1. Liliana Medina-Pimentel Jacksonville University May 8, 2015 RECOGNIZING STRESS SIGNS FOR NURSES

2. Problem According to Burke, stress to nurses is caused by pressures and work demands (2013 ). A survey done in 2012 with about 3,000 nursing participants showed that 42% of nurses were categorized as having emotional fatigue (Burke, 2013). Stress in nursing has become a worldwide concern (Happell et al., 2013).

3. Major Factors for Nurses to be Stressed Inadequate staffing Insufficient time to finish tasks Working during their break time Job dissatisfaction Workload Physical and emotional demands Working long hours Difficult patients and families Relationships with physicians

4. Physiological Changes Due to Stress The sympathetic nervous system and the adrenal-cortical systems prepare the body for the “fight-or-flight” response. By the activation of these systems, there is a production of several hormones in the body. These hormones cause accelerated heart rate, high blood pressure and sugar levels, vasoconstriction and failure of the digestive and immune systems.

5. Repeated Activation of the Sympathetic and Adrenal-Cortical Systems Troubles with temperament and sleep Digestive problems Headaches Family problems Difficulty concentrating Elevated blood pressure and cholesterol Cardiovascular diseases Infections Nervousness Depression Early Signs of Stress Chronic Signs of Stress

6. Stress Related Outcomes Nurses could get depressed They are unable to sleep They could feel inadequate They doubt themselves They have low self-esteem They tend to be irritable

7. Stress and Adoptive Behaviors Due to constant stress nurses adopt unhealthy behaviors: Smoking Drinking Inactivity Drugs Psychiatric consults

8. Job Stress Interventions Roberts and Grubb (2014) acknowledged that there should be a combination of interventions to reduce stress and ensure nurse’s safety. These interventions include: Person-focused Organization-focused

9. Person-Focus Stress management programs Nurses control a stressful situation Nurses get educated regarding stress and health Person-focus program teaches nurses skills to recognize and cope with stress.

10. Organization-Focus By using this method, the goal of an organization is to remove stressful working conditions. Some interventions include: Organizations redesign jobs and their descriptions Make nurses and management committees Improve nurses involvement and participation in creating decisions Their goal is to focus on nurse to patient ratios, modifying working hours, providing breaks, and a balance assignment.

11. Conclusion It is well known that nursing is a very challenging career. It is the nurses’s choice to recognize early signs of stress in order to prevent unhealthy adoptive behaviors.

12. References Burke, M. (2013). Managing work-related stress in the district nursing workplace. British Journal of Community Nursing, 18(11), 535-8. Donovan, R., Doody, O., & Lyons, R. (2013). The effect of stress on health and its implications for nursing. British Journal of Nursing, 22(16), 969-73. Happell, B., Dwyer, T., Reid-Searl, K., Burke, K. J., Caperchione, C. M., & Gaskin, C. J. (2013). Nurses and stress: recognizing causes and seeking solutions. Journal of Nursing Management, 21(4), 638-47. doi: http://dx.doi.org.ju.idm.oclc.org/10.1111/jonm.12037 Roberts, R., & Grubb, P. L. (2014). The consequences of nursing stress and need for integrated solutions. Rehabilitation Nursing, 39(2), 62-9. Doi: http://dx.doi.org.ju.idm.oclc.org/10.1002/rnj.97 Stressed Out Nurse Oval Ornament by Scott64. Retrieved 5/8/15 from www.cafepress.com Stress Symbol. Retrieved May 15, 2015 from sixtipstobuldresilienceandpreventbrain-damaging- stress. WWII Smoking Nurses. Retrieved May 15, from weheartit.com/entry/group/11353599