Stress and Adaptation: the Physical and Psychological
The difference between distress and eustress is...?
Distress results from a change in a person’s internal or external environment that is perceived as a challenge, a threat, or a danger. However, eustress is short-term stress that promotes positive emotional, intellectual, and physiologic adaptation and development.
What are the 3 highest risk factors associated with nursing burnout?
Working more than 40 hrs/week, reporting stressful work environments, and units with "inadequate staffing."
What are the 3 types of trauma?
Acute, chronic, and complex
Bonus: Interpersonal (IPV) and structural (racism and poverty)
What are the 3 components of the Self-Determination Theory?
Competence, autonomy, and relatedness
This type of stress occurs as a person passes through normal stages of growth and development; it can include a teenage search for independence and/or signs of aging...
Developmental stress
"The doctor must be wrong. I feel perfectly healthy, and there’s nothing wrong with me." Which defense mechanism does this statement describe in the patient?
Denial
Trauma creates a disruption in the _____ system of the brain.
Limbic
This type of motivation describes motivation from others or motivation from our own “shoulding," which causes patients to likely disengage or not be motivated in that behavior change...
Extrinsic motivation
What is the mind-body interaction?
The ability of a psychological stressor to activate a physiologic stress response. Physical symptoms may be disruptive, and if it persists, may be called a psychosomatic disorder.
What percentage of nurses report high levels of stress/burnout?
65%
List at least 5 physical impacts of trauma
Broad: hyperarousal/hypervigilance, psychosomatic issues, sleep disruptions, eating disturbances, developmental regression
Specific: mind racing, dizziness, disorientation, lightheadedness, blurry/strange vision, feeling breathless or breathing fast and shallow, difficulty in swallowing, heart racing or palpitations, nausea or lack of appetite, trembling, sweating or shivering, restless, jelly-like legs, and/or the feeling of wanting to run
What does "OARS" stand for?
Open-ended questions, affirmations, reflections, and summaries
List the 4 steps of the Alarm Reaction stage of General Adaptation Syndrome (GAS)
1. Defense mechanisms activated
2. HPA axis is stimulated, which increases catecholamine levels
3. Fight/flight response
4. Ends in countershock (reversal) phase
Nurses are most likely to experience burnout if they have ______ to ______ levels of resilience.
Options: low to moderate, low to high, moderate to high, or high to low.
Low to moderate
Name at least 2 strategies to prevent re-traumatization
Ask permission before touch/care, listen attentively, explain procedures and steps clearly, offer choice and control, validate patient experience, and respect boundaries
A 60-year-old patient is not taking medication due to forgetfulness and side effects. Which component of the Self-Determination Theory should the nurse primarily focus on?
Relatedness
This defense mechanism involves subconsciously protecting themselves from memories of horrific or painful events by forgetting...
Dissociation
What percentage of nurses left their jobs and listed burnout as the reason?
31.5%
What are the 5 core principles of trauma-informed care?
Safety, trust, collaboration, empowerment, and cultural humility
A nurse is using motivational interviewing with a patient struggling to exercise consistently. Which action(s) support competence?
A. Pointing out small successes
B. Setting unrealistic exercise goals
C. Encouraging gradual progress
D. Criticizing missed workouts
E. Reinforcing effort
A, C, E