Relaxation Strategies for Nurses

By Sheryl Ness, MA, BSN, ADN, RN

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Now more than ever, nurses need to have self-care strategies in place to manage the everyday stress of working as a nurse. Because nurses give so much to others as they help patients and their families manage a health crisis, they often lose track of caring for themselves. Dealing with the stress and anxiety of the current pandemic can have a negative effect on mental health and places even more pressure and responsibilities on nurses. Nurses often work long shifts and are being asked to do more with fewer resources these days. It is vital that they have the tools and skills to recognize stress and manage it with healthy self-care behaviors.

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Recognize Stress

The first step in the process is to recognize when stress and anxiety are becoming a problem. Constant stress affects the body more than we realize, and so it’s important to be aware of the mind-body connection. Stress hormones (e.g., cortisol, adrenaline) are meant to help the body through short periods of stress. However, long-term exposure to stress hormones can affect blood pressure, heart function, and the immune system.

So, what are some red flags to watch for? Stress can manifest in a variety of ways, including physical and emotional changes. Here are a few symptoms and/or feelings to look out for:

• Problems with sleep
• Being sick more often
• Lack of ability to concentrate/focus
• Irritability/anger
• New physical symptoms such as headache, muscle pain, chest pain, GI upset
• Increased fatigue or lack of energy
• Mood changes
• Work performance concerns
• Social isolation
• Feeling down or depressed
• Using alcohol, tobacco, or drugs to cope

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Discover Relaxation Strategies for “In the Moment”

The next step is finding the best relaxation strategy for you. Often, this can be a challenge. One place to start is to think about the relaxation strategies are you already familiar with. What has worked for you in the past? You may also want to consider which strategies are easiest to implement in the moment. We can’t always plan relaxation into our day, so having strategies that take only a few minutes might be one of the best ways to manage stress throughout the day.

If you don’t already have a relaxation “go to” strategy to use in the moment, find one that works for you. Some examples that work best in the moment include:

• Deep breathing
• Imagery or visualization
• Meditation
• Stretching/Mindful Movements
• Humor

Let’s take a deeper dive into each of these.

Deep Breathing

Deep breathing is one of the easiest ways to reduce stress on the body. To do this, simply take in a slow, deep breath (counting to 5), and then slowly let it out (counting to 5). If you can, it also helps to close your eyes so that you can focus. Be aware of your breath moving in and out. Try not to think of anything else. Do this for 3 to 5 minutes.

Imagery/Visualization

Imagery is a powerful tool that you can use to switch off the present stressful moment for a bit and take your mind to a place of happiness and joy. To do this, find a quiet spot and close your eyes. Take a few deep breaths and think about a happy memory from your past. It could be a memory that includes loved ones or people who had a positive influence on you. Or perhaps your memory is of a calm and relaxing experience while on vacation. Take your mind deep into the memory. Try to experience the memory with all your senses: what do you see, hear, smell, taste, and feel? Visualizing for as little as five minutes can have a profound effect on your stress level.

Meditation

Meditation is also a great self-care strategy for managing stress. You can pair it with relaxing music or silently repeating a specific word or mantra (such as “I am strong, I am resilient”). Find a quiet moment, take a few deep breaths, and calm your mind. If you have time, write down the feelings you are noticing. By journaling your thoughts, you can often “rewrite” your stress narrative from negative to positive.

“Nurses often work long shifts and are being asked to do more with fewer resources these days. It is vital that they have the tools and skills to recognize stress and manage it with healthy self-care behaviors.”

Stretching/Mindful Movements

Explore movement exercises that incorporate breathing and meditation with movement, such as gentle yoga or tai chi. These types of exercises not only help your body feel better, but also have a positive effect on your mind. Discover one or two of movements that you can easily incorporate into your day, whether it’s in the morning as you start your day or for 5-10 minutes when you have time for a short break during your shift.

Humor

There is nothing funny about stress. But if you can find time to fit in a little humor every day, it can only help. This strategy may be one you use with friends or family: Be silly with your partner, kids, or friends. Make something fun in the kitchen together. Watch a funny movie together. Laugh out loud and connect. To apply this strategy in the moment, think back on a funny memory to put a smile on your face for a few seconds, or simply enjoy a laugh with your nursing colleagues at the appropriate moment.

Relaxation Resources at Work

Consider workplace resources. Ask about resources from your Integrative Medicine department. These resources are not just for patients; staff are also often able to access these services to help manage stress. Ask about onsite programs that teach relaxation strategies to staff and help bring awareness to others who may also need help managing stress.

Meet with nursing leadership. Ask about designating quiet rooms with relaxing music or other relaxation tools to make it easier to take a quick R&R break during a hectic shift. Give real feedback to your nurse manager on the stress you are noticing in yourself and others.

Have a plan for self-care every day. Anticipate that you will have stress in your day. Keep yourself well hydrated and eat healthy meals to fuel your body to help manage stress as well. The mind-body connection is strong. In these busy days, you may only have a few minutes for a break, so be ready with the things you know your body needs.

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Create a Holistic Plan

As you discover what works best for you, plan your relaxation strategy. This is the time to think about your own health and well-being. Take the steps needed to keep your mind and body in the best state of being. Here are a few final tips to keep in mind:

• Make relaxation exercises a daily habit. Find what works for you and add 5-10 minutes of relaxation into your daily routine. Find an App or program that incorporates guidance and reminders.
• Eat healthy foods and stay well hydrated. Meal planning and having healthy snacks on hand are helpful.
• Be active and exercise doing something you love at least 3-5 times a week. This might be as simple as taking a 30-minute walk with a friend or going to the gym for a class or workout.
• Have your “in the moment” relaxation strategy ready to go. Practice it in advance so you can easily incorporate it anytime you feel stress being triggered during your shift.
• Do your best to find balance between work and home life.
• Ask for the things you need from others. You don’t have to do everything on your own.

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RESOURCES:

Apps (free)

• Calm
• Insight Timer
• Aura
• Sattva
• Smiling Mind
• Simple Habit

Websites

Stress Management, American Holistic Nurses Association
https://www.ahna.org/Home/Resources/Stress-Management

Health Information, National Center for Complementary and Integrative Health (NIH)
https://www.nccih.nih.gov/health

Guided Meditations, UCLA Health
https://www.uclahealth.org/marc/mindful-meditations

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REFERENCES:

Healthfinder.gov (2021). Manage stress. Retrieved from
https://health.gov/myhealthfinder/topics/health-conditions/heart-health/manage-stress

National Center for Complementary and Integrative Health (NIH). (2021).
Relaxation techniques: what you need to know. Retrieved from
https://www.nccih.nih.gov/health/relaxation-techniques-what-you-need-to-know

Office of Women’s Health. (2019). Stress and your health. Retrieved from
https://www.womenshealth.gov/mental-health/good-mental-health/stress-and-your-health

Seaward BL. (2018). Managing stress: principles and strategies for health and well-being. 9th ed. Burlington, Mass.: Jones & Bartlett Learning.
U.S. Department of Health and Human Services. (2019). Stress and your health. Retrieved from
https://www.womenshealth.gov/mental-health/good-mental-health/stress-and-your-health