Providing care to those in need brings great meaning and purpose to nursing professionals. But nursing can also come with physical and emotional demands that create stressful environments. Nurses who are working hard to provide quality care for patients may struggle to manage stress when faced with busy schedules and exacting responsibilities.

Finding ways to manage stress is essential for nurses to stay healthy and satisfied with their important work. Stress management techniques for nurses include deep breathing, meditation, and exercise. Nurses might also explore sleep management and therapy techniques.

Nurse leaders should keep in mind the importance of nurse scheduling in managing stress. They can also help nurses by being role models for self-care and by reminding staff members that self-care is vital to caring for others.

While it may seem trivial, how people breathe has a profound impact on their health. Engaging in deep breathing can be an effective way to reduce stress and anxiety. It can also improve lung function, blood pressure, and other elements of health.

One of the benefits of breathing techniques is that they can be used at any time, anywhere to help reduce stress symptoms. Breathing techniques also can be practiced for five to 15 minutes for greater benefits. To accomplish this, it’s important to:

• Schedule breathing sessions within daily routines, picking a consistent time each day
• Choose a specific place that is quiet, comfortable, and easy to access
• Make sure to dress comfortably

Deep breathing involves taking extended breaths all the way into the belly, avoiding the short, shallow chest breaths that can trigger anxiety and fatigue. Deep breathing for stress management typically involves breathing through the nose instead of the mouth and often uses counting techniques. Some of the breathing techniques that have been developed to reduce stress include:

• 4-7-8 technique: Breathe in for four seconds with the nose, hold for seven, and breathe out for eight through the mouth.
• Belly breathing: Place one hand on the belly and one on the chest, feeling the belly move and the chest remain still while breathing in through the nose and out through the mouth.
• Breath focus: Use a picture or phrase to aid in relaxation, such as picturing the air as calmness.
• Equal time: Count the breaths in equal time, such as five seconds, for inhaling and exhaling.
• Modified lion’s breath: Breathe in through the nose, and out through a wide open mouth with a “ha” sound.
• Progressive muscle relaxation: Tense and relax muscle groups in succession while breathing in and out.

Best Deep Breathing Apps: List of mobile deep breathing apps from Softonic
Breathing Exercises: Instructional videos on deep breathing from the American Lung Association
Breathing Techniques for Stress Relief: Descriptions of breathing techniques from WebMD
Focused Deep Breathing Meditation: Video guide to deep breathing from Massachusetts General Hospital
How to Use 4-7-8 Breathing for Anxiety: Description of the 4-7-8 breathing technique from Medical News Today
Learning Deep Breathing: Breathing techniques from PsychCentral
Reducing Stress Through Deep Breathing: Video guide to deep breathing from Johns Hopkins
Relieving Tension: Breathing Exercises for Nurses: Tips on mindful breathing from the Atlanta Journal-Constitution
Stress Management: Breathing Exercises for Relaxation: Guide to belly breathing from Michigan Medicine

Meditation is another powerful tool to help nurses relax and reduce stress levels. It can be helpful to find a calm, quiet place to meditate, but it’s not always necessary. Some meditation techniques can be utilized in any environment, whenever stress starts to manifest. If nurses are struggling to find a relaxing space or with blocking out external distractions, there are classes, videos, recordings, and mobile apps that can help guide them through the process.

Meditation is the process of calming the thoughts and clearing out unimportant information from the mind. When someone meditates, they seek to quiet the jumbled stream of consciousness that can cause stress and anxiety.

Meditation helps individuals find a deep state of relaxation and mental tranquility. This can result in increased patience and tolerance and reduced negative emotions, which can help nurses combat stress on the job and reconnect with a sense of purpose. Meditation can also help nurses:

• Gain a new perspective on a situation
• Increase self-awareness
• Focus on the present
• Build stress-management skills

There are five core elements of meditation for stress management, according to Mayo Clinic. The first requirement is focused attention, or the ability to dismiss distractions and focus on an object, word, or the breath. The other major elements of meditation include relaxed breathing, a quiet setting, and a comfortable position. It is also helpful to have an open mind, which allows people to evaluate thoughts that arise without judgment.
There are a wide number of meditation types to choose from, including:

• Guided meditation is the process of visualizing images or situations to aid in relaxation. This form of meditation is often led by a guide or teacher.
• Mantra meditation is the repetition of a calming word or phrase to crowd out distracting thoughts.
• Qi gong is a traditional Chinese medicine practice combining meditation, movement, and breath.
• Tai chi is a form of Chinese martial arts that includes moving through a gentle series of postures and movements combined with deep breathing.
• Yoga is a series of postures and breathing exercises designed to calm the mind through focus on balance and concentration.

It takes time to get into a regular meditation routine, and each individual determines the best way to develop one. There are a number of meditation techniques that nurses can learn to help develop strong relaxation habits such as body scanning, or the evaluation and relaxation of different areas of the body. Walking in a calming environment, paying attention to the present moment, focusing on feelings of gratitude, or taking time to reflect on a book or a song can also encourage relaxation.

3 Easy Mindfulness Meditation Techniques to Practice at Home or at the Office: Workplace techniques from Huffington Post
7 Simple Meditation Techniques to Practice at Work (to Boost Productivity): Tips for meditation at work from Inc.
How to Meditate: Written and audio meditation guides from Mindful
How to Meditate Anywhere: Mindfulness strategies for any environment from the Chopra Center
The 9 Best YouTube Yoga Channels: Listing of free yoga videos from Self
The 15 Best Yoga Videos on YouTube: Listing of top-hitting yoga videos on YouTube from Women’s Health
The Best Meditation Apps to Help with Anxiety: Listing of mobile apps to help relieve stress from Oprah Magazine
What’s the Best Meditation Technique for You?: Meditation techniques from Yoga Journal

Incorporating exercise into daily routines can make managing stress easier for nursing professionals. Exercise is one of the most proven stress-relief techniques, as it boosts endorphins and helps release physical tension. Exercise can also help build up nurses’ stamina to perform strenuous tasks such as lifting patients or routine tasks such as standing for long stretches of time.

Fitting in exercise time can be difficult when nurses work long shifts or have busy after-work schedules. It can also be hard for nurse leaders who have demanding responsibilities. While going to the gym or attending exercise classes might be ideal, there are other ways that nurses can find times to exercise for stress relief, even during work hours.

In the past, nurses were more likely to walk long distances during shifts, keeping them in good shape. But digital health tools now keep nurses tied to desks and bedside computers, reducing physical activity. However, nurses can still fit in exercise during the workday by taking short walks outside during lunch breaks, doing chair exercises, using stairs instead of elevators, or performing squats or lunges during breaks.

To stay engaged in a consistent exercise routine, nurses need to find a form of exercise that’s enjoyable. Exercise apps or fitness trackers can also help with motivation, as can finding a group of peers or friends who are interested in increasing their exercise levels.

The U.S. Department of Health and Human Services recommends a mixture of high- and low-intensity aerobic activity combined with strength-training exercises. The following types of exercise might be appealing to nurses with different routines and stress management ideals:

• Attending an aerobics, Pilates, yoga, or cycling class
• Joining a gym
• Lifting weights or completing workout videos at home
• Walking or jogging with friends, families, or pets
• Swimming
• Interval training, which incorporates short bursts of intense activity

7 Types of Workout Routines That Nurses Should Do: Static exercises that help strengthen key muscle groups from Aaptiv
YouTube Accounts to Follow for the Best Workout Videos: Listing of free online workout videos from Shape
Exercise and Stress: Get Moving to Manage Stress: Guidelines and ideas on exercise for stress management from Mayo Clinic
How Nurses Can Find Time to Exercise: Tips on exercise time management from Performance Health
Physical Activity Guidelines for Americans: Exercise and movement recommendations from the U.S. Department of Health and Human Services
The Best Fitness Apps for 2020: Listing of mobile and home fitness apps from PC Magazine

Stress and sleep have a cyclical relationship: stress can cause sleep problems, and insomnia can intensify stress. So by reducing stress, nurse professionals can improve their sleep, leading to better performance in the workplace. Likewise, sleep improvement techniques can serve as stress-reduction strategies.

Stress causes the body to produce excessive cortisol and other hormones that cause energy levels to spike. During prolonged periods of stress, these hormones can disturb the sleep cycle, causing poor-quality sleep and reducing mood regulation capabilities. This, in turn, causes more stress, along with irritability and frustration. A number of medical studies have connected stress to insomnia, or the chronic inability to fall asleep or stay asleep.

Certain stress factors may cause greater levels of sleep disruption. For instance, being overloaded at work can make it more difficult to quiet thoughts at bedtime. Other sleep-disrupting stressors could include experiencing depression, suffering from a painful condition, lacking time for exercise or relaxation, or struggling with finances or relationships. Unhealthy coping mechanisms, such as overeating or excessive alcohol consumption, can make sleep even more difficult.

Research is increasingly showing that healthy sleep patterns are important to an individual’s overall health. In addition to the benefits of sleep for stress management, getting a good night’s sleep has been connected to reduced instances of physical conditions such as heart disease, inflammation, and diabetes. Sleep can also help lower the chances of mental health conditions such as depression.

Stress-reduction methods can help improve sleep patterns. These techniques include:

• Practicing deep breathing, muscle relaxation, or meditation before bed
• Exercising at least two hours before bedtime
• Eating healthy foods
• Avoiding caffeine late in the day
• Establishing consistent sleep schedules and bedtime routines
• Improving comfort and reducing distractions in the bedroom
• Identifying and assessing stress factors
• Seeking social support such as time with friends
• Working to reduce negative thought patterns

7 Best Sleep Apps for iPhone & Android: Listing of mobile sleep apps from the American Sleep Association
Getting a Good Night’s Sleep: Steps to improving sleep from the American Psychological Association
Healthy Sleep Tips: Ways to develop good sleep hygiene from the National Sleep Foundation
Healthy Sleep Habits: Sleep tips from the American Academy of Sleep Medicine
How to Master Stress and Enjoy Restful Sleep: Stress factors and techniques for better sleep from the American Institute of Stress
Sleep Tips: Methods to improve sleep routines from Mayo Clinic
Tips to Reduce Stress and Sleep Better: Signs of stress and management techniques from WebMD

When self-care techniques are not enough to reduce stress, there are a number of external resources that can provide relief. Psychologists and counselors provide various kinds of therapy that can help reduce symptoms of stress, while also addressing underlying issues that may exacerbate stressful emotions. Nurses might also see psychiatrists when medication is the best option.

Nurse leaders can play a key role in facilitating therapy for stress management by providing a list of counseling resources for staff members. They can also connect nurses with high stress levels to resources such as in-hospital services or employee assistance programs.

Some of the mental health conditions and behaviors that are associated with stress include:

• Anxiety
• Depression
• Eating disorders
• Addictive behaviors
• Anger management troubles
• Social withdrawal

There are a number of therapy techniques that can help reduce the symptoms of stress, including:

Cognitive therapy is designed to help change patients’ thought patterns to guide them away from negativity. Therapists help patients explore their reactions to situations and come up with methods to revise those patterns of thought through psychotherapy (talk therapy) sessions.

Behavior therapy is the practice of re-creating stressful situations and practicing techniques to cope with those situations. It also seeks to recognize negative thought patterns and improve positive thinking.

Group therapy sessions can also be helpful in reducing stress. Guided by a therapist, such sessions allow individuals to discuss issues with others in similar situations.

Relaxation training helps patients learn relaxation techniques including breath retraining and progressive muscle relaxation. Some therapists also conduct guided meditation sessions.

Find a Therapist Directory: Listing of nationwide therapy services, including telehealth resources, from the Anxiety and Depression Association of America
How Cognitive Therapy Works for Stress Relief: An overview of how cognitive therapy works from Verywell Mind
How Do I Find a Good Therapist?: A list of tips and resources on how to find a good therapist from the American Psychological Association
Stress Management Therapy: A discussion of stress management therapy techniques from TherapyTribe
Therapeutic Treatments for Stress Reduction: A description of therapeutic treatments for stress from PsychCentral

Nurse leaders play an essential role in the quality of care a nursing staff is able to provide. This involves a number of factors, including effective communication methods, solid staff support services, and efficient patient care protocols. Nurse leaders are also advocates for their staff, working to reduce administrative burdens and create functional work routines. One of the major responsibilities of the nurse leader is to create an effective and fair shift schedule.

Nurse leaders can deploy specific scheduling strategies to combat the onset of stress in the workforce. Some of the ways nurse leaders can use scheduling to improve stress management for nurses include:

Nurse leaders should create open lines of communication with nurses to determine scheduling preferences. Managers should take family or school responsibilities into account when assigning shifts. Shifts should be scheduled far in advance so adjustments can be made without difficulty.

Nurse leaders must balance scheduling with patient acuity levels. Patients with complex care needs might require certain skill levels in the assigned staff members. Managers need to be familiar with nurses’ skill sets to ensure the right assignments are made.

Leaders can give workers a sense of control and empowerment by establishing shift trading policies. This takes pressure off managers and gives nurses flexibility when challenges arise. Shift trading needs to be monitored, however, to make sure patient needs are met.

Managers should only assign overtime when necessary to help avoid nurse burnout. While overtime is sometimes unavoidable, especially when facilities are understaffed, excessive overtime shifts can result in medical errors and high turnover rates.

Using a modern nurse scheduling program can help nurse leaders make better scheduling decisions. Such programs can help managers identify trends in patient volumes to determine when higher or lower staff levels are needed.

3 Things You Need to Know About Nurse Scheduling Software: Overview of the benefits of scheduling software from Becker’s Hospital Review
5 Tips for Creating a Perfect Nurse Schedule: Nurse scheduling tips from software provider Humanity
Hospital Nurse Shift Patterns and Collaboration: Strategies on how to improve shift patterns from Becker’s Hospital Review
The Best Employee Scheduling & Shift Planning Software for 2020: Listing of shift planning software solutions from PC Magazine

Nurses work in a variety of situations, from providing preventive care and well patient services to treating pandemic and natural disaster victims. While stress factors can manifest in any setting, nurses who work in emergency departments, trauma units, and other critical care settings may be especially vulnerable to mental and emotional exhaustion.

Nurses across all environments need to have techniques they can rely on to cope with and recover from stress, so they can continue to provide the greatest level of care to patients. Stress management techniques can help nurses reconnect with the meaningful purpose that brought them to the field, while improving their job satisfaction and overall happiness.

Stress is the body’s physical, mental, and emotional response to the pressures of life. Stress can result in symptoms such as stomach pain, insomnia, headaches, anger, and irritability. When symptoms are overwhelming, nurses may be more likely to call in sick. And when absence rates are high among nursing staff, even greater responsibility is placed on those who remain at work.

Stress can also result in more severe health conditions, such as hypertension and high blood pressure. Mental and emotional symptoms can evolve into mental health conditions, including anxiety and depression. Nurses might also resort to unhealthy coping mechanisms when experiencing high levels of stress. Some of these mechanisms might include smoking, excessive drinking, gambling, emotional eating, or self-harm.

Nurses are passionate about the essential work that they do, and staying healthy is key to maintaining a thriving work environment. This is where stress management techniques can help.

By practicing self-care and maintaining a positive work outlook, nurses can enjoy long professional careers. Stress management can be essential in keeping nurses from avoiding burnout, the physical and emotional exhaustion caused by long periods of stress. Nurse leaders can watch for signs of burnout — such as excessive absences or lateness, negative attitudes, or social withdrawal — and help at-risk nurses develop effective stress management techniques.

When nurses have a reduced stress burden, they are able to perform their job duties more effectively and efficiently. Nurses who are well rested and calm are less likely to make mistakes that could impact patient safety. Nurses with lower stress levels are also better able to maintain compassion and form the emotional bonds with patients that help guide the recovery journey.

Quality of care is essential to an organization’s success, which means that monitoring and ensuring the well-being of nurses must be a high priority for hospital and clinic administrators. Nurses have the most frequent contact with patients of all staff and therefore need to have a strong support network to keep stress levels from impacting their patient interactions.

Nurse leaders can help create an environment of controlled stress by supporting and guiding staff members. A nurse manager who has solid relationships with the floor nurses can keep an eye out for signs of fatigue and burnout. Leaders need to be alert to when tasks or shifts should be adjusted to reduce stress levels and can try to reduce nonessential tasks as much as possible so nurses can focus on core responsibilities.

Nurse managers — who are also prone to stress — need to maintain calm and compassion to be effective in leadership roles. One way they can do this is to lead by example, engaging in stress management techniques themselves and sharing successes with their staff. They can also acknowledge their feelings to others to let them know that stress is not something to hide.

Nurse leaders can also emphasize why stress management is important for nurses by:

• Holding workshops on stress management
• Promoting employee assistance programs
• Bringing in stress coaches, chaplains, or counselors
• Holding regular huddles to address staff well-being
• Taking time to listen to individual concerns
• Making sure that nurses have sufficient breaks to be able to build stress management exercises into their daily routines

Nurses are used to focusing on the health and well-being of others, but may forget to look after themselves. Stress management and self-care help nurses stay fulfilled, satisfied, and healthy. When nurses take the time to care for themselves, they function more efficiently and are better equipped to improve patient outcomes.

Additional Sources:

Healthy Nurse Health Nation, “Moral Distress: What It Is and What to Do About It”
Nurse.com, “Nurse Burnout, Stress from COVID-19 Pandemic Pose Challenge for Leaders
”Nursing Management, “Mindfulness to Promote Nurses’ Well-Being”