Managing Workplace Stress for Nurses

April marks Stress Awareness Month, a national campaign highlighting the impact of stress on physical and mental health and promoting healthy ways to manage it. In the nursing profession, stress is widespread and, when left unaddressed, can contribute to burnout and workforce turnover. 

Marissa Bartmess, assistant professor at the University of South Carolina College of Nursing, studies how workplace environments affect nurses and how to better prepare them for the work force.  

Recognizing the signs 

Stress can appear in different ways, from sudden physical symptoms to long-term emotional strain. Early warning signs may include heart racing, shaking hands, irritability, or a sense of dread before a shift. Bartmess recommends first looking inward and identifying how you feel. In moments of acute stress, she advises addressing the body’s response before anything else.  

Managing stress in the moment 

In high-pressure situations, Bartmess encourages nurses to focus on quick, practical techniques to reset. “Make sure your patients are safe, then step away when you can,” she says. These techniques can help nurses move out of “fight or flight” mode and regain focus. 

Simple strategies to use to help regulate the body's stress response: 

• Box Breathing (inhale for 4 seconds, hold for 4 seconds, exhale for 4 seconds, hold for 4 seconds, repeat as needed)
• Cold therapy (like holding an ice cube)
• Brief phyiscal movement (ex. jumping, dancing or running)
• Physically removing yourself from the situation when possible 

 

Addressing long-term stress 

Beyond immediate relief, managing stress requires ongoing attention to emotional and mental health. Bartmess suggests approaches such as talk therapy, cognitive behavioral therapy and mindfulness practices. 

Once the immediate stress response has passed, she recommends reflecting on the situation and making a plan for change. This may include setting boundaries, having conversations with colleagues or advocating for improvements in the workplace. "Take good care of yourself, and you'll be able to care for others." 

Preventing burnout 

Stress can either be acute or develop gradually over time. When nurses begin to feel persistent dread or exhaustion before work, it may signal the early stages of burnout. 

Bartmess encourages nurses to address stress early and explore changes within their current role or environment before considering leaving the profession. "Don’t leave the profession, find a place that works better for you within the profession."

Creating supportive workplaces 

Bartmess also emphasizes the role of leadership in reducing stress. She says organizations should create safe spaces where nurses can share concerns openly or anonymously and ensure those concerns lead to meaningful action. 

Providing nurses with decision-making power - such as through staffing or well-being committees - can help create lasting improvements.