STRESS TO

WELLNESS

Jessica Switzman, MSN, CRNA

WHAT IS STRESS?Stress is natural and unavoidable.

Sometimes, motivational and other times devastating.

STRESS A particular relationship between the

person and the environment that is appraised by the person as taxing of exceeding his or her resources and endangering his or her well-being. (Lazarus & Folkman, 1984)

NATURAL“A normal adaptive coping response that evolved over hundreds of millions of years to help our ancestors avoid sticks and get carrots.” –Rick Hanson, PhD

DISTURBING TOO MUCH STRESS can cause: Fatigue/Insomnia Headaches Gastrointestinal disturbances Weight loss or gain Relationship Disturbance Depression Addictive behaviors

FACE THE FACTS!

CRNA’SNurse Anesthetists spend endless hours devoted to the workplace, where we are constantly exposed to a variety of stressors.

Prolonged stress can have negative physical and mental consequences sometimes to the point of disability and may even affect patient care.

THE COST OF STRESS $26 billion paid annually in disability

claims r/t stress Estimated that $300 billion is lost

annually due to job related stress and diminished performance and absenteeism

60-80% of all work-related accidents are due to stress

American Institute of Stress

STRESS AND YOUR WELL-BEING Up to 90% of all visits to PCP are related to

stress

More than 50 % of lost work days are related to stress

Of all workers almost 14 % say stress caused them to quit or change jobs in the last 2 years

MORE THAN JUST A STATE OF MIND…

Physical components of stress include :

tight muscles, headaches, difficulty falling

asleep and restless sleep, abdominal

pain, allergies, asthma, inflammation

and HTN.

WHY STRESS IS BAD

We all know prolonged HTN may lead to heart disease, heart attack and stroke.

Long term inflammation may lead to weight gain, diabetes, kidney disease and maybe even cancer.

MORE BAD NEWS

Modern life exposes us to Chronic Stress-multitasking, moving too quickly, being bombarded with stimulation.

Unmitigated stress can lead to substance abuse and potentially addiction

We are not designed to flee from predators 12-14 hours a day without breaks.

BUT…….GOOD NEWS

Stress is natural and unavoidable!

By practicing wellness, we develop RESILIENCE and this enables us to combat stress.

We cannot avoid Stress, it is all around us and effects all things.

RESILIENCE

What is it? the capacity to recover quickly from

difficulties; toughness. The capacity to withstand stress and

catastrophe. Working through the emotions and effects

of stress and painful events.

Being Resilient doesn’t mean you will go through life without experiencing pain and sadness.

We all feel grief, sadness, and a range of other emotions after adversity; this is normal!!

WELLNESS A positive state of mind, body and spirit

reflecting a balance of effective adaptation, resilience and coping mechanisms in personal and professional environments that enhance quality of life. (AANA, Health &Wellness)

SIMPLE THINGS YOU CAN DO TO BUILD WELLNESS

BREATH EMOTIONS ARE CLOSELY RELATED TO OUR

BREATHING. BY ALTERNATING OUR RESPIRATORY RHYTHM WE SHOULD BE ABLE TO CHANGE EMOTIONAL GEARS.

Just by slowing our respiratory rate and making our exhalation longer than our inhalation we can activate the “Relaxation Response” and produce beneficial antidepressant, antianxiety and antistress effects.

RESTThe best way to quiet the body-mind’s “stress

response” and support the “relaxation response” is to REST!

Rest charges up the Para-sympathetic “rest and digest” system which powers the body’s reparative and digestive activities.

When deep rest is in short supply you can support the Para-sympathetic activity by taking frequent short breaks; ideally every 2 hours.

SLEEP TRY TO GET 1 EXTRA HOUR/NIGHT IMPROVE THE QUALITY by meditative

practices, deep breathing and/or by exercising early in the day.

Short Naps can be helpful; 30-45 min so as not to disturb the sleep cycle.

STRIVE FOR 7-8 HRS/NIGHT.

EXERICISE

WALK / BIKE / SWIM SHOOT HOOPS STRETCH/ YOGA

PHYSICAL MOVEMENT HELPS US STAY STRESS-RESILIENT:

VIGOROUS EXERCISE decreases ADRENALINE

GENTLER EXERCISE lowers CORTISOL

NUTRITION A WELL FED BODY IS A RESILIENT BODY

better to handle stress and recover from hormonal floods.

Try to keep SUGAR and FLOUR to a minimum while eating healthy fats and good protein will keep blood sugar on an even keel, supporting good energy, mental clarity and stable mood.

ALL leading to more grace under pressure!!!

GOOD RULES OF THUMB Eating plenty of dark FRUITS and

VEGTABLES. SHOP the perimeter of the grocery

store; most foods located in the middle aisles are processed.

EAT WHOLE GRAINS/ NUTS AND SEEDS Drink plenty of WATER LIMIT CAFFEINE AND ETOH

MEDITATION MINDFUL MEDITATON- becoming a calm

observer of your thought and emotions stimulates the para-sympathetic nervous system.

Meditation can reduce frantic neurological activity in the amygdala, the alarm bell of the brain.

Self regulation can shift activity to the neocortex or “executive center.”

POSITIVITY “Positivity Ratio” 3:1 Even with strangers positive

connections can improve our health. Studies have shown that the amygdala-

based cell receptors for oxytocin increase when we foster feeling of love, compassion and connection.

ON THE SPOT STRESS REDUCTION WALK EXHALE LONGER PAUSE TUNE INTO YOUR BODY PAY ATTENTION TO YOUR SENSES CONNECT WITH OTHERS BE PRESENT

EVEN MORE WAYS TO INCREASE

WELLNESS

1. SMILE THERAPY

A study published in the journal of Psychological science showed that breaking into a smile- one that engages the muscles around the mouth and edges of eyes- can lower HR after a stressful event.

2. BE HERE NOW!

According to new research done at the Center for mind and Brain at the University of a California Davis, focusing on the present moment can significantly reduce levels of stress hormone cortical.If you start to rehash the past or worry about the future, try drawing your attention back to the present by focusing on the sensations of your breath.

3. BE IN GOOD COMPANY-Research at the University of Hawaii, shows that stress can be contagious. We pick up the negative particles of stressed out friends, family members, and colleagues.

4. DIVE IN-Looking out at water is a mood enhancer. Perhaps because 60% of the human body is compromised of it.If you cannot get to a body of water why not try adding a water element to your patio.

5. SINGSinging releases feel-good endorphins. A 2010 study, by researchers in the United Kingdom and Australia, found that singing lowers levels of depression and anxiety, and improves general sense of well being. The respiration involved in singing slows down the Heart Rate and calms the nervous system.

LIFESTYLE CHOICES Your lifestyle choices hold incredible

power over health. You have the ability to reduce or raise the risk of many preventable diseases.

PRACTICE WELLNESS DAILY

Confidential Peer Assistance

MANA's State Peer Advisor:

Jessica Switzman, CRNA, MSN, RYTAnnapolis, MD 21409

p: 410-991-5046 (Cell)p: 410-550-0942 (work)

STRESS WEBSITES• Information on stress and how to manage

it http://www.nlm.nih.gov/medlineplus/stress.html

AANA Health and Wellness www.AANAWellness.com AANA Peer Assistance www.AANAPeerAssistance.com AANA Student Wellness

www.AANA.com/StudentWellness Helpful tips on stress management:

http://www.mindtools.com The American Institute of Stress: www.stress.org The Stress Management Society promotes up-to-date

research and information: http://www.stress.org.uk

QUESTIONS?

REFERENCES Chipas, A., McKenna B. (2011) . Stress and Burnout in Nurse Anesthesia. AANA J.

79(2) 122-128

Chipas, A., Cordrey, D., et al.(2012) Stress: Perceptions, Manifestations, and Coping Mechanisms of Student Registered Nurse Anesthetists. AANA J. 80(4)

Gill, C. (2013). Professional Wellness Applied from Day One. AANA News Bulletin, 67(5) 30-31.

Hanson, R. (2009). Buddha’s Brain: The Practical Neuroscience of Happiness, Love and Wisdom. New Harbinger.

Lazarus, R. & Folkman, S. (1984) Stress, Appraisal and Coping. McGraw-Hill

Matta, C. (2012). The Stress Response. New Harbinger

Roy-Bryne, P. (2013) The Relaxation Response Changes Gene Expression. New England Journal of Medicine.

Spayde, J. (2013). The Science of Stress. Experience Life.

Trunajek, S. (2006). Student Stress: a question of balance. AANA New Bulletin, 60 (5) 20-21