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The stress burden: strategies for management.

Stress is the body's natural psychological, physical and social response to the changes and demands of everyday life. In 2011, forty-four percent of Americans said their stress level had increased over the past 5 years (1). Common causes of stress include: money, job and job security, relationships and family responsibilities, and health problems.


Employee stress and burnout cost approximately $250 to $300 billion annually (2). One in five nurses leaves a job because of stress and burnout (3). The cost for each nurse turnover ranges from $62,100 to $67,000. For every 15 nurse positions left vacant from turnovers, it can cost up to an additional $1 million to an organization (4).

Stress can be either acute or chronic. While acute stress is normal and helpful in preparing the body to react quickly in response to a challenge or threat, chronic stress of ongoing compounded acute stressors for long periods of time, can be problematic.

Prolonged stress creates tension, nervousness and leaves the body's stress response system turned on long term. This disrupts normal body processes and can result in health problems if not corrected. Common symptoms of stress include: headaches, fatigue, digestive problems, irritability, chest pain, anxiety, anger, sleep problems, overeating, depression, decreased sex drive, and drug or alcohol abuse.

Left unchecked, chronic stress can lead to significant health problems including high blood pressure, heart disease, obesity, diabetes, and memory loss.

Stress management begins with identifying the sources and triggers of stress and developing strategies to management them. Effective strategies include the following:

* Set limits for yourself. Be assertive. Say no to requests that create excessive stress

* Remember that events will occur that you cannot control. Develop healthy coping skills

* Make time for hobbies and other interests

* Seek social support from those you enjoy

* Eat a healthy well balanced diet

* Get adequate rest and sleep to restore the body and mind

* Start an exercise routine. Almost any kind of exercise, such as aerobic or weight lifting can relieve stress. Regular exercise increases energy, self-confidence and elevates mood. Set specific goals such as committing to walk three times a week. Work out with a friend to stay committed. Change the workout routine to stay motivated, such as alternating between walking, yoga or Pilates. Always remember to consult a healthcare provider before starting a new fitness program, especially if there are pre-existing medical conditions

* Relaxation involves different techniques that decrease the effect of stress on the body. Meditation is a relaxation technique between the mind and body which promotes a sense of calm, peace and balance. It focuses on increasing self-awareness and reducing negative emotions. Meditation is often conducted in quiet settings, focusing the mind away from distractions using relaxed breathing techniques. Common relaxation techniques include: hypnosis, massage, and meditation (guided imagery, mantra, Qigong, Tai Chi and Yoga)

* Lastly, keep a positive attitude. Recognize that stress is a normal occurrence in life. How you manage stressors will determine if you successfully triumph over them or collapse from the pressures they create.


(1.) American Psychological Association. The impact of stress. Available at: Accessibility verified March 4,2012

(2.) Jones, D., Tanigawa, T., & Weisse, S. (2003). Stress management and workplace disability in the U.S., Europe, and Japan. Journal of Occupational Health, 45, 1-7.

(3.) Aiken, L.H., Clarke, S.P., Sloan, D.M., Sochalski, J., & Silber, J. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Journal of the American Medical Association, 288(16), 1987-1993.

(4.) Jones, C. (2005). The cost of nurse turnover: Applications of the nursing turnover cost methodology. Journal of Nursing Administration, 35(1), 41-49.

(5.) MayoClinic. Stress management. Available at: Accessibility verified March 4, 2012

(6.) WebMD. Stress management health center. Available at: Accessibility verified March 4,2012

Denise S Rowe, MSN, APRN, FNP, BC
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Title Annotation:healthy nurses
Author:Rowe, Denise S.
Publication:Nevada RNformation
Date:May 1, 2012
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