Stress seems to have become part of most people’s lives in the twenty-first century. Even before the pandemic, the National Academy of Medicine found that burnout had reached “crisis levels” among U.S. health care workers, with 35% to 45% of nurses and physicians — and 40% to 60% of medical students — reporting signs of burnout.
Post-pandemic, the pressures seem to have only increased. In fact, the National Library of Medicine reports that an unofficial term was born to reference this experience: post-pandemic stress disorder (PPSD). As one can likely infer, this term refers to post-traumatic stress disorder (PTSD). PPSD has resulted from the increased stress, anxiety, and trauma associated with being a health care worker during the pandemic.
The pandemic is no longer front and center in our daily lives, but the burnout numbers persist:
- According to a 2023 report published in the Journal of General Internal Medicine, 56% of nurses, 54% of clinical staff, 47% of doctors, and 46% of non-clinical staff reported burnout.
- According to a 2023 report from the U.S. Centers for Disease Control and Prevention (CDC), health care workers responding to a “quality of worklife” survey reported more days of poor mental health and were more likely to report burnout in 2022 than in 2018.
Health care workers toil in some of the most difficult circumstances. Learn more about the effects of stress on your physical and emotional well-being, and get tips on stress management for health care workers.
Challenges of Stress Management for Health Care Workers
Everyday Stress
“Everyone experiences stress,” says Alexis Hanson, DNP, FNP-C, faculty member in the Purdue Global School of Nursing. “It becomes a concern when it develops into chronic stress.”
Stress typically comes from work or life circumstances. Work stressors may include:
- Job dissatisfaction
- Heavy workload
- Long hours
- Poor management
- Unclear expectations
- Dangerous conditions
- Coworker conflicts
Other life stressors include:
- Death of a loved one
- Divorce
- Job loss
- Financial problems
- Chronic illness or injury
- Unexpected life events
“In addition, ineffective time management and procrastination are two common causes of stress that many of us have dealt with,” Hanson says. “Finding a resolution for these issues can be challenging, but there are solutions to improve these stressors.”
Chronic Stress
Stress that is unresolved over a long period becomes chronic. “Genetics is one factor that can predispose individuals to certain health or disease conditions — including hormonal issues — that can influence stress levels,” Hanson says. “Then, if you add in environmental and lifestyle factors and life experiences, stress levels can either increase or decrease depending on the situation.
“Stress can be self-limiting (happening acutely in the moment and something that can be overcome) or chronic (having a continuous level of stress with varying moments of relief).” Such chronic stress can lead to or aggravate more serious health problems.
How the Body Feels Stress
Stress hormones can put a lot of wear and tear on your body, making you more prone to illness and causing the body to age more quickly.
Stress might begin to show itself physically:
- Headache
- Fatigue
- Difficulty sleeping
- Difficulty concentrating
- Upset stomach
- Irritability
“Stress affects the mind, body, and well-being,” Hanson says. “Our main stress hormones are adrenaline and cortisol. Adrenaline fuels our fight or flight sympathetic response, which can automatically increase our energy, blood pressure, heart rate, and other bodily functions in response to a stressful situation.
“Cortisol can also rise in response to stress, with the potential to adversely affect the body in many ways. The negative influences of high cortisol levels on the mind and body, especially when one has chronic stress, can precipitate many stress-based health conditions.”
Stress-Based Conditions
“With chronic stress, some of the more common health issues patients have presented with in clinic include: anxiety, fatigue, headache, digestive issues, and high blood pressure,” says Hanson, who is also an urgent care clinic provider.
Chronic stress, involving long-term activation of adrenaline and cortisol, puts people at increased risk for many health problems. According to the Mayo Clinic, these can include:
- Weight gain
- Depression
- Heart palpitations
- Heart disease
- Hyperglycemia
- Memory and concentration problems
- Sleep issues
How Health Care Workers Can Deal With Stress
“Learning how to manage stress is based upon each individual’s goals, motivation, and choices,” says Hanson. “We can learn to be successful at overcoming stress once we find the tools that work best for each of us.
“Although a stressor may begin as a situation we feel is out of our control, we have choices on how we respond to that given situation.”
Healthy Ways to Overcome Stress
- Rest and relaxation:
- Break for a power nap: Power naps can increase energy, stabilize emotions, and restore brain functionality.
- Breathe deeply: Oxygen flow throughout the body can be increased with deep breaths. Breathe in slowly and completely through your nose, then slowly exhale through your mouth. Repeat this process 5–10 times to relieve stress.
- Experiment with yoga: Stretching can be great for your body and an excellent way to reduce stress.
- Try meditation: Meditation can calm nerves and help you focus on the positives in life rather than the negatives. Use popular apps like Headspace, Inscape, Mindvalley, and Insight Timer to practice mindfulness.
- Get a massage: You may build up physical stress in your muscles from the mental stress of your life. If this sounds like you, take a couple of minutes and massage your shoulders and neck. You may be surprised at how tense your muscles are. Better yet, schedule a massage with a licensed massage therapist.
- Adopt healthy eating and lifestyle habits: “Making unhealthy eating choices can be due to many reasons, including stress, boredom, lack of time, or convenience,” Hanson says. “When it comes to diet, exercise, and healthy eating plans, remember it is not a one-size-fits-all solution. It’s important to find an eating plan that fits into your personal lifestyle, with healthy food choices that increase your wellness and energy.”
- Go outside: Immersing yourself in nature and the warm sun can improve levels of vitamin D and help with concentration.
- Listen to music: Listening to music can help you recover from stress faster, and it can also help the endocrine and psychological stress response, according to the National Institutes of Health.
- Read or listen to stories: Reading draws your focus away from your stress. By immersing yourself in a novel, you let your brain absorb the story, and you can let the stress and everything around you dissipate. If you don’t like reading novels, you can always read news articles or other pieces of similar length. There are also audiobooks through Audible or Blinkist, where you can listen to stories instead of reading them.
- Get organized: Clean up your room or clear off a desk. Organizing is one of the best ways to recover from a stressful day at work because it will help you decompress.
- Engage in pet therapy: Having a dog, cat, or any pet around comes with many mental health benefits, according to a 2023 survey from the American Psychiatric Association. Among pet owners, 86% said their pets have a mostly positive impact on their mental health, and 88% said they consider their pets a part of their family. Those who said their pets positively affect their mental health cited several key benefits, including:
- Help reduce stress and anxiety (69%)
- Provide unconditional love and support (69%)
- Offer companionship (69%)
- Provide a calming presence (66%)
- Are true friends (63%)
- Take some time off: Whether it’s a day, weekend, or a full vacation, getting away from the stress of work can be a positive experience.
- Use essential oils: Concentrated oils, or essences, have many uses. Lavender oil is often used to fight anxiety, headaches, or muscle pain. Rub a tiny bit of oil in your hands and take a few deep breaths. But use caution: Bottled oils can be potent — up to 50 to 100 times more concentrated than the oils in plants, according to The Washington Post — and can be risky if used incorrectly.
- Take time for gratitude: “Every morning when I wake up and every evening when I go to bed, I make it my mantra to say what I’m grateful for, including my family, friends, community, career, good health and wellness, and more,” Hanson says. “Giving gratitude for what we have, what we can share, and how we can help others is a strong stress reliever and helps us to appreciate all the positive things in life.”
Health Care Leaders Need to Lead the Charge
The health care industry recognizes that stress reduction isn’t the sole responsibility of the individual worker. The National Institute for Occupational Safety and Health (NIOSH), part of the CDC, has launched Impact Wellbeing, a campaign that gives hospital leaders evidence-informed solutions to reduce burnout and build a system where health care workers thrive.
Among the campaign insights: “Health care workers do not want efforts to focus on individual resilience. Instead, they need hospital leaders to address the systemic factors at the root of staff burnout (e.g., adequate staffing, demanding work schedules, excess administrative work, etc.).”
Health care leaders can start doing this by implementing some of NIOSH’s suggestions:
- Administer the NIOSH Worker Well-Being Questionnaire to understand how your workforce is doing and identify ways to improve their well-being.
- Use the toolkit from the Dr. Lorna Breen Heroes’ Foundation to help remove intrusive mental health questions from your hospital’s credentialing applications, and make it safe for staff to seek the mental health care they may need.
- Explore NIOSH’s Fundamentals of Total Worker Health® Approaches to help improve the safety, health, and well-being of your workforce.
In 2022, the U.S. Surgeon General released the report, Addressing Health Worker Burnout, in which he said the following are things “we must do now”:
- Protect the health, safety, and well-being of all health workers.
- Eliminate punitive policies for seeking mental health and substance use care.
- Reduce administrative and other workplace burdens to help health workers make time for what matters.
- Transform organizational cultures to prioritize health worker well-being and show all health workers that they are valued.
- Recognize social connection and community as a core value of the health care system.
- Invest in public health and our public health workforce.
Health care leaders and entire health care systems bear responsibility in helping to fix the problem of worker burnout.
Self-Care for Nurses and Other Health Care Workers
As a health care professional, it’s vitally important to destress for your health and the health of your patients. Read more about the importance of self-care for nurses and how to put a plan in place.
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