By Karen Hooven, BSN, CCM, CRRN, RN

Stress. We’ve heard this word a million times. It is predominant in all walks of life, cultures, and genders. Everyone copes with Stress in their own way. Or do they? Where does one learn what Stress is, how to identify it?  

How do you “cope” or “deal” with Stress? My father always told me, “you have to take care of yourself and stay healthy-that will help you cope with Stress, if you don’t, Stress does terrible things to your body”. And I would add, to your brain health.  

I took that piece of advice for granted for many years, then, as I grew older and more “mature”, I started looking at it with new eyes. I was diagnosed with Type 1 Diabetes in my late 50’s. There is no history of Diabetes in my family. The Endocrinologist said it could be autoimmune, stress-who knows? There is no documented medical etiology for developing Type 1 Diabetes. I am convinced it was due to stress.  

Stress is real. It’s tangible. Stress has meaning-I may not understand the root cause of the stress-but I see it on the faces of my team. As their manager,  I want to help understand what the team’s perception of stress is.  

The first thought I had was to help the team identify the cause of the Stress. Stress is defined as “A state of worry or mental tension caused by a difficult situation”. We met as a team to identify the daily challenges and barriers felt when assisting patients with transition care planning. Many forms of stress reared it’s ugly head. From pre-certification delays, to Physicians waiting until 4:29pm to decide a patient was ready for discharge. Other examples of stress the team gave were families not making timely decisions about post discharge destination, lack of communication during the day about the plan of care, delay in transportation pick up, and I could go on and on. I’m sure you could name dozens more examples.  

How do you help your team? What resources do you provide? One suggestion is to start with your employer. Almost all employers are focusing on caregiver stress and how to manage it. I made copies of Stress Relief Tools which the Wellness office of my Employer published. I gave all my Team members a copy! At a recent staff meeting, I introduced “Boxed Breathing”. I was surprised that this was a new concept to the majority of the team. We practiced this skill as part of the meeting. Every so often, I re-fresh this concept with the team.  

In the Stress Relief Tools hand-out there are several concepts discussed such as Breathing Exercises and Short guided Meditation. Both topics require some time and practice but once you grasp how to do the exercise and incorporate them into your day, your day will become less stressful and more calming.  

Breathing exercises encompass ideas such as Diaphragmatic breathing (inflating and exhaling using your abdomen) and 4 x 4 breathing (inhaling and exhaling slowly-4 breaths 4 times daily).  Stress Released breathing is holding your breath to a count of 1-2-3-4 while relaxing all your muscles.  

Quiet Space Breathing focuses on paying attention to the stillness and quietness of the breath.  

Imagery is more than visualization as it is considered purposeful daydreaming. Use all your senses to develop a deep sense of awareness of surroundings. Focus on the Imagery.  

Try these Stress Relieving Tools and let me know how they work for you! My favorite is the “Boxed Breathing”. I use it often 😊.   

Feeling stressed? Check out mindfulness with CMSA by clicking here: https://cmsa.org/mindfulness-with-cmsa/

Bio: Karen Hooven RN BSN CRRN CCM is the manager of the Care management dept at Cleveland Clinic Medina Hospital. She has over 25 years of case management experience-Acute and Rehabilitation. She is the co-founder of the Cleveland Chapter of CMSA, now 8 years old, and is the current president of the chapter.