, researchers explored the correlation between the quality of care and nurse burnout among 53,846 nurses from six countries. They found a strong correlation between higher levels of burnout and nurse-rated quality of care.
In other words, burnout can become a self-fulfilling prophecy. Burnout can result in lower standards of patient care, which further informs the reduced feelings of personal accomplishment. As nurses make mistakes, they feel even lower job satisfaction and an even greater intensity of burnout, which goes around again to manifest itself once again in patient care.
How Nurses and Nursing Leaders Can Combat Burnout
Nurses are caught between a rock and a hard place — the nature of the job is stressful, but if you love what you do, you can’t quit. Although almost all nurses will go through burnout at some point, there are things that both practitioners and health care organizations can do to stave it off and help re-engage burned-out nurses.
Education is one of the critical ways that nurses can empower themselves and avoid burnout. Pursuing further education can renew your passion for what you do and help you overcome roadblocks. It also puts you in a better position to provide the latest evidence-based care to patients, which correlates to better patient outcomes and increased job satisfaction.
Nursing leaders and administrators also have a strategic role to play, as the environment in which nurses practice needs to be a supportive one. Creating a positive work environment that limits unnecessary stress and allows nurses to care for themselves and recharge can do wonders in both reducing burnout and igniting engagement.
Those same leaders and administrators can also take notes from other industries’ workplace safety practices. You can’t just say you have a safety culture, you need to commit to it by formalizing the ways in which you intend to create and maintain the culture and creating avenues to accept employee input.
There’s Always More Work to Do to Prevent Burnout
Nurses can’t get rid of the high-stress, high-stakes environments they work in. They can’t wave a magic wand and save every patient no matter how severe their condition, and they can’t stop feeling to cope.
In other words, burnout is a given part of being a nurse. While these feelings are normal, nurses also need support in preventing the bad (and downright dangerous) days from outweighing the good ones. Nurses and administrators can and must work together to prevent burnout — and while the challenge is a significant one, it is achievable if we all listen to each other.
The financial challenges of those in the current “sandwich generation” (generally those in the GenX generation), can derail retirement plans and the emotional fallout of being stretched so thin also takes a toll. When you’re in the middle, self-care can help you manage all the demands.
Journalist Carol Abaya, who has studied aging and care giving, even went a step beyond the term sandwich generation. With a nod to the complex and complicated situations in so many families, she coined some new phrases for this kind of caregiving.
Traditional: those sandwiched between aging parents who need care and/or help and their own children.
Club Sandwich: those in their 50s or 60s, sandwiched between aging parents, adult children and grandchildren. OR those in their 30s and 40s, with young children, aging parents and grandparents.
Open Faced: anyone else involved in elder care.
No matter where you fit, you are going to feel some additional stress in trying to take care of the needs of so many people. Here are some tips to help.
Talk to Others
You aren’t the only person going through what you are going through. Other people who are also juggling so many things will have some tips that will help you navigate these sometimes confusing paths. Whether it is a friend, a coworker, a faith leader, or a professional, talking with others and sharing experiences helps.
Get Help
Getting help doesn’t always mean paying for help. Look for assistance by asking what’s possible. If they are old enough, get your kids to help with tidying up your parents’ home. Enlist coordinators to help set up driving help—those can come from senior centers, volunteer organizations, or even the medical community. If you can afford help, paying for someone to do yard work or clean the house can be a huge time saver, as can grocery delivery services.
Try to Care for Yourself
In the middle of so much caregiving, any time for you seems impossible. And sometimes, it will be impossible to take care of your own needs when so many others are depending on you. But if your tank runs dry, there’s nothing left for the people you need to help or for the career you love or for the relationships you want to nurture. Because burnout is damaging and pervasive, it’s important to recognize when you need a break and what that means for you. A break can encompass a whole range of experiences—figure out what will bring you relief. Even the smallest break can offer huge benefits in recharging your outlook,
The Usual Suspects
It is repeated so often because it’s important. The trifecta of nutrition, sleep, and exercise keeps you on an even keel. Look at your pillars on a weekly basis so you don’t feel like each day has to be perfect. Overall, try to fit in some more movement, more sleep, and nutritious food that gives you energy. Being aware is half the battle and the small efforts add up.
Being in the sandwich generation means you are taking care of the needs of many people all while trying to juggle your own family and work life. It’s not easy, but taking care of yourself is an essential part of managing this time successfully.
Are you like most nurses, filling your days with taking care of everyone else but yourself? That may seem heroic, but putting yourself last ultimately leads to a dip in on-the-job productivity and career burnout. But when you take care of your own needs first, not only do you benefit, and so do your coworkers and patients.
Is there a secret formula to boosting your health and happiness? Fortunately, there is no secret. It’s simple, though not easy, to make yourself a priority in your own life.
By attending to your own self-care, you’re more likely to head off the symptoms of overload which can cut your nursing career short. But where do you start, when there are so many components of a happy, healthy life?
Self-care is easier to establish if you know what’s most important to you at this particular point in time. You may want to focus on a major life activity—eating, exercise, sleep, or relationships—because they seem like obvious drivers of well-being. Improvements in any of those important areas can certainly yield major benefits, but they’re usually tough to crack.
Even if you highly prioritize self-care, it’s difficult to say “No” to that big slice of cheesecake, fit in workouts, or turn in for bed on-time. Especially when your schedule is already jam-packed, your shifts are long, or you work nights.
Why not try another tactic? Consider setting a self-care habit in motion by starting with baby steps toward your ultimate goals. Improvements don’t have to start in your “hot zones” either. Like dominoes, a shift in one habit or routine will cascade down to every other area of your life.
Here are two powerful ideas to spark your thinking:
1. You Need a Budget.
Who even uses a budget anymore? It sounds so old-school, like playing music on 8-track tapes and paying with paper checks at the supermarket. But sitting down to crunch the numbers, and getting a grip on your income and outgo, can be an effective stress-reliever. Your financial situation may remain the same, but seeing the actual facts can stop the free-floating anxiety that’s fueled by imagination.
Your budgeting system doesn’t have to be fancy, either—just use a notebook and pencil to note and track your household expenses and income. Some people like to allocate cash to specific purchases, using an envelope system popularized by Dave Ramsey. One envelope for cafeteria lunch money, another for…
And don’t forget to plan for seasonal outlays (holiday gifts or taxes) and emergencies. That way if you need to replace a dental crown, you’ll have a buffer fund to cover it, and won’t panic as much.
There are also many apps out there for budgeting, including the grand-daddy, You Need a Budget (YNAB).
2. Do a Digital Detox.
Are you always texting, Skyping, Tweeting, Facebooking, or otherwise deep in your digital stream? That’s the case for many “social media natives” and even for their oldest colleagues.
Even if you’re following social media guidelines for nurses in your workplace, you may find that digital is a distraction, always in the back of your mind, ringing, buzzing, or vibrating to get your attention. You could get relief from all sorts of social media ills, from text neck to FOMO, by choosing a set time to disable it, for hours or days.
Some people like to set aside long weekends to go away on formal retreats, like the ones offered by Digital Detox while others simply reduce everyday use. Digital refers to all smartphones and computers (sometimes TV’s too), so resolving to stay away from electronics and screens after 8:00pm could be enough to calm your down, and make it easier to get to sleep at a decent hour.
Oh, but wait, what if you ditched your alarm clock? There are all kinds of new devices for improving your sleep hygiene that you may want to check out. One example is the Philips Wake-Up Light Alarm Clock with Sunrise Simulation, which costs less than $50. The light on this clock slowly gets brighter over a 30-minute span, to gently awaken and welcome you to the new day.
It’s important for you (and your patients) that you engage in self-care every single day. So resolve to take a baby step toward making yourself a priority in your own life.
