Stress and Coping

Stress and Coping

Stress is a condition in which one responds to changes in its normal balanced state. A stressor is any event or stimulus that causes one to experience stress. The responses made are called coping mechanisms

Sources of Stress

•Internal Stressors

•External Stressors

•Developmental Stressors

•Situational Stressors

Stress can have physical, emotional, intellectual, social and spiritual consequences

Models of Stress

General Adaptation Syndrome physiological response of the body to any kind of demand made upon it.(Selye)

Transactional Stress Theory takes into account cognitive, affective and coping responses that arise out of person-environment transactions.(Lazarus)

GAS

Psychological Indicators of Stress

•Anxiety

•Fear

•Anger

•Depression

•Use of defense Mechanisms

Physiologic Indicators of Stress•Pupils dilate

•Diaphoresis

•Tachycardia

•Pallid skin

•Hyperventilation

•Urinary output decreases

•Dry mouth

•Intestinal peristalsis decreases

•Muscle tension

•Blood sugar increases

Factors Influencing the effectiveness of Coping

•Past experiences of the individual

•Support systems of the individual

•The number, duration and intensity of the stressor

•Personal qualities of the individual

Coping MechanismsUtilize Nursing process

•Structuring

•Self-control

•Suppression

•Fantasy or daydreaming

•Exercise

•Nutrition

•Rest and Sleep

•Time Management

•Relaxation techniques

Crisis

Occurs when an event or circumstance overwhelms the individual's ability to resolve, manage, or process the event. “The role of the nurse is to shine light and hope on the most abysmal of life circumstances.”The nurses responsibility becomes that of the facilitator in addressing the need of the client.

Crisis Intervention

Is a short-term helping process of assisting clients to:

•Work through a crisis to its resolution

•Restore their pre-crisis level of functioning

Offers opportunity for growth and change

Risk Factors for Crisis

Intensity of exposure to the situationPreexisting psychiatric symptoms & diagnosisPrior history of traumatic exposureFamily history of psychiatric problems, anxiety, and/or antisocial behaviorEarly separation from parentsChildhood AbusePovertyCultural expectations that prohibit asking for helpDegree of threat to life

Evaluating

•How does the client perceive the problem

•Is there an underlying problem not identified?

•Have new stressors occurred that interfere with coping?

•Were existing coping strategies sufficient to meet outcomes?

•How does the client perceive the effectiveness of the new coping strategies?

•Are new coping strategies implemented properly?

•Did the client access and utilize resources?

•Have family members provided support?

ABC’s of Crisis Counseling

Achieve Contact ( safety & security)

Boil Down the Problem (ventilate & validate)

Cope With The Problem (predict & prepare)

Burnout

A term to describe nurses who are overwhelmed. They exhibit behaviors likened to the exhaustion stage of GAS.

Nurses need to utilize same coping techniques they recommend to their clients.