Stress and Coping

Stress is a condition in which one

responds to changes in its normal
balanced state. A stressor is any event
or stimulus that causes one to
experience stress. The responses made
are called coping mechanisms
Sources of Stress

Internal Stressors
External Stressors
Developmental Stressors
Situational Stressors
Stress can have physical, emotional,
intellectual, social and spiritual consequences
Models of Stress

General Adaptation Syndrome physiological
response of the body to any kind of demand made
upon it.(Selye)

Transactional Stress Theory takes into account
cognitive, affective and coping responses that arise
out of person-environment transactions.(Lazarus)
GAS
Psychological Indicators of Stress

Anxiety
Fear
Anger
Depression
Use of defense Mechanisms
Physiologic Indicators of Stress
Pupils dilate
Diaphoresis
Tachycardia
Pallid skin
Hyperventilation
Urinary output decreases
Dry mouth
Intestinal peristalsis decreases
Muscle tension
Blood sugar increases
Factors Influencing the effectiveness of Coping

Past experiences of the individual
Support systems of the individual
The number, duration and intensity of the stressor
Personal qualities of the individual
Coping Mechanisms
Utilize Nursing process
Structuring
Self-control
Suppression
Fantasy or daydreaming
Exercise
Nutrition
Rest and Sleep
Time Management
Relaxation techniques
Crisis
Occurs when an event or circumstance
overwhelms the individual's ability to resolve,
manage, or process the event.
The role of the nurse is to shine light and
hope on the most abysmal of life
circumstances.
The nurses responsibility becomes that of the
facilitator in addressing the need of the client.
Crisis Intervention

Is a short-term helping process of assisting
clients to:
Work through a crisis to its resolution
Restore their pre-crisis level of functioning

Offers opportunity for growth and change
Risk Factors for Crisis
Intensity of exposure to the situation
Preexisting psychiatric symptoms & diagnosis
Prior history of traumatic exposure
Family history of psychiatric problems, anxiety,
and/or antisocial behavior
Early separation from parents
Childhood Abuse
Poverty
Cultural expectations that prohibit asking for help
Degree of threat to life
Evaluating
How does the client perceive the problem
Is there an underlying problem not identified?
Have new stressors occurred that interfere with coping?
Were existing coping strategies sufficient to meet
outcomes?
How does the client perceive the effectiveness of the new
coping strategies?
Are new coping strategies implemented properly?
Did the client access and utilize resources?
Have family members provided support?
ABCs of Crisis Counseling
Achieve Contact ( safety & security)

Boil Down the Problem (ventilate &
validate)

Cope With The Problem (predict &
prepare)
Burnout

A term to describe nurses who are
overwhelmed. They exhibit behaviors
likened to the exhaustion stage of
GAS.

Nurses need to utilize same coping
techniques they recommend to their
clients.