Healthcare is unique. Where else can you feel exhilarated one moment and exhausted the next? Beware, these myriad emotions can take their toll. Awareness of trying encounters unique to nursing will help you meet your own needs. As a nurse you write care plans for patients all the time. You may need a care plan of your own. The following are examples of difficult scenarios with suggested coping strategies.

Recognize emotions. When emotions run high, they tend to drive our words. Consider this scenario: Your patient's daughter becomes enraged and accuses you of not doing everything possible to help her father. Recognize that the daughter may really be expressing her fear and worry for her father's health. Address these concerns and the complaint should diminish. Watch body language and its subtext to reveal the emotions behind the words. View the situation from the daughter's/patient's point of view to relate to their emotions.

Nurture yourself. Nurses are nurturers. Constantly caring for others can lose its appeal if, at day's end, you return home feeling spent and empty. Who cares for the caregiver? Eventually, not meeting your needs will lead to resentment. The ill feelings brewing internally may be externally demonstrated by the way you treat patients-impersonal and detached. Each day ask yourself (on a scale of 1 to 10):Are my own care needs being met? If not, what will you do about it today (e.g., see a movie, call a friend, attend a yoga class, ask your spouse to help prepare dinner)? Urge your patients to take care of themselves and take your own advice.

Don't take it personally. The healthcare environment is rife with emotionally charged encounters. Blame, accusations, and discouragement are all daily experiences. People who are ill and unable to care for themselves may be unable to choose their words carefully. Patients may occasionally attack the nurse. However, even the most trying of encounters should not be taken personally. Most patients are distressed at their situations, not at their caregivers. Focus on the problem and not the person.

Expand your perspective outside of nursing. Yes, there is life outside of healthcare. Who are your closest friends? Other nurses? If so, look to expand your perspective by pursuing friendships and activities outside of healthcare. Maintain friendships with people in other occupations and avoid work-related conversations.

Let go of that which is beyond your control. Although you cannot control events happening around you, your response can be controlled. Patients we care for do die. Deal with these difficult times by recognizing and accepting your emotions. Focus on patients who still count on you to care for them.

Keep your contribution clear. Nurses often feel like they are constantly giving to others but are rarely recognized for their efforts. It is important to keep your own sense of acknowledgment alive at work. In the perfect world, both doctors and patients would regularly recognize nurses. Yet in today's healthcare environment, chaos is constant and time is crunched. This ideal world is far from reality. View scenarios in the context of your larger positive plan and recognize yourself for steps toward that plan. Review your accomplishments at the end of every shift. Review the patients you have helped. Keep a scrapbook of your positive contributions. Remember, your impact exceeds just your patients and their families. Take time to see your role in terms of the contributions you make to patients, their families, your coworkers, your family and friends, and the overall healthcare system. Acknowledge your coworkers in an effort to strengthen relationships. This can cause a physiologic response of the release of stressreducing endorphins.

Nursing is one of the most rewarding and fulfilling occupations. Where else can you save lives and contribute to the health and well being of so many people? However, nursing can also be trying. Do not let the challenges overshadow the good. If any of the above examples reflect your experience, take time to create your own critical care plan. The rewards are plenty.