Week 10-11 Stress Coping PDF

Stress and Coping in the Acute Care Environment COMPETENCY Define patient-centered, evidenced-based care using the nursing process Discuss the use of critical thinking to prioritize basic elements of patient care when implementing the nursing process. Discuss the roles of the inter-p...

Stress and Coping in the Acute Care Environment COMPETENCY Define patient-centered, evidenced-based care using the nursing process Discuss the use of critical thinking to prioritize basic elements of patient care when implementing the nursing process. Discuss the roles of the inter-professional collaborative practice members. CONCEPTS Stress & Coping: Conditions which alter physiological and /or psychosocial equilibrium and the body’s attempt to return to homeostasis. Collaboration: Process in which the interprofessional healthcare team works toward a common goal by combining their skills, knowledge, and resources to improve client outcomes while avoiding duplication of effort. UNIT OUTCOMES Describe the stages of the general adaptation syndrome. Differentiate acute and chronic stress experienced by patients. Identify basic coping strategies to manage patient stress in the acute health care environment. Concepts Related to Stress and Coping Stress The body’s general, nonspecific response to the demands placed on it by a stressor Patient is exposed to a tension-producing experience Can lead to - personal growth (eustress) - if overwhelming can lead to illness (distress) Concepts related to Stress and Coping Coping Process where individuals can control or modify their responses to stressors Strategies vary from one situation to another Problem-focused Emotion-focused What Does Stress Look Like? What would a patient experiencing stress demonstrate as it relates to subjective and objective data? How can you identify? What Does Stress Look Like? Eye contact Energy Level Concentration Sleep disturbances Altered food intake Observed emotions Verbal statements Scientific Knowledge Base Fight -or- Flight Response Scientific Knowledge Base The sympathetic nervous system prepares a person for action: Increasing heart rate Diverts blood from the intestines and skin Increases blood to the brain and striated muscles Increases blood pressure, respiratory rate, and blood sugar levels. Neurophysiologic responses to stress: the medulla oblongata, the reticular formation, and the pituitary gland. Medulla oblongata controls heart rate, blood pressure, and respiration. Reticular formation, neurons in the brainstem and spinal cord, continuously monitors the physiological status of the body through sensory and motor tracts. Pituitary gland, attached to the hypothalamus, produces adrenocorticotropic hormone (ACTH), which produces cortisol resulting in the release of glucocorticoids to raise blood sugar levels and inhibit inflammation. General Adaptation Syndrome (GAS) Stress response An immediate physiological response of the whole body to stress; involves several body systems, especially the autonomic nervous and endocrine systems, and includes immunological changes. A three-stage reaction to stress: Alarm reaction Resistance stage Exhaustion stage  3 Stages of GAS 1. Sympathetic Response (Alarm) The alarm reaction brings an increase in blood volume, blood glucose levels, epinephrine and norepinephrine (secreted by the adrenal medulla), heart rate, blood flow to muscles, oxygen intake, and mental alertness. 3 Stages of GAS 2. Parasympathetic Response (Resistance) In the resistance stage, the body stabilizes. Hormone levels, heart rate, blood pressure, and cardiac output return to normal, and the body begins to repair damage. If the stress response is chronically activated causes excessive wear and tear on the person and leads to chronic illness. 3 Stages of GAS 3. Exhaustion stage, the body is no longer able to resist the effects of the stressor, and the struggle to maintain adaptation drains all available energy resulting in death. Alarm-> Resistance-> EXHAUSTION Types of Stress Chronic Chronic stress -> Chronic illness Acute Time-limited events ->acute stress-> Acute illness Factors Influencing Stress and Coping Situational factors Arise from job changes, caregiver stress Maturational or Developmental factors Vary with life stages Sociocultural factors Environmental, social, and cultural stressors Physical factors Health status, lifestyle, nutrition, exercise Coping with Stress Older Adult Culture Older Adults Day to day living can be a source of stress Loss of mobility, loss of independence, loss of spouse/friends Life experiences can make problems seem insignificant because they have acquired stress management techniques Culture Culture defines what is stressful to an individual and ways of coping: What is a major stressor in one culture may be a minor problem in another culture Some cultures believe emotions should be controlled where other cultures encourage expressing emotions. Safety for the Patient Experiencing Anxiety and Stress Safety of the patient is the priority concern, so the nurse should stay with the patient experiencing severe anxiety. Use of therapeutic self as a nurse – Nurse-patient relationship - Basis of trust Nursing Actions that Can help REGULAR exercise Guided Imagery and visualization Meditation and grounding Healthy nutrition Journal writing Support system Other Ideas ? Coping: Implementation Guided imagery is used as a means to create a relaxed state through the person’s imagination, often using sensory words. Imagination allows the person to create a soothing and peaceful environment. Beach – the nurse describes Forest – the nurse describe Coping: Implementation The nurse oversees the environment of healing; limiting noise, dimming lights at night, assigning the same nurses to care for one patient, and keeping the area clean. Explain procedures briefly, using short, clear sentences providing information to comfort the patient. Your patient/client is awaiting to go to radiology for a test…. Anxious and hyperventilating What will you do? Work-Life-Balance AND SELF-CARE