Directors of nursing services (DNSs) and other managers can support and motivate staff in two critical ways: individually and organizationally. Taking the following steps can help staff deal with the anxiety of caring for residents in a pandemic:  

Teach staff how to help each other—and themselves  

Judy Davidson, DNP, RN, FCCM, FAAN, a nurse scientist at UC San Diego Health and co-chair of the Strength Through Resiliency Task Force at the American Nurses Association, offers the following two stress reduction techniques that DNSs can use themselves and teach staff as well:   * Tap Out and Take a Lap. “If you see someone at work whose anxiety level is rising, you figuratively tap them out and invite them to take a lap of the unit with you. A lap of the unit usually takes about one minute, and that is all it takes to do this stress reduction technique,” says Davidson. “While walking, you coach them through a little breathwork. If they are really panicked, just do four breaths in and four out. Doing that for five cycles will add up to a minute—which is all it takes to break the stress response that the person is under and ground them again so they can get back into the game.”   If the person isn’t totally panicked, “they may be able to tolerate a more complex breathing pattern, four-seven-eight: Breathe in for four, hold for seven, and breathe out for eight. Four to five repetitions of that will give you a minute that you have walked around the unit, and now both you and your colleague are feeling better,” says Davidson. “I recommend anyone to do that for helping out in-the-moment stress.”   * Scanning for Normalcy. “When you are fearful, you reflexively scan your environment for threats. It is a basic human instinct, but we are going to break the fear response by turning that on its head,” says Davidson.   “When you leave work and you want to leave it behind you, do this exercise,” she suggests. “Turn your head all the way to the left. That’s important because turning your head will activate the vagus nerve to help calm you down. Once you have your head all the way to the left, you slowly turn your head [back toward the right] and notice everything beautiful and normal that you can see. For example, ‘There is a bird in the tree. There is a leaf on the ground. That flower is just opening.’   “By the time you get to the other side, you have gone away from that stress response and you have brought yourself back to recognizing what is normal in your environment,” she continues. “Do that when you leave work and then any time you are walking outside for a little bit of exercise, and it will bring you back into normal moments. You can’t be in fear-based mode 24/7.”  

Connect staff with key resources

The Centers for Disease Control and Prevention (CDC) has established a resource page, Healthcare Personnel and First Responders: How to Cope with Stress and Build Resilience During the COVID-19 Pandemic. This page reviews symptoms of stress (e.g., irritation, anger, or denial); identifies stress-related disorders (e.g., post-traumatic stress disorder), as well as compassion fatigue and burnout; and provides contact information for free resources (e.g., the Lifeline Crisis Chat). In addition, the CDC offers the following tips for improving coping skills and enhancing resilience:  

Communicate with your coworkers, supervisors, and employees about job stress.

Talk openly about how the pandemic is affecting your work.

Identify factors that cause stress and work together to identify solutions.

Ask about how to access mental health resources in your workplace.