Anger Management for Nurses: How to Not Feel Powerless

11/20/2020

Tips to turn your nurse anger to a positive change

By Debra Wood, RN, contributor

Whether it’s seeing a person without a mask in the grocery store, driving past a crowded bar, or dealing with nurse staffing shortages and a lack of personal protective equipment, there is no scarcity of things that will raise nurses’ anger level. 

But anger can prove disabling, so learning some anger management techniques can help nurses survive in this COVID-19, crisis-filled world.   

Nurses working with COVID-19 patients are making sacrifices, are working hard and are stretched, leading to anger—but anger can be managed, reported Kim Colegrove, author of Mindfulness For Warriors: Empowering First Responders to Reduce Stress and Build Resilience and founder of the Pause First Academy in Kansas City, Missouri.

Sandra P. Thomas, PhD, RN, FAAN, chair of the PhD Program in Nursing at the University of Tennessee, Knoxville and author of Transforming Nurses' Stress and Anger, has researched nurses’ anger. 

Thomas’s findings show that anger is often a result of nurses feeling:

  • Overloaded and overwhelmed;
  • Powerless to bring about needed changes in the workplace;
  • Unsupported by management; or 
  • That some patients were not being treated ethically.

Thomas found that while nurses’ anger was legitimate, how they deal with it often was not. Nurses either “stuffed” the feeling; used food, drugs or alcohol to self-medicate; or flew off the handle at others, alienating people.  

Anger’s dangers

“Anger gives you a sense of power or control over something you cannot control in the moment,” said Donald Altman, MA, LPC, owner of MindfulPractices.com in Portland, Oregon, and author of Simply Mindful: A 7-Week Course and Mental Handbook for Mindful Living.

An angry person’s blood pressure rises and heart rate goes up.

Additionally, anger rouses the person’s nervous system, cortisol is released and the immune system suppressed, with fewer T-cells and natural killer cells, Altman explained. 

“If you are in an environment where you are already at risk, you need to buffer that and boost your immune system,” he said. 

Chronic stress or anger often leads to unhealthy eating and can adversely affect relationships and communication. 

Strategies to conquer anger

Thomas recommended “people who are accustomed to stuffing the anger down need to learn how to express it assertively and the people who are too hot-tempered need to learn some calming strategies, such as breathing techniques or getting the anger out through physical exercise, such as jogging.”

Additionally, she noted that effective anger management for nurses involves taking “constructive action on the precipitants of your anger whenever you can through the ABCs of Assertiveness, Bargaining and Coalition-forming with others who care about the common problem that is anger provoking.”

Thomas also suggested doing anger-releasing exercises when no constructive action is possible, so that the anger does not fester and become residual bitterness and resentment. 

“Stress fuels anger and therefore you must know your limits,” she said. “If you're highly stressed at work, cut yourself some slack at home, and vice versa. Cry, laugh, play, pray. Interact with people who uplift your mood and help you relax, avoiding ‘stress carriers’ who drag you down.”

Her additional anger management tips for nurses include:

  • Avoid discussing value-laden topics
  • Walk away from situations that will “push your anger button”
  • Work on any old anger issues left over from your family or past events in your workplace
  • Reward yourself for trying new anger management behaviors, and 
  • Deliberately generate positive emotions by tallying up positive events that occurred in your day, such as being there for a parent anxious about her sick child, teaching a new diabetic, or comforting a patient in pain.

Practice self-care

Meditation, mindfulness and yoga can help your mental health

Colegrove recommends holistic wellness practices that cover mind, body, spiritual, and relational and social health—every aspect of being a human being.

“A lot of people are so stretched and stressed out by their jobs that they let go of their social life, and it ruins interpersonal relationships,” Colegrove said.

Meditation, mindfulness and yoga can help people get more in control of their mental health, to respond instead of react, and to stay with the tool until one experiences relief, she said. Nurses could meditate during a break. But Colegrove recommends meditating regularly to achieve improvements in brain activity.

“Meditation promotes mindfulness, and mindfulness is a way of living more present in each moment,” Colegrove explained. “When your thoughts and heart are racing, you can train yourself, even on the go, to take that breath or two. ... You develop the ability to de-escalate yourself.”

Learn loving kindness meditation

“Loving kindness meditation is an ancient way of self-soothing and developing compassion,” Altman said. “Science today has shown the words in the loving kindness meditation or affirmation can actually help us feel safer, calmer and more trusting and open to others.”

The words are sent to oneself to help develop calm. The nurse can do loving kindness meditation on a break or in the car in just three minutes.

“You began by thinking of someone who has warm feelings for you,” Altman said. Then, you imagine that person telling you, “May you be well, happy and at peace, free from pain, hunger and suffering.”

The next step is to say the words to yourself. You can even adapt the words to fit you better. For instance, you might say, “May I be loved, accepted or understood,” he noted. Then extend the words to others. 

“Everyone can benefit from these kind words,” Altman added. “Extend the warm feeling to the entire world.” 

Nurses also can combine the loving kindness words with diaphragmatic breathing or going outside, since nature tends to have a calming effect on people. Altman also recommends reflecting and responding with respect, after letting go of the anger. 

Awareness that heals

Robert Strock, LMFT, author of Awareness That Heals: Bringing Heart and Wisdom to Life's Challenges, explained the importance of being fully aware of anger in order to overcome it. 

“It requires facing reality of what you feel, the situation and wanting to do good, and it has to be possible,” Strock said. 

He outlined seven steps for using awareness to heal and manage anger:

1.   Awareness of the challenging emotion.

2.   The intention to heal.

3.   Containment. “It’s never helpful to suppress or blindly express anger,” Strock said. “You want to find a way to express it, but not in a way it will create harm.”

4.   Identifying vulnerable emotions, such as helplessness, abandonment or grief.

5.   Identifying needs that are possible to fill (perhaps more PPE, more vigilance wearing masks). Then pivot from anger, finding a way to shift that energy toward passion for a solution. That may include calling a Congressman or writing to the local newspaper.

6.   Communicating with the best tone of voice possible to achieve healing.

7.   Discerning how much to focus on acceptance and self-compassion and how much on activism and actions.

Nurses obviously deserve self-compassion and self-appreciation, said Strock, noting that many are currently doing the hardest work they have ever done in their lives. But it is important to shift the mind from angry feelings toward an intention to heal yourself, he explained. “If you control your thoughts, it will eventually help your feelings.”

“Ask yourself, ‘Which are the best healing activities for me?’” Strock said. “You have to focus on what is possible, and what is possible is self-caring.”

 

NursingJobs.com has thousands of nursing positions across the U.S.

APPLY TODAY to get connected with a top recruiter.

Suggested for you

Sign up and stay in the know with NursingJobs.com



We just need a little bit more from you...