Hi, i am Anna Vanderputten and
welcome to stress management.
I would like to start
off by defining stress.
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.
Not all stress is negative.
Some there is very good it helps
us get things done. It protects us.
But everyone experiences stress and
stressors can be internal or external.
So types of stressors
that we are talking about
can be Physiological/Psychological
But there an individual reaction
based on perceived threat.
So to measure these subjective stressors
Homes and Rahe Stress Scale was developed
and designed to assess the potential
health risks associated with stress.
These are life events
that contribute to stress
and they assist in identifying stress and
associated behaviors or triggers.
The higher the score
the higher the life events.
So these might be death and
the family is very stressful
moving so all these
events that happen in our
lives contribute to stress.
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.
It occurs in three stages.
Beginning with the Alarm stage.
This is a stimulation of
the sympathetic nervous system.
The well known "fight or flight" response.
And its release of
cortisol and catecholamines
and complicated other systems.
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.
But the body selects effective defense mechanisms.
Cortisol levels may begin to drop
if they are no longer needed.
As stress continues
the body reaches what is known
as the Exhaustive stage
and this is a prolonged
stage where the body is then
And it's resources are
begin to be depleted.
And the body may become
than susceptible to disease.
So in the process in the continuing you have that
you are alert and focused. This is really beneficial.
You begin to attain
resolution to the stress.
Or if it is continuous you
get Resource depletion.
So let's look at little more at adaptation.
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.
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.
So Genetics and Age are
also physiological factors
the very young the very old.
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.
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.
So we also have Resilience -
is the individual's flexibility
or ability to recover.
So the body may be affronted
with a stressor
but because they have other supports
and resistance in their life.
They are flexible. They
are able to comeback.
This is system nursing thinking.
So what are the effects of stress?
They can be put into two
categories: Acute or Chronic.
Very similar to the Alarm
stage. But in the Acute,
its beneficial when
its time limited.
The Autonomic Nervous System (ANS) - stimulate alertness
vigilance, focused attention.
Its a limited coping reserve however.
So when we have Physiological
response in trauma the body
surges to protect itself.
But is meant to be time limited.
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.
Its also linked to numerous
health disorders over time.
You have to realize this doesn't happen
all many chronic stress for a year
this is over time.
So you would have health disorders
developed such as cardiac
GI, which is related to
the autonomic nervous system.
Psychological effects can impair
our mental health as well
and it can lead to mental illness
such as Anxiety and Depression.
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.
Let's look at ways of
effective management of stress.
We generally treat
stress in three ways.
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.
So that's your stressor and then you
are going to treat it with antibiotics.
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.
So then the next area
that you can look at is
to increase our resiliency
for adapting to stress.
What we talked about previously,
you wanna promote stress,
good nutrition and
engage social support.
Its very important for people to
have other people in their life
to help, share the weight
of stressors in our life.
And then of-course Coping Mechanisms.
When we look at coping mechanisms,
we are talking about emotional
or behavioral responses used to mange stress.
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.
We want to promote relaxation
techniques - music, deep breathing,
massage therapy and promote
exercise. Exercise is an
excellent coping mechanism for stress.
It allows the body
to release this access
energy and is really beneficial.
So all three of these approaches
as nurses we want to be
looking at health promotion.
That's really where we are
looking at and you are treating
from three different approaches.
So we have the underline
principles of stress.
But i wanna to review with
you some nursing summary.
How does this effect the
and when you are in your
work environment taking a test.
Let's look at that. So as a
nurse and in this nursing summary
we are looking at Indicators of stress.
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.
So nursing indications to
minimize patient stress
would be to allow the patient to
verbalize their feelings or concerns.
You want to listen attentively to built
the trust and safety when the patient
ANA rapport with the nurse.
So you also wanna provide
information and education
for effective stress management
depending upon the
So i will just give an example
of indicators of stress.
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.
So this is all i am saying is that
be attentive to those indicators
you rule out everything else.
Sometimes stress is the answer.
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.
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.
You wouldn't just walk up to someone and
say, "O, i am gonna give you oxygen"
because you haven't assess them.
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.
And again you would reduce your
choices by eliminating
obvious incorrect choices.
And then prioritize your choices
also may be putting safety
first. If you are
stuck on couple of them.
And then double check your answer. Read
your sense and then read your answer
and then just make
sure that the answer
judgment and make sense.
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.