stress in nursing

REDUCING STRESS IN NURSING

BY: Khai Ho & Josh Saleeby

POSTER PRESENTATION:

• TOPIC: Reducing Stress in Nursing• SAMPLING POPULATION: hospital base nurses• SAMPLING METHOD: Convenience sampling

(research other related works, survey, and questionnaire)

• ASSESSMENT TOOLS:

SAMPLING METHOD AND POPULATION

• 2003 Canadian Community Health Survey (CCHS), sampled all healthcare workers in Canada. Of 413,00 participants in the health care survey 67% of RN reported of have stress at work. Female rank higher at 46%. Age factor from 35-54 y/o ranked at 50%. Stress were higher for people with income of $60,000 or above compared to those with income of less than $20,000. 75% of nurses say that their stress are quite extreme and are dissatisfy with life. 54% say that they are in bad/poor health.

SAMPLING METHOD AND POPULATION CONTINUE

Email survey of 15 med-surgical nurses and 15 telemetry nurses done St. John Macomb Hospital in Warren, MI by Khai Ho.

Survey Questions of 30 nurse : Stress assessment for nurse.

yes no

Do you experience stress from work? 100% 0%

Is the stress work related (pt, family, workload, jobs description, environment, salary, other fellow employees?

90% 10%

Does your stress affect your work? 3% 97%

Is your stress manage? 80% 20%

Does your stress affect your life outside of work

10% 90%

What is Stress

• Stress is the emotional and physical strain caused by our response to pressure from the outside world.

• Common stress reactions include tension, irritability, inability to concentrate, frustration and a variety of physical symptoms that include headache and a fast heartbeat

TYPES OF STRESS

POSTIVE STRESS

• Eustress: A positive form of stress that helps us to perform, and is usually experienced when we are going through happy events like a graduation, a wedding, the birth of a child, a competitive event, or a vacation.

NEGATIVE STRESS• Distress This is one of the types

of stress that the mind and body undergoes when the normal routine is constantly adjusted and altered (acute and chronic stress).

• Hypostress : is lack of stress, experience by people who are constantly bore.

• Hyperstress: is the type of negative stress that comes when a person is forced to undertake or undergo more than he or she can take (job).

CAUSE OF STRESS IN NURSING

• Job design and workload• Interpersonal relationships

at work• Relationships with patients

and their families• Work organization and

management of work• Technical aspects of nursing• Personal

• dealing with death and dying, ambiguity

• conflict with other staff• inadequate preparation for

dealing with emotional needs of family

• lack of staff support (RN shortage) and resources

• concern about treatment and pt care

• Concern about technicalknowledge and skills

SOURCES OF STRESS DESCRIPTION

CAUSE OF STRESS IN NURSING CONTINUE

• AGE• HOURS WORKED• SHIFT

• aged 35 to 54 reporting high work stress, the highest among age groups

• Health care providers who worked 35 or more hours per week were much more likely than those working fewer than 35 hours per week to report high stress.

• Health care providers whoseschedule was other than a regular daytime shift weremore likely to report high work stress

SOURCES OF STRESS DESCRIPTION

HOW DOES STRESS AFFECT HEALTH

• There appears to be general agreement that the experience of work-related stress generally detracts from the quality of nurses’ working lives, social life, increases minor psychiatric morbidity, and may contribute to some forms of physical illness.

• For example, in 1993, the United Kingdom Health and Safety

Executive published a document entitled Self-reported work-related illness. This survey representative national sample of 75,000 nurses.

• Musculo-skeletal disorders were the most common cause of ill-health among all respondents (42 per cent of cases), followed by stress and depression.

• Nurses were among the highest groups who reported significantly raised rates of stress and depression.

MODALITES TO COPE WITH STRESS

• Identify the stress• Analyzed the stress• Evaluating the risk• Design stress management strategies• Implementing• evaluation

STEP 1: IDENTIFYING THE STRESS

The approach to stress management can only begin once a potential problem has been recognized and accepted. That nurses may be experiencing stress through work which could potentially present as a threat to their health and social life.

SIGNS OF STRESS

• Availability to work, sickness or absence• Accident or incident• Disciplinary action or compliant • Seeking help from fellow employee or

counseling• Low attitude and esteem for the job• Frustration, irritability, anger

STEP 2: ANALYZE THE STRESS

• Sources of stress (where, when and why)Where is the stress coming fromWhen did the stress startWhy did the stress happen

• What types of stress it is

STEP 3: EVALUATING THE STRESS• Can the stress endanger my ability to work and take

care pt?• Can the stress be a hazardous to my social life and

family?• Is the stress affecting my ability to work, concentrate,

or make decisions?• Is the stress causing my personality change

(depression, labile affect, dull, suicidal, frustration, anger, anxious, anxiety)?

• Is the stress changing my usual habits (exercise or diet)• Does the stress affect my relationship with my fellow

employees ?

STEP4: DESIGNING STRESS MANAGEMENT STRATEGIES

In designing stress management strategies, attention should focus on the total work system, which includes the organizational, social and physical environments, the technology in use, the work systems, and the people involved.

STEP4: DESIGN STRESS MANAGEMENT STRATEGIES CONTINUE

1. Types of strategy: This would involve what type of stress you are experiencing, what your symptoms are (anger, depression, sad, anxiety), and the level of your stress

2. Target: Who are what should the intervention be aim at (individual, or organization)

3. Agency: Who is responsible for caring out the intervention (RN, or the organization

All interventions must have objectives or goals to be achieved!!!!

The Total System Matrix

TYPES OF COPING MECHANISMS

• Goals setting, self esteem enhancement, active listening• Remedial Action• Practice, preventative maintenance. • Set priorities in your life.• Avoid negative people.• Use time wisely. • Stop saying negative things to yourself. • Develop your sense of humor.

REMDIAL ACTION:1. Change your thinking: (Reframing and

Positive thinking)2. Change your behavior (be assertive, get

organized/time management, ventilation, humor, diversion and distraction

3. Change your life style: (diet, exercise drink water, pet therapy, music therapy, sleep, nature walks, guide imagery, leisure, and pacing

COPING MECHANISM FOR NURSE AT WORK• Reframing: is finding ways to see the problem from a different

perspective• Be assertive: standing up for your personal rights and

expressing your thoughts, feelings and beliefs directly, honestly and spontaneously in ways that don’t infringe on the rights of others

• Ventilation: let your anger out, talk about it, write it down• diversion and distraction: take a vacation or a short walk, it

gives you time to catch your breath and think about the problem objectively.

• Group therapy or interaction: allows every ones to speak, provide compromise

STEP 5: IMPLEMENTING

• Start by understanding your objectives or goals

• Start with the a more reachable goal and work from there

• Prevent further stress

STEP 6: EVALUATION

• Were the objectives achieved• Was the stress reduced or eliminated • Do you feel like your old self before the stress• Is your quality of life improved (work, social,

family, personal)• Was the intervention affected or does it need

changes

References• Kathryn Wilkins. (November 2007). Work stress among health care

providers. Retrieved November 12, 2007 from Statistics Canada. Website: http://www.statcan.ca/english/freepub/82-003-XIE/2006011/articles/10367-en.pdf

• (October 2003). Results of the September 2002 Survey of Registered Professional Nurses, Volume II. Retrieved November 12, 2007 from Office of the Profession “New York State Educational Department”. Website: http://www.op.nysed.gov/nursing-survey-final-regents-report-nov.htm

• (2007). Coping With Stress. Retrieved November 12,2007 from Holistic Online. Website: http://www.holisticonline.com/stress/stress_home.htm