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Not Sweating the Small Stuff: A Guide to Overcoming Stress


Find out how to maintain calm in a storm of busy.

Nurse practitioners (NPs) know that concern and a sense of urgency are regularly required in health care, but it’s very common for strong emotions to morph into something more overwhelming — and for the same emotions to follow an NP out of practice settings and into private life. One of the most common and significant of these feelings is stress.

As defined by the World Health Organization, stress is “a natural human response that prompts us to address challenges and threats in our lives.” In emergency situations, stress is necessary and even desirable. The problem occurs when stress ceases to be an important reaction to rare challenges and instead becomes constant, distracting and unrelenting. And stress doesn’t just feel bad — it’s bad for us, and the negative effects of stress on Americans in particular are well documented. In his article “Life Event, Stress and Illness” in The Malaysian Journal of Medical Sciences, Mohd Razali Salleh Mohd finds that “emotional stress is a major contributing factor to the six leading causes of death in the United States: cancer, coronary heart disease, accidental injuries, respiratory disorders, cirrhosis of the liver and suicide.” In other words: being too busy can frustrate, but stress can kill.

Managing stress and preventing burnout takes a concerted effort to turn helpful solutions into healthy habits. This National Stress Awareness Month, The American Association of Nurse Practitioners® (AANP) has gathered resources to test for, recognize and combat stress in the workplace and at home. In this article, you will learn the difference between stress and busyness, hear advice from Dr. Mimi Secor, DNP, FNP-BC, FAANP, FAAN, about navigating stress and find resources for reducing stress — including continuing education (CE) sessions available in-person at the 2023 AANP National Conference or on-demand from anywhere.

When Busyness Becomes Stress

Every NP’s experience is different, but few will cite “there’s just not enough to do” or “I have too much unstructured free time” as a downside to working in the NP role. In fact, workdays may become so packed with activity that crucial habits — eating balanced meals, getting enough sleep — take a backseat to professional concerns. What is the difference between a busy day and a stressful one?

To help clarify, Mental Health America created a “stress screener” with 16 quick questions to help map stress levels and to distinguish between busyness and stress. Featuring queries related to energy levels, eating habits and more, the screener works to give an insight into your habits that simple self-reflection can’t always provide — and recommends activities to help mitigate stress. Another resource for stress mitigation comes via The Centers for Disease Control and Prevention, which suggests “one small way each day” to combat stress with one guide specifically targeted at clinicians.

NPs looking for guidance from a fellow NP on stress will want to listen to episode 19 of NP Pulse: The Voice of the Nurse Practitioner®, where Dr. Mimi Secor provides an overview of what causes stress and how to make self-care a habit. Secor invented the acronym PANDEMIC (planning/preparing, accountability, nighttime, diet, exercise, mindset, inspiration/intimacy, cortisol) as a guide to identify and manage stress. Some of her suggestions should sound familiar — exercise and diet, for starters — though Secor also targets the mental with “mindset.” Says Secor, “We have so many negative messages coming into our brains – especially as females…you have to start rewiring yourself, because if you don’t develop a positive mindset, nothing is going to work on a long-term basis.”

Secor is an excellent spokesperson for the PANDEMIC process because she is both honest about her struggles (sweets and treats are a sticking point) and her successes. At 62, Secor embarked on an ambitious journey to get healthy and fit, and succeeded to the point that she has become a bodybuilder and an avid promoter of lifestyle change. She explained in the podcast episode, “As a result of becoming healthy during my doctoral program (an improbable journey), I realized that sharing my story and what I had learned about becoming and staying healthy might be helpful for others.”

Secor’s message is particularly geared toward busy professionals, and her message about adding exercise to one’s daily routine is as applicable and important to rushed parents as it is gym regulars. One great incentive to start practicing what Secor is preaching is that exercise has a twofold benefit: it reduces health problems and minimizes stress. An article called “The Effects of Exercise on Stress in Working Women” in The Journal for Nurse Practitioners finds that “while there are various lifestyle and coping strategies for reducing stress, such as socialization, meditation, and leisure time, exercise is a natural means to have a positive effect on health.”

NPs Against Burnout

Given that stress and burnout are unfortunately common in the NP role, it’s natural that NP leaders are continuing to combat both through a variety of media. “Erica D the NP” created “The Burned-Out Nurse Practitioner” with the goal to “help overwhelmed advance practice registered nurses (APRNs) create a better work-life balance and conquer the NP burnout,” according to her website. She offers a number of resources, including a blog on topics like “NP stress vs. burnout: 5 differences,” and “4 mindset shifts to resolve NP burnout.”

Sarah Michelle, APRN, MSN, FNP-C, FNP-BC, has created a podcast called “Becoming a Stress-Free Nurse Practitioner,” touching on topics primarily aimed at new NPs and NP students. Subjects include studying while pregnant or sick (or possibly both!) and interviews with other health care professionals. On the inaugural episode of her podcast in February 2021, Sarah Michelle shares her experience of having her first public panic attack while doing a skill performance — and the lessons she learned about herself in the process of overcoming stress.

Finally, NPs who enjoy YouTube may want to experience the “Destress with Deep Breathing” video created by NP Michelle Civello, APRN, FNP-BC. Civello walks the viewer through breathing exercises and a guided meditation, all set to an ambient soundtrack and at the very manageable run time of just under four minutes.

More Resources for Stress Relief

AANP is committed to helping you learn more about stress while you also earn CE credits. At the 2023 AANP National Conference in New Orleans, you may choose between courses related to stress — including several directly related to the stresses of working as an NP. Sattaria Dilks, DNP, PMHNP-BC, FAANP, will present “Emotional Well-Being in Nursing,” in which she “will discuss strategies to provide for taking care of ourselves in order to be present for our patients and families.” Another course focused on the health care professional is “Caring for the Caregiver: Wellness and Self-care for NPs,” presented by Vanessa Pomarico-Denino, EdD, FNP-BC, FAANP. Pomarico-Denino “will discuss stress, wellness, burnout, the differences between these three terms, how to recognize it and address it in your own lives.”

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NPs know that busyness will always be part of their role as health care providers; they also know stress doesn’t have to be. As spring arrives, AANP encourages all NPs to destress and take some deep, slow breaths — and know that your NP organization is here to support you as you navigate the busyness of everyday life.