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‘What, me worry?’ How nurses can keep worries at bay

What is compassion fatigue in nursing?

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In the days when a nurse uniform involved a skirt and lots of starch, you might have been called a “worry wart.” But today researchers call this tendency “neuroticism,” loosely defined as a type of personality that experiences higher levels of anxiety.

By any name, too much worry can harm nurses at work and in their personal lives, whether it's playing into insomnia or sapping your immune system. A 2013 study published in Psychological Medicine assessed a sampling of young adults over a 10-year timespan and confirmed a correlation between neuroticism and an increased incidence of developing PTSD in response to trauma, for example.

And while high neuroticism is not considered a mental disorder on its own, the tendency to worry too much can also lead to increased substance abuse, anxiety and mood disorders, according to studies referenced in Psychology Today.

But in an ultimate irony, the message here is, "Don't worry too much about this." "If you are like millions of people around the globe, you probably experience some degree of neuroticism," Christopher Bergland, an endurance athlete and coach, explained in Psychology Today. "Luckily, under most circumstances, you can use mindfulness techniques to guide your thoughts and create explanatory styles that diminish neuroticism."

As a nurse with life-and-death duties and constant exposure to pain and negative outcomes, you may have extra reasons to mull things over, maybe even obsess a bit. But your veteran nursing peers and other medical professionals and workplace experts have advice that can help even nurses stop worrying too much:

Be prepared

Developing a system for the things you need for your shift to run smoothly can help eliminate senseless worry, according to correctional RN John Martin. He advises creating a sort of survival kit of "must haves." His includes an extra Tubex syringe holder, bandage scissors, stethoscope and multiple pens and Sharpie markers. "I have a bag in the car with extra clothes, medications and hygiene items if I have to stay overnight or longer due to weather," he added. "And I keep Tylenol and Motrin, cough drops, breath mints, spare socks and underwear in my locker. That's a lot of stuff I never have to worry about."

Get away whenever you can

Make an escape when you get the chance, advised Emory Decatur Hospital nurse manager Regina Duncan. "Whether it is freezing inside a tent with the kids or traveling to a foreign country, getting away from the pressure of daily responsibilities gives me a new perspective. It clears my mind from what is urgent so I can focus on what is important."

Plan to worry

This is an oldie but goodie, and as counterintuitive as it may sound, it works, according to a Penn State study from 2011. Instead of spending lots of energy trying not to worry at all, set aside 30 minutes, in a given day, dedicated just to worrying! Range far and wide with your thoughts, let all the fears in. And then, stop it. Until tomorrow.

"When we're engaged in worry, it doesn't really help us for someone to tell us to stop worrying," Tom Borkovec, a professor emeritus of psychology at Penn State University told LiveScience. "If you tell someone to postpone it for a while, we are able to actually do that."

The four steps involved, according to Borkovec:

  1. Pause to note when you are worrying.
  2. Set a particular place and time of day to worry.
  3. Actively postpone worrying any other time of day.
  4. Use your worrying time to come up with solutions to your worries.

Put it down on paper

The same concept that works when you're mad at a family member can also help with workplace worries. You know, the letter you write and then never send? It really helps to write one of these "transactional letters" ahead of a big challenge, from a test to a conversation about a raise or cutting back on your hours, according to worry researcher Sian Beilock.

"It might be counterintuitive, but it's almost as if you empty the fears out of your mind," Beilock, then an associate professor in psychology at the University of Chicago and now the president of Barnard College, told U.S. News. "You reassess that situation so that you're not as likely to worry about those situations because you've slain that beast."

Massage your worries away

Anxiety results when your body constantly activates adrenaline and experiences surges in cortisol. It's part of the human stress-response system, sure, but nurses are constantly responding to stress so it starts having a bad effect. "Long-term activation of the stress-response system and the overexposure to cortisol and other stress hormones that follows can disrupt almost all your body's processes. This puts you at increased risk of many health problems, including anxiety," according to the Mayo Clinic.

One wonderful way to decrease cortisol levels is with two sessions of Swedish massage per week for six weeks, according to a monotherapy trial conducted at Emory University. Lead researcher Mark Hyman Rapaport, MD, Chief of Psychiatric Services for Emory Healthcare, does acknowledge this won't work for everyone. "We know that some people enjoy being touched by others and some do not," he said.

Minimize how many choices you must make each day

If you can settle simple decisions once and for all, go for it. Knowing that you always wear a certain pair of shoes for work, order the third entree on the menu at a restaurant or park on the third floor can take some strain off your worried brain.

According to a study published in the October 2018 Nature Human Behaviour journal, choice overload can lead to unnecessary regret and second-guessing, not to mention extra time and agony invested in making the simplest decisions. "Although we may feel freer and in control when we have lots to choose from, this actually ends up distressing us when it comes to making the decision," Colin Camerer, a professor of behavioral economics at Caltech and author of the study, told Business Insider.

Pay it forward

Once you've conquered your own tendencies to blow all mistakes and tensions at work out of proportion, see if you can't help a co-worker with their anxiety, recommends Vanderbilt Health ICU nurse Delaney McCann. "Be kind when you can see another nurse is getting wound up," she said. "We are human. Anytime someone comes to you with a mistake, don't crucify them. Instead, help them get it corrected and assess so you can both move on."

Just to make the worry wart issue even more insidious, consider this: According to Georgia Institute of Technology researcher Chris Martin, worrying too much might give you certain health advantages. According to the abstract from his working paper, “People who are simultaneously highly conscientious and highly neurotic have better physiological health than their peers. This trait configuration is termed healthy neuroticism.”

But here’s the kicker: Martin’s paper is titled “Healthier Without Knowing It: Healthy Neuroticism Does Not Predict Self-Rated Health.” So even if you have the personality that both makes you worry about health risks and causes you to take steps to put yourself in a better situation, your neurotic tendencies can keep you from realizing the good you’re doing. Guess that’s just one more thing to worry about.

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