To whom can nurses turn for support when they have difficult cases or almost unbearable stress, either at work or in their personal lives?

"Nurses can be invaluable as support for each other," said Anita Motil, RN, employment supervisor at Northside Hospital in Atlanta. "Sometimes the best support system is right there beside you — a nurse in your department who shares the same values as you or has similar traits."

Motil said that building a support network in the workplace is a good way to reduce stress and avoid burnout. At Northside Hospital, each new nurse is paired with a mentor and a preceptor on his or her first day on the job, even if the new hire is experienced. Although the formal relationship ends after a new nurse has adjusted to the hospital's environment, some nurses find that their mentors and preceptors continue to provide invaluable support.

"The relationship between the mentor and the nurse can be incredibly strong, even if they change departments within the hospital," Motil said. "We also encourage nurses and other allied-health professionals to forge relationships hospitalwide.

"Sometimes, it just helps to have another perspective, and a trusted colleague can act as a sounding board, while being candid and caring."

For personal issues, the best resources may be hospital chaplains or employee assistance programs.

"Staff chaplains are great resources for patients and families, and they can also provide the right kind of support and caring for nurses," Motil said. "They're familiar with the demands of the hospital setting, the stresses that come with being a caregiver and the pressures of making life-or-death decisions. And they're trained to be good listeners and advisers."

Employee assistance programs are not new; they have evolved into a broad-based source of information and help on many levels.

"If you have a personal problem and need a confidential place to talk it out, an employee assistance program is designed to help," Motil said.

Another source of support can be workplace leaders.

"It can become evident fairly quickly which nurses are the leaders in your department," Motil said. "Solidifying a relationship with someone who has strengths that complement yours can be invaluable. A person with excellent clinical and critical-thinking skills may benefit from finding a mentor with strong interpersonal skills, and vice versa.

"Sharing concerns and asking for help to improve your approach to a situation can benefit both parties — the one doing the asking and the adviser. Drawing on the strengths of your peers can truly enhance your own."