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Fight or flight response Our response to stress involves many physiological changes that are collectively called the fight or flight response. In situations in which you must react immediately to danger, it is advisable to either fight off the danger or flee. For example, you are walking back from class at night, thingking about all the studying you need to do and you begin to cross the street. Suddenly, out of nowhere, a cars headlights are coming right at you. Since your best response is probably not to fight the car, you run as fast as you can to the other side of the road. In that split second when you see the car careening qiuckly toward you, your musclas tense, your heart beats faster, your adrenaline pumps faster and is released at increased levels into your bloodstream, your breat hing becomes more shallow and rapid, and your pupils dilate to see the car better. This is the fight or flight response. Receiving alert signals from the brain, the sympathetic nerves signal most of the organs of the body, and the adrenal glands are activated. Within the brain itself, neural pathways, involved in increased attention and focus, are activated. In this way, performance and learning can be heightened. Again, all these changes are adaptive and helpful to your survival in getting out harms way. In the preceding example, when you get to the other side of the road and relize that your okay, your body begins to relax and return to its normal state. You take a large, deep breath, expresseing a big sigh of relief. Your muscles may feel even weaker than usual, your breathing may become deeper adn heavier than is typical, and you may feel shaky as your body goes from extreme arousal to relaxing very quickly. Figure 3 1 a depicts the changes from the normal state then back to normal. Accompanying this fight or flight reaction is a slower response. During stressful events, the pituitary gland secretes a peptide called adrenocorticotrophin, or ACTH, into the blood, ACTH travels through the blood to the adrenal gland,, where it signals the production of a hormone called cortisol. Cortiol aids the body in recovering from stressful experiences by freeing up energy stores. The logic behind the slower stress response is that the quick fight or flight response uses up a lot of the bodys available energy. The slower response helps to replenish that energy. The body usually has some shall amount of cortisol circulating in the blood at all times. When the stress response lasts too long or is iniated too frequently, the cortisol level is increased. After enough of these small increases. The body soon resets its control mechanism to maintain a higher constant amount of cortisol in the body.

INTERVENTION FOR STRESS Stress accompanies every diseases and illness. It is therefore important that nurse be able not only to recognize stress but also to assist people to cope with stress.

It has already been mentioned that stress is highly individual; a situation that to one person is a major stressor may not affect another. Some methods to help reduce stress will be effective for one person, other for another. A nurse who is sensitive to patiens needs and reactions can choose those methods of intervention that will be most effective for each individual. The following interventions are suggested for nurses dealing with patients under stress : 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. Be sensitive to spesific situations and experiences that increase stress for patients Orient the patient to the hospital or agency Support the patient and familiy at a time of illness Give the patient time to ventilate feelings and thoughts Give the patient in a hospital some way of maintaining identity Encourage the patient to participate in the plan of care Repeat information when the patient has difficulty remembering Defer as many questions to newly admitted patients as possible until later in the stay Encourage physical activity to dissipate stress Ensure that expectations are within the patients capabilities Bring patients and their families into contact with people in community agencies who can help them make valid plans Reinforce possitive environmental factors and reognize negative ones to help reduce stress Provide information when the patient has insufficient information Assist a patient to make a correct appraisal of a situation Provide an environment in which a person can function independently to some degree without assitance Arrange for othe niticed your patient with simiral experiences to visit Communicate competence, understanding, and empathy rather that stress and anxiety

Try some or all of the following strategies for managing your time more productively and creatively: Set priorities. Decide your task into three groups : essential, important, and trivial. Focus on the first two ignore the third. Scedule task for peak efficiency. Youhe undoubtedly noticed youre most productive