Nursing can be one of the most stressful jobs in the medical field. Nurses are responsible for looking after the physical, and sometimes even emotional, well-being of patients. Additionally, nurses often have the most facetime with patients, which intrinsically increases patient bonds. This is why it’s so important for nurses to not only have strong practical skills but also develop strong coping mechanisms to manage stress and avoid burnout.
If you or a loved one in the nursing field is showing signs of emotional or mental distress, this guide can help. We’ll provide a glimpse into the impacts of burnout, stress, and other mental health challenges, as well as provide actionable tips and resources for addressing them.
In this article:
- The stressors of nursing
- Effects of stress
- Managing stress on the job
- External factors that impact nurses’ stress
- Additional resources for nursing support
The stressors of nursing
The stressors unique to nurses may include:
- Time pressure: Nurses often experience time pressure and tight deadlines, because people’s health and well-being are relying on them. These high-pressure situations can increase stress in the day-to-day.
- Increased exposure to infectious diseases: Like all medical professionals, nurses are at increased exposure to infectious diseases. This can increase anxiety and stress, particularly for nurses who share their living space with family or friends, as they can become exposed as well.
- Increased exposure to work-related violence or threats: Nurses often spend the most time with patients that are at the highest risk for being threatened, insulted, or even attacked by patients with altered mental states.
- Overscheduling: Many nurses work 12-hour shifts regularly due to the level of care they provide patients and the urgency of the situation. This is much longer than the standard eight-hour shift of most professions and can cause serious stress and fatigue.
- Emotional demands: As previously mentioned, nurses usually spend the most time with patients going through hardships. This can be emotionally demanding, especially if they have to be the communicator between the patient and their loved ones.
- Ambiguous roles: Nurses are most likely to experience role ambiguity or role conflict, which is when the specific responsibilities of their role aren’t clearly defined. This can cause nurses to overwork, as they don’t have healthy boundaries to fall back on.
- Chronic understaffing: Nursing departments are often understaffed, either due to a lack of qualified individuals or for budgetary reasons. This puts a higher strain on the existing nurses to work longer shifts and take on more patients.
These are stressors unique to nurses — nurses may also experience systemic stress of the medical field as a whole, such as reduced access to PPE.
Effects of stress
Stress can affect both your physical and mental health. The effects of stress at work can include:
- Decrease in performance;
- Decrease in work satisfaction;
- Depression;
- Anxiety;
- Trouble sleeping;
- Coping with substances;
- Burnout.
Signs of burnout
Burnout can be experienced alongside the above-mentioned effects of stress, or independently. It can involve many of the same side-effects of work-related stress, however, burnout is specifically characterized by the following signs:
- Fatigue at work;
- Irritability, hopelessness, or cynicism;
- Inability to concentrate at work;
- Repeat headaches or gastrointestinal distress;
- Disillusionment with your job or industry;
- Anxiety-related to going to work or doing work-related tasks.
Burnout can continue for weeks, or even months, and can worsen depression, anxiety, and disillusionment.
Burnout coping mechanisms
There are several ways that you can handle burnout, but with and without taking time off work. Depending on the severity of your burnout, you may need to explore different options. Some coping mechanisms for burnout include:
- Take deep breaths: Something as simple as taking a few deep breaths can help reduce feelings of stress and anxiety. Integrate breathing practices into your work routine when you start to feel stressed.
- Practice mindfulness: Mindfulness is the practice of focusing only on the current moment. This can be a great way to reduce stress and compassion fatigue for nurses, particularly in emergencies. There are several mindfulness practices that you can engage with as a form of stress relief.
- Take a few days off work: For more severe cases of burnout, you may need to take some time off work. Getting space to rest, recharge, and engage in outside activities from work can be a great way to relieve work-related stress.
- Change up your work routine: If you are unable to take time off work, then try changing up your work routine. This could range from changing shifts to even doing tasks in a different order. Breaking from a stressful routine may help improve focus, and make your daily life feel fresher and less stagnant.
- Practice healthy habits: Some of the best tools for combating burnout are sleep, water, and eating healthy. When we are rested, hydrated, and fueled, we can experience upticks in energy and mood. Try to get eight hours of sleep a night, and carry a water bottle with you to work.
Dealing with compassion fatigue
Another specific stressor for nurses can be compassion fatigue. Compassion fatigue is defined as feeling despondent or feeling apathy toward those suffering after being consistent regular exposure. This apathy could seriously endanger patients who may be in a critical state, but it’s also a problem for nurses in every aspect of their lives — even their personal lives.
Some of the ways that you can combat compassion fatigue include:
- Make time for your self-care;
- Lean on your support network;
- Seek out therapy or support groups;
- Engage in outside activities and relationships.
Compassion fatigue can be a job hazard for those who work with sensitive populations, like nurses, that never really goes away. The best thing you can do is treat it as it comes, and develop healthy coping mechanisms to lessen the impact.
Managing stress on the job
During times of high stress at work, it’s important to have coping mechanisms and stress tips you can lean on. These strategies should be used in tandem with more in-depth self-care and wellness practices outside of work, however, these can help mitigate immediate stressors.
Tips and strategies
The following strategies can help you quickly relieve stress while working. These can be done in just a few minutes, with things you can easily find, or bring, to work:
- Soak up some sun: It’s been shown that exposure to sunlight increases your serotonin, which can help reduce feelings of depression and anxiety. If you can, step outside to soak up some sun, or stand in front of a large, unobscured window for a few minutes.
- Hand massage: There are several pressure points you can massage in your hands to help reduce stress when massaged. Unlike other massages, hand massage can be performed by you, with little resources and time, which makes it ideal for an at-work stress reliever.
- Count backward from 10: Counting backward from 10 can be a good grounding technique for anxiety. This method can help disrupt anxious thoughts, help you practice mindfulness, and give you a chance to refocus on the task at hand.
- Stretch: Stretching can help relieve muscle tension, which can reduce feelings of stress in the body. Even simple stretches like raising your hands above your head, touching your toes, and rotating your torso side to side can be helpful.
- Chew gum: Chewing gum has been found to reduce stress due to its repetitive, mindless action. It has also been shown to regulate your heartbeat, increase alertness, and help with multitasking in certain studies. If your work allows chewing gum, this can be a great option for reducing stress while continuing to work.
- Splash cold water on your face and hands: It has been shown that cold showers reduce cortisol, which is a stress-causing hormone, and increase endorphins. If you don’t have access to a shower while at work, simply splashing cold water on your face and hands will suffice. This practice can also help disrupt anxious thoughts and increase alertness in high-stress moments.
These are just a few practices that can help you manage stress at work. Ultimately, what will help the most is finding the practices that work in your schedule, with the resources available to you.
Seeking help
If you’re experiencing acute stress at work, it may be time to reach out for help. Internal resources may include your HR department or department head. They may not be aware of circumstances that are causing undue stress or may be able to offer solutions.
You may also be able to seek support from nursing unions or professional advocates if you aren’t receiving internal support.
Knowing when to leave a job
Sometimes, it can be hard to know the difference between temporary stress at a job and chronic stress caused by the job itself. This is especially common in fields like nursing, which can be highly unpredictable in terms of daily stress and expectations. If you’re considering whether or not to put in a resignation letter, you may ask yourself these questions:
- Am I receiving the support I need from management?
- Is there a situation or specific factor causing my stress that I can remove?
- What would it take for me to stay? Is that within the realm of possibility?
- Would I feel differently at a different clinic/company/department?
It’s important to note that resigning from your job doesn’t automatically reflect poorly on your resume or negatively impact your future job prospects, so don’t let this be the only factor keeping you unhappy and overextended in your current job.
There are several career resources especially for nurses looking to change jobs, with little to no cost for nurses. These could include resume creation help, interview guides, and educational development, to name a few.
External factors that impact nurses’ stress
Because nurses work with the public, their jobs are highly susceptible to external stressors. This could include things like natural disasters and even large-scale health crises like COVID-19.
These external stressors can be difficult to handle, as there is no guaranteed “end date” to them, and more often than not, nurses have little to no control in these scenarios. However, there are ways that nurses can seek support during these times of external stressors. These support outlets can include:
- Professional support groups and organizations: Professional nursing organizations and support groups can offer emotional support, and may even have other resources, including advocacy and development, to help nurses through crisis events.
- Nursing forums: If you can’t, or are uninterested in joining a formal organization, nursing forums can provide emotional support by connecting you to other nurses, who have similar experiences to you. Using these forums can help reduce feelings of isolation or hopelessness, particularly during crisis events. You can also find advice by from nurse peers on Q&A sites or on Incredible Health.
- Training courses: You may be able to take crisis-specific training courses, such as COVID-19 courses, that can give you the skills to manage crises. These courses can increase your agency and empowerment during crisis events. You may even be able to get reimbursed for these courses, under continuing education credits.
Additional resources for nursing support
Other resources for nurses that can help improve personal and professional well-being are listed below. These resources are available at low or no cost and can be used by any kind of nurse in need of support.
Financial resources and initiatives
Financial resources and incentives can offer boons to nurses working in high-stress environments by reducing financial burdens or providing freebies. These include:
- Nursing discounts: Many businesses, particularly in the wake of COVID-19, have started offering discounts or freebies to healthcare workers, including nurses. You can look online to find where you can cash in on these freebies.
- Healthcare bonuses: Legislation, like that currently in the works in California, is looking to provide bonuses to nurses working on COVID-19 units as an incentive. The national conversation about hazard pay for nurses has been going on since the beginning of the pandemic, and currently varies state by state.
- Nursing education fund: The nursing education fund is designed to help nurses pursue continuing education and professional development by offering course reimbursement. If your workplace doesn’t already offer reimbursement for CE courses, programs like this can ensure you’re not paying out of pocket.
Professional nursing organizations
The following professional nursing organizations can provide support, research, advocacy, mentorship, and a plethora of other resources to nurses. Although you can certainly find regional or local organizations that suit your needs, here are some of the most well-known national nursing organizations:
- Agency for Healthcare Research and Quality;
- Health Resources and Services Administration;
- American Academy of Nursing;
- National League for Nurses.
Regardless of the difficulties you encounter in your job as a nurse, remember that there are organizations and peers who want to help you overcome your mental health challenges and provide the best possible care.
Mental health resources for nurses
Aside from financial support or professional nursing organizations, there are some additional resources that nurses should explore when experiencing burnout, excessive stress, or other mental health problems. These can help nurses learn the basics of managing stress related to their work, as well as connect with organizations who can provide support in other ways. This includes:
- ANA Enterprise – Healthy Nurse, Healthy Nation: The connection between physical health and mental health is undeniable. Adequate physical activity, nutrition, and rest can contribute to an overall better state of mind. With this in mind, the “Healthy Nurse, Healthy Nation” program is designed to help nurses get in shape, get better rest, and improve their stress management. Connecting with peers and sharing your success milestones are great motivators for improving your mental health.
- Give an Hour – Hospital Heroes Program: The “Hospital Heroes Program” is a collaboration between Give an Hour and Aetna, a CVS health company. It is a program designed to provide mental health assistance to frontline health workers during any disaster (such as the COVID-19 pandemic). You can text FRONTLINE to 741741 or call 1-800-985-5990 to connect with a crisis counselor.
- Heroes Health Initiative: Tracking your mental health is an important part of self-care. UNC School of Medicine’s Heroes Health Initiative provides a free mobile application that allows nurses to track theri mental health and find appropriate mental health resources.
- NurseGroups: If you’re interested in joining a confidential videoconference group to discuss your mental health challenges, NurseGroups is a great resource. You can join an individual session or sign up for recurring invites on a weekly basis. You can also find useful self-care resources here.
- Osmosis/#FirstRespondersFirst – Nursing Resilience: Nurses interested in learning more on mental health training for first responders can find a free e-learning course at Osmosis University. This course promises to help participants identify burnout, self-identify stress and its impact on their work, and take action to avoid improper stress management techniques.
- Therapy Aid Coalition: This is a 100% volunteer-operated organization that provides free and low-fee therapeutic services for essential workers in the U.S. impacted by the COVID-19 pandemic. They’re developing a nationwide network of psychotherapists to serve nurses, among other essential workers.
Nursing is a high-stress profession. These resources, tips, and techniques can help you mitigate this stress and practice healthy work/life habits. By doing so, you can make the best of your nursing career and increase your overall satisfaction with the profession.
