The following is a synopsis of the history of our awareness of stress:
• Walter Cannon (1871–1945) pioneered the initial understanding of stress. He investigated the sympathetic nervous system as it reacts to heat and noticed that the body responds in a predictable sequence (Selye, 1956). • Han Selye furthered Cannon’s work by defining stress as the "rate of wear and tear on the body" and stressors as the "causative agents of stress" (1956). Selye found that stressors may be physical, such as infection, injury, and pain, or may be psychological, such as fear, anger, and sadness. He identified what he called a general adaptation syndrome (GAS), whereby the body seeks to maintain homeostasis or balance. • Lazarus enlarged our understanding of stress and the ways people deal with it when he observed that, when individuals view a new or evolving situation, they first decide whether it is a threat. He called this primary appraisal. Then, as individuals continue to monitor a threat, they evaluate their ability to cope with it by what Lazarus called secondary appraisal (1956). In this second step of appraisal, individuals may judge themselves unable to handle the situation and withdraw. Others, especially caregivers, are apt to believe they "should" be able to handle anything and attempt to do so no matter how great the cost.
Seyle, Cannon, and Lazarus (Folkman, 1984) further recognized that stressors can lead to burnout and job fatigue if there are no coping mechanisms in place - this is especially true for the professional nurse. According to the American Nurses Association, nurses report that there are many factors that promote stress and lead to the classic “crash and burn” syndrome that many nursing professionals experience.
The following are just some of the issues that nurses face that often contribute to stress:
• Anxiety related to demands of the job. • Inefficient coping related to the lack of knowledge for job requirements. • Spiritual distress related to the inability to find meaning or purpose in professional and personal life. • Ineffective leadership ability; ineffective assertiveness training. • Inability to motivate staff. • Ineffective ability to balance work, family, and personal life. • Lack of supervisory support. • Poor co-worker relationships.
These stressors can lead to the classic “burn-out” syndrome. Instead of persisting until this happens, nurses can learn more effective coping strategies, become self-aware, acknowledge their own limitations, and acquire emotion-focused and problem-solving skills (Selye, 1956). Likewise, managers can provide physical and emotional support for staff members because they value them and understand the stressful nature of their work. Nurses are strong at supporting patients and families through stressful situations, so perhaps they can simply adopt these same strategies for their own stressful battles.
The following are several strategies that nurses can use combat stress:
Learn to Identify Feelings
Breaking through denial and admitting there's a problem is a step toward finding solutions to stress. Feelings can be named in one word: betrayal, guilt, anger, sadness, frustration, etc... Registered Nurses are trained to treat others with compassion, but unless they identify their own emotions, they can't generate compassion for themselves and begin to heal. Journaling, meditating and praying are strategies to help one get in touch with those deep rooted inner feelings. Similarly, interests such as poetry, gardening, working, animals, and painting are useful methods to unleash these deep rooted feelings. Consider the nurse who has just