Caring for Stressed-out Patients—and Yourself

By Melissa Wirkus Hagstrom, contributor

Earlier this year, National Public Radio (NPR), the Robert Wood Johnson Foundation and the Harvard School of Public Health conducted a nationwide poll that examined the role stress plays in different aspects of Americans’ lives.

Caring for Stressed-out Patients—and Yourself

The survey found that we’re really stressed out.

Nearly half (49 percent) of the 2,500 adult respondents reported that they had a major stressful event or experience in the past year, and 43 percent reported that the most stressful experiences were related to personal health concerns.

Because stress and health are tied together, nurses and other clinicians are in a powerful position to help patients experiencing stress. They can starting with identifying the physical signs of stress in patients, colleagues and themselves.

Dawn Bazarko, DNP, MPH, RN, FAAN, senior vice president, Center for Nursing Advancement at UnitedHealth Group, founder of Moment Health, and a founder of the Robert Wood Johnson Foundation’s Future of Nursing Scholars program, explained that the report indicated that the people who were experiencing health care crises--whether their own or a family member’s--were likely to report experiencing a great deal of stress in their lives, often feeling overwhelmed with too many responsibilities and financial issues.

“Stress is just such a part of life overall and when we can’t effectively manage it, it becomes chronic in nature and it can then take a huge toll on our health and our overall life effectiveness,” Bazarko said. “That tends to be the case for many of us, including nurses as care providers and certainly people who are experiencing health care crises. When you are sick yourself, this becomes even more magnified.”

According to the study, the specific groups who were more likely to experience periods of great stress include those with poor health conditions (60 percent), disabled (45 percent), chronic illness (36 percent), income less than $20,000 (36 percent), experience dangerous work situations (36 percent), single parent (35 percent), and a parent of a teen (35 percent).

Many patients experiencing stress don’t feel like they have the tools to manage their stress effectively. Bazarko believes that nurses are optimally positioned to identify stress in their patients and offer holistic solutions to reduce stress, improve well-being and empower patients to take better care of themselves.

“Nurses are really seen as trusted agents where patients and families are more apt to share with them what’s really going on below the surface, and that gives them insight into possible solutions to help eliminate some of the challenges that patient is experiencing.”

Stress can manifest in many forms. The most common physical ailments that can result from stress are gastrointestinal disorders, back pain, headaches, and other disturbances such as depression, anxiety and social isolation.

Bazarko said that nurses should watch out for behavior changes such as increased irritability, angry outbursts, withdrawal, crying episodes and an inability to cope. These afflictions can all indicate patients experiencing stress.

The poll found that the majority of people under a great deal of stress reported changes to normal eating and sleeping patterns and other behavioral changes that could negatively impact health. For example, 70 percent of respondents said they slept less than they normally do when stressed, and 41 percent said they slept more, while more than 40 percent reported eating less than they usually do and 39 percent said they ate more.

“You also have changes in eating. Oftentimes people under stress eat too much or too little,” Bazarko said. “They may experience sleep disturbances and fatigue, and a loss of interest in things they may typically enjoy. If you suspect there is an issue, we as nurses should ask.”

Nurse, heal thyself

As caretakers, nurses are definitely not immune to stress, and self-care is an important aspect of a successful nursing career.

“Nursing and the health care profession alone is a stressful place to work. As nurses, we are often putting ourselves last and caring for everybody else at the expense of ourselves, and so nurses do carry a lot of stress and experience burnout. If we are not taking care of ourselves it’s impossible for us to care of others.”

Setting a good example by showcasing positive health behaviors is just one way nurses can take care of themselves and help the patients they come into contact with every day.

“Exercise and mindfulness meditation are two of the most important things that nurses and patients can do to combat stress,” Bazarko concluded. “Mind–body therapies can be particularly helpful and even something as simple as taking a deep breath can be really profound. There are a lot of techniques that nurses can teach their patients to cultivate present moment awareness, calm the busy mind and relax the body.”

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