A Nurse’s Guide To Managing Anxious Moments 4324

A Nurse’s Guide To Managing Anxious Moments


In those anxious moments, what can you do to get through it? How can you cope and recover in a healthy way?

Important: When you are in crisis, there is help available. You are not alone. Call, text, or chat. If you or someone you know is struggling or in crisis, call or text 988 or chat at 988lifeline.org. These connect you to the 988 Suicide & Crisis Lifeline.


Imagine you work in an emergency department and a combative patient is giving you a hard time. Not only is the patient getting aggressive, but you’ve also got other patients to care for with little time to spare. You haven’t had a break in hours, you need to use the restroom, and you’re exhausted. You feel your anxiety rising. 
While this is a hypothetical example, these types of situations are all too common in health care settings. During the COVID-19 pandemic, 86% of health care workers surveyed by Mental Health America reported experiencing anxiety. You’re exposed to challenging or traumatic scenarios often, which creates fear, stress, and panic.

In those anxious moments, what can you do to get through it? How can you cope and recover in a healthy way?

First, Be Prepared!
Prior to the start of your work, assess your anxiety level and mental health in general.  Get help before you are in crisis, if possible.  This may mean contacting your health care provider, your Employee Assistance Program, or other mental health care resources, personnel, and providers.

Strategies to Deal with Anxious Moments at Work
As a nurse, you barely have time for a restroom break, let alone a moment to calm your anxiety. Keep the below strategies in your back pocket to lull your body and mind in the moment. You can use many of these methods even if you are unable take a break. 

Diaphragmatic breathing
There’s a reason the 4-4-8 breathing exercise is so popular: It works. This method is perfect for nurses because it doesn’t require a lot of time. The next time your anxiety is rising, step to the side and take one minute to follow these steps:
  1. Take your time as you breathe in and out and become aware of the natural rhythm of your breath.
  2. Let your breath flow in and out effortlessly.
  3. Inhale for a count of four. Take a breath so big that it feels like you can’t fit any more air into your lungs. Your abdomen should expand.
  4. Hold for a count of four.
  5. Exhale for a count of eight. As you release the air, tighten your abdominal muscles.
  6. Repeat four times.

Positive internal talk
You practice hand hygiene often. Use those 20 seconds of handwashing to recalibrate and lower your anxiety. During those moments of scrubbing, focus your thoughts on one of the following:
  • Recite an affirmation or mantra that speaks to you. Try something like “Challenges are opportunities to grow and improve” or “I can do hard things.”
  • If you are spiritual or religious, pray.
  • Hum a song that brings you peace and slows your heart rate.
  • Give yourself a pep talk. In your mind, speak to yourself as you would talk to a close friend or family member.

You can use these methods whenever you need to — especially if it helps you conquer anxious moments. If you find yourself discouraged or overwhelmed, try to reign in your mind with positivity.

Lavender is often used as a remedy for stress, anxiety, and sleeping problems. One study found that the use of lavender and rosemary essential oil sachets reduced anxiety and pulse rates among test-taking nursing students.

Before your shift begins, put a couple of drops of lavender or bergamot essential oils on a tissue. Keep the tissue in your pocket throughout your shift. During an anxious moment, breathe in the scent from the tissue — you should notice the anxiety-reducing effects almost immediately.

For inspiration, consider this real-life example: #healthynurse Ashley Johnson, MSN, AGPCNP-C, DNP(c) uses aromatherapy during her shifts to improve her mental wellness.

Comfort items
Tuck a small memento, such as a seashell from a relaxing vacation or a family member’s beloved trinket, in your pocket. When you feel anxiety rising, reach into your pocket and touch the item to calm yourself down. Let it take you back to that memorable time in your life. Recalling that happy memory or person in your mind is beneficial, but touching it increases the anti-anxiety benefits even more.

Simple stretches
Experts say you can hold emotional stress in your muscle tissues, and stretching helps release some of that buildup. Here are a few easy stretches you can do in the heat of an anxious moment without having to step away from the scene:
  • Press the end of your tongue to the roof of your mouth. This simple action helps your jaw relax.
  • Tilt your head forward and slowly rotate your neck counterclockwise and then clockwise.
  • To relax your facial muscles, repeatedly raise and lower your eyebrows.
  • Relieve some of the tension in your shoulders by raising and lowering (shrugging) them like you’re making an “I don’t know” motion.

When your stress levels go up, mindfulness helps you pay attention to the present moment. Mindfulness has a physiologic effect by shifting you from your sympathetic (fight or flight) to your parasympathetic (rest and digest) nervous system. Try this technique:

With both feet firmly on the ground, while either standing or sitting:
  1. Focus as much attention as possible on sensations in the sole of the left foot—perhaps pressure or sensations from contact with the sock or shoe.
  2. Then shift attention to sensations in the sole of the right foot, with as much attention as possible.
  3. Tune in to your breathing — feel your breath as it moves in and out.
  4. Continue your tasks in a more grounded and present way.

This mindful technique is ideal for times of stress to help ground you and create space from the stressful situation you’re facing.

It’s hard to be grateful while feeling panicked, but you can use gratitude to transform your thoughts from negative to positive. When you start to feel panicky, try to interrupt your anxiety with gratitude. Follow these steps:
  1. Pause. Take a deep breath.
  2. In your mind, list 3 good things from the past 24 hours. It could be positive interactions you’ve had, cheerful emotions you’ve felt, or upbeat thoughts.
  3. Think about what caused those 3 good things.
  4. Take another deep breath before getting back to work.

To learn how to incorporate more gratitude into your daily life, check out the 9-part podcast mini-series from the Well-Being Initiative.

Sometimes you need to get yourself out of a stressful situation to feel a sense of relief. If the situation allows, walk away to calm your racing heart during an anxious moment. Do a slow lap around your department unit. As you’re walking, follow some of the strategies above like repeating a calming mantra in your mind, humming a relaxing song, or focusing on your breathing.

Resiliency rooms
If your organization has a resiliency room, take advantage of it to recover from stressful moments. Use it as a retreat to escape the chaos and find calm. These rooms often have resources like:
  • Soft lighting, soothing images, and aromatherapy
  • Adult coloring books with mindfulness themes
  • A white noise machine with peaceful sounds like rain or ocean waves
  • Comfortable chairs
  • Yoga and massage
  • A variety of religious materials
  • Tangible items to hold onto, such as rocks or stress balls, for comfort

If your organization doesn’t have a resiliency room, explore whether it’s possible to create one. For inspiration, see how #healthynurse Melinda Taylor created a resiliency room at her workplace as part of her DNP project.

Fresh air
Research shows that people often feel positive emotions like awe, connectedness, and hope when they’re in nature. During an unsettling situation, you need to generate as many positive emotions as possible.

If you’re able, walk away from whatever is making you anxious and get outside for some fresh air. Take a minute to do some breathing exercises, listen to the sounds of nature, or simply be present. When you go back in the building, imagine that you are physically leaving your anxieties and stressors outside, rather than bringing them with you.

Support for Anxious Moments
When you’re in the throes of an anxious moment, evidence-based strategies can get you out of it. The Well-Being Initiative is a resource for mental health. It offers tools and resources that focus on caring for nurses as they tirelessly care for others. But there are 2 more components that work wonders with overcoming anxiety in the workplace: Your support system and resilience.

When you’re dealing with symptoms of anxiety, you need people around you who can step in, give you space, and allow you a few moments to recover. While we can’t always control who we work with, we can decide who we spend time with outside of work. Choose to be around or influenced by people that you enjoy — those who uplift you. Avoid naysayers and chronic complainers as much as possible.

Another crucial component for getting through anxious times is building resilience. You can’t prevent anxiety from ever happening, but you can try to prepare yourself with strategies like problem-solving therapy and self-care. When you’re not in the throes of anxiety, focus on tasks that build your resilience — like journaling, meditating, or mindfulness — so you’re better prepared for the next anxious moment.

Important: When you are in crisis, there is help available. You are not alone. If you or someone you know is struggling or in crisis, call/text 988 or chat at 988lifeline.org to connect to the 988 Suicide & Crisis Lifeline.

Nurses, what do you do to get through anxious moments at work? We’d love to hear your healthy strategies. Share with us in our private Facebook group, on Twitter, or Instagram, and tag us with #healthynurse.


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Blog Mental Health 02/13/2023 10:42am CST

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The nature and stresses of the nursing profession can take a toll on your mental health. This domain deals with your psychological affect and health. Mental wellbeing practices, stress relief resources, and personal stories are just some of the assets included here.