12 Tips for Nurses to Deal with Pre and Postshift Anxiety
Whether you are a new nurse or a seasoned professional, you may be trying to cope with anxious feelings and thoughts before or after your shift. It isn't uncommon for nurses to deal with pre and postshift anxiety. Many nurses struggle with fears around rejection, inadequacy, and making mistakes as a nurse.
These feelings can make you drag your feet getting ready for work, which only increases your stress and nursing anxiety. But some strategies and techniques can help reduce anxiety levels before and after shifts. They can help you cope with the daily risks faced by nurses.
Discover 12 important tips you can use in your routine that can reduce stress and anxiety on this page. Reducing emotional exhaustion and stress may help decrease your risk for burnout, too.
12 Tips From Nurses for How to Soothe Anxiety
It can be typical to experience stress while working in healthcare. After all, you are often responsible for another person's health, safety, and life. That can get rather nerve-racking!
Read through these strategies and consider including one or two at a time until they become a habit. Before long, you'll be reaping the reward of less stress and more peace in your life.
1. Incorporate Regular Exercise Into Your Routine
Exercise plays a significant role in stress management. Stress is inevitable and impossible to totally eliminate. However, you can learn to manage it. One of the best-known coping strategies is exercise.
The mental and physical benefits of exercise include:
- Improved cognitive function
- Improved concentration
- Improved sleep quality
- Immune system support
- Muscle development
- Calorie burn
Deji "DJ" Folami is an intensive care unit registered travel nurse who values exercise to help reduce stress and keep him healthy. Despite working the 7 a.m. to 7 p.m. shift, he gets up early to go to the gym.
"I take my physical health very seriously and exercise at least five days a week, including running and lifting weights, most often before I go to work," Folami says. "I find that it helps keep me energized."
Reducing your overall stress level can help lower your nursing shift anxiety level before and after work. It may also lower your risk of making a medical error. Mistakes increase your stress level. Suddenly you're in a vicious cycle of stress, anxiety, and an increased potential of making another mistake.
2. Find a Fulfilling Community Outside of Work
Working long hours in a stressful situation can leave you emotionally and physically exhausted. It may feel too difficult to connect with a community outside of work when you are tired from a full day at work.
However, you need that human connection to prevent nursing anxiety, reduce stress, and improve your productivity and creativity.
There are several ways of connecting with people. Consider:
- Joining a religious or spiritual group
- Volunteering with a local organization
- Starting a book club or game night
- Joining a running club
- Going on group hikes
- Spending quality time with friends or family members
Ditch the television and consider playing a game, taking a walk, playing miniature golf, or connecting over coffee. The idea is to talk, have fun, and seek community, which helps you feel less anxious and more connected to your support systems.
3. Create a Calming Morning Routine
How you start your day impacts how the rest of the day progresses. The Navy Seals begin each day by making their bed because they know they can build on that completed task as they go through the day. In the same way, you can fall back on a calming morning routine as your day gets more hectic.
Folami starts each morning reading the Bible and praying before heading to the gym to work out. He uses this routine to calm his mind and focus on the remainder of the day.
Susan J. Farese, MSN, RN, is a veteran and owner of a communications company. She begins her day drinking herbal tea or golden milk.
Golden milk is a traditional Indian drink made with plant-based or cow milk and turmeric. You may also add cinnamon, ginger, honey, and other spices.
Some of the benefits attributed to golden milk include:
- Reducing inflammation
- Improving mood and memory
- Supporting brain function
- Boosting the immune system
- Aiding in digestion
You might create your own calming morning routine that includes an early morning walk, journaling, or sitting and sipping a cup of coffee or tea.
4. Create an Uplifting Commute to Work
Your mood and energy level help define how you perceive a stressful situation but you can intentionally elevate your mood before work by taking a few simple steps.
Consider keeping a list of inspiring podcasts that you can play on your commute. You may also consider grabbing a special treat on your way to work that makes you feel pampered and loved.
Put together a playlist of musical tunes that you know lift your mood and strengthen your mind. Play it on your commute to work. Music has proven to improve your mood and productivity.
Music can drag you out of a bad day and set the mood for a good day. Music is a universal bond across cultures and has scientific evidence that it benefits mental health.
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5. Before Starting Your Shift, Calm Your Mind
When you approach a stressful situation with a calm mind, you have a greater chance of conquering the situation. Breathing techniques are an easy and effective way to calm your nervous system. When you are anxious before your shift, try regulating your stress hormones by taking three big, slow breaths before your shift.
Another breathing technique that helps reduce stress hormones is box breathing. It is a simple deep breathing exercise you can do in your car, at lunch, or anytime you have 3-4 minutes to yourself. The technique activates the parasympathetic system and lowers your stress level.
Box Breathing Technique
- To start, sit or stand straight and breathe out slowly to release all the air from your lungs.
- Breathe in slowly through your nose to the count of four.
- Hold this breath for the count of four.
- Then exhale to the count of four.
- Hold your breath for a count of four.
- Start again, breathing in slowly through your nose to the count of four.
- Repeat this for three to four rounds.
Folami recommends consciously leaving your stress in the car as you are going to work. This helps to clear his mind and prepare him for patient care. Breathing techniques can aid in a clear mind.
"Once I get out of the car, I think about leaving any stress I have in the car, so I can start my shift with a clear mind that's ready to have a positive impact on my patients as well as my coworkers," he says.
6. Create a Calming Commute to Home
After your shift, you may again face nursing shift anxiety and stress from the 8-12 hours you spent giving patient care. You want to leave your stress at work so it doesn't impact your relationships with your family and friends.
On your commute home, try:
- Using box breathing described above
- Listening to calming music
- Talking with a friend on the phone who understands the stresses of patient care
Having an effective wind-down routine for nurses helps you decompress after a long day. Once you're home, take a walk in nature or a hot soak in the tub before facing the evening activities. You could also brew a cup of lavender, chamomile, or mint tea, which are each recognized for its calming effect on mood and emotions.
7. Get to Work Early
One way to avoid anxiety and practice self-care is to arrive at work with time enough to decompress before clocking in.
Being late is the leading cause of stress, according to one survey. The survey of 2,000 adults also found 63% claimed to have had days where they were stressed from the moment they woke up until they went to bed.
Decide to get to work early each shift, so you don't start the shift anxious because you were late. Being early also gives you time to mentally transition to work, get organized for your shift, and check in with colleagues before you get started.
8. Take Care of Yourself While You Work
It's important to take care of yourself while you're working too. Starting your shift with a calm mind helps start your shift well, but don't neglect your mental health while you're working. Folami has a routine he uses throughout each day that he calls PEELS.
PEELS stands for:
These are reminders to care for his physical, emotional, and mental health as he cares for others. Praying doesn't have to be religious, but rather a time to meditate or still the thoughts in your mind.
He also uses positive reinforcement throughout the shift, reminding himself:
"I am good at this, that's why I AM here. No matter what happens, I choose to make it a good day."
Managing anxiety also means taking care of yourself physically. For example, drink plenty of water throughout your shift to stay hydrated. Take care to eat well before your shift and take the time to eat a healthy meal during your shift. It can be difficult to take a break, but this is important for your mental and physical health.
It can also help reduce your nursing anxiety level when you are flexible in your plans for your day or your shift. In healthcare, you don't know when an emergency will happen and disrupt your schedule. Staying flexible and managing expectations reduces the stress that an emergency can cause.
9. After Your Shift, Exit With a Coworker
No one knows better the stress and anxiety from working as a nurse than another nurse. If you can, leave work with a coworker. Talking and sharing your negative emotions can be healing.
Researchers have found that labeling your feelings reduces the neural activation in your amygdala, the area of the brain responsible for the flight or fight response. When you label your emotions and talk about them, it moves your response away from the limbic region and you become more mindfully aware.
10. Engage in Creativity or Writing
When you engage in journaling or other types of writing, it can also move your emotions away from reactivity and anxiety. Farese enjoys using creative art to help reduce her nursing anxiety and stress levels. Her creative outlets are photography, writing, and teaching poetry. But you can choose to engage in any creative work that feeds you and makes you feel good about what you create.
Farese uses writing to help decompress after a long shift or stressful day. She recommends thinking about the day's experiences and writing them down.
"It is a way to keep mental health in check, especially with the stress, burnout, anxiety, and depression from dealing with patients during the COVID-19 pandemic," she says.
You might journal after work, write poetry, or even a simple haiku. Putting your thoughts down and telling your story can lessen the stress you've accumulated during the day and give you a sense of clarity.
11. Create a Calming Environment to Come Home to
Coming home from a stressful shift to a chaotic home environment only builds on the stress and anxiety you were trying to reduce on your way home. You might keep a clutter-free area of the house where you can relax after a long shift, or ask your partner for support in tidying the house before you come home.
Consider the lighting and music you use in the room. These factors can help improve your mood and lower your nursing shift anxiety. Using a scent in the room can help improve your mood, feel calmer, and trigger good memories.
Aromatherapy, which is the therapeutic use of essential oils, works by stimulating the limbic system, which is the area of the brain that regulates and modulates emotion. It may also act on the hypothalamus, the gland that influences your hormones.
"Learn about and practice meditation or mindfulness exercises during this time," Farese recommends. "Surround yourself with things that calm you down and affirm your strength, power, resilience."
12. If Staffing Levels Are Causing You Stress, Notify a Supervisor
Nurses know the usual staffing ratios on their unit. Robin Squellati, Ph.D., APRN-C, is a faculty member at Walden University. She advises nurses to proactively protect their mental health and patient outcomes by addressing nursing retention rates and staff changes with nursing supervisors.
"Notify the supervisor of a potential need for more staffing as soon as you hear about even one more admission over the acceptable ratio," she says. "Hopefully, a float nurse can be secured before the new admission arrives."
The National Institute of Nursing Research has found that mandatory nursing staffing can lower the rate of patient mortality and nursing burnout. Mandatory staffing levels also improve job satisfaction and allow nurses to take better care of their patients.
In the study, researchers compared California patient outcomes where there is mandatory nursing staffing, against Pennsylvania and New Jersey, without mandatory staffing. They determined there could have been 486 fewer surgical deaths in Pennsylvania and New Jersey if they had mandatory staffing.
According to the American Nurses Association, there are 15 states where there are laws or regulations that address staffing in some way. However, only California stipulates a minimum nurse-to-patient ratio.
Advocating for real change as a nurse for healthy nurse-to-patient ratios for you and your fellow nurses is a sustainable way to minimize the stress and burnout of working on an understaffed floor.
Healthy staffing ratios in conjunction with stress-reduction tools offered on this page are sure to decrease stress before or after your nursing shift.
Meet Our Contributors
Deji "DJ" Folami, RN
Deji "DJ" Folami is an intensive care unit registered travel nurse with Cross Country Healthcare from Oklahoma. Over the years, he has worked in different areas including home health. Folami specializes in critical care nursing and travel nursing. He has an A.A.S nursing degree with civic honors from Oklahoma City Community College and is working on his bachelor's degree in nursing.
Having come into nursing with business sales experience, Folami understands the value in having patients return to the same healthcare facility because that hospital is a trusted healthcare partner that meets their needs.
Susan J. Farese, MSN, RN, SJF Communications
Susan J. Farese is president and owner of SJF Communications in San Diego, which provides public relations, marketing, social media, writing, and mentoring services. Farese's experience in military and civilian nursing includes clinical, administration, education, research, and consulting roles. She is the author of "Poetic Expressions in Nursing: Sharing the Caring" and teaches in-person local or virtual Capturing Your Creativity with Haiku workshops.
Robin Squellati, Ph.D., APRN-C
Robin Squellati is an advanced practice registered nurse and faculty member for Walden University's master of science in nursing program. Squellati is a certified nurse practitioner and a veteran of the U.S. Air Force, where she served as a nurse for 28 years.
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