Managing stress and developing resilience on placement

Whilst being on placement can be a very rewarding and exciting time, it can also be stressful.

Factors that can cause stress on placement

Typical aspects that can cause stress are:

Not fully knowing what to expect
A change in accommodation
Being in an unfamiliar environment
Building relationships and learning to work with new people
Being away from usual support mechanisms, family and friends
Need to develop knowledge and practice- a steep learning curve
Managing workload and expectations (yours and those of the practice educators)
Travel (if not living locally)

Medical learning environment

All of these factors are legitimate reasons for feeling stressed but remember that this is common.

Stress occurs when pressure exceeds our perceived ability to cope. Some of the coping strategies that you have already developed because of other experiences may be unhelpful. Aim to develop a positive response to the stress to improve your mental well-being and optimise your performance on placement. Removing the stress (that you may also encounter in other aspects of your personal and work life) is not possible. We need to learn to recognise stress and take charge of our responses to it. This will help you to become more resilient.

The first step to developing resilience is the ability to identify the signs and symptoms of stress early and then to put effective plans in place. This will help you to develop coping strategies to manage your stress levels and to perform to the best of your ability while on placement.

Signs and symptoms of stress

Thoughts

Negative thoughts such as:

‘Can’t cope’
‘I’ll lose control’
‘I’m not good enough’
‘I don’t know enough’
‘I’ll embarrass myself’
‘Everyone else is further ahead than me.’

Behaviours

Fight or flight responses:

Avoid
Procrastinate
Withdrawal from people or situations
Staying up too late
Overwork
Drinking more alcohol or caffeine
Is there an increase of 'bad habits'?

Emotions

You may feel emotions such as:

Worry, anxiety or panic
Feeling detached or disengaged (all the time!)
Isolated or lonely
Frustration or anger
Feeling out of control
Crying (or feel like crying) more than usual

Physical

You might notice:

Increased heart rate
Sweatiness
Shortness of breath
Churning stomach
Muscle tension
Headaches/migraines
Poor attention and memory
Skin flare-ups

Coping strategies for managing stress and developing resilience

These topics are introduced in the module Introduction to Dietetics and further developed in Principles and Practice of Dietetics. You may find it helpful to revisit your learning from these sessions. We recommend that you speak to your mentor about how you are feeling. Alternatively, you may choose to talk to your supervisor or your placement tutor.

Common strategies you might find useful:

Slow your breathing
Downloading a paced breathing app may help you.
Being in the moment or mindfulness meditation
This requires practice and takes time to be developed. Find out more about mindfulness
Be aware of your strengths
Focus on your achievements (even small ones) and reward yourself for them
Establish a healthy work/life balance
Spend time with family and friends. Take time to relax and to re-charge your batteries
Talk to friends, a mentor or a supportive colleague
Identify what makes you feel better, e.g. listening/dancing to music, watching comedy, playing games with friends, contact with pets/animals, etc.
Get a good night’s sleep
Be more physically active
Some people find spending time in nature calming and therapeutic
Eat a balanced diet
Journal or writing a diary
Maintain your hobbies

counselling

Most importantly, do not suffer in silence. If you are struggling please do ask for help.

Students with disabilities often have the added stress of dealing with the impact of those disabilities in a new environment. UoN Accessibility may be able to offer support.

Further resources

eBook:

Healey J. and Spencer M. (2008). Surviving your Placement in Health and Social Care. Open University Press, Maidenhead. Available through the UoN Library NUSearch Facility

Websites:

Mind has a range of different resources on dealing with stress and pressure, and developing resilience.

Stress Busting has further information about the symptoms and causes of stress, as well as suggestions on how to deal with it.