Make Your Stress Benefit You

Stress is unavoidable. In the perioperative setting, stress can be serious given the high pressures and traumatic events periop nurses face on a daily basis. Natalie Johnson, MS, a Health and Wellbeing Consultant, describes the stress she sees among perioperative nurses as excessive, which is typically known as the worst kind of stress.

“Excessive stress makes us feel powerless, it’s the kind of stress that impacts our performance, health, and well-being in a negative way,” Johnson says. In her work with health care professionals around the world, she helps leaders and their teams harness stress by understanding what it is and how it can be managed to create resilience individually and within a team.

Deconstructing Stress

While stress in general tends to be perceived negatively, Johnson says a closer look shows us how stress can be positive and actually help us become more effective leaders, better performers and create resilience.

She goes on to describe the types of stress:

• Normal stress: This is the normal stress of our day. The job, the household duties and other regular demands that we have. Normal stress maintains our resilience capacity and is not negative, as long as it’s balanced with some recovery.
• Training stress: This is stress that we create intentionally. It’s a choice that you make with the goal to improve. Training Stress increases our capacity and creates more resilience. Examples include engaging in a crucial conversation to improve a strained relationship or taking on a new challenge such as graduate study to better yourself.
• Excessive stress: This is when our stress snowballs out of control and we feel helpless and perhaps even depressed or hopeless. Excessive stress has been linked to negative impacts on performance and health. Excessive stress can even cause physical reactions such as difficulty breathing. Excessive stress is normal stress without any recovery or it’s an acute event such as a death, diagnosis of a disease or even something we might consider positive like having a baby. Excessive stress decreases our resilience capacity.

Using Recovery for Stress Transformation

By identifying the type of stress you are feeling, you have the power to change it, Johnson says.

For example, if you identify your stress as excessive, you can incorporate recovery (more on that in a minute) to change your stress to Normal Stress. If you have Excessive Stress and you change your perception by identifying the growth opportunities and positive aspects of that stress you can change it to Training Stress which increases your resilience.  

The key is to be aware of your stress and how it’s impacting you. Then keep it in check by changing your perception and incorporating recovery strategies. Here are three recovery strategies Johnson suggests perioperative nursing leaders can promote among their teams:

1. Engage in Personal Mindfulness and Micro-recovery

   Be mindful, pause and think about how you are feeling. If you recognize that stress is impacting you in a negative way, ask yourself why and then be intentional about recovery and change or reframe your perception about stress (this is called Cognitive Reframing). Be mindful that how you respond impacts your own performance and those around you.

   Try these micro-recovery strategies that take less than a minute: 

• Breath – Deep breaths from the diaphragm can reverse the physiological stress response;
• Practice gratitude – Write or think about 10 things you are grateful for;
• Movement - stretch or engage in a brief physical activity;
• Remind yourself of the people that matter most to you - call or text them. Let them know you are thinking of them;
• Random act of kindness - do something kind for no reason at all.

  One nurse leader Johnson worked with developed a strategic recovery trigger so that every time she touched a door knob, she took three deep breaths to help keep her calm and focused.



2. Talk About Common Stressors at the Department Level

   During a staff meeting talk openly about high stress events or common scenarios the broader team may be experiencing.

   “Often we discover multiple people on the same team think a specific stress is normal while others on the team believe that same stress is excessive. If you don’t talk about it together, members of your team could miss the fact that a situation is impacting colleagues’ (and even the whole team’s) performance in a negative way,” Johnson acknowledges.



3. Bring Recovery into Smaller Team Situations

A shared understanding of feelings and experiences with stress among smaller teams, such as during a preoperative huddle, can bring stress recovery into daily work. “Talk about risks or concerns with a procedure that are creating anxiety, and specifically how you can support each other. This conversation in itself can help to alleviate anxiety,” she suggests.

During a surgery, team leaders can encourage deep breathing or a brief stretch to allow personal micro-recovery strategies as part of a cultural norm. Nursing leaders can also initiate a shift debrief one hour prior to shift end to help team members debrief about stressful situations from the day and discuss what was learned from those situations. It’s a strategy in reframing and also helps from work to home.

“Leaders are the ones that make the difference in changing culture and instilling and reinforcing resilience strategies that help teams become more resilient from their stress,” Johnson says.

Johnson recently shared some of these strategies on behalf of Johnson & Johnson’s Human Performance Institute with perioperative nursing executives.

FREE RESOURCES FOR MEMBERS

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Guideline Essentials: Is poor team communication causing stress? Reduce stress from your workday by utilizing your easy-to-use Guideline implementation tools on Team Communication and more, including:

• Gap Analysis Tools: Tools to assess areas in which your facility may not be compliant with the guidelines.
• Policy & Procedure Templates: Ready-to-use customizable templates for developing your facility’s policies and procedures
• Competency Verification Tools: Ready-to-use customizable templates for verifying competency to meet facility requirements