Guest Editorial APRIL 2005, VOL 81, NO 4

G U E S T E D I T O R I A L

Reintegrating the mind and body

ne of the characteristics of a well-respected leader is self-awareness. Although perioperative nurses are experts at multitasking and

identdjing and evaluating external cues and stimuli, they may not be as skilled at interpreting internal stimuli and behavioral cues.

Many professionals fail to identdy 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 anxi- ety in patients quickly, but they may have difficulty identifying internal feel- ings and behaviors that result from per- sonally 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.’

One step to understanding anxiety is to recogruze its presence and mani- festation in daily life.’,2 Early recogni- tion may help reduce anxiety. Un- fortunately, the perioperative culture frequently reinforces an external ver- sus an internal perspective. Often, perioperative nurses react to environ- mental cues, rather than perceptively identifying internal physical and emo- tional 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 socie- ty has fractured the mind-body con- nection. We need to practice identify- ing anxiety and stress reactions, but it may take time to re-establish mind- body pathways to truly practice holis- tic health and wellness.

THE EFFECTS OF ANXIE~ Anxiety frequently results in sympa-

thetic nervous stimulation.3” Many peo- ple experience rapid heart and breath- ing 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 hor- mones are released. Behaviorally, indi- viduals may feel tense and restless. As they become more anxious and less able to holistically perceive their sur- roundings, they may become less coor- dinated, 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 idenfdy personal signs and symptoms of anxiety.

EVENTS PRECIPITATING ANXIEIY When individuals have an idea of

how their anxiety manifests, it is help- ful 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 dif- ferent responses. These responses could be on a continuum from a panic state caused by a lack of control over the sit- uation 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 anxi- ety. One event may not cause anxiety in

Michelle Byme RN

AORN JOURNAL 7 7 7

APRIL 2005, VOL 81, NO 4 Guest Editorial

everyone, so it is important to examine what events in your life cause you anxiety.

DEALING WITH ANXIEW Often when we need relax-

ation and recreation the most, we feel that we cannot justify the time to heal and rejuve- nate. l h n k of recreation as re-creation. Each of us needs something different to de- stress from inundation by external events. Some indi- viduals may suffer from lone- liness, which may elicit uncomfortable feelings. For others, solitude may be just what is needed to reduce anxiety. The following are suggestions to improve holis- tic health. 0 Read-Find pleasure in fic-

tion, photographs, or spiri- tual literature.

have difficulty verbalizing, we are able to write down. Keep a journal of feelings and behaviors. As you write, you may be sur-

0 Joumalqf ten , what we

prised at how much it releases tension.

0 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, bal- ance, and relaxation. There is no competition in yoga or Tai Chi. This is all about developing an awareness of your body’s needs.

0 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.

ships-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

0 Develop new friend-

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 signifi- cant others. A reintegration of mind and body will make a difference. *:*

MICHELLE BYRNE RN, PHD, CNOR

NORTH GEORGIA COLLEGE DAHLONEGA, GA

ASSOCIATE PROFESSOR OF NURSING

NOTES 1. M C Townsend, Psychiatric Mental Health Nursing: Conccpts of Care, fourth e d (Philadelphia: F A Davis Co, 2002). 2. D D Burns, The Feeling Good Handbook (New York: Plume, 1999). 3. A H Fishel, ”Nursing manage- ment of anxiety and panic,” N u r s i q Clinics of North America 33 (March 1998) 133-151. 4. R Ivi Sapolsky, Wlzy Zebras Don‘t Get Ulcers: An Updated Guide to Stress, Stress-related Diseases, and Coping, second ed (New York: W H Freeman & Co, 1998).

2005 AORN Standards Book Now Available The 2005 edit ion of AORN’s Standards,

Recommended Practices, and Guidelines i s now available. This edit ion contains new guidelines for bariatric surgery, as wel l as revised recommended practices for

cleaning and processing anesthesia equipment, electrosurgery, endoscopic minimally invasive surgery, high-level disinfection, and surgical attire.

New guidance statements for care o f t he perioperative patient w i th an implanted electronic device; f ire prevention in the OR;

perioperative staffing; preoperative and postoperative patient care i n ambulatory surgery; safe on-cal l practices; safe specimen identif ication, collection, and handling; and sharps in jury prevention

also are included, as are new position statements on patient safety and R N f irst assistants.

Purchase the textbook w i th the updated study guide and receive 20 contact hours for completing the examination. To order, cal l customer service a t (800) 755-2676 x 1 or v is i t http://www. aorn. org/bookstore/default. asp.

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