Essentials of Nursing Leadership and Management, 5th Edition

chapter 13 | Work-Related Stress and Burnout 211

Reframing

Reframing is looking at a situation in many differ-
ent ways. When you can reframe stressful situa-
tions, they often become less stressful or at least
more understandable. If you have an extremely
heavy workday and believe it is due to the fact that
your nurse manager created it for personal reasons,
the day becomes much more stressful than if
you realize that, unfortunately, all institutions are
short-staffed.

Humor

Laughter relieves tension. Humor is a good way to
reduce stress both for yourself and your patients.
Remember, however, that humor is very individual,
and what may be funny to you may be hurtful to
your patient or coworker.

Social Support

Much research has been done to show that the
presence of social support and the quality of rela-
tionships can significantly influence how quickly
people become ill and how quickly they recover. A
sense of belonging and community, an environment
where people believe they can share their feelings
without fear of condemnation or ridicule, helps to
maintain a sense of well-being. Having friends
with whom to share hopes, dreams, fears, and con-
cerns and with whom to laugh and cry is para-
mount to mental health and stress management. In
the work environment, coworkers who are trusted
and respected become part of social support sys-
tems (Wolinski, 1993). Box 13-7 lists some addi-
tional tips for coping with work stress.
Nurses are professional caregivers. Many years
ago, Carl Rogers (1977) said that you cannot care
for others until you have taken care of yourself. The
word self ishmay bring to mind someone who is
greedy, self-centered, and egotistical; however, to
take care of yourself you have to become creatively
self ish.Learn to nurture yourself so that you will be
better able to nurture others.
Stress reduction, relaxation techniques, exercise,
and good nutrition are all helpful in keeping ener-
gy levels high. Although they can prepare people to
cope with the stresses of a job, they are not solu-
tions to the conflicts that lead to reality shock and
burnout. It is more effective to resolve the problem
than to treat the symptoms (Lee & Ashforth,
1993). Box 13-8 lists the keys already discussed to
physical and mental health management.

Organizational Approaches to Job Stress

The nursing shortage phenomenon has cause many

organizations to address issues of stress on the

job as a method of recruitment and retention.

Organizational change and stress management are

useful approaches for preventing stress at work.

The National Institute for Occupational Safety and

Health has identified factors that lead to a healthy,

low-stress workplace ( Judkins, Reid, & Furlow,

2006; Sauter et al., 1999):

■Employee recognition for performance

■Opportunities for career development

■An organizational culture that values the

individual

■Management decisions that are aligned with

organizational values

box 13-7

Coping With Daily Work Stress

Spend time on outside interests, and take time for yourself.

Increase professional knowledge.

Identify problem-solving resources.

Identify realistic expectations for your position. Make sure

you understand what is expected of you; ask questions if

anything is unclear.

Assess the rewards your work can realistically deliver.

Develop good communication skills, and treat coworkers

with respect.

Join rap sessions with coworkers. Be part of the solution,

not part of the problem.

Do not exceed your limits—you do not always have to say

yes.

Deal with other people’s anger by asking yourself, “Whose

problem is this?”

Recognize that you can teach other people how to treat you.

box 13-8

Keys to Physical and Mental Health

Management

Deep breathing

Posture

Rest

Relaxation

Nutrition

Exercise

Realistic expectations

Reframing

Humor

Social support