releasing years of built-up stress as a caregiver
Sometimes I wish I had a magic wand. Ok, it’s more than sometimes. I would be the best magic-wand-wielding nurse out there changing the environments in which we practice.
(I would also use this magic wand to bring giant support groups to parents, but that’s for a different post)
With my wand in hand, I would first head back to Nursing School. We learn a great number of wonderful things there. All about caring for others.
The missing unit in nursing school is how to care for ourselves. We need a whole unit dedicated to the foundation of how we care for ourselves as caregivers based on emotional health, the nervous system, and the stress cycle.
We need to learn in great detail about the fight-flight response, what physical changes happen in our body, specific stressors for caregivers, self-care, and strategies to release stress from our bodies.
I remember being pretty stressed out in nursing school with the usual stressors:
exams. And then more exams
the intense feeling of walking through the metal detectors of the hospital for the first time
roommate dramas
sticking random strangers and crying newborns with needles
seeing someone started on dialysis made me want to throw up so I ran out of the room
But, like all other nursing students, I took it all in as best as I could and continued my studies. I felt stressed, but not emotionally exhausted or super anxious before each shift.
Unfortunately, those feelings of emotional exhaustion and anxiety developed over years of caring deeply for others, while simultaneously not caring for myself.
One of the things I wish they taught me in nursing school was just how often I was going to be involved in scary, unpredictable situations. Events that become normal and routine to us are actually interpreted by our body as threats to our safety:
running in to a Code
holding a patient down to put on restraints
discussing the care plan with a patient or family member who is angry or becoming hostile
always being alert by keeping ourselves between a “disruptive” patient and the door
My point is, we are often not given the tools we need to process the emotions and stress that cycles through our body after these events. We think, “that’s just what nurses do!” Well, we are badasses, but we are not immune to biology.
I remember coming out of one Code after transferring the patient, looking at my coworkers like “WOW, what just happened?!” and then bing! My brain says, “shoot! You had an antibiotic due 45 minutes ago and now it’s going to be late” and running off to the next patient.
I didn’t give myself even 1 minute at the time to debrief with everyone.
Since I attributed this nervous-system-triggering event as just all part of the job, I didn’t pay attention to how it felt in my body.
I built up stress from exposure to numerous stressors and kept it in my body for years. I suspect you, dear caregiver, have done the same.
In their book Burnout: The Secret to Unlocking the Stress Cycle sisters Emily and Amelia Nagoski emphasize the absolute importance to what they call “completing the stress cycle.”
We are very familiar with the fight-flight response, why it is triggered and what happens in our body. We are far less familiar with what to do NEXT.
Let’s take the example of the Code mentioned above. I was going about my shift when an Environmental Services worker came out to the nurses’ station to say one patient had food coming out of her mouth. I didn’t know this patient so I went to investigate, and ended up calling a Code.
Immediately, my body was flooded with chemical and hormonal changes in an effort to prepare to “fight or flight”. Since we know this is a life or death situation for our patient, our brain interprets the event as our life needs to be protected at all costs. Hence, the beating heart, shaking hands and sweaty palms.
Once the Code, the stressor that caused the fight-flight response, has ended, our body does not immediately come out of this survival mode.
Our body needs to know we are safe.
Even if you repeat “I am safe” in your head, your body still has not processed all the chemical changes.
In this example my stress cycle involves:
the triggering stressor: the Code
my response to the event: beating heart and shaking hands, immediately moving into action for the patient
End of the stressor: Code is completed, running on to the next task
Completing the stress cycle: hard NOPE!!
The sisters call the process of letting your body know that you are safe: “completing the stress cycle.”
(It’s helpful here to differentiate how the authors define stress and stressors:
stressors: the things, real or imagined, that activate the fight-fight stress response in your body. Things like charging tigers, traffic, bickering kids, aggressive patients, work, self-criticism; we often call these “triggers,” as in, my kids totally trigger my anger!
stress: the actual biological processes that happen in your body when you experience a stressor. Think hormones and chemical changes, epinephrine, glucocorticoids, elevated BP etc)
The authors recommend physical movement as the best way to let the stress go from your body. We can’t exactly go for a brisk walk right there during our shift to alert our body that we are safe, but we can spend a few minutes taking deep breaths. With the exhale being longer than the inhale. This is what I should have done after the Code. We have nurse leaders to ask for help and to be able to take 5 minutes to let the shakes wear off.
Then on our days off it is imperative to move at least 30-60 minutes to remove all the old, built up, grungy stress that has accumulated over the years of you delivering amazing care to others.
I know, this seems like a tall order. Who has time for 30 minutes of exercise every day? Most caregivers I know also have kids and partners and aging parents they are caring for, too.
But what is all this built-up stress costing you in terms of your health? Your physical health with headaches and joint pain. Your mental health with anxiety and feelings of overwhelm or burn-out.
Physical and emotional exhaustion from caring for others is real. We need to care for our body and mind in order to release all that stress leading to painful symptoms.
Besides movement, there are other ways to “complete the stress cycle” and free your body of the daily stressors it encounters:
Meditation
Connection with loved ones
Affection: did someone say hugs?!!!
Crying: I do this a lot. There is so much stress built-up that I’m still working through, releasing emotion and exhaustion
Time in favorite hobbies: reading brings me the most rest ever
I think of completing the stress cycle as spending time in the parasympathetic state. In this modern age we basically run in the stressed-out, autonomic nervous system state all day. It’s in the parasympathetic state that we find peace and joy, as well as sleep well and actually digest our food and benefit from all those other healthy things we are trying to do!
If you find yourself feeling burned-out, emotionally exhausted, or overwhelmed then I encourage you to begin releasing the stress today. You don’t need to jump straight to 30 minutes each day. Start with 5 minutes of deep breathing, connecting to your feelings inside. Forgive and release.
Notice how your body feels after you begin giving yourself 5 minutes each day dedicated to releasing stress. The changes felt will inspire you to increase the amount of time spent in quiet, in stillness, in calm.
You don’t need to hang onto this old stress. You will feel soooo much better once you begin completing the stress cycle.
