Coping with stress in hospital

What is stress?

Stress is a primitive physiological response. It has been described as the 'fight or flight' response. The analogy frequently given is of the cave man being challenged by another cave man or a wild animal. He is faced with a stark choice. He can both stand his ground and risk being injured or decide to take flight and live to fight another day. While faced with this threat the body produces extra amounts of two particular hormones known as adrenaline and noradrenaline. These prepare you for action — fight or flight.

Modern man still experiences the same physiological responses in reaction to the pressures of modern life. Although the perceived sense of threat for modern man is of a lower order to his primitive predecessor, the intensity of the chemical response is similar for both. The physical experience of stress is related to the release of adrenaline and noradrenaline into the bloodstream.

Referral to the hospital outpatient department or being admitted as an inpatient is acknowledged as being a very potent stressor.

How do I recognise stress?

Physical symptoms of stress:

  • A pounding heart.
  • Short, fast breathing.
  • A dry mouth.
  • Clammy hands.
  • Tension headaches.
  • Gritting or grinding of teeth.
  • Tense muscles.
  • Blushing.
  • Panic attacks.
  • Diarrhoea or constipation.
  • Fatigue.

Mental symptoms of stress:

  • Anxiety.
  • Worry.
  • Guilt or nervousness.
  • Increased anger or frustration.
  • Depression.
  • Racing thoughts.
  • Nightmares.
  • Problems in concentrating or learning.
  • Difficulty making decisions.
  • A sense of being overloaded or over-burdened by problems.

Behavioural symptoms of stress:

  • Nervous habits such as finger or foot tapping.
  • Increased irritability or edginess.
  • Increased use of alcohol or cigarettes.
  • Defensiveness or suspiciousness.
  • Withdrawal from social situations.
  • Difficulty sleeping.

How do I cope with stress in the hospital environment?

  • Bring in familiar objects such as family photographs, books or pillows.
  • Listen to relaxing music during procedures. Audiocassette players with headphones are generally available in most procedure rooms.
  • Dont be afraid to ask for what you need. If you are cold ask for another blanket. If you are experiencing increased levels of pain inform the nurse. If you cannot sleep tell the night nurse. If appropriate she can organise a sleeping tablet for you.
  • Ask not to be disturbed when you want to rest.
  • Be positive in the way you talk to yourself, eg. ‘Many people have coped well with this test and so will I’.
  • Try not to focus on the possibilities of what can go wrong.
  • Take your mind off the problem by using distraction — read a magazine, listen to the radio or play an audiotape. Remember that laughter can be a very effective method of relieving stress.
  • If you are unclear about the nature of the procedure you are about to undergo ask one of the nurses for clarification.
  • If you are afraid say so to a member of the ward staff. Your fears may be groundless.
  • Many hospital patients derive great comfort from speaking to a chaplain. If you would like to speak to the chaplain just ask.

Preparing for going home:

  • Ask for any information you may require before going home. Ask the staff to write down details if necessary.
  • If you have any problems following discharge from the hospital, contact your GP or specialist nurse, eg. diabetes nurse specialist.

Written by Margaret Boland, nurse tutor, James Connolly Memorial Hospital, Blanchardstown, Dublin.

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