Nursing in survival mode: how to stop your stress turning into distress

Protect your emotional well-being by acquiring helpful habits and letting go of unrealistic expectations

By the end of January, some of us would normally be reflecting on our new year resolutions. This time a year ago, we may have been asking ourselves ‘am I on track with my goals?’.

But that was then, and this is now. The landscape of nursing has changed, hopefully not forever, but this is a winter unlike any other and we are now in survival mode, where feeling drained and exhausted is normal.

If you look at Maslow’s Hierarchy of Needs, most of your energy is probably focused on your physiological and safety needs. This is not the time for making grand plans – the last thing you need is the added pressure of unattainable goals, so ‘self-actualisation’ can wait.

When stress tips over into something destructive

With so much pressure and uncertainty both at work and at home, it is unrealistic to expect to be free of stress right now.

Stress can manifest itself in different ways – physically, emotionally, mentally and behaviourally – but it is important to remember that even though stress is inevitable, distress is not.

‘It is also worth checking that your habits are actually working for you, not against you’

This is best described in the Nursing Standard podcast on how nurses’ can look after their own well-being during the COVID-19 pandemic, where Colin Hughes, psychotherapist and lecturer in mental health nursing at Queen’s University Belfast, talks about recognising when ‘normal stress’ tips over into potentially harmful distress.

• RELATED: When stress gets too much: how to take control of what threatens to overwhelm you

The starting point is to reflect on the signs and symptoms you experience when you are stressed – don’t think of anyone else, just concentrate on how you know when your stress levels are raised.

Strategies for psychological protection

Mr Hughes describes strategies to ease stress and protect your psychological well-being based on what is happening now, including creating new routines. He even suggests timetabling when you rest, as well as accepting what you can and cannot control and reducing time spent online.

Mr Hughes recommends getting into the habit of short debriefs at the end of every shift – even five minutes can help you and your colleagues create a boundary between work and your life outside.

• RELATED: How to switch end of your shift

Now is not the time to compare yourself to others. On top of everything else you have to cope with, don’t beat yourself up by wishing you were stronger or more resilient. For now, you just need to get through one day at a time, protecting your physical, mental and emotional well-being as best you can.

Your reserves are being tested like never before, but you know yourself better than anyone else and what helps you cope may be different to what helps your colleagues.

Adjust your habits and recalibrate the demands you make of yourself

With lockdown having a profound effect on hobbies and recreation, you may have to adjust some of your coping strategies. This means accepting where you are and letting go of where you wish you were or expected to be.

If you normally run 5k to switch off after a difficult shift, for example, you may find that you do not have the energy, and that’s okay. This too will pass, but for now, try going for a shorter run or a walk.

• RELATED: Self-care for nurses: it’s not selfish to think of your own health and well-being

It is also worth checking that your habits are actually working for you, not against you. I find the news addictive yet distressing, so am trying to be mindful of how much time I spend scanning news online or watching it on television.

I also have to watch how much idle screen time I am consuming. I love reading books, so try and do this instead of wasting time online, reminding myself that I don’t need to be an expert in COVID-19 statistics across the UK.

Don’t wait to seek help if you notice signs of distress

Finally, and most importantly, if you are not coping, don't struggle on alone. As soon as you notice warning signs, such as what you are feeling is outside your ‘normal stress’ parameters, you must seek additional support.

Whether this is informally from a friend or colleague or more formal professional support, the main thing is to reach out. Don’t listen to that internal voice saying, ‘I should be able to cope better,’ listen instead to the kind and caring voices of those around you.

Related articles

• When stress gets too much: how to take control of what threatens to overwhelm you
• How to switch end of your shift
• Self-care for nurses: it’s not selfish to think of your own health and well-being
• Nursing Standard podcast: Looking after your own well-being

Mandy Day-Calder is a life/health coach with a nursing background. She runs a healthcare training company