Stress and Nursing Practice: A Reflective Essay

Nursing is a profession that demands emotional resilience, critical thinking, and the ability to adapt to high-pressure environments. How much do you know about stress and the nursing practice?  Well, the stress inherent in nursing practice is magnified during critical situations, often leaving a lasting impact on practitioners. This essay explores a personal case that defined my journey as a nurse, how it shaped my practice, and the strategies I employed to manage its emotional toll. Additionally, it examines the importance of debriefings in managing stress and their potential role in fostering resilience among healthcare professionals.

A Defining Case in My Nursing Career

One of the most challenging moments in my nursing career occurred during my time in a hospital’s emergency department (ED). A young patient was brought in following a severe motor vehicle accident. The patient was in critical condition, and despite the medical team’s exhaustive efforts, they succumbed to their injuries. I was tasked with assisting in the resuscitation efforts, including administering medications, recording vital signs, and ensuring the necessary equipment was ready. The frenetic pace of the ED amplified the emotional intensity of the situation.

The gravity of the event left me feeling overwhelmed and deeply saddened, as the patient’s family arrived shortly after and had to be informed of the tragic outcome. Witnessing their grief and despair was heart-wrenching, and the sense of helplessness lingered long after the shift ended.

How the Case Affects Me and My Practice

The case profoundly influenced my practice and perspective as a nurse. It underscored the fragility of life and the unpredictability of healthcare settings. Initially, I struggled with feelings of guilt, questioning whether there was something more I could have done. This self-doubt was compounded by the emotional toll of witnessing the family’s suffering, leading to sleep disturbances and a sense of burnout.

However, over time, I recognized that such cases are inevitable in nursing and that self-blame is unproductive. This experience deepened my empathy and strengthened my resolve to provide the best care possible. It also reinforced the importance of emotional self-care and seeking support from colleagues and mentors.

Coping with the Stress of the Event

To manage the stress resulting from this event, I adopted several strategies:

1. Seeking Peer Support
   Engaging in conversations with trusted colleagues was instrumental in processing the emotions surrounding the incident. Sharing experiences provided reassurance and normalized the feelings of grief and vulnerability.
2. Utilizing Professional Counseling
   Professional counseling services helped me understand the psychological impact of trauma in nursing and provided techniques to manage stress effectively. Cognitive-behavioral strategies, such as reframing negative thoughts, were particularly useful.
3. Mindfulness and Self-Care
   Practicing mindfulness meditation and engaging in self-care activities like exercise and hobbies helped restore balance to my personal and professional life.
4. Education and Training
   I pursued training in trauma-informed care and stress management to equip myself with tools to handle similar situations in the future. This not only enhanced my skills but also bolstered my confidence in critical care scenarios.

The Importance of Debriefings

Debriefings are a structured approach to reflect on events, particularly those involving high stress or adverse outcomes. They provide an opportunity for healthcare professionals to process emotions, share insights, and identify areas for improvement.

Benefits of Debriefings

• Emotional Processing: Debriefings help mitigate the risk of burnout and post-traumatic stress by offering a safe space for staff to express emotions.
• Team Cohesion: By fostering open communication, debriefings strengthen teamwork and mutual understanding among colleagues.
• Learning Opportunity: Analyzing events allows teams to identify strengths and areas for improvement, ultimately enhancing patient care.

Debriefing Practices in My Workplace

While debriefings are not routinely conducted in my workplace, informal discussions often occur after critical incidents. These ad-hoc conversations, though valuable, lack the structure and depth of formal debriefings. If a formal debriefing were to take place, it would likely involve:

• Participants: Nurses, physicians, social workers, and other staff involved in the event.
• Facilitator: A senior nurse or a mental health professional trained in conducting debriefings would lead the session.
• Topics Discussed: The session would explore what occurred, individual roles, emotional responses, and strategies for coping. Additionally, opportunities for system improvement and future preparedness would be addressed.
• Location: A private, neutral setting within the hospital, such as a conference room, would ensure confidentiality and focus.

Feasibility and Impact of Debriefings

Implementing formal debriefings in my workplace is feasible, given adequate training and organizational support. The benefits would likely outweigh the logistical challenges, as debriefings can serve as a proactive measure to address staff well-being.

Enhancing Nurse Resilience

By normalizing discussions about stress and emotions, debriefings can reduce stigma around seeking support. They can also help build resilience by fostering a culture of learning and mutual respect.

Reducing Compassion Fatigue

Compassion fatigue, often described as the cost of caring, is a significant risk for nurses. Debriefings allow for collective emotional relief, reducing the cumulative impact of stress and promoting a sense of shared responsibility.

Conclusion

The defining case in my nursing career tested my emotional resilience and professional capabilities, leaving an indelible mark on my practice. Reflecting on the event and employing coping strategies has enabled me to grow both personally and professionally.

Debriefings represent a critical yet underutilized tool in managing stress within nursing practice. By providing a structured forum for reflection and emotional processing, they can enhance team dynamics, improve patient outcomes, and safeguard the well-being of healthcare professionals. Advocacy for the regular implementation of debriefings is essential to create a supportive and resilient nursing environment.

References

1. Ager, A., & Loughry, M. (2004). Debriefing: Intervention strategies for caregivers. Intervention, 2(1), 22-29. https://doi.org/10.1093/intqhc/2.1.22
2. Stamm, B. H. (2010). The ProQOL Manual: Professional Quality of Life Scale: Compassion Satisfaction, Burnout, and Compassion Fatigue. Pocatello, ID: Sidran Press.
3. Mitchell, J. T. (1983). When disaster strikes: The critical incident stress debriefing process. Journal of Emergency Medical Services, 8(1), 36-39.
4. Figley, C. R. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In Compassion Fatigue: Coping with Secondary Traumatic Stress Disorder in Those Who Treat the Traumatized. Brunner/Mazel.
5. Mealer, M., Jones, J., & Moss, M. (2012). A qualitative study of resilience and posttraumatic stress disorder in United States ICU nurses. Intensive Care Medicine, 38(9), 1445-1451. https://doi.org/10.1007/s00134-012-2600-6