3 Steps to Combat Depression

The COVID-19 pandemic is creating a wave of fear, anxiety, and depression across health care that perioperative nurses are not immune to.

In fact, the pandemic is putting the spotlight on the perioperative suite, where donning and doffing PPE, maintaining sterility and transmission-based precautions, and positioning patients for long procedures appropriately is now imperative for the entire healthcare organization to perform well, according to Mary Alice Anderson, MSN, RN, CNOR, AORN perioperative practice specialist.

“These pressures can take its toll,” Anderson says. “We know that the best nursing care comes from bringing our best selves to each shift, patient, and minute, which requires nurses to prioritize taking care of themselves and reducing occupational stress that may lead to depression, compassion fatigue, and burnout.”

Are You Fighting Depression?
Nurses who are aware of underlying depression can take steps to decrease its potential effect on their lives and careers, however, nurses new to depression brought on by the pandemic “may not be aware of internal dilution of joy and its outward effects, until it becomes obvious to others or begins to create real issues in their personal or professional lives,” Anderson cautions.

Here are several key signs of depression:

• Stress, including irritation, anger, or denial
• Uncertainty, nervousness, or anxiety
• Feeling helpless or powerless
• Lacking motivation
• Feeling tired, overwhelmed, or burned out
• Experiencing sadness
• Having difficulty sleeping or concentrating

Anderson says it’s important to recognize any signs of depression in yourself and colleagues in order to develop positive coping skills, to empathetically consult when you see signs and symptoms in others, and to seek help and professional assistance when needed. 

Know How to Fight Back

Despite the feeling of powerlessness that comes with depression, there are easy actions nurses can take in their daily life to protect their happiness and ability to care for patients, Anderson explains.

She suggests these three actions to shift feelings of depression:

1. Practice Mindfulness
   Mindfulness is one of the best, easiest, quickest ways to regain perspective in the moment, Anderson stresses.

Consider taking a mindful break each time you must wash your hands (which is, consequently, a lot right now). Feel the foam of the soap or alcohol in your palm and each finger, take a deep breath and smile to acknowledge the work you have or will do that day. A deep (potentially audible) sigh will relax your face, jaw, and shoulders when you exhale to physically de-stress yourself.

Also consider adding deep breathing or count-breathing exercises to your mindful breaks by inhaling and exhaling for four counts, then holding at the top and bottom for four counts.

2. Stay in Touch with Your Emotions

Becoming aware of your emotions and regulating any negative effects your emotions have on your reactions and behaviors can increase your sense of control, develop your resilience, and strengthen interpersonal communication, which can decrease the risk of stress turning to depression, burnout, or compassion fatigue, she suggests.

Voice recording your thoughts on the way to and from work can allow stress decompression and awareness of your accomplishments and potential areas for improvement the next day.

3. Talk About It

During lunch breaks, engage in a no-judgment discussion of nursing care and work-life balance concerns with others to seek perspectives and share practical insights to help yourself and others. 

Practice Self Care
Whether or not you are experiencing signs of depression, the increased demands and uncertainties that coronavirus has brought to perioperative nursing are real—making self-care a must for every nurse.

Here are Anderson’s recommended practices for building resilience to insulate yourself from the negative effects of the pandemic:

• Keep a consistent routine for healthy habits: including sleep, meals, breaks, and exercise
• Limit repeated traumatization by exposure to negative media
• Recognize the negative consequences of misusing substances to cope
• Journal to practice acknowledging and labeling emotions as they come
• Meditate through the absence of movement or active yoga
• Connect with others, especially to find good role models or serve your peers and community to become more mindful together
• Give yourself time with nature, off-line without technology

“Resilient healthcare personnel are less susceptible to depression and burnout regardless of the situation, so any and all practices that increase your individual health and wellbeing through resilience are worth pursing and trialing for yourself to improve your quality of life during the COVID-19 pandemic and returning back to the new normal afterwards,” Anderson advises.

“Nurses have to be ready to run the pandemic-marathon. Keeping yourself well—physically, mentally, emotionally, financially, and spiritually for the unforeseen long-haul is essential.”