When a traumatic or otherwise medical turn-of-events forces patients and their families to deal with serious, sometimes even life-and-death situations, it doesn’t always bring out the best in people. Yet as a nurse, there are many things you can do to de-stress an otherwise stressful situation. Taken together, these six small steps can yield significant results in calming everyone’s frazzled nerves.

1. Don’t Poke the Bear.

Remember that if you’re injured you can’t care for anyone, so be aware of your own actions and don’t aggravate someone who’s already aggravated. Although you may end up calling security if a person is escalating and you need assistance, oftentimes you can defuse the situation by just listening and being kind. Nodding your head and letting an otherwise frazzled individual rant and rave may not be a cure-all, but it could lower the room temperature. As Holly Carpenter, BSN, RN, policy associate in nursing practice and work environment for the American Nurses Association, notes:  “If you’re just reflective and empathetic, people will sometimes calm down. By taking the wind out of their sails, you’re helping them de-escalate. Often they just want to be heard.” 

2. Be Aware of Differing Family Dynamics.

Some relatives are by nature boisterous so just because you hear screeching doesn’t necessarily mean there’s a fight afoot. Teasing and sarcasm may just be the way they communicate. Likewise, one culture’s method of dealing with family and family issues may not be your method. So be aware of your internal biases and draw on the cultural competencies you learned in nursing school to ensure that you’re not the one making everyone’s stressors worse.

3. Speak Up.

Don’t take the situation personally, but also don’t be afraid to ask for another assignment if you’re tapped out by the drama. When it gets so heady that you don’t even want to enter the room, it’s reasonable to say to your manager, “You know, I’ve had this patient three days in a row and I just can’t be as good with him (or her) as I’d like to be. Is there anyone else who could try it for a few days?” By doing so, “you’re taking care of your own stress while ensuring that the patient doesn’t feel the fallout,” says Leslie G. Oleck, MSN, PMHCNS-BC, LMFT, a psychiatric clinical nurse specialist and a graduate instructor at the Indiana University School of Nursing.

4. Impose Visitor Policies.

Although it’s tempting to be the nice nurse who lets one more visitor into the room or gives everyone an extra 15 minutes, enforcing quiet hours is a good strategy for keeping troublemakers at bay. Rules push curfews on people who may be causing anxiety for the patient and you. Also, you want to know who really belongs to the immediate family, especially if you’re working on a restricted floor such as the ICU. For HIPAA and other reasons, it’s important, albeit sometimes difficult, to identify who’s who in the mix. When you do, you sideline those extra people who maybe visiting too often and asking too many questions much to the chagrin of an already upset family.

5. Get Further Training.

You likely have a psychiatric or mental health class under your belt from nursing school, so you should be able to pick up the relevant clues or dynamics about a family in distress. It’s never a waste of time, however, to enroll in any class that your employer offers to sharpen your communication skills or deepen your ability to recognize, negotiate, and resolve conflicts. Whatever the crisis, you want the best possible tools for anticipating, preventing and, if necessary, responding. That means filling out any incident reports so that your colleagues too have a heads-up to avoid a recurrence on later shifts. Also, brush up on the advice from your professional association and other relevant agencies.

6. Give it a Break.

Rather than eating lunch with your colleagues, take advantage of the fitness facilities your health center offers during that hour. That way you’re not bringing your patient-family concerns to the table. Also, while daily breaks are essential, time off from work is a must. “Nurses often feel guilty about taking vacations because they’re leaving everybody behind,” Oleck says. “But getting away for a few days or a week can help recharge your batteries so that you can come back and be the best patient caregiver ever.”

Chris Hinz

Chris Hinz is a freelance writer based in Milwaukee, Wisconsin.

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