A new course in relaxation techniques helps nurses reduce their own levels of stress and improve the health and recovery of their patients.
By Judy Siegel-Itzkovich
Stress, lower-back pains, insomnia, depression, irritability, hypertension, "burnout" and other problems are considered occupational hazards among hospital "angels in white." Over the past year, nurses have also had to treat victims of suicide bombers, drive-by shootings and stabbings, as well as the worst civilian disaster in Israel's history - the Versailles banquet hall collapse in Jerusalem last May, in which 23 wedding guests were killed and hundreds injured.
A group of 25 nurses at the Hadassah-University Hospital in Jerusalem's Ein Kerem neighborhood were thus very fortunate to participate in the first-ever instructors' training course for nurses on stress reduction. The seven-month course included easy-to-apply deep relaxation methods, including yoga, meditation techniques, and therapies based on touch, such as acupressure and shiatsu massage.
Dr. Sarah Sallon, a British-born pediatrician and director of the Hadassah Medical Organization's six-year-old Natural Medicine Research Unit, initiated the course. In 1997, Sallon, who spends much of her time promoting the study of traditional Tibetan medicines, suggested to the HMO management that a pilot program in stress reduction be held for hospital nurses working in high-stress units.
The course was taught by South African immigrant Debbie Eisner, a yoga teacher trained by the Wingate Institute for Physical Education near Netanya. After the course, nurses who had taken part reported a significant reduction in sick leave, and 40 percent of the smokers either quit altogether or reduced smoking considerably. The nurses also reported significant decreases in their levels of anxiety, irritability, depression, lapses of concentration, insomnia and fatigue. The effects were so beneficial that a year ago, Eisner suggested a more extensive instructors' course, so nurses could teach the techniques they learned to colleagues. The course, also taught by Eisner was subsidized by Los Angeles philanthropist Louis L. Borick,
with additional money raised by Julia Darwood of Hadassah-International UK.
Although most of the nurses went directly from the end of their shift - exhausted and tense - to the two-hour weekly lesson, to their surprise they left physically and mentally refreshed. The course was formally recognized by the Ministry of Health for credits in "continuing nursing education", and three-quarters of the participants have asked that a higher-level course be offered in the fall.
In order to test the effects of the course scientifically instead of relying solely on anecdotal evidence, Sallon chose a well-matched control group of nurses who had not taken part in the course and compared their responses to in-depth questionnaires with participants before the course began and after it ended. She found that nurses who had volunteered to take the course had predictably higher stress and "burnout" levels before the course than their counterparts in the control group. But after completing the course, the nurses recorded significantly less muscle tension, irritability, back pain and stress compared to the control group, and they also reported that their general health had improved. "They showed an improved ability to relax, and were also better able to cope with stress outside of work," Sallon notes.
Atara Lev-Paz is a nurse in the pediatric neurology intensive care unit. "Stress is unfortunately an integral part of a nurse's work," she explains. "Even in nursing school it was recognized as a major occupational issue, but there weren't many solutions." Lev-Paz began using relaxation techniques on herself at home and at work. "I recorded sessions, and I played them for colleagues. Recently, when a patient was complaining about a severe headache, I asked him to lie down in a comfortable position and helped him through a "body scan". In this technique, you breathe a certain way, consciously and gradually directing oxygen to the part of the body that hurts. He located that part of the body, relaxed it and let oxygen in. This wasn't a placebo effect; there is a physical basis for this. When the blood supply and
its oxygen is directed to a specific organ, it expands. This alleviates pain."
Rahel Levanon, a nurse at the Hadassah-Mt. Scopus neonatal intensive care unit - one of the most demanding units in the hospital - explains that the constant demands of monitoring and treating premature babies allows her little time to rest. She regularly uses the relaxation techniques she learnt in the course, even while stopping at a traffic light on her way home from a night shift. She also applied them on her husband when he was seriously ill. "What we learned is not only very useful for nurses, but would be very beneficial for anyone feeling tense, wherever he or she may be."