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  • Writer's pictureMegan Filoramo

Skipping the first step

The human body is amazingly complex and yet also in many ways predictable.

We know exactly what will happen if we try and provide care for a patient while they are agitated.

They can’t learn, they can’t cope, and they are slower to heal.

We understand the importance of helping them calm down and measure it not only by direct observation but by the decrease in their blood pressure, heart rate, and respiratory rate.

Honestly, it’s a big part of our jobs as nurses, taking care of the nervous system first so we can then take care of the physical body effectively.

We help them down-regulate their nervous system through breathwork, distraction, savoring (aka. Asking them to share something that is important to them: children, pets, hobbies), touch, reassurance.

It’s a no brainer.

And yet… (there’s always an “and yet”) for some reason we don’t acknowledge that the same would be true for us.

Nurses are not good at tapping into their own nervous systems and using the same down-regulation techniques.

Ironically, it’s not because we don’t care, in fact, the opposite is true. We are desperate to feel calmer and less overwhelmed.

So why does this happen? If we know the importance, why don’t we do it?

The answer is two-fold.

First, we spend a large portion of our day intentionally ignoring the signals our body gives us.

We have to pee, we ignore it.

We are starving, we wait until later. Too busy.

We experience something emotional with a patient and we hold back the tears or frustration and go into the next patient room.

Ignoring our body (aka our nervous system signals) ends up being an intrinsic part of the job. No wonder we are so good at it.

But let’s go back to the beginning. We know the inherent dangers of not down-regulating the nervous system. We know if we don’t do it, our overall health and wellness will suffer.

So what’s the solution for the well practiced disregard of our nervous systems?

We have to do some type of body work, we have to reestablish that connection. There are a lot of options but let’s start small and simple.

Let’s breathe.


For real.

It doesn’t even have to be done in the stressful moment- the sympathetic nervous system will stay wound up until we get to it (unfortunately). We can do it when we get in the car at the end of the day, or before we start charting on a new patient.

We can use box breathing/ 4-4-4-4 breathing to start. Inhale for a count of 4, hold for a count of 4, exhale for 4, hold for 4. Repeat.

This is the breathing technique that the Navy Seals use. If it can help them, it can help us.

If that’s too much, just taking a couple of deep breaths, unclenching your jaw and dropping your shoulders is a good place to start.

Let’s try treating our own nervous systems the way we treat our patients’.

It’s the step we can’t ignore.


It’s time to stop ignoring the stress you are experiencing at work. The cost is too great. If you need some help getting started, click here to set up a time to talk.

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