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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Serie: Student Survival Skills
- Sprache: Englisch
Wellbeing Strategies for Nurses Practical strategies for combating burnout and improving mental health while working as a nurse Wellbeing Strategies for Nurses explores clear, straightforward, and practical techniques for cultivating resilience and positive mental health strategies in the face of a demanding clinical environment. This pocket-sized book is easy to carry during your clinical placement and offers tips, advice, and hard-won words of wisdom from student and qualified nurses to support you through a challenging, yet rewarding, career. You'll find stress-busting tools as well as exercises intended for long-term relief of stress incorporated throughout the book. Readers will also find: * A thorough introduction to self-care and wellbeing for nurses, as well as discussions of stress and guided meditation practice exercises * Comprehensive explorations of breathing, humour, and nature therapy * Practical discussions of muscle relaxation and the importance of healthy foods and hydration * Treatments of the sense of smell, aromatherapy, guided meditation, mindfulness, and the five senses approach to wellbeing Perfect for pre-registration adult nursing students in their first and second years of the programme, Wellbeing Strategies for Nurses will also benefit nursing associates, health care assistants, assistant practitioners, and professionals returning to the field after a period of absence.
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Seitenzahl: 368
Veröffentlichungsjahr: 2023
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Table of Contents
Cover
Series Page
Title Page
Copyright Page
Preface
Introduction
Acknowledgements
PART 1: OCCUPATIONAL ILL‐HEALTH
Chapter 1: SELF‐CARE AND WELLBEING
COMPASSION FATIGUE
BURNOUT
STRESS‐RELIEVING STRATEGIES
RELAXATION TECHNIQUES
LOOKING AT THE EASTERN APPROACH
YOGA
QIGONG
TAI CHI
BODY MASSAGE
WEB RESOURCES
Chapter 2: STRESS
WHAT IS STRESS?
THE GENERAL ADAPTATION SYNDROME
THE COST OF STRESS
DUTY OF CARE
A MODEL OF STRESS?
HOW DO WE KNOW WE ARE STRESSED?
WHAT ARE THE CAUSES OF STRESS?
STRESS‐RESISTANT PERSONALITIES
TYPE A AND TYPE B PERSONALITIES
DEALING WITH STRESS AND BURNOUT
CAN PLANNING HELP?
SETTING GOALS
HOW CAN RELAXATION THERAPIES HELP WITH STRESS?
COMPLEMENTARY THERAPIES
COMPLEMENTARY THERAPY SELF‐CARE
TENSION
STRESS‐RELIEF STRATEGIES FROM AROUND THE WORLD
QUICK FIX FOR ANXIETY AND FEELINGS OF PANIC
Chapter 3: SLEEP WELL
SLEEPLESS NIGHTS
WORRYING ABOUT NOT GETTING ENOUGH SLEEP
SLEEP DEPRIVATION
CLEAN SLEEPING
WORKING NIGHT SHIFTS
BREATHING YOURSELF TO SLEEP
NATURAL REMEDIES FOR SLEEP
WHITE NOISE
PART 2: STRATEGIES TO COMBAT STRESS
Chapter 4: BREATHING THERAPY
HOW DOES IT WORK?
HYPERVENTILATION
HEALTH BENEFITS OF DEEP BREATHING
SIMPLE BREATHING TECHNIQUES
WEB RESOURCES
Chapter 5: MUSCLE RELAXATION
PROGRESSIVE MUSCLE RELAXATION
BRIEF HISTORY OF PMR
WHAT ARE THE BENEFITS OF PMR?
WHAT EVIDENCE IS THERE THAT PMR WORKS?
TENSION AND RELAXATION
PMR EXERCISES
MUSCLE RELAXATION
RELIEVING TENSION WITH DISTRACTION
WEB RESOURCES
Chapter 6: NATURE (BIOPHILIA THEORY)
HEALTH BENEFITS OF NATURE
THE BIOPHILIA HYPOTHESIS
MENTAL HEALTH AND NATURE
MINDFUL MOMENT IN NATURE
CONNECTING WITH NATURE
SOUNDS OF NATURE
FOREST BATHING
HOW TO GAIN THE BENEFITS OF NATURE
WEB RESOURCES
Chapter 7: NUTRITION, HYDRATION, AND EXERCISE
THE IMPORTANCE OF GOOD NUTRITION FOR OUR WELLBEING
VITAMINS AND MINERALS
THE IMPORTANCE OF GOOD HYDRATION FOR WELLBEING
DEHYDRATION
HIGH‐WATER‐CONTENT FRUITS AND VEGETABLES
THE IMPORTANCE OF EXERCISE FOR WELLBEING
Chapter 8: COLOUR THERAPY
CHROMOTHERAPY TREATMENT
TOOLS USED IN COLOUR THERAPY
HISTORY OF COLOUR THERAPY
COLOUR IDIOMS
HOW WE SEE COLOURS
THE IMPORTANCE OF COLOUR
SCIENCE OF COLOUR THERAPY
COMMON COLOURS USED DURING COLOUR THERAPY
ENVIRONMENTAL COLOURING
COLOUR THERAPY FOR MOODS AND EMOTIONS
HOW EFFECTIVE IS COLOUR THERAPY?
WEB RESOURCES
Chapter 9: AROMATHERAPY
HOW DO ESSENTIAL OILS WORK?
THE SCIENCE OF SMELL
CAUTIONS AND THERAPEUTIC GUIDELINES
ESSENTIAL OILS
USING ESSENTIAL OILS IN THE HEALTHCARE SETTING
ESSENTIAL OILS AND STRESS RELIEF
WEB RESOURCES
Chapter 10: SHARING WITH FRIENDS
FRIENDS ENRICH OUR LIVES
HOW TO NURTURE FRIENDSHIPS
STRIVE TOWARDS HAPPINESS
WEB RESOURCES
Chapter 11: HUMOUR THERAPY
THE BENEFITS OF LAUGHTER
LAUGHTER THERAPIES FOR STRESS RELIEF
HUMOUR AND A WORD OF CAUTION
TWITTER JOKES
HOW TO BRING MORE LAUGHTER INTO YOUR LIFE
HOW TO DEVELOP YOUR SENSE OF HUMOUR
WEB RESOURCES
Chapter 12: GUIDED MEDITATION
WHAT IS MEDITATION?
WHAT ARE THE BENEFITS OF MEDITATION?
TYPES OF MEDITATION
EVIDENCE FOR USING MEDITATION
MEDITATION FOR BEGINNERS
WEB RESOURCES
Chapter 13: MINDFULNESS
MINDFULNESS TAKES MANY FORMS
BODY‐SCAN MINDFULNESS
MINDFULNESS AIMS TO HELP
SCIENTIFIC EVIDENCE FOR USING MINDFULNESS
HOW TO PRACTICE MINDFULNESS
MINDFUL JOURNALS
WEB RESOURCES
Chapter 14: VISUALISATION (GUIDED IMAGERY)
WHAT IS THE DIFFERENCE BETWEEN VISUALISATION AND MEDITATION?
BENEFITS OF VISUALISATION FOR RELAXATION
CREATING A RELAXING ATMOSPHERE
WEB RESOURCES
Chapter 15: ARTS AND CRAFTS
ART THERAPY TO ALLEVIATE STRESS
CRAFTING AS STRESS RELIEF
PUZZLES
WEB RESOURCES
Chapter 16: STILLNESS
PRACTISING STILLNESS
BENEFITS OF PRACTISING STILLNESS
HOW TO PRACTICE STILLNESS
CONNECTING WITH YOUR SENSES
PART 3: GUIDED MEDITATION FOR GROUPS AND INDIVIDUALS
Chapter 17: SPRING
GUIDED MEDITATIONS SPRING
GUIDED MEDITATIONS SPRING
Chapter 18: SUMMER
GUIDED MEDITATION SUMMER
GUIDED MEDITATION SUMMER
Chapter 19: AUTUMN
GUIDED MEDITATIONS AUTUMN
GUIDED MEDITATIONS AUTUMN
Chapter 20: WINTER
GUIDED MEDITATIONS WINTER
GUIDED MEDITATIONS WINTER
Answers to Activities
Appendix A: EFFECTS OF STRESS
Appendix B: COLOURING A RAINBOW
Appendix C: GLOSSARY OF THE PROPERTIES OF ESSENTIAL OILS
Appendix D: WELLNESS BINGO
Index
End User License Agreement
List of Tables
Chapter 1
Table 1.1 Symptoms of compassion fatigue.
Table 1.2 Risk factors in developing Burnout Syndrome.
Table 1.3 Action steps to prevent Burnout Syndrome.
Table 1.4 Seven tactics for stress relief.
Table 1.5 16 benefits of yoga.
Chapter 3
Table 3.1 Good sleep.
Table 3.2 NHS's suggested pre‐bedtime preparations.
Table 3.3 The benefits of a good night's sleep.
Table 3.4 Tips for a good night's sleep.
Table 3.5 12 signs of sleep deprivation.
Table 3.6 Six foods that can help you get a good night's sleep.
Table 3.7 Complications of shift work sleep disorder.
Chapter 5
Table 5.1 Recognition and relaxation.
Chapter 6
Table 6.1 Benefits of nature according to the US National Park Service.
Table 6.2 The five pathways of connecting with nature.
Table 6.3 Stages of a forest mind.
Table 6.4 How to get involved with nature.
Table 6.5 How to bring the outside in.
Chapter 7
Table 7.1 Suggested guidelines for calorie intake.
Table 7.2 Some of the essential vitamins and minerals.
Table 7.3 Vitamin/mineral deficiencies and mood.
Table 7.4 ‘Happy foods’.
Table 7.5 High‐water‐content fruits and vegetables.
Table 7.6 Moderate aerobic, vigorous, and very vigorous activity.
Table 7.7 Three‐minute exercise routine.
Table 7.8 17 ways exercise may make you happier.
Chapter 8
Table 8.1 Colour spectrum wavelengths.
Table 8.2 Environmental colours.
Table 8.3 Food colours and their benefits.
Table 8.4 Colours and their emotional response.
Chapter 9
Table 9.1 12 useful essential oils.
Table 9.2 Two expensive essential oils.
Table 9.3 Properties of essential oils.
Table 9.4 Essential oil blends to use in a reed diffuser.
Table 9.5 Essential oils used for certain conditions.
Chapter 10
Table 10.1 Ways in which friends can help to reduce our stress.
Table 10.2 Tips to nurture your friendships.
Table 10.3 Five Scandinavian life philosophies that can make you happier.
Table 10.4 Five reasons baking is good for mental health.
Chapter 11
Table 11.1 The benefits of laughter.
Table 11.2 The physical, mental, and social benefits of humour.
Table 11.3 The top 25 comedy movies of all time.
List of Illustrations
Chapter 2
Figure 2.1 (a, b) A model of stress.
Figure 2.2 Coping mechanisms.
Figure 2.3 Personality traits.
Figure 2.4 Tips for dealing with stress and burnout.
Figure 2.5 Stress‐relieving strategies from around the world.
Chapter 6
Figure 6.1 The benefits of forest bathing.
Chapter 8
Figure 8.1 Light box.
Chapter 15
Figure 15.1 Filling balloon.
Figure 15.2 Tying the Stress Ball.
Figure 15.3 Completed stress ball.
Guide
Cover Page
Series Page
Title Page
Copyright Page
Preface
Introduction
Acknowledgements
Table of Contents
Begin Reading
Answers to Activities
Appendix A EFFECTS OF STRESS
Appendix B COLOURING A RAINBOW
Appendix C GLOSSARY OF THE PROPERTIES OF ESSENTIAL OILS
Appendix D WELLNESS BINGO
Index
WILEY END USER LICENSE AGREEMENT
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Student Survival Skills Series
Survive your nursing course with these essential guides for all student nurses:
Medicine Management Skills for Nurses, 2nd EditionClaire Boyd9781119807926
Clinical Skills for Nurses, 2nd EditionClaire Boyd9781119871545
Study Skills for NursesClaire Boyd9781118657430
Care Skills for NursesClaire Boyd9781118657386
Communication Skills for NursesClaire Boyd and Janet Dare9781118767528
Acute Care for NursesClaire Boyd9781119882459
Calculation Skills for Nurses, 2nd EditionClaire Boyd9781119808121
Reflective Practice for NursesClaire Boyd9781119882480
WELLBEING STRATEGIES FOR NURSES
Claire Boyd
RGN, Cert Ed
Practice Development Trainer
This edition first published 2023© 2023 John Wiley & Sons Ltd
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.
The right of author Claire Boyd to be identified as the author of this work has been asserted in accordance with law.
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Limit of Liability/Disclaimer of WarrantyThe contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.
Library of Congress Cataloging‐in‐Publication DataNames: Boyd, Claire, author.Title: Wellbeing strategies for nurses / Claire Boyd.Other titles: Student survival skills series.Description: Hoboken, NJ : Wiley‐Blackwell, 2023. | Series: Student survival skills series | Includes bibliographical references and index.Identifiers: LCCN 2022052839 (print) | LCCN 2022052840 (ebook) | ISBN 9781119893554 (paperback) | ISBN 9781119893561 (adobe pdf) | ISBN 9781119893578 (epub)Subjects: MESH: Nurses–psychology | Self Care | Relaxation Therapy–methods | MindfulnessClassification: LCC RT41 (print) | LCC RT41 (ebook) | NLM WY 87 | DDC 610.73–dc23/eng/20230120LC record available at https://lccn.loc.gov/2022052839LC ebook record available at https://lccn.loc.gov/2022052840
Cover Design: WileyCover Images: © Media Manager; Wiley; ohaiyoo/Adobe Stock Photos; Vaclav Krivsky/Shutterstock
Preface
As healthcare professionals, we look after the wellbeing of our patients/clients. This book is about looking after you, the carer. With nurses leaving the profession in record numbers, often citing stress and burnout as contributing factors, this book is a vital addition to the other books in the student survival series.
This book looks at wellbeing strategies used in healthcare, education, business and many other sectors due to the ‘duty of care’ philosophy.
There are over 180 exercises and activities for the individual so you can dip your toes in and find the ones that work for you. As with other books in the series, this book has been divided into sections, with Part Three designed for groups if you wish to get together with colleagues and friends for a more in‐depth wellbeing session.
All these strategies have been practised on student nurses, nursing associates, registered nurses and midwives, and other healthcare staff and have been adapted for optimum enjoyment.
Keep in mind: if you feel overwhelmed with stress, please see a professional, sooner rather than later.
Introduction
There is no job on earth quite like the nursing/caring profession. It has been a huge privilege to nurse patients back to health and even at times to facilitate a dignified and comfortable death.
After caring for patients, it has never ceased to amaze me when patients who have been discharged send me a ‘thank you’ letter – not because I thought my care was poor, but because they took the time and trouble to do this! A little kindness goes a long way.
Now to take off the rose‐tinted spectacles: there have also been times in my nursing career when I went home in tears because of my frustration with my heavy workload and inability to provide the care I came into the profession to deliver to my patients. This sub‐optimal care was, to be honest, just fire‐fighting: for example, covering for colleagues due to sickness and understaffing issues, working many extra unpaid hours, and being so exhausted that when I eventually arrived home, I was too tired to eat the lovely supper my family had prepared for me. Working in neurosciences, I also had to contend with the occasional patients with steroid‐induced psychosis throwing chairs and punches towards me. In short, working in healthcare can be mega‐stressful!
As a healthcare professional working for the NHS and in the healthcare sector for 40 years, I am used to dealing with these pressures and ‘winter pressures’ when wards are full and ambulances are stacked outside A & E with patients waiting to be admitted with the flu virus, chest infections, and an increase in slips and falls due to slippery pavements. But the last few years have been like no other time in healthcare – staff fatigue and exhaustion have taken on a whole new dimension because of the coronavirus pandemic. Only today, a colleague told me that working in these conditions is ‘soul destroying’. You can only run on empty for so long before the wheels come off. Healthcare professionals now need the care and kindness we are so used to giving to others.
As a nurse and a holistic therapist, I prepare relaxation sessions for my stressed colleagues, using beautiful pictures of nature to gaze into, beautiful smells to bring joy, lovely foods to evoke happiness, breathing exercises to relieve stress, mindfulness to slow down our frantic pace of life, humour to initiate the ‘happy hormones’ (e.g. Serotonin) and meditation and visualisations to take us to beautiful settings in our mind's eye.
This book uses all these strategies I use during my sessions. If you only want to use the guided visualisation scripts, you will need someone to read the words to you, or you can record them yourself on your phone and play them back when you have some ‘me time’. This time is not a luxury; it is vital for your wellbeing, just like eating and drinking.
Perhaps you would like to use some of the smaller exercises and tips for relieving stress, like using essential oils or mindfulness. Perhaps you want to go the whole hog and prepare an entire session, including dressing the room – such as laying out shells and exotic fruits for the tropical paradise session. Each seasonal guided visualisation session takes about 40–50 minutes (or less time, if you wish).
You do not have to be a trained therapist in any of the therapies in this book, as I have chosen safe exercises for the layperson to enjoy. For example, you will not be putting essential oils on the skin to massage, so you do not need to know the science of the oils or contraindications or even how the oil was obtained (steam, expression, etc.).
Just as a postscript, there are many ‘New Age’ books on the market with some dubious claims. This book only looks at accepted wellbeing strategies used in healthcare. However, if stripping off nude and rolling in long grass and nettles covered in morning dew works for you, then carry on! (Apparently this is a real thing in parts of Scandinavia – no judgements here!)
Take from this book whatever you need.
As with other books in the series, this book comes in three parts:
Part One looks at stress and what it does to our bodies, and why strategies for self‐care are so important. We will also look at why shift work can disrupt our natural sleeping patterns and how we can counteract this.
Part Two looks at 13 strategies to combat stress. We discuss each in a no‐nonsense way and give you the important information – what you need to know without all the fluff, keeping it short and snappy.
Part Three consists of guided meditation exercises using seasonal themes, such as a tropical paradise and a walk in the snow. I will show you how to dress a room for larger groups or use the visualisation exercises just for you. All these exercises have been used by healthcare workers who have enjoyed the experiences and helped me adapt the sessions for the perfect relaxation experience. Like other books in this series, this book has been developed for the healthcare worker by healthcare workers who have given me tips and guidance for each of the strategies. For example, during an earlier version of the meadow guided meditation script, I talked about ‘listening to the distant croaks of the frogs in the long grass’. Afterwards, one of my colleagues told me that she has a phobia of toads and frogs, and this made her anxious, destroying her enjoyment of the session. Needless to say, all mention of frogs and toads was removed from the script!
Other books in this series have a “Test Your Knowledge” section at the end of each chapter. This book has an activity related to the chapter contents – something for you to enjoy. There are also little exercises to dip your toes into the therapies. Find what works for you. For me, you can't beat a sprinkling of all the therapies in one session.
Let me tell you about some lovely Filipino nurses I once had the pleasure of working with. First, you need to imagine the sense of wonder of seeing snow for the first time ever; they were delighted to see a blanket of white across the hospital grounds and rushed to put on their coats and go out and hear the crunch beneath their feet. It seemed unkind to inform them that this was, in fact, just a heavy frost. When it did actually snow, you could hear their shrieks of joy for miles! When was the last time you experienced such happiness?
Please take time to care for yourself. Remember, care begins with self‐care. And if you are struggling, seek professional help for your wellbeing.
Acknowledgements
Thanks go firstly to my work colleagues at North Bristol Healthcare Trust, including the student nurses and nurse associates who attended the relaxation sessions I prepared – how we enjoyed floating on a cloud and wiggling like seaweed on our yoga mats! How we also enjoyed all the lovely places we visited in our imagination. Happy days! Thanks for all the encouragement to share this book with a wider audience.
Thanks also go to Rob, my lovely husband and soul mate, for the beautiful photos. And to my son Simon, who, years ago, when I was studying for my diploma in thermal‐auricular therapy (ear candling) and before I had a treatment couch, fell asleep on the floor after the treatment; we left you for a couple of hours and just stepped over you while going about our day! Thanks also to Owen and Rhys (my fantastic grandsons), who allow me to practice some of my techniques on them!
Thanks also to all at Wiley who helped bring this series of books to fruition.
This book is dedicated to all the NHS and community carers and the vital keyworkers who kept and continue to keep the country running during times of lockdown and pandemic. Enjoy!
PART 1OCCUPATIONAL ILL‐HEALTH
Stress
Anxiety
PTSD
Compassion Fatigue
Burnout
Chapter 1SELF‐CARE AND WELLBEING
LEARNING OUTCOMES
By the end of this chapter, you will have an understanding of the importance of self‐care and wellbeing in healthcare to help with compassion fatigue, burnout, and post‐traumatic stress disorder.
Different approaches to wellbeing techniques will be explored, including acupuncture, acupressure, yoga, Qigong, Tai Chi, and massage.
How are you feeling today? I ask this because we know the NHS is in a ‘jobs crisis’ with large numbers of healthcare professionals in the UK leaving the profession, citing as their reasons for leaving ‘pay, working conditions and feeling under huge pressure’. Those leaving the profession often are not replaced, and the shortfall of healthcare professionals is reaching record levels, which puts more pressure on those still hanging on and caring for the vulnerable.
But who is looking after you? We do need to look after ourselves, as laid out by the Nursing & Midwifery Council document ‘Future Nurse: Standards of Proficiency for Registered Nurses’ (2018). This document states that at the point of registration, the nurse will:
1.5 understand the demands of professional practice and demonstrate how to recognise signs of vulnerability in themselves or their colleagues and the action required to minimize risks to health
1.6 understand the professional responsibility to adopt a healthy lifestyle to maintain the level of personal fitness and wellbeing required to meet people's needs for mental and physical care.
In short, it is all about self‐care and wellbeing. We need to care for ourselves and our colleagues, which may be easier said than done in today's healthcare climate.
Self‐careThe actions we take for ourselves to remain fit and healthy and understand when we can look after ourselves and when we need to seek help from other healthcare professionals.
WellbeingRepresents a broader bio‐psycho‐social construct that includes physical, mental, and social health.
The self‐care process can start by reflecting on what makes us happy. When we are going through trying times, it can be easy to focus on the negative aspects of our lives – causing us even more stress and anxiety. Before we go down a negative spiral, it is important to focus on the things that make us happy. Moving from the negative to the positive is an important aspect of the healing process. And note that we may need help with this process (counselling, general practitioners, etc.).
COMPASSION FATIGUE
Unique to the healthcare sector is the occupational stressor known as compassion fatigue, whereby the carer connects with a patient and feels how they are feeling. This opens them up to absorbing and experiencing the patient's trauma, suffering, and pain – known as vicarious traumatisation. This exposure stimulates our fight‐or‐flight response, which we then continually suppress, leading to consequences for our physical and mental health.
The symptoms of compassion fatigue can be seen in Table 1.1.
If we ignore the body's response to vicarious trauma, the physical symptoms will only get worse. This is when we need to take steps to care for ourselves before we experience burnout.
Table 1.1 Symptoms of compassion fatigue.
Phase 1
Anxiety
Vicarious trauma stimulates the nervous system into flight or fight, and you feel the effects of adrenaline on the body – raised heart and breathing rates, shaking, and muscle tension. It becomes harder to think clearly and concentrate and may be harder to sleep. It becomes more difficult to relax.
Phase 2
Irritability
Chronic stress may induce headaches, fatigue, and multiple minor illnesses as the immune system becomes compromised. The tension may affect your musculoskeletal system, causing chronic neck and back pain. You may eat more (or less) than usual.
Phase 3
Withdrawal
As you experience chronic fatigue and constant aches and pains, you may start to neglect your physical and emotional health. If you take time off from work, you do not feel any better on your return.
Phase 4
Robot
These symptoms are very similar to those suffering from depression and also include headaches, generalised aches and pains, digestive problems, and a feeling of low‐level anxiety and very low mood.
BURNOUT
Burnout is a syndrome resulting from chronic workplace stress that has not been successfully managed. It is characterised by three dimensions:
Feelings of energy depletion or exhaustion
Increased mental distance from one's job or feelings of negativism or cynicism related to one's job
Reduced professional efficacy
Risk factors associated with increased susceptibility to developing Burnout Syndrome can be seen in Table 1.2.
Table 1.3 shows some of the actions we can take to prevent Burnout Syndrome in the workplace.
Table 1.2 Risk factors in developing Burnout Syndrome.
Individual risk factors
Poor self‐esteem
Poor coping strategies
Idealistic world view
Unrealistically high expectations
Financial issues
Organisational risk factors
Heavy workload
Conflicts with co‐workers
Diminished resources
Lack of control or input
Effort‐reward imbalance
Understaffing
Rapid institutional changes
Risk factors for nurses
Variability in work schedules
Rapid turnover of patients
End‐of‐life events
No breaks during shifts
Table 1.3 Action steps to prevent Burnout Syndrome.
Manage
Understand that there are ways in which you can manage your work‐related stressors that put you at risk of Burnout Syndrome.
Engage
Engage in the support of management, co‐workers, friends, and family that may help you cope with stress – this is not a weakness.
Breaks
Take breaks at work and away from work. Go outside for a walk to get some fresh air during your breaks.
Enjoyment
Think about what you enjoy about your work, and focus your attention on your interests and passions.
Techniques
Gain techniques to be used at work when dealing with stressful work experiences and after work to relax and recharge.
STRESS‐RELIEVING STRATEGIES
To effectively combat stress, we need to activate the body's natural relaxation response. We are all unique human beings, and stress‐relieving strategies are not a case of ‘one size fits all’. Each of us has preferred calming stress busters. The following bullet points show some of the strategies you may utilise to reach a state of calm and unwind after a stressful day or on a day off:
Spending a day at a spa
Eating chocolate
Drinking a glass of wine at the end of the day
Taking a walk in the country
Going for a swim
Going to the hairdresser/having your hair washed
Going for a run
Meditating
Going somewhere for quiet time (stillness)
Going to the gym
Reading a book
Undertaking some arts and crafts (hobbies)
Watching a movie
Listening to music
Going to a café for a hot beverage (and a piece of cake) with friends
Soaking in a warm bath
Having a massage
Gardening
Playing with your pet animal
Watching a football/rugby match (could be stressful if your team lose)
Doing yoga
Working on a jigsaw puzzle
Modelling with LEGO bricks
I live in the West of England, and one of my favourite ways to destress is to go for a short walk in the Cotswold countryside and then stop in an Olde Worlde tea shop for a cup of tea and some cream scones (jam first, cream on top). Sometimes I forego the walk! (Several of my colleagues like to go to the gym after work – I can't think of anything worse!) My husband likes to snuggle up on the settee with a hot cup of tea, dunking his biscuits (yuk!) whilst watching a good movie on Netflix. In other words, it really is horses for courses. Also, everything in moderation: we should not become dependent on pouring alcohol down our gullets to ‘feel better’ as this could be a slippery slope.
The important thing is that we all need an outlet for our stress. Good health relies not just on the physical aspect but also the mental health aspect – a truly holistic approach. Also, if money is an issue, as it is for most of us, unless you can dip in the sea or go in for wild swimming in the local riverways, paying to swim in the local swimming pool or visiting the hairdresser frequently may be impractical due to cost.
Making ‘Me Time’
Sometimes we may feel we don't have enough hours for such luxuries as ‘me time’ because work and life encroach on our precious days. When we are not at work, we may have family life to contend with, washing, shopping and cooking, or simply catching up on sleep due to exhaustion. Perhaps we also have assignments to complete. Believing we can't spare a little time for self‐care is a false economy. You can't run a car on fumes; the car requires refuelling when almost empty, just like the body needs calm time to combat stress. You take medicine for a headache, so why not take medicine for the soul, as stress‐relief strategies are often called? Caring for your mental health is not a luxury. Using the car analogy again, if the engine breaks down, the car won't work. If the body is struggling due to stress, you won't be efficient in your work or personal life.
EXERCISE 1.1 Yoghurt Mask
Spending a little time for yourself need not cost a fortune. A nice pampering exercise if you have a little plain yoghurt left over is to use it as a face mask, which will leave your skin feeling refreshed and smooth. Remember to put some old towels under your head on the pillow for spillage!
One of the most beneficial substances to use as a face pack is yoghurt (live, natural yoghurt, full‐fat if possible). Fresh, live yoghurt can help all skin types, particularly excessively dry or oily skin. The lactic acid in yoghurt (due to its fermentation) is similar to that of the skin acid mantle and appears to exert a balancing action on the secretions of skin fluids.
Add mashed‐up banana, papaya, or any over‐ripe fruit of your choice to two teaspoons of yoghurt. Rub the mixture into your face. Relax. You may wish to put two cucumber slices on your eyes (to reduce puffiness). Rinse off with plenty of water.
Healthcare Stress
We have already seen how working in healthcare can be extremely stressful. In the first quarter of the twenty‐first century, the world was introduced to the coronavirus pandemic, and healthcare workers were hailed as heroes for caring for unprecedented numbers of patients with the virus. Many worked extra shifts to cover for colleagues isolating with the virus or on sick leave, perhaps due to sheer exhaustion. We also needed to care for patients – the death and grief of the patients who knew they were dying. We are not robots, so these sad memories will stay with us forever. Caring for the carer has never been so important.
DID YOU KNOW?
One in nine health staff left the NHS during the coronavirus pandemic – and the exodus is speeding up, according to official figures (2022). 140 000 workers quit amid the crisis, and according to staff surveys, another 31% are thinking of leaving. Exhaustion, low pay, and stress were cited as reasons for this exodus. Unison's Christina McAnea states that staff are suffering from exhaustion, burnout and PTSD in some cases (https://www.pressreader.com/uk/sunday‐mirror/20220424/281582359187651).
PTSDPost‐traumatic stress disorder. A mental health condition that develops following a traumatic event, characterised by intrusive thoughts about the incident, recurrent distress/anxiety, flashbacks, and avoidance of similar situations.
RELAXATION TECHNIQUES
It is safe to say that finding a strategy for stress relief has never been so important. It is really just finding the strategy that works for you. Roughly speaking, the most popular approaches can be grouped into seven main categories, as shown in Table 1.4. We will look at each of the examples throughout this book and/or in this chapter.
Table 1.4 Seven tactics for stress relief.
Tactic 1
Focus your mind to bring about the relaxation response.
Examples: Deep breathing (
Chapter 4
) Meditation (
Chapter 12
) Mindfulness (
Chapter 13
) Progressive muscle relaxation (
Chapter 5
)
Tactic 2
Redefine the situation mentally so that it is no longer viewed as a threatening situation.
Examples: Humour (
Chapter 11
) Imagery (
Chapter 14
)
Tactic 3
Use Eastern methods to restore your mental and physical balance.
Example: Acupressure (
Chapter 2
)
Tactic 4
Use yoga/yoga breathing to calm the mind and relax the body.
Examples: Yoga breathing (
Chapter 2
) Yoga (
Chapter 2
)
Tactic 5
Relieve muscle tension through exercise and massage.
Examples: Stretching (
Chapter 2
)Massage (
Chapter 1
)Physical exercise (
Chapter 7
)
Tactic 6
Fill your mind with thoughts of pleasure rather than threats.
Examples: Aromatherapy (
Chapter 9
)Music (
Chapter 15
)Nature (
Chapter 6
)Social support (
Chapter 10
)
Tactic 7
Use coping strategies for stress before stress becomes a problem.
Examples: Eating well (
Chapter 7
) Hydrating well (
Chapter 7
) Sleeping well (
Chapter 3
)
Overthinking
Even the most chilled of us get stressed at times – going over and over a situation in our mind and being unable to shake off these thoughts. Perhaps we had a difficult shift or received harsh feedback from an assignment or the placement we are on. These thoughts may make us anxious and lead to depression over time. But we can do something about it.
Stop and rethink: Going over the same negative situation again and again is not healthy. Look for the positives instead of concentrating on the negatives, no matter how small you think they are. Many people have told me that when a family member became ill, it put all their stress and anxieties about other things into perspective.
Example:Spoke harshly to my colleague and feel bad about this. I can't stop feeling upset about this.
Finding the positive:With hindsight, I now believe that I did not speak over‐harshly, and she does need to concentrate on the task in hand for patient safety. I did the right thing.
Make time to worry: Set aside some time to write down all your worries. Then work through the list to find solutions to the problems you can control and let go of the things you can't control.
Example: Can't afford to pay all my bills this month. Speak to the bank about extending my overdraft.
Did not get the promotion I went for. Let this go as I was too good for them. Look out for other Band 6 positions and work on my interview skills.
Seek help: If you feel you can't find a solution to your worries, never hesitate to seek help.
Examples:
If you worry about your job – speak to your manager.
If you worry about your mental health – speak to your GP or workplace counsellor.
If you worry about money – speak to your bank and/or Union, who have financial advisers.
Remember to speak to your colleagues, friends, family, and professionals – do not suffer alone.
If you feel your negative thoughts are becoming overwhelming, cognitive behavioural therapy (CBT) can help to reframe your negative thoughts, enabling you to cope with your anxiety.
STUDENT TIP
As a first‐year student, I once worked with a third‐year student who just didn't like me. That's fine as we can't get along with everyone. Instead of going over and over thinking about what I was doing to make her dislike me so much, I turned this around and realised that the problem was actually hers, which helped to relieve my stress. I was always polite and professional to her. The last I heard, she left the nursing profession – some people just aren't cut out to be kind and compassionate.
Taking Control
If you ever think ‘I can't do anything about my problem’, your stress will inevitably get worse, as this feeling of loss of control is one of the main causes of stress and lack of wellbeing. Taking control is empowering and a crucial part of finding a solution.
However, you need to accept the things you can't change, as changing a difficult situation is not always possible. It is therefore important to concentrate on the things you have control over.
Research in Treating Anxiety and Psychological Disorders
Anxiety and psychological disorders affect 264 million people worldwide. Unfortunately, anti‐anxiety medications aren't effective for everyone, and many of these drugs have unwanted side effects. As a means of understanding the brain networks and mechanisms that underlie fear and anxiety and hopefully offering a new and better approach to treatments, Bristol University researchers have been studying the brain's cerebellum. The cerebellum is connected to many regions of the brain that are linked to survival, including the PAG (periaqueductal grey).
TERMINOLOGY
The periaqueductal grey is a structure in the brain that coordinates survival mechanisms, including the ‘freezing’ behaviour when we feel paralysed with fear.
Researchers have found that the PAG can form a ‘fear memory’ when fear is felt, accompanied by freezing, meaning the cerebellum encodes a fear memory that returns and replays (think post‐traumatic stress). The Bristol University researchers have shown that manipulating the cerebellar‐PAG pathway can lessen fear‐conditioned freezing in animals.
The Bristol University Researchers explain:
Our results show that the cerebellum is part of the brain's survival network that regulates fear memory processes at multiple timescales and in multiple ways, raising the possibility that dysfunctional interactions in the brain's cerebellar‐survival network may underlie fear‐related disorders and co‐morbidities. (www.mirror.co.uk/lifestyle/health/hope‐scientists‐targeting‐new‐area‐26970056)
This has radically changed our way of thinking about anxiety. Previously, we believed anxiety was generated in deep brain centres such as the amygdala and in response to stress hormones. Finding this other site for anxiety in the cerebellum gives a whole new approach for drugs and therapies, targeting new ways of treating psychological conditions such as PTSD.
EXERCISE 1.2 Melting the Ice Sculpture
This is a good exercise to help release the anxieties and tension that lead to stress:
Close your eyes and imagine a beautiful ice sculpture of a swan in front of you.
Mentally list anything in your life that is causing stress: at work, at home, anywhere.
Each time you think of something, say it out loud. Imagine that as you say it, a warm gust of air travels towards the ice swan, and the sculpture begins to melt.
Continue venting all your worries and watching the swan melt before you.
Soon all your worries have turned the swan into a crystal clear puddle of water, taking all your stress with it.
DID YOU KNOW?
The Japanese have invented a ‘scream jar’. This is a handheld jar that you can scream into to let out all your stress. You put the jar neck up to your mouth and literally scream into it. It is soundproofed, so you may only hear a faint whisper.
Learning New Skills
Learning some simple yoga poses may help with stress levels in ways we did not know previously. Research has shown that learning new skills can improve your mental wellbeing by:
Boosting self‐confidence and raising self‐esteem
Helping to build a sense of purpose
Helping you connect with others
Even if we feel we do not have time or do not need to learn new things, there are many ways we can incorporate this into our lives, such as:
Learning to cook something new
Working on a DIY project (something we have been meaning to fix for a while)
Signing up for a course that interests us, such as learning a new language
Signing up for a class in something we have always wanted to learn, like Salsa dancing or yoga
Taking up a new hobby
