Supporting Nurses and Midwives through nervous system regulation

Nurses and midwives are often working in environments that require high cognitive load, and are at times, unpredictable, emotionally demanding, and physically/psychologically exhausting. This may not just be an acute experience; over time this can lead to chronic nervous system dysregulation, compassion fatigue and burnout. With increasing rates of burnout and retention among healthcare workers due to the consistent pressures faced within the industry (Holland et al., 2019), it’s important to know what can be done about it.

While awareness surrounding this is pivotal, how do you actually support yourself early and before burnout sets in? What contemporary support systems have you got in your organisation? Are they individualised and effective? Are these initiatives preventative or reactive?

A variety of factors can contribute to sustained pressure and physiological stress, including, shift work (often associated with disruptions in circadian rhythm), high acuity or challenging patients, exposure to traumatic or distressing cases, staffing shortages, lack of resources or support, increasing patient demand, imbalances in clinician to patient ratios or variations in skill mix (Booker et al., 2024, Panda et al., 2021, Sidhu et al., 2020, among others).

When you’re under stress, the sympathetic nervous system is activated (often referred to as the fight or flight response). Without appropriate recovery or, regulation strategies, this physiological response remains activated, leading to an array of signs and symptoms often seen among nurses and midwives. These can manifest as increased anxiety, disrupted sleep, emotional dysregulation and reduced cognitive abilities. Over time, this may develop into a state of chronic stress that can cause longer term health issues such as hypertension, cardiovascular disease, gastrointestinal issues and changes in immune function.

Chronic stress doesn’t just impact you as an individual, but also affects your wider team, organisation and even patient safety. While many organisations have fundamental wellbeing strategies in place, the challenge often centres on whether those initiatives are effective, preventative, relevant to healthcare and accessible when needed. Supportive meditation and sound-based practices can be easily integrated into workplaces, complementing and even enhancing existing initiatives.

For those that have tried meditation before and ‘it didn’t work’, this may be because you were using a style that did not suit your individual needs. There are a variety of meditation styles such as mindfulness, guided visualisation, concentrative meditation, movement or walking based meditation, zen meditation, positive word meditation and sound-based practices. A key element of meditation is understanding which style suits your individual needs best.

A holistic approach to meditation focuses on the whole person, rather than just centring on mental calmness and emotional regulation. It may include a range of mindfulness-based practices and supportive lifestyle adjustments, aiming for long-term health and overall wellbeing.

Evidence demonstrates that when meditation is used regularly, the nervous system is supported from a sympathetic state to a parasympathetic state. Physiological effects such as a reduction in stress hormones, a decreased heart rate, reduced blood pressure and a slower respiratory rate may be seen after practicing meditation. It also has the benefit of promoting shifts through different brain wave stages and supporting a more regulated state.

Further evidence suggests that consistent meditation practice may support emotional regulation and anxiety symptoms. Growing research has also shown benefits of meditation (for example mindfulness-based practices) among healthcare professionals, including burnout reduction and improvement in overall wellbeing.

For some, silence can be dysregulating. This is why gentle, predictable sound, when used safely with a trauma informed approach, can be supportive, especially in combination with meditative practices.

Sound is not just an auditory experience. When sound travels through the air (as a mechanical wave created by vibration), the high fluid content within the body conducts particularly well, which is why sound can often be ‘felt’. This sensory input may support a more settled physiological state, with growing research suggesting that sound-based practices may support nervous system regulation, reduce tension and lower anxiety (Goldsby et al., 2017).

Although these approaches are not a substitute for medical intervention, when used safely and consistently, these practices may have a positive impact on your wellbeing and provide you with an accessible holistic support option.

The Calm Collab is Sydney-based, offering meditation and sound-based sessions created specifically for high pressure roles. Sessions can be done both in and out of the workplace at either an individual or organisational level.

You can learn more about the Calm Collab via their website or follow them on Instagram @thecalmcollab. If you’d like to contact them directly, you can email [email protected].

As a former Registered Nurse (both in the UK and Australia) and Registered Paramedic (previously working on the frontline in Australia), The Calm Collab was created from one healthcare professional to another. Founded by Sophie Griffiths, after observing the workload pressures among the healthcare industry. This led her to explore the need for practical nervous system support in high pressure roles where preventative measures are key to avoiding burnout.

Her work now focuses on supporting nurses, midwives, students and other healthcare professionals with evidence informed, trauma-aware approaches for nervous system regulation through meditation and sound-based practices. Learn more or enquire at: thecalmcollab.com.au

Booker, L. A., Fitzgerald, J., Mills, J., Bish, M., Spong, J., Deacon-Crouch, M., & Skinner, T.

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Goldsby, T.L., Goldsby. M.E, McWalters, M., & Mills, P.J. (2017). Effects of Singing Bowl Sound Meditation on Mood, Tension, and Well-being: An Observational Study. Journal of Evidence-Based Complementary & Alternative Medicine, 22(3), 401-406. doi: 10.1177/2156587216668109.

Holland, P., Tham,T.L., Sheehan, C., & Cooper, B. (2019). The impact of perceived workload on nurse satisfaction with work-life balance and intention to leave the occupation. Applied Nursing Research, 49, 70-76. https://doi.org/10.1016/j.apnr.2019.06.001.

Panda, S., Dash, M., John, J., Rath, K., Debata, A., Swain, D., Mohanty, K., & Eustace-Cook, J. (2021). Challenges faced by student nurses and midwives in clinical

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Sidhu, R., Su, B., Shapiro, KR., & Stoll, K. (2020). Prevalence of and factors associated with burnout in midwifery: A scoping review. European Journal of Midwifery, 4, 4. doi: 10.18332/ejm/115983.