The Ongoing Stress of the Pandemic: Help for Nurse Caregivers

At this point in time there is no certainty about when the pandemic will end. It could be a matter of months or it could be another year or more before a vaccine is developed and cases come down. As caregivers face seasonal influenza and long-term care of COVID-19 patients, the following are some new ideas from Cleveland Clinic caregivers on how to manage the challenging months ahead.

Cleveland Clinic health system Interim Chief Nursing Officer Meredith Foxx, MSN, MBA, APRN, offers these suggestions that have helped her in managing long-term stress.

Escapism. At nurse leader meetings, Foxx goes around to each nurse and asks them to share what they are doing to escape the day-to-day stress of patient care. It might be a TV show, a new exercise routine, getting out in nature or a creative hobby. Spending time talking about what everyone is doing provides some levity and gives the nurses a chance to decompress, she says.

Set boundaries. Many family members and friends will ask nurses questions about the virus and expect them to have all the answers, she notes. And they may want to talk about pandemic because you are in healthcare. But because nurses provide patient care and face the virus each day, getting away from the topic is important. While Foxx is an advocate for her family and friends and she wants to help them alleviate stress, she asks her loved ones to limit time discussing the topic with her.

Maintain positive activities. “Whatever you have done prior to the pandemic, find alternative ways to find that joy,” Foxx suggests. Some approaches she has tried include hosting her book club virtually, finding ways to run competitively via virtual events, and supporting community needs.

Cleveland Clinic Psychologist Susan Albers, PsyD, says dealing with stress for months on end can lead to becoming ill and fatigued. “This pandemic has been all about change: change in your work environment, change of wearing masks and change of who you hang out with. That natural resistance to change is another layer to all of this stress,” she says. Here are some recommended stress relievers that she offers nurses.

Get outside. Studies show that spending just 15 minutes outside reduces blood pressure and boosts our serotonin hormone. It also provides that vitamin D we all need. And even when the weather gets cold, it is still important to get outside. It can be as easy as hanging out in your yard or taking a walk — just be sure to practice proper social distancing guidelines, Dr. Albers says.

Avoid sleep deprivation and turning to bad habits. She suggests focusing on things like getting enough sleep, which can help put you in a better emotional space to combat stress. She says getting an extra 30 minutes of sleep and staying away from things that make your sleep worse helps. “In times of stress, people sometimes turn to things that help them cope, but turning to things like alcohol and emotional eating really compound problems,” Dr. Albers says.

Monitor your news watching. Limit your exposure to news about the pandemic, both in terms of how much time you spend on it and where you get your information from. “Be really aware of the time of day you’re tracking the news. Don’t watch it at night right before you go to bed or first thing in the morning,” she suggests. Instead, wait for the right moment to catch up. “Wait for when you’re in a good emotional space. You can flip through to find what kind of news you need. Just be mindful about what you consume.”

Ask for help. One of the most important things in ongoing periods of uncertainty is to keep an eye out for depression. “If you start to experience this, if you feel like you’re just so down about it or in a very negative space, it’s helpful to consult a professional because chronic stress can turn into depression,” she says.

Finally, Cleveland Clinic’s Nurse Wellness Manager Holli Blazey, CNP, recommends exercise and mindfulness, specifically using the Three Good Things concept, a daily writing practice. “I love presenting Three Good Things to our nurses,” says Blazey. “It takes just 10 minutes to write down three good things from your day, and it becomes a habit that helps you switch from negative thoughts to put the focus on the positive. It works! I even bought my teenager a journal to do this and she actually does it and enjoys it.”