Stress is a consequence of or a general response to an action or situation that places special physical or psychological demands or both on a person. Human beings can tolerate certain amounts of stress. Small amounts of stress (eustress) can have positive effects by energizing people towards goal, however excessive stress can seriously and negatively impact a person’s health and job performance. (1)
Health care is a stressful profession and takes its toll at physical, emotional, and mental levels. To effectively care for other people you must take good care of yourself. Medical service involves taking care of other peoples' lives and mistakes or errors could be costly and sometimes irreversible. It is thus expected that the medical doctor and other staffs themselves must be in a perfect state of mind devoid of morbid worries and anxieties. This is however not usually the case because the doctor apart from being affected by the same variables that impose stress on the general population, is also prone to stress because of the peculiarities of his work situation and the expectation of the society at large.
To start with, getting into the medical education is like passing through the proverbial eye of the needle. Training at both the undergraduate and postgraduate levels are long and tedious.(2)
Medical professionals face a lot of stressors like work overload, excessive working hours, sleep deprivation, repeated exposure to emotionally charged situations, dealing with difficult patients, conflicts with other staffs. In addition to this work related stress, irregular social and family life is the main component of ongoing burn out process in these professionals.
The doctor is still perceived as a very comfortable person in our society and expectations are usually high financially and otherwise. Failure or inability to ‘meet up’ may constitute a significant stress factor in some physicians. Hostile job environment, administrative ineptitude and bureaucratic bottlenecks can make the job situation very frustrating. Inadequate infrastructure, unavailable and obsolete equipments make the long years and fortune spent in training unrewarding. Unsecured future, delays in promotion and inappropriate capacity utilization are some of the causes of unfulfilment and stress in the job place.(2) This could be compounded in our environment by denied holidays and lack of manpower. Stress creates a personal cost to the individuals concerned, a financial cost to the organizations in terms of absence, early retirement and complaints, and a health cost to patients in terms of the risk of poorer quality care that is received by patients from stressed or dissatisfied staff. Medical professionals especially doctors are at increased risk for divorce and suicide. Gender specific differences have also emerged with higher stress in women.(3)
The ‘burnt out phenomenon’, a terminology made popular by Felton consists of a triad of emotional exhaustion, depersonalization (treating patients as if they were objects) and low productivity/achievements. It is particularly common in health professionals under stress.(2)
Several factors determine whether an individual experience stress at work or other situations –
• Subjects perception of the situation,
• Past experience,
• Personality,
• Social support.
Managing stress requires the utilization of basic resiliency skills such as developing an attitude of optimism and hope, overcoming the daily effects of stress, and maintaining appropriate levels of fun and enjoyment in life.
What is resiliency? In physics, it is the ability of a material to quickly return to its original form after being bent, stretched, or twisted. Psychological resiliency is a similar concept. It is the ability of people to return to normal by bouncing back from the ups and downs of life. Resilient people consistently choose an optimistic outlook on life. An optimistic attitude is one of hopeful expectation for positive results. It is also flexible because a flexibly optimistic viewpoint does not discount the negative events of life, but intentionally and realistically looks for the best outcome in any situation. It is this looking for the best that pulls resilient people through hard times and puts them back into shape. A positive attitude reduces the potential for stress and depression.
The second element of resiliency is to know how to manage stress. Avoid whatever stress by saying “No” and to set limits and also practice unwinding from stress. Such unwinding may be through physical exercise, as with a daily workout at the gymnasium, or it might involve the practice of meditation or yoga. Unwinding from everyday stress can be as simple as taking a slow, mindful walk. The ability to manage stress makes workers more efficient.
The third characteristic of resilient people is that they enjoy life by making the intentional choice to participate in it.(4)
Changes required are active participation in "communication skills" training and implementation of the same in practice. The medical curriculum should include courses on stress management. Our hospitals and clinics need to be more patient and staff friendly.(5)
Stress is not what happens to us. It's our response to what happens and response is something we can choose!
References:
1. Sharma E. Role Stress among doctors. Journal of Health Management. April 2005;7(1):151-156.
2. Familoni OB. An overview of stress in medical practice. Afr Health Sci. 2008;8(1):6–7.
3. Balch CM, Freischlag JA, Shanafelt TD. Stress and Burnout Among Surgeons. Arch Surgery. Apr 2009;144(4):371-376.
4. Awakenings: Simple Solutions for Life's Problems. Available at http://www.lessonsforliving.com Accessed on 05 April, 2011.
5. Chatterjee S, Choudhury N. Medical communication skills training in the Indian setting: Need of the hour. Asian J Transfus Sci [serial online] 2011 [cited 2011 Apr 5];5:8-10. Available from: http://www.ajts.org/text.asp?2011/5/1/8/75968
Health care is a stressful profession and takes its toll at physical, emotional, and mental levels. To effectively care for other people you must take good care of yourself. Medical service involves taking care of other peoples' lives and mistakes or errors could be costly and sometimes irreversible. It is thus expected that the medical doctor and other staffs themselves must be in a perfect state of mind devoid of morbid worries and anxieties. This is however not usually the case because the doctor apart from being affected by the same variables that impose stress on the general population, is also prone to stress because of the peculiarities of his work situation and the expectation of the society at large.
To start with, getting into the medical education is like passing through the proverbial eye of the needle. Training at both the undergraduate and postgraduate levels are long and tedious.(2)
Medical professionals face a lot of stressors like work overload, excessive working hours, sleep deprivation, repeated exposure to emotionally charged situations, dealing with difficult patients, conflicts with other staffs. In addition to this work related stress, irregular social and family life is the main component of ongoing burn out process in these professionals.
The doctor is still perceived as a very comfortable person in our society and expectations are usually high financially and otherwise. Failure or inability to ‘meet up’ may constitute a significant stress factor in some physicians. Hostile job environment, administrative ineptitude and bureaucratic bottlenecks can make the job situation very frustrating. Inadequate infrastructure, unavailable and obsolete equipments make the long years and fortune spent in training unrewarding. Unsecured future, delays in promotion and inappropriate capacity utilization are some of the causes of unfulfilment and stress in the job place.(2) This could be compounded in our environment by denied holidays and lack of manpower. Stress creates a personal cost to the individuals concerned, a financial cost to the organizations in terms of absence, early retirement and complaints, and a health cost to patients in terms of the risk of poorer quality care that is received by patients from stressed or dissatisfied staff. Medical professionals especially doctors are at increased risk for divorce and suicide. Gender specific differences have also emerged with higher stress in women.(3)
The ‘burnt out phenomenon’, a terminology made popular by Felton consists of a triad of emotional exhaustion, depersonalization (treating patients as if they were objects) and low productivity/achievements. It is particularly common in health professionals under stress.(2)
Several factors determine whether an individual experience stress at work or other situations –
• Subjects perception of the situation,
• Past experience,
• Personality,
• Social support.
Managing stress requires the utilization of basic resiliency skills such as developing an attitude of optimism and hope, overcoming the daily effects of stress, and maintaining appropriate levels of fun and enjoyment in life.
What is resiliency? In physics, it is the ability of a material to quickly return to its original form after being bent, stretched, or twisted. Psychological resiliency is a similar concept. It is the ability of people to return to normal by bouncing back from the ups and downs of life. Resilient people consistently choose an optimistic outlook on life. An optimistic attitude is one of hopeful expectation for positive results. It is also flexible because a flexibly optimistic viewpoint does not discount the negative events of life, but intentionally and realistically looks for the best outcome in any situation. It is this looking for the best that pulls resilient people through hard times and puts them back into shape. A positive attitude reduces the potential for stress and depression.
The second element of resiliency is to know how to manage stress. Avoid whatever stress by saying “No” and to set limits and also practice unwinding from stress. Such unwinding may be through physical exercise, as with a daily workout at the gymnasium, or it might involve the practice of meditation or yoga. Unwinding from everyday stress can be as simple as taking a slow, mindful walk. The ability to manage stress makes workers more efficient.
The third characteristic of resilient people is that they enjoy life by making the intentional choice to participate in it.(4)
Changes required are active participation in "communication skills" training and implementation of the same in practice. The medical curriculum should include courses on stress management. Our hospitals and clinics need to be more patient and staff friendly.(5)
Stress is not what happens to us. It's our response to what happens and response is something we can choose!
References:
1. Sharma E. Role Stress among doctors. Journal of Health Management. April 2005;7(1):151-156.
2. Familoni OB. An overview of stress in medical practice. Afr Health Sci. 2008;8(1):6–7.
3. Balch CM, Freischlag JA, Shanafelt TD. Stress and Burnout Among Surgeons. Arch Surgery. Apr 2009;144(4):371-376.
4. Awakenings: Simple Solutions for Life's Problems. Available at http://www.lessonsforliving.com Accessed on 05 April, 2011.
5. Chatterjee S, Choudhury N. Medical communication skills training in the Indian setting: Need of the hour. Asian J Transfus Sci [serial online] 2011 [cited 2011 Apr 5];5:8-10. Available from: http://www.ajts.org/text.asp?2011/5/1/8/75968