Selina Blatz remembers when she and her nursing colleagues were so busy, they forgot to go to the bathroom. On breaks, they'd scarf down coffee, doughnuts or cookies. Asking for help seemed like an admission of inadequacy, so they just kept going.

"The majority of nurses are women who tend to put others' needs before their own," Blatz says. "At the end of the day, they're so depleted and empty they are not truly reenergizing themselves."

Much has changed since then

Hospitals and health systems now recognize the need for employee stress management and offer several options. A nurse practitioner in women's health and certified health and wellness coach with the HealthEast Care System, Blatz runs the Women's Wellness Journey at St. John's Hospital in Maplewood to help women take control of behaviors that put them at risk for disease. www.stjohnshospital-mn.org/womens_wellness/index.cfm

Sara Rezek, a librarian and Health Resource Center supervisor at Regions Hospital in St. Paul, which is part of the HealthPartners family of care, provides employees with on-site exercise, stress reduction, and wellness activities and information. http://www.regionshospital.com/Regions/Menu/0,,2159,00.html

"It's important for healthcare workers to remember that it's OK to take care of themselves, too," Rezek says. "We're fortunate at Regions to be able to provide some of those healthcare practices at work."

Self-care programs

Regions and some other HealthPartners sites offer low- or no-cost classes on a rotating basis, including Pilates, tai chi, qigong, meditation, healing touch and yoga, including "laughter yoga," which encourages group laughter focusing on core muscles. The organization also offers 15-minute massages at $1 a minute. Co-workers are usually willing to cover for each other during sessions, according to Rezek.

Many women seek out the Women's Wellness Journey program because of weight issues, but stress is often the core problem. "Weight, poor eating habits and inactivity are a result of not knowing how to manage their stress," Blatz explains. "It's very complex."

Short- and long-term solutions

Blatz and Rezek have plenty of ideas on how to manage stress, both instant stress-busters and longer-term solutions. In addition to healthy eating, getting adequate exercise and sleep, they suggest:

• Ask a co-worker for help.

• Take a walk during a scheduled break.

• Every 90-120 minutes, get a drink of water or walk up some stairs to mentally "change channels."

• Use positive visualization.

• Counter negative thought patterns with positive ones, such as, "I am capable. I have handled situations like this before. I give great patient care."

• Keep a gratitude journal.

• Organize your responsibilities, and if possible, your workspace.

• Be aware of how your body is responding. Stop, take a deep breath and control what you can.