Stress Management in the PACUJESSICA SELVAGGIO DNP, FNP-C

Common Sources of Stress in Nursing Being unable to effectively comfort or help patients

Caring for high acuity patients

Providing life-sustaining measures

Dealing with difficult patients and their families

Acting as the “middle-man” among multiple providers, the patient, and the patient’s family

(Vahedian-Azimi et al., 2017)

Stress in HealthcareHigh demands and responsibilities

Most common among nursing personnel who interact directly with patients

Providers often compromise their own self-carePersistently high stress levels lead to burnout

Burnout common among healthcare workers, especially nurses working in the hospital settings

(Gauthier et al., 2015; Duarte & Pinto-Gouveia, 2016)

Negative Effects of StressSubstance misuse/abuse or poor diet choices

Immune system dysfunction or chronic diseases such as cardiovascular disease and diabetes

Poor job performanceDecreased patient satisfaction

Increased medication errors or lapses in judgement

Increased risk for adverse events or negative patient outcomes

(McConachie et al., 2014; Lyndon, 2016; Grensman et al., 2018; Duarte & Pinto-Gouveia, 2016).

Effectively Managing StressImprove coping abilities

Decrease the likelihood of outbursts due to frustrations

Prevent negative coping habitsImprove overall well-being, including the physical and psychological effects of stress

Improve patient care and outcomes by improving workplace performance

(Grensman et al., 2018; Steinberg, Klatt, & Duchemin, 2017)

Stress….

What are we going to do about it?

Mindfulness-Based Cognitive Therapy

Mindfulness-Based Stress Reduction (MBSR) Model

A teaching curriculum developed by Jon Kabat-Zinn professor at University of Massachusetts

Teach healthy individuals how to observe stressful situations in a neutral and accepting manner

Utilizes mindfulness practices, meditation, self-awareness, and yoga

Traditional model:8-week curriculum2-hour weekly group sessions with a certified Mindfulness instructorOne 6-hour group retreat

(Horner et al., 2014; Khoury, Sharma et al., 2015).

Emptying the mindBeing aware of the

present momentAcknowledgeing

thoughts that contribute to stressPaying attention in a

nonjudgemental and nonreactive manner

(Horner et al., 2014; Grensman et al., 2018)

30 Seconds to MindfulnessPhil Boissierehttps://www.youtube.com/watch?v=ad7HqXEc2Sc

So… Let’s Practice being Mindful

PACU InterventionsWeekly Emails containing mindfulness practices

1-minute daily mindfulness guided meditation

Integrate mindfulness into daily tasks

1-Minute Daily Meditation How will it work?Report to unit as scheduled and clock inDesignated meditation station located in a

quiet area of the unitStart guided meditation and set available

timer for 1 minute

How will I do it?Download Mindfulness or Meditation

application to personal device, bring headphones. Or a community device will be made available

with a guided meditation provided

Think of an action that you do every day

As you’re performing that action, pay attention to it.

Try performing it for a longer time than usualPay attention to the bodily movements and sensations this task involves

Be aware of what this action means to you

“Just as you wash your hands before eating, clear your mind before engaging with the world.” - Mooji

Questions?!Jessica.selvaggio@unchealth.unc.edu

References

Duarte, J. & Pinto-Gouveia, J. (2016). Effectiveness of a mindfulness-based intervention on oncology nurses’ burnout and compassion fatigue symptoms: A non-randomized study. International journal of nursing students, 64. 98-107. Doi: 10.1016/j.ijnurstu.2016.10.002

Gauthier, T., Meyer, R., Grefe, D., & Gold, J. (2015). An on-the-job mindfulness-based intervention for pediatric ICU nurses: A pilot. Journal of pediatric nursing, 30 (2), 402-409. Doi: 10.1016/j.pedn.2014.10.005

Grensman, A., Acharya, B. Wandell, P., Nilsson, G., Falkenberg, T., Sundin, O., & Werner, S. (2018). Effect of traditional yoga, mindfulness-based cognitive therapy, and cognitive behavioral therapy on health-related quality of life: A randomized controlled trial on patients on sick leave because of burnout. BMC complementary and alternative medicine, 18 (1). Doi: 10.1186/s12906-018-2141-9

Horner, J., Piercy, B., Eure, L., & Woodard, E. (2014). A pilot study to evaluate mindfulness as a strategy to improve inpatient nurse and patient experiences. Applied nursing research, 27 (3), 198-201. Doi: 10.1016/j.apnr.2014.01.003

References (Continued)Khoury, B., Sharma, M., Rush, S., & Fournier, C. (2015). Mindfulness-based stress reduction for healthy

individuals: A meta-analysis. Journal of psychosomatic research, 78 (6), 519-528. Doi: 10.1016/j.jpsychores.2015.03.009

Lyndon, A. (2016). Perspectives on safety: Burnout among health professionals and its effect on patient safety. Patient safety network: Agency for healthcare research and quality, retrieved from https://psnet.ahrq.gov/perspectives/perspective/190/burnout-among-health-professionals-and-its-effect-on-patient-safety

McConachie, A., McKenzie K., Morris, P., & Walley, R. (2014). Acceptance and mindfulness-based stress management for support staff caring for individuals with intellectual disabilities. Research in developmental disabilities, 35(6), 1216-27. doi: 10.1016/j.ridd.2014.03.005

Steinberg, B., Klatt, M., & Duchemin, A. (2017). Feasibility of a mindfulness-based intervention for surgical intensive care unit personnel. American journal of critical care, 26(1), 10-18. Doi: 10.4037/ajcc2017444

Vahedian-Azimi, A., Hajiesmaeili, M., … Miller, A. (2017). Effects of stress on critical care nurses: A national cross-sectional study. Journal of intensive care medicine. doi: 10.1177/0885066617696853