176 Healthcare: Workplace Stress and Violence

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Stress in Healthcare

stress in healthcare
Occupational stress has been a long-standing concern in the health care industry.
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Occupational stress has been a long-standing concern in the health care industry. Studies indicate that health care workers have higher rates of substance abuse and suicide than other professions and elevated rates of depression and anxiety linked to job stress. In addition to psychological distress, different outcomes of job stress include burnout, absenteeism, employee intent to leave, reduced patient satisfaction, and diagnosis and treatment errors.

Job Stress and Health

Stress sets off an alarm in the brain, which responds by preparing the body for defensive action. The nervous system is aroused, and hormones are released to sharpen the senses, quicken the pulse, deepen respiration, and tense the muscles. This response (sometimes called the fight or flight response) is important because it helps us defend against threatening situations. The response is preprogrammed biologically. Everyone responds in much the same way, regardless of whether the stressful situation is at work or home.

Short-lived or infrequent episodes of stress pose little risk. But when stressful situations go unresolved, the body is kept in a constant state of activation, which increases the rate of wear and tear to biological systems. Ultimately, fatigue or damage results, and the ability of the body to repair and defend itself can become seriously compromised. As a result, the risk of injury or disease escalates.

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1. Unresolved stressful situations _____.

a. do not exist
b. are personality weaknesses
c. shows you should quit your job
d. can cause "fight or flight" syndrome

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All hospital employees are exposed to many stressors at work that can cause workplace stress and burnout.

Potential Hazard

All hospital employees, especially emergency department employees, are exposed to many stressors at work that can cause workplace stress and burnout. Many factors such as shift work, long hours, fatigue, and intense emotional situations (e.g., the suffering and death of patients) contribute to the stressors.

Stressors in the healthcare setting include the following:

  • inadequate staffing levels
  • long work hours
  • shift work (work schedule that is performed in rotations)
  • role ambiguity
  • exposure to infectious and hazardous substances

2. Stressors in the healthcare setting include which of the following?

a. Stable work hours
b. Shift work
c. Lack of job rotation
d. Patient mental health

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Early Warning Signs of Stress

early warning signs
There are several early warning signs for stress at work.

Cardiovascular Disease

Many studies suggest psychologically demanding jobs, such as in the healthcare field, that allow employees little control over the work process increase the risk of cardiovascular disease.

Musculoskeletal Disorders

Based on research by NIOSH and many other organizations, many believe job stress increases the risk for the development of back and upper- extremity musculoskeletal disorders.

Psychological Disorders

Several studies suggest that differences in rates of mental health problems in healthcare (such as depression and burnout), are due partly to differences in job stress levels.

Workplace Injury

Although more research is needed, there is a growing concern that stressful working conditions interfere with safe work practices and set the stage for injuries at work.

Suicide, Cancer, Ulcers, and Impaired Immune Function

Some studies suggest a relationship between stressful working conditions and these health problems. However, more research is needed before firm conclusions can be drawn.

3. What is listed as an early warning sign for workplace stress?

a. A heightened immune response
b. Back and musculoskeletal disorders
c. Infrequent workplace accidents
d. Less employee involvement

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Stress Symptoms

stress symptoms
It is critical healthcare workers recognize what stress looks like.

Providing healthcare can lead to stress, anxiety, fear, and other strong emotions. How you cope with these emotions can affect your well-being, the care you give to others while doing your job, and the well-being of the people you care about outside of work. It is critical healthcare workers recognize what stress looks like, take steps to build your resilience and cope with stress, and know where to go if they need help.

Here are some common symptoms of stress at work:

  • feeling irritation, anger, or denial
  • feeling uncertain, nervous, or anxious
  • feeling helpless or powerless
  • lack of motivation
  • feeling tired, overwhelmed, or burned out
  • feeling sad or depressed
  • having trouble sleeping
  • having trouble concentrating

4. What is NOT a common workplace stress symptom?

a. Lack of concentration
b. Feeling irritated or angry
c. Having trouble sleeping
d. Feeling bored with the job

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Stress Among Nurses

stress in nurses and physicians
There are several factors linked with stress among nurses and doctors.
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Stressors vary among health care occupations and even within fields, depending on the task being performed. In general, studies of nurses have found the following factors linked with stress:

  • work overload
  • time pressure
  • lack of social support at work (especially from supervisors, head nurses, and higher management)
  • exposure to infectious diseases
  • needlestick injuries
  • exposure to work-related violence or threats
  • sleep deprivation
  • role ambiguity and conflict
  • understaffing
  • career development issues
  • dealing with difficult or seriously ill patients

Stress Among Physicians

Among physicians, the following factors are associated with stress:

  • long hours
  • excessive workload
  • dealing with death and dying
  • interpersonal conflicts with other staff
  • patient expectations
  • the threat of malpractice litigation

The quality of patient care provided by a hospital may also affect health care worker stress. Beliefs about whether the institution offers high-quality care may increase job pressures and workload due to the requirement for more significant support and resources.

5. Which of the following factors is associated with stress among physicians?

a. Understaffing
b. Sleep deprivation
c. Excessive workload
d. Happiness

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How to Cope

To help reduce stress, it is important to take breaks and get exercise when you can.
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  • Communicate with your coworkers, supervisors, and employees about job stress.
    • Identify factors that cause stress and work together to identify solutions.
    • Ask about how to access mental health resources in your workplace.
  • Identify and accept those things which you do not have control over.
  • Increase your sense of control by keeping a consistent daily routine when possible.
    • Try to get adequate sleep.
    • Make time to eat healthy meals.
    • Take breaks during your shift to rest, stretch, or check in with supportive colleagues, coworkers, friends, and family.
  • When away from work, get exercise when you can. Spend time outdoors, either being physically active or relaxing. Do things you enjoy during non-work hours.
  • If you feel you may be misusing alcohol or other drugs (including prescriptions), ask for help.
  • Engage in mindful techniques, such as breathing exercises and meditation.

Real-Life Solution

A Houston, Texas hospital is testing a new concept in its emergency department to help staff decompress during stressful days. It is called "Rejuvenation Station." It looks like a phone booth, but it's a private, peaceful place to decompress. Staff can choose from six soothing nature videos to watch in the soundproof pod. It's available to all emergency room staff, from security and housekeeping to doctors and nurses.

6. To help cope with job stress, _____.

a. ask for reassignment regularly
b. engage in mindful techniques
c. isolate yourself from others
d. use intermittent fasting techniques

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Possible Solutions

There are many solutions to help prevent stress among hospital staff.

There are many solutions to help prevent stress among hospital staff, including, educate employees and management about job stress and establish programs to address workplace stress, such as:

  • An Employee Assistance Program (EAP) can improve the ability of workers to cope with difficult work situations. Stress management programs teach workers about the nature and sources of stress, the effects of stress on health, and personal skills to reduce stress (e.g., time management or relaxation exercises).
  • Organizational Change Programs change hospital policies and procedures to reduce organizational sources of stress. Employers may want to bring in a consultant to recommend ways to improve working conditions. This approach is the most direct way to reduce stress at work. It involves the identification of stressful aspects of work (e.g., excessive workload, conflicting expectations) and the design of strategies to reduce or eliminate the identified stressors. Some strategies include:
    • Ensure that the workload is in line with workers' capabilities and resources.
    • Design jobs to provide meaning, stimulation, and opportunities for workers to use their skills.
    • Clearly define workers' roles and responsibilities.
    • Give workers opportunities to participate in decisions and actions affecting their jobs.

7. Which of the following can improve the ability of workers to cope with difficult work situations?

a. Organizational Change Programs
b. Occupational Changes
c. Employee Involvement
d. Employee Assistance Program (EAP)

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