Running head: STRESS MANAGEMENT IN NURSES

Stress Management in Nurses

Lisa Snider & Elizabeth Junemann
Ferris State University

STRESS MANAGEMENT IN NURSES

Abstract

Nurses face a great deal of stress in health care settings. There are many proactive approaches to
managing stress within this environment. This paper explains the effects of stress on nursing staff
and helps to identify some helpful techniques for stress relief. It can be of great benefit to adopt
relaxation and stress reduction techniques in daily practice. Techniques can include meditation,
music, exercise and many more activities. Each health care setting offers a unique set of
challenges and stressors. Nurses must be aware of stressors in the workplace and take action in
order to effectively care for patients and maintain a sense of personal wellness. Stress
management and health promotion can be achieved through education and application of proven
therapeutic techniques.

STRESS MANAGEMENT IN NURSES

Stress Management in Nurses
Nurses are expected to be caretakers but often do not take the best care of themselves.
There are numerous issues that nurses have to deal with on a daily basis that create stress. Most
jobs in the field of nursing are very stressful but some areas face different challenges and some
may be at a higher risk for stress overload than other areas. Nurses face issues from shortstaffing, mandatory overtime, and long shifts as well as rushed chaotic environments and
increasing responsibilities, and thats just at work. The home lives of many nurses are just as
stressful as their jobs. Stress can reap havoc on an individuals body, mind, and spirit, and is
something that must be dealt with and not swept under the rug. There are abundant techniques
that can be used as stress relievers, including meditation, aromatherapy, music therapy, and

exercise. It is important for nurses to be aware of these techniques and find what works for them
to decrease their stress.
Stress
Healthcare professionals are frequently exposed to a number of job stressors that can
adversely affect both their mental and physical health and also decrease work engagement and
treatment outcomes, (Fiabane, Giorgi, Sguazzin, &Argentero, 2013). Stress can decrease the
nurses ability to think properly and inhibit his memory. If a nurse forgets a treatment or
medication it could be life threatening to a patient. Continued stress also leads to fatigue, which
can be detrimental in the job of a nurse. Studies have revealed that nurses are at a higher risk
than most professions of developing emotional distress such as anxiety, depression, and burnout
related to job stress, (Fiabane, Giorgi, Sguazzin, &Argentero, 2013). The job of nurses is not
going to be getting any less stressful in the near future, so it is imperative that nurses learn way
to cope with and relieve their stress on a regular basis.

STRESS MANAGEMENT IN NURSES

Meditation
Meditation is a technique that has been used for thousands of years across the world. It is
thought to have begun with the Hindu religion and it is a method in which the mind is trained to
relax. The participant takes deep cleansing breaths and clears the mind of is thoughts, allowing
the themselves to consciously decrease stress, blood pressure, and anxiety by purposeful calming
of the thoughts. Meditation takes deep thought and concentration but it can be used by anyone
who believes in it and is willing to give it a try. It is a simple act that a nurse could do before or
after work or even on their lunch break or bathroom break, any time that they get a few minutes
of quiet alone time they could perform meditation to decrease their stress.
Aromatherapy
The word aromatherapy is used to describe the use of essential oils for aromatic
inhalation, compresses, and topical application through massage, (Gaware, et al., 2013).
Research has shown that aromatherapy can be effective in treating many different conditions
including stress. Lavender, jasmine, chamomile, and rose, are a few essential oils that are known
to have a calming affect. Essential oils, used in a variety of ways, can stimulate brain function
and promote healing, (Gaware, et al., 2013). Aromatherapy is another simple technique that
could be used by nurses. If allowed in the nurses station or break room these scents could be
available for inhalation or they could be applied to the skin to be absorbed into the bloodstream
to help have a calming affect throughout the day.
Music Therapy
Music therapy is a technique that would be a little more difficult for a nurse to participate
in during his or her shift than meditation or aromatherapy, but it is still possible and it would also

STRESS MANAGEMENT IN NURSES

be a good technique to be used before or after a shift to alleviate stress. Music has been shown
to beneficially affect stress-related physiological, as well as cognitive, and emotional processes,

(Thoma, et al., 2013). Music is used as a type of distraction therapy to allow the listeners mind
to escape its current stressors and become lost in the music. Some forms of music also give the
listener something to relate to so that they know they are not alone in their turmoil and it lifts
their spirit. The type of music used is dependent on the listeners preference and is generally
classical or instrumental, but can also be vocal. Music can affect the hypothalamus and
sympathetic nervous system, inducing the body to release calming hormones, and decrease
physiologic stress, (Thoma, et al., 2013). Music therapy would be an affective tool for nurses to
use in their vehicle on their way to or from work or at home before or after work as a stress
relieving technique.
Exercise
Exercise is a technique that can be very beneficial to an individuals health, as well as a
successful stress management tool. Proven links exist between chronic stress and disease, which
can be alleviated through regular exercise, (Coulter, Dickerman, & Maradiegue, 2009).
Exercising requires commitment and is more difficult for some people to perform, but people
that exercise will testify that it decreases stress and increases energy when done on a regular
basis. In addition to all of the physical health benefits received from exercising, it also releases
endorphins, which help to improve mood and decrease stress. Nurses can use exercise as a
modality of stress management before or after work. They can find a type of exercise that is best
suited for them and their individual strengths and weaknesses, ranging from stretching and yoga
to cardio and kickboxing. Employers are also beginning to offer incentives for their employees to
exercise such as a free or reduced gym membership, lower health insurance rates, and exercise

STRESS MANAGEMENT IN NURSES

equipment on site, (Coulter, Dickman, & Maradiegue, 2009). Nurses should determine if their

place of employment offers any resources before they go out and get a gym membership on their
own.
Environment
Nurses work in a variety of different settings and encounter unique forms of stress.
According to an article in The Journal of Advanced Nursing, Stress in nurses is an important
issue as it can affect the nurse's health (Gonge et al. 2002), the quality of the care they provide
(Leveck & Jones 1996), and their desire to remain in nursing (Hasselhorn et al. 2008)
(Farquharson et al., 2013). Each nurse may handle stress differently depending on environment,
experience, and personal resilience. Some areas of nursing such as, the intensive care unit,
emergency department, and hospice services offer unique experiences with unusual stressors.
ICU
Work within the intensive care unit can pose great challenges to critical care nurses.
According to Martins and Robazzi,
Work in the ICU is complex because patients are considered critical and present an
imminent life risk. Nurses deal with difficulties related to the technical complexity of
patient care, and are exposed to the high-maintenance demands of patients, their families,
doctors, and institutions, all of which can cause feelings of suffering within them (2009).
It is apparent that this specialty field puts nurses at high risk for job related stress. An increase
in work-related stress can be caused by environments with death, pain, and suffering. Patients
admitted to intensive care units are often in unstable conditions that can cause burn-out and
distress among nurses (Martins & Robassi, 2009). It is important for nurses in this situation to
find ways to relieve stress and maintain health promotion.

STRESS MANAGEMENT IN NURSES

ED
Another specialty area that has a great deal of stress is the emergency department.
According to Gholamzadeh, Sharif, and Dehghan Rad,
Recognition is growing that health care professionals, especially emergency department

staff, are at risk for experiencing critical incidents. Emergency Department nurses are in a
position that is expected to deal with additional stressors. These include unexpected
numbers of patients at any time, unexpected rapid changes in patients situations and
response to distressing or traumatic incidents such as sudden death, patient violence,
inappropriate attendees and physical or verbal abuse on a daily basis. Emergency nursing
is a highly stressful profession (2011).
Emergency room nurses face very demanding and difficult situations on a daily basis.
Gholamzadeh, Sharif, and Dehghan Rad state, Most people can cope with stress for short
periods but chronic stress produces prolonged changes Knowing what emergency workers do
to cope and survive extreme incidents may help us understand and assist those who are more at
risk (2011). It is important for emergency nurses to be aware of stressors and to have
resources for stress management.
Hospice
Hospice nurses play an incredibly important role within the field of health care. Nurses
are presented with a great deal of stressors in this specialty area of nursing. According to the
Journal of Hospice and Palliative Nursing,
Nurses who work in the hospice environment deal with multiple stressful events daily.
The staff-client relationships, which can include interactions with the patients and their
families and friends, can often involve and evoke strong emotions. These situations,

STRESS MANAGEMENT IN NURSES

difficult under ideal circumstances, can become more difficult when influenced by
occupational stressors (Martens, 2009).

Hospice nurses provide an invaluable service to communities, patients, families, and health care.
Hospice nurses are subjected to death and dying on a daily basis. It is apparent that this could be
a major stressor and something many would struggle with. It is critical that nurses in this
situation recognize workplace stress and find healthy outlets for stress management.
Conclusion
Overall, stress plays a huge role in the nursing field and can be a heavy burden. Nurses
must be educated on workplace stressors and directed to resources for stress management and
health promotion. There are many therapeutic stress relief techniques that anyone can
incorporate into a daily routine. Meditation, aromatherapy, and exercise are just a few proven
ways to reduce stress. Each individual responds to stress in a different way depending on
environment, experience, and personal resilience. Intensive care units, emergency departments,
and hospice services present unique stressors. It is important for nurses to relieve stress and
maintain a state of wellness in order to be successful. Nurses must be healthy in order to safely
and effectively care for others.

STRESS MANAGEMENT IN NURSES

References
Coulter, P.A., Kickerman, K., Maradiegue, A. (2009) The effects of exerise on stress in working
women. The Journal for Nurse Practitioners, 5(6), 408-413. Doi:
10.1016/j.nurpra.2008.05.008
Farquharson, B., Bell, C., Johnston, D., Jones, M., Schofield, P., Allan, J., & ... Johnston, M.
(2013). Nursing stress and patient care: real-time investigation of the effect of nursing
tasks and demands on psychological stress, physiological stress, and job performance:
study protocol. Journal Of Advanced Nursing, 69(10), 2327-2335. doi:10.1111/jan.12090
Fiabane, E., Giorgi, I., Sguazzin, C., Argentero, P. (2013). Work engagement and occupational
stress in nurses and other healthcare workers: the role of organisational and personal
factors. Journal of Clinical Nursing, 22(17-18), 2614-2624. Doi: 10.1111/jocn.12084
Gaware, V., Nagare, R., Dhamak, K.B., Khadse, A.N., Kotade, K.B., Kashid, V.A., Laware, R.B.
(2013). Aromatherapy: art or science. International Journal of Biomedical Research,
4(2), 74. Retrieved from http://ijbr.ssjournals.com/index.php/journal/article/view/231
Gholamzadeh, S., Sharif, F., & Dehghan Rad, F. (2011). Sources of occupational stress and
coping strategies among nurses who work in admission and emergency departments of
hospitals related to Shiraz University of Medical Sciences. Iranian Journal of Nursing
and Midwifery Research, 16(1). Retrieved from: http://0www.ncbi.nlm.nih.gov.libcat.ferris.edu/pmc/articles/PMC3203298/

STRESS MANAGEMENT IN NURSES

10

Martens, M. L., (2009). A comparison of stress factors in home and inpatient Hospice nurses.
Journal of Hospice and Palliative Nursing, 11(3), 144-153. DOI:
10.1097/NJH.0b013e3181a1ac87
Martins, Jlia Trevisan, & Robazzi, Maria Lcia do Carmo Cruz. (2009). Nurses' work in
intensive care units: feelings of suffering. Revista Latino-Americana de Enfermagem,
17(1), 52-58. Retrieved from: http://www.scielo.br/scielo.php?
script=sci_arttext&pid=S0104-11692009000100009&lng=en&tlng=en. 10.1590/S010411692009000100009.
Thoma, M. V., Marca, R. L., Bronniman, R., Finkel, L., Ehlert, U., Nater, U.M., (2013) The
effect of music on the human stress response. Public Library of Science, 8(8). Retrieved
from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734071/