Hazardous Duty: How Nurses Cope with Stress and Grief on the Job

By Jim Stallard,

Closeup photograph of a nurse and patient holding hands
Summary

Nursing can be stressful and emotionally exhausting, leading to risk of compassion fatigue. But there are many effective methods available for reducing stress and managing grief that may arise.

Many nurses find their work to be tremendously fulfilling. But nursing can also be stressful and emotionally draining.

Patricia McTague-Allen, an oncology Nurse Leader at Memorial Hospital at Memorial Sloan Kettering, acknowledges the challenges. “I don’t think we always appreciate how hard it can be to go from providing support for someone in great discomfort, or who is terminally ill, and then be able to bounce back and go into the next room and smile,” she says.

Nurses often develop deep relationships with patients, who may be in the hospital for extended periods. It can be easy for nurses to become emotionally invested and to find it difficult to detach. This raises the risk of developing compassion fatigue. The condition is marked by extreme tension, isolation, lack of feeling, and loss of the capacity to feel and care for others.

Tips for Reducing Stress and Compassion Fatigue

This type of chronic stress can seriously impact nurses’ physical and mental health. But there are effective ways to relieve stress and prevent compassion fatigue. Here are six strategies nurses can adopt:


  1. Talk to your colleagues. Fellow nurses are the ones who truly understand what you are dealing with — more so than even the most supportive spouse or close friend. “What really helps is talking with those who are involved in the same situation as you,” says Victoria Murphy, who has been a nurse at MSK for more than eight years. “You can cheer each other on and pull each other through.”

  2. Learn to detach during off hours to re-center and rejuvenate. Nurses need to separate and maintain their own lives. MSK oncology Nurse Leader Maureen Laffey says that some nurses in their first few years will check in during off-hours to see how a patient is doing. “They carry it with them 24/7,” she says. “After a while, it can saturate them and become too much.” It’s important to maintain a clear division between home and work life. On days off, be certain to disengage from work concerns and focus on family, hanging out with friends, exercising, indulging a hobby — in short, doing things that make you happy.

    What really helps is talking with those who are involved in the same situation as you.
    Victoria Murphy nurse
  3. Take advantage of available resources for help. Most hospitals offer nurses resources such as private counseling, stress reduction classes, and designated spaces for relaxation. MSK has a variety of support programs to help relieve stress and grief. One that started this year is called the Zen Den, a weekly event for nurses and other staff members to meet for a half-hour for meditation, arts and crafts, or even to watch a short movie. MSK also holds remembrance ceremonies to help nurses deal with grief over patients who have died.

  4. Be vigilant about signs of stress or depression in fellow nurses. Nurses know their coworkers’ state of mind better than anyone. They often can be the first to detect when a colleague is becoming overtaxed or suffering from the physical and emotional exhaustion commonly known as burnout. If someone is showing signs of fatigue, irritability, anxiety, or apathy, they may need support or intervention.

  5. Support each other in being able to step away from the nursing unit for brief periods. Nurses often feel obligated to stay near their patients at all times, but stepping away from the environment for even 30 minutes can make a big difference. “There’s a lot of guilt in nursing about taking time for yourself, so we implemented a buddy system on the unit,” Ms. McTague-Allen says. “Your buddy is supposed to make sure you take a break. We encourage them to leave the floor for lunch for their own well-being.”

  6. Never lose sight of the value of your work to patients and family. Nurses bring comfort and ease suffering, even in cases where the patient’s outcome is not good. “Nurses always wish they could have done more, especially when a person dies,” says Ms. McTague-Allen. “It’s important to appreciate how much you did do and how much you comforted the family. They may not remember your name five or ten years from now, but they’ll remember your kindness and how you made them feel.”

Comments

The PASTRY Program, which was started on the inpatient Pediatrics unit at MSKCC, and has spread to many units, has helped to support nurses. It’s main goal is to combat moral distress, while also providing coping mechanisms for RNs. This initiative has validated nurses and aided in processing and healing. It’s through programs, initiatives, and awareness, like the PASTRY program and Zen Den, that rejuvenate nurses to keep them serving our patients and playing integrate roles in patients’ journeys. Thank you for highlighting this vital topic.

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