One of the most important factors in our overall emotional well-being is managing our stress – which is easier said than done, of course.

What is stress first aid?

Stress first aid is a framework to improve recovery from stress reactions, both in oneself and in coworkers. The goal of this framework is to identify stress reactions in ourselves and others along a continuum and to help reduce the likelihood that stress outcomes develop into more severe or long-term problems.

Where do you fall on the stress continuum?

This chart is called the Stress Continuum. Where would you place yourself on this scale? Where are your coworkers?

When Laura Ramsey, staff support chaplain at Hershey Medical Center, asks people how they are doing, she most often gets variations of “fine” or “okay.” What she likes about the Stress Continuum is that she can follow that response with “Okay. Well, how fine are you? Are you green fine, yellow fine, orange fine or red fine?”

Signs of stress

In order to know where we fall on this scale, it is also helpful to recognize common signs of stress. Here are a few examples:

  • Change in eating habits
  • Change in weight
  • Loss of will power
  • Apathy/Losing interest
  • Can’t hold a conversation
  • Excessive guilt
  • Taking lots of time off
  • Drinking more
  • Conflict in relationships
  • Fatigue/more sleep
  • Don’t give self a break (leaders)
  • Changes in relationships Possible signs of stress
  • Loss of control
  • No longer feeling like self
  • Can’t get tasks done
  • Can’t think clearly
  • Things excessively piling up
  • Isolating self
  • Feeling overly busy, hurried
  • Physical changes
  • Going through the motions
  • Memory problems
  • Post-traumatic stress symptoms
  • Depressive or anxiety symptoms

First steps to cope with stress

After we’ve identified where we fall on the Stress Continuum and know our signs of stress, what do we do to cope?

There are seven steps – called the seven c’s – in the stress first aid model to cope with stress.

  1. Assess, observe and listen.
  2. Get help. Refer as needed.
  3. Get to safety ASAP.
  4. Relax, slow down and refocus.
  5. Get support from others.
  6. Restore effectiveness.
  7. Restore self-esteem and hope.

The first two are the most important – check and coordinate.


This step is done by recognizing stress symptoms in yourself and others and identifying where you fall on the scale. Sometimes just acknowledging where you are can help you take the steps you need to prevent the stress from escalating further.


This second basic step is also key. After you have identified where you are at, it is important to get support. If you do not know what support is available, connect with your leadership to get connected.

For example, we have an Employee Assistance Program which you can read all about here:

Wellness Wednesday: Penn State Health’s new employee assistance program, SupportLinc, goes live – Penn State Health News

One hospital system that uses the stress first aid model has adapted a daily mantra of “Check you, check two!” The idea is that every day you check in with yourself and two co-workers to see how they are doing. Do you notice a change in a co-worker? Is something different within yourself? Time to apply stress first aid. Remember, it is truly just first aid and there is more support available. Recognizing stress and connecting to support is just the beginning.

Let’s do the same here at Penn State Health. Can you “check you, check two” today and every day?