6 major categories emerged from the data analysis about coping strategies of

nurses with job stress: Situational control of conditions, seeking help,

preventive monitoring of conditions, self-control, avoidance, and escape the
situation, and spiritual coping.

3.1 Situational Controlling of Conditions

Analysis of interviews with the participating nurses showed that the nurses use
varieties of ways to control job stressful situations as well as stress in which
they control stressful conditions regarding the circumstances of the situation
through appropriate measures within the framework of the professional duties,
routine administrative procedures and individual preferences and abilities.
This interaction as a situational control strategy methods includes: immediate
action to control acute condition of patients, taking immediate action to control
professional errors, informing the physician and other members of the treatment
team, performing physician orders, informed and transparent position,
understanding and sympathizing with the patient and with the patient’s
attendants, leaving work with delay to ensure and control of working
conditions, time management, changing shift and taking permission to leave and
take advantage of the police and the judiciary.
Participant No. 7 who worked at the coronary care unit, told the researcher
about how to deal with the stress of acute condition change and prompt curative
measures to control the situational conditions.
“We had a patient with bradycardia and his heart rate was 50, suddenly in
reduced to 30, and then he had a cardiac arrest and we had a lot of stress. We
become calm only when we take an atropine injection to the patient, because
after all we took some actions”
The participant No. 9 also told about time management of works to control
high-pressure conditions such as doing a lot of work and duties within the
limited time shifts:
“I try to do my work on time so that I can get them out.
To remove the concerns and stresses related to weekly work schedule, such as
the interference of work with personal and family affairs was shown up in term
of situational controlling of conditions strategy as changing shift and taking a
day off which reflects the experience of the participant No. 6 in this regard:
“If I was on the evening shift and my colleague the morning shift, I change my
shift with my colleague since I had to leave the hospital”(Participant No. 6).
3.2 Preventive Monitoring of Situation
Exploring how nurses cope with job stress showed that coping has preventive
functions in some cases. This means that nurses carry out monitoring in the
form of actions such as follow-up, monitoring, checking, control, being on call,
increasing the accuracy, concentration, and safety, and made attempts to prevent
the situations in which tension is rising in them. Although this strategy unlike
other strategies focused on the future, taking this strategy was coping with the
aim of controlling current stress and seemed to include a kind of sense of
control over present stressful conditions.
One of the nurses in this study expressed his experience regarding proactive
monitoring of the situation through regular evaluation of patient status and
ongoing actions:
“I visit ordinary patient who did not take any hazardous medicine every two
hours and the patients who took hazardous medicine every hour”(Participant
No. 4).
In some wards, such as CCU nurses conduct the kind of monitoring and control
which was besides features such as predicting possible events and readiness to
take the appropriate measures as soon as possible which was named on call in
this study. This proactive monitoring of situations helps reduce the stress of
nurses as well as increasing nurses’ readiness and dominance. Participant No. 7,
who was a nurse working in the coronary care unit, told the interviewer about
using this method:
“We nurses bear always in mind that everything may happen to the patient and
we should take necessary measures to reduce our stress”.

3.3 Seeking Help

The findings of the study showed that, when facing work stressful situations,
nurses, in some cases, use strategies in which they ask for help, take the
supports of the coworkers or other staff or even the family members and try to
cope with professional stressful situations. The results of this study reflect the
fact that although previous strategy, i.e. situational controlling of condition and
preventive monitoring of the situation, was based on self-confidence coping
strategies, in seeking help strategy the nurses prefer to consciously use reliable
and effective social capabilities around themselves (the staff of the institution
and the family) in order to cope with job stress.
For example, seeking help from colleagues or nursing managers was manifested
in stressful situations in which the nurses required informational support, or
encountered challenges in their daily assigned duties and responsibilities for any
given reason. The participant No. 13 expresses her experience in this regard:
“When I have a question I do not feel ashamed and ask the supervisor or my
colleagues”.
To cope with the job stress, the nurses sometimes shared job stress problems
with their families which usually give them emotional and informational
supports. The participant No. 11 told the researcher:
“When I have a job stress, I talked to my mother or my spouse”.

3.4 Self-Controlling
The results of the interview with the participants showed that, to cope with job
stress, the nurses used the strategies where they tried to emotionally and
cognitively focus on self-control rather than stressful external conditions and
increase their adaptation to the situation that disrupt the balance of these
aspects. The self-control strategy were carried out by the nurses with using
methods such as positive thinking, the silence, tolerance and forced acceptance,
crying, self-learning, the use of recreation and sports.
Concerning positive thinking to overcome negative thoughts and feelings at the
time of treatment for a patient with acute situation, participant No. 7 stated:
“Sometime in facing acute changes in the patient, in order to calm them up, I
tell me that what I did make the patient better. I tell myself do not be afraid, she
gets better, wait”.
The results also showed that nurses use recreation and sports to evacuate
occupational stress and reduce the impact of work conflict and help physical
and mental reconstruction. This self-control method which is based on what the
nurses expressed helped them cope with the stress of the job. Participants
No.14, who was a young nurse, told the researcher about his experiences on
how to cope with job stress:
“I love music, instead of thinking about the work problems at home; I try to
calm myself with music”.

3.5 Avoidance and Escape the Situations

The strategy which is done through avoidance and escape methods is appeared
in the stressful situations where the nurses preferred to avoid or escape from
them for reducing tensions and stress and achieving peace. Avoiding carrying
out an action, declining the request of others, giving no attention to negative
feelings, diverting away bad thoughts, and avoiding and escaping from stressful
situations are some behaviors that nurses use in avoidance and escape coping
strategy. Participants (No.10) said:
“One thing I do when I am stressful about events that occurred in the hospital, I
make me busy in home with computer or internet or do some chores to forget
the problem”.

3.6 Spiritual Coping

Participating nurses expressed spiritual coping as one of their strategies to cope
with job stress. This approach, which was manifested as spiritual practices such
as the prayer or reading the Quran, could include features such as seeking help
from God and feeling support from a superior force which was taken by nurses
in different work situations. And this spiritual coping, causes tension relieving
in the nurses. For example, participants No.13 told the researcher In this regard:
“Effect of spirituality is very high. Sometimes working pressure is high. It makes
you tired. If there is no power of faith you feel alone also I read Quran when I
leave home to go to work and it has good effects”

Coping Styles
There are many coping styles that people use, and some may prove more effective
than others, depending on the nature of the stressful situation and the person who is
employing them. Ineffective coping mechanisms, also referred to as maladaptive
coping, may also be applied to stressful events or internal conflict, often
unconsciously. Maladaptive coping mechanisms are counterproductive.
Among researchers, coping styles are commonly assigned broad categories that
draw distinctions between methods. For example, instrumental coping (referred to
as problem-solving) focuses on ways to tackle the issue in order to reduce stress
around a given situation, while emotion-focused coping gathers tools to nurture
one's emotional health during the stressful period. Additionally, coping is identified
as being either active or avoidant. Active coping strategies involve an awareness of
the stressor, followed by attempts to reduce the negative outcome. By contrast,
avoidant coping is characterized by ignoring the issue, often resulting in activities
that aid in the denial of the problem (e.g., drinking, sleeping, isolating).
Specific Coping Strategies
Now that we've examined common styles of coping, let us take a look at specific
coping strategies:
 Humor. Pointing out the amusing aspects of the problem at hand, or "positive
reframing," is thought to help deal with small failures.
 Seeking support. Asking for help, or finding emotional support from family
members or friends, can be an effective way of maintaining emotional health
during a stressful period.
 Problem-solving. As described above, problem solving is an instrumental coping
mechanism that aims to locate the source of the problem and determine
solutions. This coping mechanism is often helpful in work situations.
 Relaxation. Engaging in relaxing activities, or practicing calming techniques, can
help to manage stress and improve overall coping.
 Physical recreation. Regular exercise, such as running, or team sports, is a good
way to handle the stress of given situation. This may involve yoga, meditating,
progressive muscle relaxation, among other techniques of relaxation.
 Adjusting expectations. Anticipating various outcomes to scenarios in life may assist
in preparing for the stress associated with any given change or event.
 Denial. Avoidance of the issue altogether may lead to denying that a problem
even exists. Denial is usually maintained by distractions, such as excessive
alcohol consumption, overworking, or sleeping more than usual.
 Self-blame. Internalizing the issue, and blaming oneself (beyond just taking
responsibility for one's actions), leads to low-self esteem and sometimes
depression.
 Venting. An externalizing coping technique, venting is the outward expression of
emotions, usually in the company of friends or family. In moderation it can be
healthy; however, ruminating on the negative can lead to strained relationships
over time.
 Stress a guaranteed part of any nursing career.
Understanding how to deal with the stress can be
difficult, especially for new nurses. New RNs could
feel overwhelmed and disillusioned about their
responsibilities. Some feel that they are
underprepared, doubt their abilities, and even worse,
contemplate leaving the profession. We want to share
these 20 coping skills for new nurses. These 20
coping skills for new nurses will help new nurses feel
confident and satisfied being part of the nursing
profession.

 1) 20 coping skills for new nurses:

Remember it’s not personal.
 Being in the healthcare industry isn’t just stressful for
the nurse, but also your patent and family members. If
they lash out at you know that their frustration isn’t
geared to you. Their stress could be concern for their
loved one, financial, or the facility. If you are put in
 this experience remember to first take a deep breath.
You don’t want to overreact or say anything negative.
Instead find your floor manager and explain the
situation to them. Cooler heads will prevail.

 2) 20 coping skills for new nurses:

Practice deep breathing exercise.
 Deep breathing exercises has proven to be an
effecting coping skill. It will reduce stress, improve
your mood, and allow you to not to hold onto things
that are out of your control. There are plenty of
resources out there to help you properly find deep
breathing exercises. If nothing more, close your eyes,
take inhale for a 5 count, and exhale for a 5 count.
Then repeat.

 3) 20 coping skills for new nurses:

Find a quiet place.
 Taking breaks is a necessary requirement for people
in all industries, especially for nurses. As a new nurse,
it is important to locate a place where you can escape
for a few moments. Find a quiet room at your facility
or perhaps there is a garden where you can sit and
collect your thoughts. Finding a quiet place will
rejuvenate your mood and allow you to have a
successful rest of the day.
 4) 20 coping skills for new nurses: Use
a journal to write or draw.
 Having a journal is a great form of expression.
The Wall Street Journaltalks about the power of daily
writing in a journal. If you prefer to draw and express
via art that’s find too. Everyone has something that
works for them. The key is to find what works for you
to help you remain calm when dealing with stressful
situations.

 5) 20 coping skills for new nurses:

Find a mentor
 Mentors help guide us and are there when we need
them. As a new nurse, find a seasoned nurse that can
show you the ropes of the facility will go a long way in
coping for new nurses. Being a nurse is a stressful job
so having someone you can lean on and get you up to
speed is critical.

 6) 20 coping skills for new nurses: Be

honest
 New nurses have a constant need to fit in. Sometimes,
that can cloud your judgement in what you know.
New nurses can be reluctant to say that they don’t
know how to do a specific patient care activity. If you
are faced with this situation be honest. Ask your
colleague or nurse manager for help. Again, this could
be something you speak with your mentor about.
 7) 20 coping skills for new nurses:
Master your skills
 The quickest way to feel confident as a nurse is to
master your skills. Having this level of confidence will
make handling any related task seem like second
nature and give you satisfaction in your new role.

 8) 20 coping skills for new nurses: Eat

well-balanced meals
 As a nurse, you are always on the go. This makes it
easier to neglect eating properly. The key to eat a
well-balanced meal is preparation. Make your meals
ahead of time. Don’t skip meals. The healthier you can
eat will increase your energy and productivity.

 9) 20 coping skills for new nurses: Get

enough sleep
 Your body needs time to rest and “re-charge your
batteries.” After a busy day of work, getting the
proper amount of sleep is a necessity to take on the
new day. You will find out that when you neglect
sleep that you are not your normal self.

 10) 20 coping skills for new nurses:

Get on an exercise routine
 Your schedule might not always allow you to exercise
daily. However, it is important that you find time to
exercise. Whether that is going to the gym, a run
 around your neighborhood, or a morning walk, the
key is to find something that fits with your schedule.
When you find something that fits with your schedule
you will find it easier to stick with it.

 11) 20 coping skills for new nurses:

Put stress into perspective
 The fact is that you cannot control everything that
happens. Focus on what you can control. Don’t stress
over things you can’t control. When you put this into
perspective you will find that things aren’t as bad as
you think.

 12) 20 coping skills for new nurses:

Maintain a positive attitude
 This supports the coping skill to not stress over things
you cannot control. Make an effort to replace negative
thoughts with positive one. When you have a positive
attitude, you will feel like you can handle anything
thrown at you.

 13) 20 coping skills for new nurses:

Don’t fight frustration
 If you are angry, sad, or having a negative feeling
allow yourself time to deal with it. News flash, these
feelings are common as a new nurse. Accept and
acknowledging your feelings. Don’t deny or try to
suppress your feelings. Talk about your feelings.
Write how you are feeling. Take time to find a quiet
 place. Whatever method you choose know that it’s
okay to feel upset.

 14) 20 coping skills for new nurses:

Look back on other stressful times
 Every storm eventually runs out of rain. When faced
with a stressful time, it is important to look back at
another stressful time. Remind yourself that past
stressful periods passed and this too will pass.

 15) 20 coping skills for new nurses:

Join a committee
 This might be one of those things that you roll your
eyes when you first read. As a nurse, your days go by
fast and time is limited. That is exactly why joining a
committee will help you cope as a new nurse. Joining
a committee will allow you to make an impact on your
facility. You can provide ideas to improve your
patient’s needs. Make your voice heard.

 16) 20 coping skills for new nurses:

Take a vacation
 As a nurse, you will be working long days. However,
when you get time off make an effort to get away and
relax. Explore a new city, schedule a fun day trip with
your friends, go see family. Whatever you decide,
make sure you take time to relax so you come back
ready to work.
 17) 20 coping skills for new nurses:
Get organized
 One way to stay on top of your game is being
organized. Nurses are handing a lot of responsibilities
daily. Thus, taking time to set your daily priorities can
help you formulate a plan to complete everything.

 18) 20 coping skills for new nurses:

Over communicate
 The more your team knows the better you can
support each other. Communicating with your team is
a great way to cope with stress as a nurse. A Nursing
World article said, “Stress in hospitals is unavoidable.
However, it can be managed.” It is managed by
communicating. When an open dialogue is fostered,
stress levels can decrease.

 19) 20 coping skills for new nurses:

Find the right situation for you
 If you know the specialty you want do you know the
right setting you want to work? Do you know the
right shift you want to work in? Do you know the
right location you want to work? The nursing world is
vast. You might find that you have less stress when
you work nights compared to days. Or maybe the
setting you’ve been in all your life is continuing to
cause you stress. Mix it up. Find what works with you
and don’t be afraid of change.
  20) 20 coping skills for new nurses:
Leave the day with a clear mind
 Your days are long and busy. You have accomplished
a lot during your day. When the day is done don’t
stress over things that weren’t accomplished. You
can’t change anything at home. Reflect on your shift,
plan out your next day, get a good night sleep, and
take on tomorrow. Move on. Otherwise you will carry
that un-needed stress the next day.

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