By Marc Milano, MD, FACEP 
As you may recall, my last post discussed how to start building one’s emotional intelligence. Over the next few posts, I will address each of the major skills you will need to master:
- Quickly reducing stress on the fly
- Conquering relationship stress with emotional awareness
- Using nonverbal communication and humor to deal with challenges
- Resolving conflicts
Let’s look at the first skill:
The ability to quickly reduce the stress of the moment.
Think about this quote: “Stress can hijack your best intentions.” We’ve all seen this in action. The usually pleasant and compassionate individual becomes curt and snappy. You’ve probably justified his actions by saying to yourself, “he (or she) is just having a bad day.” More than likely this is a result of unrecognized or poorly managed stress.
Thus, we must first learn to recognize when we’re stressed. Sounds simple, but with the level of distraction and focus we have in the emergency department, or even with our administrative duties, it’s easy to overlook the presence and effects of stress upon us. Emotional awareness is the first step. If we are to meaningfully change behavior in ways that are consistent and reliable, we must learn how to overcome stress in the moment by becoming emotionally aware.
To accurately assess a situation, comprehend what another person is saying, be aware of our own feelings and communicate clearly, we must first mitigate high levels of stress. The ability to rapidly calm ourselves and reduce stress can help us stay balanced, focused and in control, regardless of the situation.
Conquering Stress: Functioning Well in the Heat of the Moment
Develop your stress-busting skills by working through the following steps:
- Recognize when you’re stressed – The first step to reducing stress is recognizing what stress feels like. How does your body feel when you’re stressed? Are your muscles or stomach tight or sore? Are your hands clenched? Is your breath shallow? Being aware of your physical response to stress will help you regulate tension when it occurs. It’s different for everyone, but the key is to get in touch with that physical sensation. I personally have been able to “feel” my stress via a sensation of numbness in my cheeks. This is the critical first step.
- Identify your stress response – Everyone reacts differently to stress. If you tend to become angry or agitated under stress, you’ll respond best to stress-relieving activities that quiet you down (Close your eyes, sit or lie down, turn off the lights). If you tend to become depressed or withdrawn, you will respond best to stress-relieving activities that are stimulating (Exercise, listen to upbeat music). If you tend to freeze—speeding up in some ways while slowing down in others—you need stress-relieving activities that provide both comfort and stimulation (Movies, reading).
- Discover the stress-busting techniques that work for you – The best way to reduce stress quickly is by engaging one or more of your senses: sight, sound, smell, taste and touch. Each person responds differently to sensory input, so you need to find things that are soothing and/or energizing to you. For example, if you’re a visual person you can relieve stress by surrounding yourself with uplifting images. And if you respond more to sound, you may find a wind chime, a favorite piece of music, or the sound of a water fountain helps to quickly reduce your stress levels.
We will journey together through the other four skills in successive entries. Take the first steps today – get to know your signs of stress so you can better control it.
Marc A. Milano, MD, FACEP, is chief of the department of emergency medicine at Bayshore Community Hospital in Holmdel, N.J. He serves as physician head coach of the Patient Satisfaction Coaching Program at Emergency Medical Associates, an emergency medicine practice headquartered in Parsippany, N.J. Dr. Milano received his undergraduate degree from Rutgers University, his medical degree from St. George’s University in Grenada, and completed his emergency medicine residency at Newark Beth Israel Medical Center.
