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The Emergency Department at Harborview sees anything from gunshot wounds to low-grade fevers. What in normal times can be considered a fast-paced and high-pressure job is now amplified due to the COVID-19 pandemic.

The average reported stress level for adults in the U.S. as it relates to the pandemic is at a 5.9 (one being little to no stress and 10 being great stress) according to the American Psychological Association’s 2020 stress report. That’s a significantly higher level than the average stress level reported in the 2019, which was 4.9.

We talked to Elisha Angus, BSN, RN, CEN, TCRN, an Emergency Department nurse at Harborview Medical Center, about how she keeps her cool during times of stress.

Prioritize and be present

When you have too many items on your CVS receipt-sized to-do list and you are trying to manage multiple tasks at once, Angus recommends “triaging” your tasks.

“I keep in my mind a list of what has to be done and I triage those tasks,” says Angus. “Like what patients need to be seen first and who can wait for that Tylenol.”

In the fast-paced and ever-changing environment of the Emergency Department, nurses like Angus need to make those triaging decisions quickly.

But the pandemic has reduced some of that need for speed, especially when working with patients under investigation for COVID-19. Staff wearing full personal protective equipment (PPE) can’t quickly bounce between patient rooms since they have to don and doff their PPE before entering and exiting.

“COVID-19 has taught me to pause more and be more present,” Angus says.

Take a lesson from the Emergency Department during a pandemic: Trust your ability to determine your priorities and then give your focus to those responsibilities.

Take a step back

“I do think the change with COVID-19 has increased stress levels,” says Angus. “When you’re hot and sweaty in your PPE, under stress and doing your work with people watching you, it can be really exhausting.”

To help keep cool, Emergency Department nurses have the ability to tap out of situations when they need a physical or mental break. Angus says that when a nurse needs to tap out, a team member steps in to support them.

Taking breaks and prioritizing your needs is essential because as much as refilling your energy reserves is about you, it’s also about having the capacity to support your team and do your job.

The next time you are feeling overwhelmed or have lost your cool, try stepping back, taking a deep breath and identifying what support you need (and asking for it).

Ask for help

“I feel the most stressed when we are boarding a lot of patients, the waiting room is full and the acuity is highly sick people,” says Angus. “In these situations, I rely on my co-workers for their knowledge or ask for their help.”

Angus seeks expert council when she feels overburdened at work or when she is in a new situation. A nurse since 2016, Angus says that she still runs into new circumstances. When she doesn’t know the best course of action, she uses her more experienced co-workers as resources.

“There is a vast amount of knowledge in the Emergency Department, some people have been there for 30-40 years,” says Angus. “They don’t come across new situations often and, if they do, they have been in similar ones.”

For Angus, asking for help isn’t weakness, it’s being resourceful and responsible.

Although asking for help can often feel vulnerable, it can also help you succeed and tackle your priorities without falling behind and make new or daunting tasks easier to navigate.

Treat being wrong as a learning opportunity

In the Emergency Department they have a “mess up, fess up” mentality where if you make a mistake, you immediately report it and ask for help.

“In the Emergency Department, it’s a human life that you are helping, and a mistake can be very impactful,” says Angus.

Angus wants to normalize owning up to mistakes.

“We grew up in a culture where being wrong isn’t acceptable,” says Angus. “I don’t like to be, but it’s important to let go of your pride because we learn from being wrong.”

Owning up to your mistakes (and asking for help) can be liberating, especially if the fear of messing up is causing your stress or worry.

Leave your stress at work

After a long and busy day in the Emergency Department, Angus looks forward to her hour commute. It’s time where she can sit in silence or listen to podcasts to help her decompress.

“If you have a certain amount of space designated for dealing with stress, then you can only fill that space with a finite amount of worries and problems. At work, your worry space is full and if you take that home there is no space to hold for others,” says Angus.

Creating time or your own ritual to decompress and transition from work to home life is an important act of self-care and a good one for helping you maintain your cool.

Even if you are working from home, you can still find an activity, like going for a walk, that helps signify the end of your workday and allows you the time and space you need to recharge.

Show yourself compassion

“Don’t be too hard on yourself,” says Angus.

We are all experiencing higher levels of stress this year, and it’s OK if you don’t always feel like you are keeping your cool.

Give yourself a break, drop the negative self-talk and extend yourself a little compassion.