NIOSH: Take steps to reduce hazard of stress
HCWs need more than just coping strategies
It just takes an evening of viewing the television drama E.R. to know that hospital work is stressful. But the stress that evolves into an occupational hazard isn't from treating trauma victims or mysterious illnesses.
The stressful work environment inadequate staffing, long hours, poorly defined roles, lack of communication can lead to physical, behavioral and psychological problems, including high blood pressure, sleeplessness, absenteeism, job dissatisfaction and depression. It also can impair performance and affect the interaction between employees and patients.
The National Institute for Occupational Safety and Health (NIOSH) provides an overview of stress as a hazard in hospitals and possible interventions in a brochure on Exposure to Stress. The brochure is part of a series on occupational hazards in hospitals (www.cdc.gov/niosh/docs/2008-136/).
"Many people think it's just part of the job that they have to deal with, [but] it is important to look at occupational stress as an occupational hazard," says Naomi Swanson, PhD, chief of the organizational science and human factors branch at NIOSH in Cincinnati.
Despite the inherent challenges in health care, stress can be reduced both through stress management techniques and organizational interventions, she says.
Stress management techniques include exercise, meditation and relaxation, and coping mechanisms. But that is not enough, according to NIOSH: "Although worker interventions can help workers deal with stress more effectively, they do not remove the sources of workplace stress, and thus may lose effectiveness over time."
NIOSH encourages organizational changes that:
- ensure that the workload is in line with workers' capabilities and resources;
- clearly define workers' roles and responsibilities;
- give workers opportunities to participate in decisions and actions affecting their jobs;
- improve communication;
- reduce uncertainty about career development and future employment prospects;
- provide opportunities for social interaction among workers.
Multidisciplinary care teams for example, composed of physicians, nurses, pharmacists, managers can improve communication and give frontline workers a greater opportunity for input. The most successful interventions in hospitals involve "teams of employees identifying problems within the workplace and recommending solutions," says Swanson.
Researchers in Quebec tested the effectiveness of work teams at a hospital and four long-term care centers. The work teams met regularly to "constraints," such as high psychological demand, limited decision-making latitude, an imbalance between effort and reward, and sleep problems. They worked on issues that included scheduling, training, communication, and ergonomics.1
After a year, the hospital and long-term care centers showed improvement on a number of psychosocial measures while a control hospital and long-term care facilities with no intervention showed no improvement.
Reference
1. Bourbonnais R, Brisson C, Vinet A, et al. Effectiveness of a participative intervention on psychosocial work factors to prevent mental health problems in a hospital setting. Occup Environ Med 2006; 63:335-342.
It just takes an evening of viewing the television drama E.R. to know that hospital work is stressful. But the stress that evolves into an occupational hazard isn't from treating trauma victims or mysterious illnesses.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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