The 4 A’s of Stress Management

By Betty Frandsen RN, NHA, MHA - May 13, 2014

The 4 A’s of Stress Management

After more than 30 years working in long-term care – 14 of those as a director of nursing -- you don’t need to tell me that our job is stressful! Stress management is a skill needed by everyone, but particularly needed by nurses.

As care providers, we must take time to identify the triggers that create stress and to develop strategies for dealing with them. Start by trying one of the “Four A’s” developed by the Mayo Clinic for coping with stress.

1. Avoid

Where possible, take control of your environment in order to avoid stress. Stress can be reduced by planning ahead. Don’t take on more responsibility than you can reasonably manage. Organize your day by listing tasks in order of importance. Complete the most pressing responsibilities first, and save the others for later or ask for assistance from a co-worker.

2. Alter

During times of stress, attempt to make changes that impact your stress level for the better. Communicate by using “I” statements when asking others to change their behavior—for example, “I feel frustrated by this heavy workload. Can you help me balance this?” To manage time better, group phone calls, computer tasks, and other responsibilities together if possible. If an individual tends to take up a lot of your time, politely say, “I only have five minutes to cover this, so please tell me what I can do for you.”

3. Accept

There are times when the only response is to accept things as they are. Talk about the stressors with a person you trust in order to relieve the pressure. If experiencing anger at someone, free yourself from it by forgiving the individual and moving on. Avoid negative self-talk and focus on the positive. Learn from past mistakes and accept them as “teachable moments.”

4. Adapt

Redefine the need to achieve perfection in order to function with less frustration. Stop gloomy thoughts when they occur. Try to reframe the situation by looking at it through another person’s eyes. Adopt a saying to use in tough situations, such as “I can handle this” or “This will pass.” Look at the big picture to put things in perspective. Ask, “Will this matter in a year? In five years?” Viewing stressors from this angle can make situations feel less overwhelming.

Stress won’t disappear, but with practice you can learn to manage stress and reduce the frustration it causes.
Additional nurse management resources from AANAC:

4 Steps for Beating DON Burnout
Managing Challenging Situations

Betty has worked in long-term care for over 30 years, including 14 years as a Director of Nursing, and as an Administrator. She is currently the Curriculum Development Specialist for AANAC.

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