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STRESSED OUT NURSES
A Hadassah Medical Feature

By Wendy Elliman
Hadassah Medical Feature
February 15, 2001

Jerusalem-- "Nurse!" cries the patient, needing an instant, compassionate and caring response from a knowledgeable, competent practitioner.

"Nurse!" calls the physician, relying on prompt and efficient action from a highly trained professional.

Her daily work includes the drama of accidents, severe illness, frightened parents and relatives, and coping with disease and death.

"Nursing is one of the highest stress professions," said Dr. Sarah Sallon, Director of the Hadassah Medical Organization's five-year old Natural Medicine Research Unit. "Work-related stress has been recognized as playing a role in anxiety, depression, reduced quality of life, absenteeism and interpersonal conflicts, as well, possibly, in diabetes, gastrointestinal disorders and cardiovascular disease."

Dr. Sallon's unit has developed the Training Course for Nurses in Stress Reduction to address the high-tension level. A pilot group of 28 nurses, aged 20s to 60s, will spend some 80 hours over the next six months learning stress-management skills.

"We made a preliminary investigation of relaxation therapies, primarily yoga and Tai Chi among the general population," said Dr. Sallon. "We saw a 75 percent drop in absenteeism from work, a 40 percent drop in smoking, reduced anxiety, depression, irritability and fatigue, along with better concentration and improved sleeping habits. We believe stress relaxation may help manage or even prevent certain diseases, especially those with strong stress elements, such as hypertension and cancer."

Building on the research, a course was custom-tailored for nurses. There are four modules, each focusing on a different technique for relaxation. The first module teaches easy-to-apply deep relaxation methods, such as looking inward; the second balances physical, emotional and mental energies through yoga; the third focuses on meditation techniques; and the fourth uses therapies based on touch, such as acupressure and shiatsu.

"Our work at the bedside requires constant patience and compassion, as well as a lot of professional competence and high tech skills," said Dr. Nurit Wagner, Head of Nursing at Hadassah Medical Organization. "Nurses invest in long and arduous training, but then leave the profession because of burn-out. I'm eager for them to have the skills to cope with the pressure-cooker environment."

Dr. Wagner went beyond recommending the new course. The head of nursing in the thousand-bed hospital set an example by becoming one of the course's first students.

"I nearly skipped one session," says Wagner, "because I felt I was coming down with the flu. But I went to the session and by the end of the workshop, I was fine. The relaxation techniques gave me an energy that has stayed with me."

After the nurses learn to relax themselves, they become trainers, learning how to teach relaxation to others. The course has been formally recognized by Israel's Health Ministry for Continuing Nursing Education credits. Los Angeles philanthropist Louis L. Borick of Los Angeles and the Great Britain chapter of Hadassah-International are funding the experimental program.

"Both the course itself and the Health Ministry recognition are firsts," says Dr. Sallon. "We'll be carefully monitoring its success."

Each participant is matched with a control subject-a nurse who hasn't taken the course-to compare job-related tensions, susceptibility to work-pressure, coping ability, mood and basic level of health.

Meanwhile the non-scientific feedback is coming in.

"I got a hysterical phone call from my teenage daughter who had broken up with her boyfriend, and I had a patient burned in a car crash who needed a painful bandage change," said one participating nurse. "I took three deep breaths and relaxed into the situation as I'd been taught - and was able both to calm my daughter and give my professional best to my patient."

Added a colleague, "I've been a nurse for many years, but with my own very close friend now dying of cancer, I've found it difficult to bring my professional skills to her bedside. Last visit, I gave her a therapeutic massage."


Wendy Elliman, a freelance writer living in Jerusalem, frequently writes on medical topics.












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