(med page today)-- Nurses have intense experiences that most other healthcare workers don't. As a result, they tend to have a great deal of stress. Having friendships with other nurses tends to alleviate it and help in more ways than you might imagine.
Only nurses understand what other nurses truly go through, said nurse practitioner, former attorney, author, and career/lifestyle blogger Meika Mirabelli, JD, MSN, FNP-C, founder of Beauty in a White Coat, which helps both healthcare students and professionals live balanced, successful lives through sharing career and studying tips. Mirabelli knows firsthand how having friendships with other nurses can make a huge difference in the workplace -- and how not having them can hurt.
"I have experienced horrible treatment by nurses who were in the field of nursing longer than I have been. During those times, I would have to lock myself in the bathroom to hide and cry. I would count the days until I was done with that job and celebrated when I turned in my resignation," Mirabelli said. But the good has outweighed the bad.
"I have also worked with great nurses with whom I still have a bond today. My experience with those wonderful nurses definitely reduced stress and made me a better nurse and a better person. I have thoroughly enjoyed my shifts when I have coworkers that I could call my friends. I also was able to sleep better at night and looked forward to going to work."
Research has shown that friendships between nurses can reduce stressful situations. A 2016 study published in PLOS ONE found that the "degree of cohesion among friends had a positive impact on the level of job stress experienced by nurses." The study concluded overall that the "strength and density of such friendship networks were related to job stress. Life information support from their friendship network was the primary positive contributor to control of job stress."
While it's important to understand what research has discovered, it's just as -- if not more -- crucial for nurses to know how this can help them in real-life situations.
Why Friendships Help
"There will always be bonds and friendships forged when you work with people in close proximity for long periods of time," said James LaVelle Dickens, DNP, RN, FNP-BC, FAANP, who serves in the U.S. Department of Health and Human Services regional office in Dallas, Texas, as the senior program manager officer for the Office of Minority Health. "Having strong friendships at work is known to reduce stress. A study by Gallup found that people with a best friend at work are seven times more likely to be engaged with their job."
"I can think of many times when friendships with other nurse practitioners (NPs) have made a difference in my life," said Dickens. "Sometimes, it's having someone lift our own spirits after we've delivered a difficult diagnosis to a patient. Sometimes, it's offering a younger colleague with coaching to help them be the best professional they can be."
Benjamin Evans, DD, DNP, RN, APN, PHMCNS-BC, president of the New Jersey State Nurses Association, noted that "Nobody really understands what a nurse does like a nurse, so those relationships provide support, and that support helps bring stress down."
Evans explained that what makes nurses so different from other healthcare professionals is that they are with patients more than anyone else. Other healthcare professionals may come and do a test, treatment, or procedure on a patient, but then they leave. The nurses are the ones who stay behind and help the patients cope with their stress, pain, or fear resulting from these processes or their conditions.
But this is just one example of why nurses have so much stress. Dickens said that other reasons are heavy caseloads, interactions with patients and their family members who may not recognize the significant challenges of their complex health conditions, and dealing with death.
"Oftentimes, the families are more demanding than the patients," Evans said.
"Every decision a nurse makes affects the health status of their patients," said Judith Schmidt, RN, MSN, ONC, CCRN, CEO of the New Jersey States Nurses Association. "The public doesn't realize how stressful these areas can be. If a nurse makes a mistake, it can mean a patient's life. You have the life-and-death situations with the patients, their families, and the administration."
"Nurses have the type of job that requires a lot of mental clarity, physical demands, and empathy towards patients and their families," said Flo Leighton, MS, RN, PMHNP-BC, a board-certified psychiatric nurse practitioner in private practice at Union Square Practice as well as an adjunct faculty member at New York University Rory Meyers College of Nursing.
The difficult work, both physical and mental, is why having friendships is necessary. It's also great to have others who completely understand you.
Friends "Get" You
Erin Parisi, LMHC, CAP, owner of Erin C. Parisi Counseling & Consulting, LLC, learned about nursing friendships while working as a therapist in a residential treatment setting alongside nurses every day. "My biggest takeaway has been that having friends who are 'in the trenches' with you helps manage stress. In nursing, not only are you coping with the system you work in, with a boss/manager you may or may not like, and office politics, but you also have a really specialized knowledge that not everyone has," said Parisi. "In a system where not everyone you work with is in the same role, you might end up feeling a little more alone in your job. Non-nurses who don't have the same or similar training may not understand your jokes or fully wrap their heads around your stressors.
"A lot of nurses have a dark sense of humor, which not everyone has an appreciation for. Not only is the friendship of a fellow nurse providing stress relief, but being able to make dark/weird/gross jokes to someone else who will understand and also think it's funny can reduce stress in a big way," Parisi said.
"Sharing a laugh in the midst of a stressful day lowers your blood pressure and helps put everything in perspective," said Dickens. Having someone else who understands what makes nurses tick and what makes the profession unlike any other serves as the backbone of these types of relationships, he adds. "Having that support network and camaraderie does an NP's mental health a ton of good."
Shanna Shafer, RN, BSN, nursing expert, managing editor, and strategic communications manager at BestNursingDegree.com has spent 10 years in the nursing field working in everything from home health, hospice, a community health center to vascular access, and in a burn intensive care unit. At the burn unit she said, "Friendships with other nurses blossomed and were essential to my own survival and mental health." The bonds that nurses develop in various situations are amazing, she said.
Parisi added that nurses witness and work on a daily basis with experiences that most people do not. While everyone else in a nurse's group outside work -- non-nurse friends, family, spouses, and significant others -- can provide support, they simply can't connect with nurses like other nurses or coworkers can.
"Given the fact that nurses spend so much time at work -- sometimes even more time than at home with loved ones -- having friends at work can help make a shift more enjoyable. Nurses who work with you know what the day-to-day struggle looks like on any given shift," said Leighton. "The ability to get perspective from a work friend who understands how to handle on-the-job situations builds resilience and normalizes stressful situations. It makes us feel like we're understood and not alone in the tasks that challenge us."
Having someone who "gets" you can reduce stress and make you feel better in various workplace situations. "Research has shown that social health is an importance factor in stress management. Therefore, friendships among nurses could influence rewarding benefits in processing work-related stressors," said Amy Moreira, LMHC, owner of More MH Counseling, LLC. "The nursing field is a challenging, demanding, and rewarding job with its own characteristics that are, at times, not fully understood by the general public ... A nurse who finds friendship with other nurses can benefit from their shared direct experience, allowing themselves to feel better heard and understood -- which is an important part of healing in stress management. Potential solutions can be offered from a different perspective with a more solution-focused outcome than advice from other friends and family. Workplace friendships among nurses allows for in-the-moment support and allows for open processing without the need to explain certain contextual aspects."
Nurses Eat Their Young
There's the old adage that "Nurses eat their young." Some more experienced nurses have been known to let the young ones flounder. Nurse.org, though, has a new campaign to dispel this adage called "Nurses support their young." The campaign is significant because when nurses are friends, the stress of the entire unit, floor, or facility can decrease.
"It's important for nurses to friend new nurses to allow for effective learning and adjustment on the team, including the patient," explained Moreira. "Establishing friendships and aiding newer nurses can contribute to a more positive workplace environment and job satisfaction. Friendships between nurses can allow for a more experienced nurse to take on a 'coaching' role that enables stress-free learning with laughter, support, and understanding. Working past any frustrations associated with newer nurses lacking knowledge can often be processed when reflecting upon past mishaps in the experienced nurse's own career."
Schmidt explained that "It makes for a healthy work environment when there are coworkers whom you work with whom you can be friends with and discuss difficult issues and challenges that you couldn't to someone outside the profession."
And a healthy workplace will influence other people and environments as well.
The Ripple Effect
When nurses are friends, they aren't just nice to each other, but they look out for each other. While working as a staff nurse, Leighton developed a core group of nursing friends. "We collectively pitched in to make sure that if someone needed a day off or a last-minute shift coverage, we helped one another. It was an unspoken understanding that we took care of one another," she said.
"While I think that friendship is important in all aspects of our lives, we do know that workplace friendships are tied to higher levels of job satisfaction, engagement in work and performance, as well as overall team cohesion," said Dickens. "I wholeheartedly believe that a support system at work and in our personal lives is key."
Nurses who have friends in their workplace can also assist each other during stressful situations by giving each other someone to vent to. "It can put that nurse who is stressed in a better frame of mind. It almost permeates an entire unit if one nurse is stressed and could cause others to become stressed," he said.
Dickens added that if a nurse is stressed, patients can sense it in the nurse's voice and body language. But the opposite is true as well: a happy nurse can make a happy patient.
And sometimes a happy nurse can just make a happy nurse. That can be essential enough. Nurses who are less stressed because of friendships can have improved mental, emotional, and physical wellness, said Moreira. "Nurses with reduced stress often prioritize self-care, which allows them to give their best selves to others."
