Jessica Switzman, MSN, CRNA
Stress is natural and unavoidable.
Sometimes, motivational and other
times devastating.
A
particular relationship between the person
and the environment that is appraised by the
person as taxing of exceeding his or her
resources and endangering his or her wellbeing. (Lazarus & Folkman, 1984)
 “A
normal adaptive coping
response that evolved over
hundreds of millions of years to
help our ancestors avoid sticks and
get carrots.” –Rick Hanson, PhD
 TOO
MUCH STRESS can cause:
 Fatigue/Insomnia
 Headaches
 Gastrointestinal disturbances
 Weight loss or gain
 Relationship Disturbance
 Depression
 Addictive behaviors
Nurse Anesthetists spend endless
hours devoted to the workplace,
where we are constantly exposed to
a variety of stressors.
Prolonged stress can have negative
physical and mental consequences
sometimes to the point of disability
and may even affect patient care.
 $26
billion paid annually in disability claims
r/t stress
 Estimated that $300 billion is lost annually
due to job related stress and diminished
performance and absenteeism
 60-80% of all work-related accidents are due
to stress
American Institute of Stress

Up to 90% of all visits to PCP are related to
stress

More than 50 % of lost work days are related to
stress

Of all workers almost 14 % say stress caused
them to quit or change jobs in the last 2 years
Physical components of stress include :
tight muscles, headaches, difficulty falling
asleep and restless sleep, abdominal
pain, allergies, asthma,
inflammation and HTN.
We all know prolonged HTN may
lead to heart disease, heart
attack and stroke.
Long term inflammation may
lead to weight gain, diabetes,
kidney disease and maybe even
cancer.
Modern life exposes us to Chronic Stressmultitasking, moving too quickly, being
bombarded with stimulation.
Unmitigated stress can lead to substance abuse and
potentially addiction
We are not designed to flee from predators 12-14
hours a day without breaks.
We cannot avoid Stress, it is all
around us and effects all things.
Stress is natural and
unavoidable!
By practicing wellness, we
develop RESILIENCE and this
enables us to combat stress.
What is it?
 the capacity to recover quickly from
difficulties; toughness.
 The capacity to withstand stress and
catastrophe.
 Working through the emotions and effects of
stress and painful events.
Being Resilient doesn’t mean you will go through life without
experiencing pain and sadness.
We all feel grief, sadness, and a range of other emotions after
adversity; this is normal!!
A
positive state of mind, body and spirit
reflecting a balance of effective adaptation,
resilience and coping mechanisms in personal
and professional environments that enhance
quality of life. (AANA, Health &Wellness)
 EMOTIONS
ARE CLOSELY RELATED TO OUR
BREATHING. BY ALTERNATING OUR RESPIRATORY
RHYTHM WE SHOULD BE ABLE TO CHANGE
EMOTIONAL GEARS.
 Just
by slowing our respiratory rate and making
our exhalation longer than our inhalation we
can activate the “Relaxation Response” and
produce beneficial antidepressant, antianxiety
and antistress effects.
The best way to quiet the body-mind’s “stress
response” and support the “relaxation response”
is to REST!
Rest charges up the Para-sympathetic “rest and
digest” system which powers the body’s
reparative and digestive activities.
When deep rest is in short supply you can support
the Para-sympathetic activity by taking frequent
short breaks; ideally every 2 hours.
 TRY
TO GET 1 EXTRA HOUR/NIGHT
 IMPROVE THE QUALITY by meditative
practices, deep breathing and/or by
exercising early in the day.
 Short Naps can be helpful; 30-45 min so as
not to disturb the sleep cycle.
 STRIVE FOR 7-8 HRS/NIGHT.
PHYSICAL MOVEMENT HELPS US STAY
STRESS-RESILIENT:
 WALK
/ BIKE / SWIM
 SHOOT HOOPS
 STRETCH/ YOGA
VIGOROUS EXERCISE decreases ADRENALINE
GENTLER EXERCISE lowers CORTISOL
A
WELL FED BODY IS A RESILIENT BODY
better to handle stress and recover from
hormonal floods.
 Try to keep SUGAR and FLOUR to a minimum
while eating healthy fats and good protein
will keep blood sugar on an even keel,
supporting good energy, mental clarity and
stable mood.
 ALL leading to more grace under pressure!!!
 Eating
plenty of dark FRUITS and VEGTABLES.
 SHOP the perimeter of the grocery store;
most foods located in the middle aisles are
processed.
 EAT WHOLE GRAINS/ NUTS AND SEEDS
 Drink plenty of WATER
 LIMIT CAFFEINE AND ETOH
 MINDFUL
MEDITATON- becoming a calm
observer of your thought and emotions
stimulates the para-sympathetic nervous
system.
 Meditation can reduce frantic neurological
activity in the amygdala, the alarm bell of
the brain.
 Self regulation can shift activity to the
neocortex or “executive center.”
 “Positivity
Ratio” 3:1
 Even with strangers positive connections can
improve our health.
 Studies have shown that the amygdala-based
cell receptors for oxytocin increase when we
foster feeling of love, compassion and
connection.
 WALK
 EXHALE
LONGER
 PAUSE
 TUNE
INTO YOUR BODY
 PAY ATTENTION TO YOUR SENSES
 CONNECT WITH OTHERS
 BE PRESENT
A study published in the journal of Psychological
science showed that breaking into a smile- one
that engages the muscles around the mouth and
edges of eyes- can lower HR after a stressful
event.
According to new research done at the Center for
mind and Brain at the University of a California
Davis, focusing on the present moment can
significantly reduce levels of stress hormone
cortical.
If you start to rehash the past or worry about the
future, try drawing your attention back to the
present by focusing on the sensations of your
breath.
Research at the University of Hawaii, shows
that stress can be contagious. We pick up the
negative particles of stressed out friends,
family members, and colleagues.
Looking out at water is a mood enhancer.
Perhaps because 60% of the human body is
compromised of it.
If you cannot get to a body of water why not
try adding a water element to your patio.
Singing releases feel-good endorphins. A 2010
study, by researchers in the United Kingdom
and Australia, found that singing lowers
levels of depression and anxiety, and
improves general sense of well being.
The respiration involved in singing slows
down the Heart Rate and calms the nervous
system.
 Your
lifestyle choices hold incredible power
over health. You have the ability to reduce or
raise the risk of many preventable diseases.
PRACTICE
DAILY
WELLNESS
Confidential Peer Assistance
MANA's State Peer Advisor:
Jessica Switzman, CRNA, MSN, RYT
Annapolis, MD 21409
p: 410-991-5046 (Cell)
p: 410-550-0942 (work)
•
Information on stress and how to manage
it
http://www.nlm.nih.gov/medlineplus/stress.html

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AANA Health and Wellness www.AANAWellness.com
AANA Peer Assistance www.AANAPeerAssistance.com
AANA Student Wellness
www.AANA.com/StudentWellness
Helpful tips on stress management:
http://www.mindtools.com
The American Institute of Stress: www.stress.org
The Stress Management Society promotes up-to-date
research and information: http://www.stress.org.uk

Chipas, A., McKenna B. (2011) . Stress and Burnout in Nurse Anesthesia. AANA J. 79(2)
122-128

Chipas, A., Cordrey, D., et al.(2012) Stress: Perceptions, Manifestations, and Coping
Mechanisms of Student Registered Nurse Anesthetists. AANA J. 80(4)

Gill, C. (2013). Professional Wellness Applied from Day One. AANA News Bulletin, 67(5)
30-31.

Hanson, R. (2009). Buddha’s Brain: The Practical Neuroscience of Happiness, Love and
Wisdom. New Harbinger.

Lazarus, R. & Folkman, S. (1984) Stress, Appraisal and Coping. McGraw-Hill

Matta, C. (2012). The Stress Response. New Harbinger

Roy-Bryne, P. (2013) The Relaxation Response Changes Gene Expression. New England
Journal of Medicine.

Spayde, J. (2013). The Science of Stress. Experience Life.

Trunajek, S. (2006). Student Stress: a question of balance. AANA New Bulletin, 60 (5)
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