Reintegrating the mind and body

AORN Journal, April, 2005 by Michelle Byrne

One of the characteristics of a well-respected leader is self-awareness. Although perioperative nurses are experts at multitasking and identifying and evaluating external cues and stimuli, they may not be as skilled at interpreting internal stimuli and behavioral cues.

Many professionals fail to identify personal anxiety, stress behaviors, and defense mechanisms in themselves. As students, perioperative nurses are taught about the concept of anxiety, but it most likely is externally directed. Perioperative nurses can identify anxiety in patients quickly, but they may have difficulty identifying internal feelings and behaviors that result from personally threatening situations. Anxiety is contagious, and it can spread through an OR faster than any microbe. Anxiety may be the foundation for interpersonal conflicts, medical errors, and even health problems. (1)

One step to understanding anxiety is to recognize its presence and manifestation in daily life. (1,2) Early recognition may help reduce anxiety. Unfortunately, the perioperative culture frequently reinforces an external versus an internal perspective. Often, perioperative nurses react to environmental cues, rather than perceptively identifying internal physical and emotional changes. Comments such as "ignore the pain," "finish the task," "leave your personal problems at home," "don't cry on the job," "never disclose how you feel," or "don't think, just do it," reflect how our society has fractured the mind-body connection. We need to practice identifying anxiety and stress reactions, but it may take time to re-establish mind-body pathways to truly practice holistic health and wellness.

THE EFFECTS OF ANXIETY

Anxiety frequently results in sympathetic nervous stimulation. (3,4) Many people experience rapid heart and breathing rates when they become anxious. Many individuals talk faster, fidget, and become hyperactive. Shortness of breath, urinary frequency, or urinary urgency also may manifest. In addition, people may overeat or under eat, depending on what and when hormones are released. Behaviorally, individuals may feel tense and restless. As they become more anxious and less able to holistically perceive their surroundings, they may become less coordinated, have impaired concentration, become angered easily, have increased forgetfulness, or become accident-prone. Insomnia is another common complaint. Other individuals may view an anxious person as fearful, irritable, jumpy, or impatient. It is important to reflect on individual life situations and identify personal signs and symptoms of anxiety.

EVENTS PRECIPITATING ANXIETY

When individuals have an idea of how their anxiety manifests, it is helpful to identify events or situations that precipitate anxiety. Reactions to events are individualistic. Similar situations may cause different levels of anxiety in different people. For example, in a group of five people, a flat tire on each individual's car might result in five different responses. These responses could be on a continuum from a panic state caused by a lack of control over the situation to possible happiness if a person uses the time waiting for the tow truck for pleasurable experiences, such as reading, walking, or attending happy hour. It is an individual's perceptions or past experiences that activate anxiety. One event may not cause anxiety in everyone, so it is important to examine what events in your life cause you anxiety.

DEALING WITH ANXIETY

Often when we need relaxation and recreation the most, we feel that we cannot justify the time to heal and rejuvenate. Think of recreation as re-creation. Each of us needs something different to destress from inundation by external events. Some individuals may suffer from loneliness, which may elicit uncomfortable feelings. For others, solitude may be just what is needed to reduce anxiety. The following are suggestions to improve holistic health.

* Read--Find pleasure in fiction, photographs, or spiritual literature.

* Journal--Often, what we have difficulty verbalizing, we are able to write down. Keep a journal of feelings and behaviors. As you write, you may be surprised at how much it releases tension.

* Do meditative exercises--If you have never tried yoga, here is your chance. Be warned, however, that the first few times you may feel uncomfortable. Yoga is a synthesis of mind-body stretching, balance, and relaxation. There is no competition in yoga or Tai Chi. This is all about developing an awareness of your body's needs.

* Pray or meditate--Letting go of control can be very calming and peaceful. Letting God or a higher being provide insight and direction may be just what you need.

D Develop new friendships--Do you have at least three people who you can call to share good or bad news? If not, find some new activities and avenues to develop new relationships.

Perioperative nurses must integrate work and play. Reducing the anxiety in your life may enhance the pleasure you experience and improve the relationships you have with colleagues and significant others. A reintegration of mind and body will make a difference.