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curve they likely haven't expe- rienced since medical or nurs- ing school, when they were much younger and able to adapt much easier." A constant churn of underlying stress impacts people in different ways, points out Dr. Murray. "They might have trouble sleep- ing, fall into unhealthy eating habits or become more agitated than normal," she says. Dr. Murray recommends pri- oritizing sleep and adding as much structure as possible to your professional and personal lives in order to regain a sense of control and comfort in rou- tines. "There are a lot of effec- tive ways to manage stress, but it takes time and effort," she says. "You have to work at it and change whole systems in your life to see meaningful improvement." Regroup and recenter During the height of the pan- demic's initial wave, Ms. McLean had to learn how to establish an airway while outfit- ted in full PPE and trying to breathe calmly through an N95 mask. At the time, there was very little trusted information about the risk of exposure to the coronavirus, which only added to her anxiety. "The biggest stress was from coming home to my family," says Ms. McLean. "There were so many unknowns about the virus and I was petrified of hurting my husband and kids. The stress level every day during the peak of the pandemic was heavy. Things 2 4 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • O C T O B E R 2 0 2 0 You must take concrete steps to prioritize your mental health, now more than ever. If you're not sure where to start, here's some advice. • Talk about your needs. Confide in a colleague, friend or rel- ative — anyone who makes you feel comfortable and supported. • Seek help. Check if your facility offers an employee assis- tance program. It's a safe place to start looking for helpful resources. The Substance Abuse and Mental Health Services Administration website (samhsa.gov) has a COVID-19 page and also lists websites that offer professional advice on how to han- dle stress and resources for suicide prevention and substance misuse problems. • Prioritize self-care. Schedule time for yourself. If you don't have time for a spa day, spend a few minutes alone in your car at the end of the workday. Play a mindless game on your phone or stream your favorite music. • Look for positives. Before going to sleep each night, think of three things that went well that day. Start with the basics — you woke up that morning and so did the people you love. It starts to snowball from there. Just like negative thinking can cause a downward spiral into despair, focusing on the positives will improve your mood and outlook on life. — Catherine Skowronsky, MSN, RN, ACNS-BC, CMSRN GROUP THERAPY Encourage staff to express how they feel and what they need in a safe space. YOU'RE NOT ALONE Feeling Stressed and Overwhelmed? Lee S. Weissman/Northwell Health