Stress Management (Nursing)

00:01 Hi, i am Anna Vanderputten and welcome to stress management.

00:04 I would like to start off by defining stress.

00:07 Hans Selye was the first to describe stress as "a state manifested by a specific syndrome of the body in response to to any stimuli that made an intense systemic demand on it" Stressors are the stimuli producing the body's response.

00:24 Not all stress is negative.

00:26 Some there is very good it helps us get things done. It protects us.

00:30 But everyone experiences stress and stressors can be internal or external.

00:36 So types of stressors that we are talking about can be Physiological/Psychological But there an individual reaction based on perceived threat.

00:46 So to measure these subjective stressors Homes and Rahe Stress Scale was developed and designed to assess the potential health risks associated with stress.

01:00 These are life events that contribute to stress and they assist in identifying stress and associated behaviors or triggers.

01:08 The higher the score the higher the life events.

01:13 So these might be death and the family is very stressful marriage, divorce, moving so all these events that happen in our lives contribute to stress.

01:27 So what happens next? The body response and adapts to stress which is known as the General Adaptation Syndrome and this is the body's ability to respond to stress and return to homeostasis.

01:42 It occurs in three stages. Beginning with the Alarm stage.

01:46 This is a stimulation of the sympathetic nervous system.

01:49 The well known "fight or flight" response.

01:51 And its release of cortisol and catecholamines and complicated other systems.

01:57 But what you need to know is that it goes into a Resistance stage where the body sustain itself with glucose and cortisol and adrenalin remain.

02:07 But the body selects effective defense mechanisms.

02:11 Cortisol levels may begin to drop if they are no longer needed.

02:16 As stress continues the body reaches what is known as the Exhaustive stage and this is a prolonged stage where the body is then become overwhelmed.

02:29 And it's resources are begin to be depleted.

02:33 And the body may become than susceptible to disease.

02:37 So in the process in the continuing you have that you are alert and focused. This is really beneficial.

02:43 You begin to attain resolution to the stress.

02:47 Or if it is continuous you get Resource depletion.

02:52 So let's look at little more at adaptation.

02:56 Why are some people able to adapt to stress and others don't do as well? Well there is a physiological factors to consider that affect our ability to adapt and number 1 is physical condition.

03:09 Overall health is very important. If your already in a weaken stage you are not going to be able to deal with much stress and the resources are already depleted.

03:21 So Genetics and Age are also physiological factors the very young the very old.

03:27 Nutrition, very important and of-course Sleep Cycles. I think we all have experienced nights where we haven't had enough sleep and we don't do as well in our day or we are not able to handle as many stressors that come our way.

03:40 The Psychosocial factors that affect our ability to cope with stress are strong social relationships. People who have a lot of social support deal better with stress. Also hardiness, this is an individual perception its personal sense of control where individuals perceives stress in different ways. What may be a huge stressor for one person is not as big deal to another person.

04:11 So we also have Resilience - is the individual's flexibility or ability to recover.

04:18 So the body may be affronted with a stressor but because they have other supports and resistance in their life.

04:28 They are flexible. They are able to comeback.

04:30 This is system nursing thinking.

04:34 So what are the effects of stress? They can be put into two categories: Acute or Chronic.

04:40 Very similar to the Alarm stage. But in the Acute, its beneficial when its time limited.

04:47 The Autonomic Nervous System (ANS) - stimulate alertness vigilance, focused attention.

04:53 Its a limited coping reserve however.

04:56 So when we have Physiological response in trauma the body surges to protect itself.

05:05 But is meant to be time limited.

05:08 If not we move into the Chronic which is a decrease overall decreases the body's immune response to resist disease and this is related to cortisol and suppresses our immune response.

05:22 Its also linked to numerous health disorders over time.

05:27 You have to realize this doesn't happen all many chronic stress for a year this is over time.

05:33 So you would have health disorders developed such as cardiac GI, which is related to the autonomic nervous system.

05:42 Psychological effects can impair our mental health as well and it can lead to mental illness such as Anxiety and Depression.

05:52 So you can imagine that this is make sense; because, overall a long period of time, if you are constantly dealing with stress it can wear you down to where you can't see hope anymore and you can become depressed.

06:07 Let's look at ways of effective management of stress.

06:11 We generally treat stress in three ways.

06:14 First and the best approach is to look at the stressors. Identify them and look at the source. So when we treat the source of the stressors we are looking at may be an example would be infection.

06:27 So that's your stressor and then you are going to treat it with antibiotics.

06:31 We also wanna minimize exposure to stressors and awareness of "triggers" and avoiding those "triggers". So an example might be someone who has asthma and he is addicted to drugs. Well you are not going to keep drugs all around the person who has the allergies to it.

06:48 So then the next area that you can look at is to increase our resiliency for adapting to stress.

06:56 What we talked about previously, you wanna promote stress, good nutrition and engage social support.

07:04 Its very important for people to have other people in their life to help, share the weight of stressors in our life.

07:12 And then of-course Coping Mechanisms.

07:15 When we look at coping mechanisms, we are talking about emotional or behavioral responses used to mange stress.

07:23 So you want to avoid unhealthy behaviors. Your patients most people tend to revert to coping in unhealthy ways such as alcohol, overeating, and sometimes substance abuse.

07:41 We want to promote relaxation techniques - music, deep breathing, massage therapy and promote exercise. Exercise is an excellent coping mechanism for stress.

07:54 It allows the body to release this access energy and is really beneficial.

08:01 So all three of these approaches as nurses we want to be looking at health promotion.

08:07 That's really where we are looking at and you are treating from three different approaches.

08:16 So we have the underline principles of stress.

08:20 But i wanna to review with you some nursing summary.

08:23 How does this effect the nursing-patient relationship and when you are in your work environment taking a test.

08:34 Let's look at that. So as a nurse and in this nursing summary we are looking at Indicators of stress.

08:41 What you might see in a patient? May be an increased heart rate, increased respirations and muscle tension, anxiety, or they are very emotional very fearful or angry.

08:54 So nursing indications to minimize patient stress would be to allow the patient to verbalize their feelings or concerns.

09:02 You want to listen attentively to built the trust and safety when the patient ANA rapport with the nurse.

09:11 So you also wanna provide information and education for effective stress management depending upon the patient's diagnosis.

09:20 So i will just give an example of indicators of stress.

09:24 I am on the unit, i see the patient's alarm is going up heart in a 1Ts 110s, 120 we go in the room and she saying like her "abdomen hurts." As we pursue and make sure we rule out everything find out the problem and has to use a restroom.

09:44 So this is all i am saying is that be attentive to those indicators you rule out everything else.

09:52 Sometimes stress is the answer.

09:55 So i wanna to offer some tips for success as you move forward You want to think when you are looking at your NCLEX testing. You want to think assessment before you take any action or implementation.

10:09 So if there is a choice where you going to take an action really wanna look for something that is going to indicate that you are assessing the patient first.

10:18 You wouldn't just walk up to someone and say, "O, i am gonna give you oxygen" because you haven't assess them.

10:23 And then you also want to use critical thinking skills to choose the best answer. There all four of your answers may be correct but you want to choose the best given that scenario.

10:35 And again you would reduce your choices by eliminating obvious incorrect choices.

10:42 And then prioritize your choices also may be putting safety first. If you are stuck on couple of them.

10:48 And then double check your answer. Read your sense and then read your answer and then just make sure that the answer demonstrates good judgment and make sense.

10:59 This is Anna Vanderputten. Thank you for allowing me to talk to you about stress management and i wish you Good Luck on everything you do.