Advice and development

Understanding human factors and how they can help nurses manage stress

Human factor skills equip you to read tricky situations and respond to them in a positive way

Human factor skills equip you to read tricky situations and respond to them in a positive way

Picture: iStock

Human factors is the science of how we think, act and interact with each other in different circumstances. Essentially, it is about being human, and how external and internal conditions affect our behaviour.

Human factor skills are the tools we use to function in everyday life, such as communication, working as a team, and using situational and spatial awareness. We use human factor skills all the time in both our personal and professional lives we just dont identify them as such.

Multidisciplinary learning reveals diverse responses to human factors

Over the past five years, I have been using simulation to teach

Human factor skills equip you to read tricky situations and respond to them in a positive way

Picture: iStock

Human factors is the science of how we think, act and interact with each other in different circumstances. Essentially, it is about being human, and how external and internal conditions affect our behaviour.

Human factor skills are the tools we use to function in everyday life, such as communication, working as a team, and using situational and spatial awareness. We use human factor skills all the time in both our personal and professional lives – we just don’t identify them as such.

Multidisciplinary learning reveals diverse responses to human factors

Over the past five years, I have been using simulation to teach human factor skills to health professionals, including nursing, midwifery and medical students.

Human factor skills: a definition

The Health and Safety Executive defines human factor skills as environmental, organisational and job factors, and human and individual characteristics that influence behaviour at work in a way which can affect health and safety.

Students are taught in multidisciplinary groups because not only are we a team who should train together for the best possible outcomes for our patients, we all relate and respond to human factors in different ways.

We will each have our own interpretations of events or situations, and what one person may find difficult, another may see differently. By working together, we are more likely to come up with a solution to a problem.


Recognising stress helps you take positive action

Understanding human factors can help us cope with anxiety and stress. Think back to your first clinical placement, and all the expectations you put on yourself and others. Getting ready the night before your shift, not knowing what awaits you, then entering the clinical environment for the first time.

Do you remember feeling both physically and mentally stressed? The raised heart rate, increased breathing, over-thinking the situation? This is a natural response to stress, and you are not the first person to feel this way.

Fight or flight response

Stress can be both good and bad. When we are stressed, we release adrenaline into our body, which gives us the ‘fight or flight’ response. This surge of adrenaline can motivate us, enabling us to respond quickly to situations and heighten our awareness, which makes us more productive.

But there is a limit to how far this adrenaline will push us, and that limit is different for everyone. When we get too stressed, we make mistakes, some of which we may not even recognise until colleagues point them out to us. Too much stress and we can develop fixation, or ‘tunnel vision’.

Have you ever been late leaving the house to catch a train, for example, because you couldn’t find your wallet? You rush off towards the station, forgetting to have breakfast, only to find the train is running late anyway.

This is an example of stress; you got up and ready, aiming to leave at a certain time, but you became fixated on a problem and forgot to eat, all because you were stressed.

Coping with difficult work situations

Now let’s apply this to a healthcare situation. I recently had to do a rapid sequence induction, a process for endotracheal intubation, and was handed the drugs I needed, which I had checked.

But as I had not laid out the tray myself, I froze when I started administering the drugs as I could not understand the layout of the tray. I knew I was stressed, so after checking the patient was safe, I took ten seconds to clear the tray and reset it to how I needed it to be, leading to a safe intubation.

By recognising I was stressed, I was able to take a step back and organise my thoughts so I could function better. This also avoided fixation later during the procedure.

Every time you start a new placement, there is a lot of information to take in, even before you arrive in the clinical area. When you open the door you hear call bells, alarms, bleeps going off, people talking. Then there are the unfamiliar smells, the bright lights, and staff wearing different uniforms.

All of these add to our cognitive load and we can struggle to take it all in, which increases our stress levels.

So how can this stress be managed? Here are my top tips.

How nurses can ease their work-related stress

    • Prepare thoroughly Preparation can help reduce stress, so try to prioritise and prepare your workload in advance where possible. Get organised the night before your shift by making a checklist. This can make you feel more calm and help ensure you don’t forget anything
    • Take time out In the immediate situation, take time out and do something productive, such as washing your hands. This gives you the time and space to organise your thoughts. We can also reduce stress by taking time out for ourselves. Having a moment, even if it is just to stretch and stand in the sun, helps us to take stock and prioritise our thoughts. Self-care is not optional in nursing
    • Communicate Stress can be reduced just by saying it out loud, so tell your colleagues if you are feeling stressed. Other students will probably be feeling the same, and once you have said it’ everyone is aware of the issue and empowered to deal with it. Communicating this information shows you are aware of stress as a factor when delivering healthcare
    • Debrief If I go home and tell my wife I’ve had a stressful day with a ventilated patient with an adrenaline infusion, she might look at me blankly. But if I talk to my work colleagues about this, not only can I share information, which helps relieve the stress of the job, I can get feedback if I want it. Our work is physically and emotionally draining and talking about it enables us to offload some of our concerns. Debriefing is one of the most powerful tools we have; we can use it to learn what we did well and what we might do differently next time, and it relieves the pressure that can lead to overthinking, which just adds to the stress we are already under

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