Everyday life entails some level of stress. Although some people have been advised to reduce or avoid stress, for most of us, stress is inescapable. The good news is that recent research seems to indicate that not all stress is bad and that learning how to manage stress might be better than trying to avoid the unavoidable. We spoke to three members of Fairview Southdale Hospital’s emergency department—a typically high-stress environment—about how they define, manage and effectively respond to stress.
Defining Stress
Stanford University health psychologist Kelly McGonigal writes in The Upside of Stress that stress is what arises when something you care about is at stake. She believes that stress and meaning are inextricably linked and that you cannot create a meaningful life without some stress.
This definition becomes clearer when viewed through the lens of employees at Fairview Southdale’s emergency department. Patient care supervisor Peggy Steven notes that stress in her department is about saving lives–which they know how to do–but mostly about patient flow. “We worry about those who are waiting,” Steven says. “The stress is around wanting to provide excellent care from start to finish.”
Primary charge nurse James Kelton defines stress as the physical and emotional tension derived from adverse events or demanding situations, such as having to deliver bad news. He says, “[Nurses] must be advocates for patients and answer questions. We must hold steady.”
Kelton also believes there is a difference between good stress and bad stress. “Good stress is what motivates you, gets your adrenaline flowing and helps you to be sharp and alert. Bad stress is what gives you high blood pressure.” This view of good and bad stress is backed by McGonigal, who says, “Studies don’t show performance is enhanced by reducing stress but by our stress response.” While on the job, Kelton reminds himself whenever the emergency department lobby fills with people that this is what he lives for and to “focus on what matters.” He notes, “I can’t control the number of people coming in, but I can control what’s right in front of me.”
Dr. Shelli Bochert agrees that a constant flow of patients whose conditions can change at any moment can be a source of stress, but that the emergency department is also an environment where certain personalities can thrive under certain conditions. The recent renovation and expansion of the Fairview Southdale emergency department includes upgrades specifically designed to help provide a more ideal environment for staff and patients to better manage the stress associated with emergency medicine.
Coping skills
When we asked these emergency department staffers how they manage stress, here’s what they had to say:
Steven: “Teamwork and collaboration. Our setting is unique in that we all work together as a team. Also, our assessment skills. When someone walks through the door, we’re trained to have a good idea of what’s going on.” Steven also works to remember good things, noting that psychologist and author Martin Seligman tells people to regularly recall three good things about their day and the role they played in that.
Kelton: “I live an hour away and that can be good because [the commute] means I have time to let things go before I go to sleep.” He also loves music and says listening to music during his car ride can be cathartic and good for his mood. (At the top of Kelton’s playlist are upbeat songs by Boston, Journey and Kool and the Gang.)
Bochert: “I like to travel and regularly plan big trips to where I can climb mountains and be in nature with no phone.” Bochert also likes to escape to her Minnesota cabin where there is no television or telephone and guests are politely asked to put their phones away. “Even the drive is a time of decompression,” she says.
Bochert admits that emergency medicine might attract the kinds of personalities who enjoy busyness and have learned to work well in a high-pressure environment filled with noise and interruptions. That said, she didn’t realize how much the new emergency department design at Fairview Southdale would help minimize some stressers. There are larger patient rooms to accommodate family members. The staff is now situated in an interior workspace, sort of like a hub or mission-control that is separated from the check-in area; as a result, it’s quieter and can provide for better focus. Patient rooms with sliding doors instead of curtains for better privacy and noise reduction encircle the central staff workspace. “Now, when one patient is feeling sick, they can no longer overhear another patient who is getting sick. [The new design] is more relaxing for everybody,” Bochert says.
Foster Resilience
McGonigal notes that remembering the context of what you are going through can reduce the tendency to feel like a victim of stress and instead help find meaning in your stress. Emergency department staffers at Fairview Southdale Hospital participate in regular case reviews. These meetings are sort of like debriefing sessions that mostly focus on the clinical aspect of health care: What went wrong? What went right? Is there anything that could have been done better? But it’s also a time to share feelings with trusted teammates who are in the trenches with you and who understand what you’re going through. A hospital chaplain may even participate to help staffers talk through the emotional aspects of a particularly difficult situation.
Working so closely to anguish, trial and tragedy creates a cherished camaraderie among employees. Low turnover helps develop a high level of trust among colleagues and facilitates effective teamwork. Steven says, “We want people to want to come back to work and be engaged.” This is encouraged by allowing any employee to offer possible solutions to problems and help select goals that will improve the work environment or break down any barriers to success. Everybody has a say.
Empowerment helps people to better manage feelings of stress. So the next time you’re feeling stressed, try to remember how these professionals cope with daily stress and focus on the resources you have that can help you to rise to the challenge.
