Do you know how to cope with stress on the job?
What it means, how to mitigate it
Everyone experiences it at some time or another. For some people, it crops up infrequently and goes away quickly, while for others it’s around so often that they wouldn’t know life without it. The problem, of course, is stress, and in today’s home care field, that problem may seem to be around for the long haul.
Whether originating from personal reasons or factors in the workplace, there is no doubt that stress on the job can lead to a host of problems. In the short term, those suffering from its effects can find difficulty in concentrating on the tasks at hand and may find themselves easily agitated and suffering from mood swings, sleeping problems, and changes in appetite.
Prolonged periods of stress can lead to physical illness, poor job performance — and eventually burnout — and even serious depression, says Washington, DC-based clinical psychologist Judith A. Graser, EdD. (For warning signs, see box, above. For some advice on relieving stress, see tips, p. 103.)
Is it stress or burnout?
To be sure, there is a difference between burnout and stress although they are frequently used interchangeably. Burnout, explains Graser, is caused by a variety of factors with stress among them. Stress is brought about by work-related events, unobtainable goals, and even an employee’s excessive and unrealistic drive.
The less control people have over their situations, the more likely they are to experience stress, Graser notes. Hence, those in middle management positions may find themselves bearing the greatest load, for often they are the ones saddled with large amounts of responsibility but with little or no say in final decisions. Upper management may have weightier decisions and even more of them, but says Graser, "they typically can delegate some of the workload and free themselves to concentrate on the more important matters."
Interestingly enough, some studies have shown that women are more susceptible to stress. A study conducted by Murray Research Center at Radcliffe College in Cambridge, MA, found that women bear the brunt more frequently than men, not because they are weaker, but because they are more likely to be in stress-producing jobs. On top of that, despite the vast numbers of women in the workplace, it is still the woman who is more likely to be assigned the role of family caregiver, no mean feat for someone who is already in the care-giving profession.
"These women really feel caught in the middle between what they are responsible for in the workplace and what they need to do at home," notes Graser. "It’s important that they realize they cannot do everything and do it perfectly." Perfectionists then are doubly cursed and feel that they must continue working until everything is done and done right. A good idea? Wrong, she says. "The idea that working long hours produces better work is flawed. In reality, it squashes creativity and makes it more likely that mistakes will happen."
These days, perhaps no one is as caught in the middle as home health care professionals. Here are some pointers from the people in the trenches on keeping calm, cool, and collected:
-Sandra Smith, RN, MPH, administrator, Angel Home Health and Hospice, Franklin, NC.
"The greatest stressor comes in trying to provide quality care in an environment where Medicare makes that almost impossible. That, combined with staff cuts, is probably the biggest cause of stress.
"Before there was a freeze put on educational programming, we could train people and bring people into the agency to talk to staff on different issues. Now, our master social worker is also a licensed therapist, and she usually does something once a year on dealing with stress.
"We have staff meetings and give employees the opportunity to talk about stressors, and we have social workers on the hospital staff who are available for counseling if an employee needs it. The hospital with which we are affiliated has a mental health contract that employees can use if needed.
"We also encourage people to do some fun things. We occasionally hold staff meetings at the recreational park and have a staff picnic with team-building games. Through the hospital, they also have a program called HealthQuest, where you get a full work-up done and it includes a section devoted to stress management. If you score high on that section, they offer classes and tips on reducing stress. You get points for completing the courses and can redeem them for some fun prizes."
- Jean Arias, RN, MS, CHCE, administrator, Baptist-South Miami Home Care.
"We went through a merger at the first part of this year. All the employees from both agencies had to re-interview for their jobs, so no one felt secure. For those people who were affected, the hospital found positions in the system that were open and people had several choices. So that made it less stressful, but, nevertheless, it was a highly stressful situation overall.
"I brought in a master social worker who gave us stress management workshops. I had staff meetings twice a week, and we sat and talked about the systems merging. We gave continuing orientation sessions to people who weren’t acquainted with the new way of doing things. I tried to lighten the mood and brought in baked goods and cookies, and we tried to laugh a lot. Humor is probably one of the greatest stress relievers that we have. If we can face our problems with a little more humor than we’re used to, I think it would really help.
A supportive system is needed
"We were lucky in that we had the support of a system that’s listed as one of the top 100 employers in the country. They had experts on hand to listen to staff and hold sessions with management and staff and hear their problems. Employees were excused from their jobs and were allowed to go and talk.
"I think it helped that these sessions were with people in human resources or the executives of the hospitals because staff knew these people took the time to listen to them. Employees felt valued and felt that their word counted.
"Personally, I exercise and watch my caffeine, and no matter how tired I am, I try to listen to what my body is telling me as far as rest. For just stress in general, I think it’s important to deal with problems head on and not to procrastinate because sometimes those problems will just get worse. If it’s causing you stress, it’s best to face the problem head on and get it over with."
- Rick Collett, administrator, Hutcheson Home Care, Fort Oglethorpe, GA.
"We’re part of a medical system, so we do have some stress management classes that are done in-house by our personnel. All these classes are available for all employees to attend. For me it’s external factors like reimbursement issues that cause the most stress, but for the field staff it’s having to comply with all the changes in regulations that we’re going through such as with OASIS. We’re Joint Commission-certified, and having to deal with all these regulations creates the most stress for us. . . . For the clerical staff, too, because they have to learn how to deal with all the changes in paperwork and submission.
"My philosophy is that I exercise a lot. I think that’s always been the key for me. I can always tell if I don’t because my blood pressure goes up a little bit. When I’m really fed up, I’ll schedule myself a mental health day. I encourage this with all my staff — supervisory and whoever. I encourage them to do the same and take time off. This goes for nurses, too. Even if they want to work seven days a week — and some people desperately need the money — we monitor that. We don’t have a set level where we say. You can’t do this any more.’ But we talk with them and make sure that they’re OK. If we see those signs of burnout, that they’re more short-tempered or making sloppy errors on the job, we’ll cut back their schedule or encourage them to take time off. That’s what vacation is there for.
"I think we’re starting to have a more wellness-oriented workplace in our culture, and we’re trying to get all our employees at least thinking that and hearing it from us. I, for one, strongly believe it’s the way to go and include the message of this too shall pass’ in our newsletters."
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