An Insight into Stress Management in Healthcare Industry (Essay Sample)

Coping with Stress: An Insight into Stress Management in Healthcare Industry
Executive Summary
Stress is a pattern of negative physiological states and psychological responses that occur in situations when the individuals perceive threats to their wellbeing which they would be unable to meet. Like other individuals physicians also suffer from stress which leads to psychological morbidity of depression, anxiety and substance abuse amongst the physicians which may further impacts their family, social life of that doctor and even their relation with the patients or colleagues in the health care set up resulting in clinical errors and lawsuits.
There are various sources of stress that affects a physician and is related to a number of issues like the type of medical practice a physician is involved in (private versus public or hospital based versus community based) and even the type of specialty. To be successful in the professional world it is important that every individual including medical practitioner should be able to cope with stressors for their individual performance and sustain the performance of the team. Successful coping will lead to decreased exhaustion stage and burnouts and improve the sustained quality care giving by minimizing medical errors. Effective stress management techniques may be beneficial to aid in the coping process.
The individual physician should be aware from the feedback of their own physiological and psychological variables and plan his assignments meticulously even in situations of increased work load as increased workload calls for proper time management which unless followed leads to physical and psychological stress and ensure burnouts. They should practice teamwork, and act as leaders to address job delegation and conflict management for the efficacy of the health care delivery process reducing medical lawsuits and lesser stress at the workplace.
Background
According to physicists stress has been defined as that pressure or force which is been exerted on a body. On the other hand Psychologists stress has been defined as a set of complex factors or demands that are placed on the body and how the body copes or adapts to those demands. Lazarus and Folkman (1984) provided a more comprehensive definition of stress. They defined stress as a pattern of negative physiological states and psychological responses that occur in situations when the individuals perceive threats to their wellbeing which they would be unable to meet. In fact Lazarus (1975) put forward a concept that whether stressors( factors that cause stress in an individual) are harmful or not solely depends on an individual’s ability to appraise the stressors , interpreting them mentally and showing a physiological or psychological reaction that forms the basis of stress.
Individuals in the health care industry are also subjected to various stressors in day to day in their occupational settings. Amongst other workers the physicians or doctors are also subjected to stress. In fact studies have reflected that doctors suffer from stress more than the general population. Firth and Cozens in their study reflected that 28% of the physician community suffers from stress compared to 18% in the general population (Firth-Cozens, 2003). It has been also noted that increased levels of stress has been associated with psychological morbidity of depression, anxiety and substance abuse amongst the physicians (Chamber et al, 1992).
Transactional Model of Stress
The widely accepted model of stress as put forward by Lazarus and Folkman is the Transactional Model of stress. The model conceptualizes stress as a result of imbalance between demands and resources or when external or internal pressure of stressors exceeds an individual’s perceived ability to cope. This means factors that appear to be stress in one set of individuals might be a welcome challenge for other set of individuals who have the better ability to cope with the stressors by negating them successfully.
The importance of the transactional model is that, it also introduces room for intervention. This means that stress can be reduced by enhancing the self and psychological resources of an individual .This will help the individuals to grow a changed perception of the stressors, that earlier caused stress. The overall aim is to enable the individuals to cope with stress and increase their confidence to overcome the negative effect of those stressors. Moreover in addition the demand or pressure that has been imposed on the individual may also get modified because by increasing the predictability and controllability through contingency planning, training and risk management. Primary and Secondary intervention strategies are important to negate the effects of stress (Hill et al, 1998).
Sources of Stress in Physicians
There are various sources of stress that affects a physician and is related to a number of issues like the type of medical practice a physician is involved in (private versus public or hospital based versus community based) and even the type of specialty. There are various potential sources of stress that either relates to the job or the organization, the individual himself/herself, and also the work life balance and public interactions. The various situations are enumerated below:
* Job related factors
* Workload: It is often found that most competent physicians are saturated with increased workload to maintain the goodwill of organization.
* Time Pressure: Increased workload calls for proper time management which unless followed leads to physical and psychological stress.
* Administrative duties cumulate the workload pressure of direct care giving.
* Compromise on social parameter like sleep deprivation, infrequent meals imposes physical stress
* Regular threats of malpractice suits and consumer protection acts impose mental stress that leads to complexities and flexibility of delivering health care.
* More education and training regarding updating of medical skills and clinical knowledge.
* Organizational Behavior
* Career structure and Career uncertainties might create delay in promotions of physician to the next higher level which might cause the physicians to get de-motivated due to financial and positional delays.
* Inadequacy of resources and staff leading to increased and diverse workload.
* Lack of senior or peer support due to financial capabilities of the organization which can lead to mental stress of critical decision making process during care giving.
* Culture and climate of the organization may add to stress due to unethical lobbying.
* Individual factors
* Personality traits like perfectionism and assertiveness in approach.
* Have high demands on him and on others for performance, which may stimulate burnouts in long run.
* Dealing with patients’ condition and mental attachment with the patient may act as psychological stress due to confrontation with emotional and physical suffering.
* Interactions and Relationships with others
* Staff conflicts and professional bullying
* Level of support from family members
* Patients and Patient family’s behavior.
* Work-life balance
* Spill over of work
* Decreased time for exercise or leisure activities and other stress bursting activities.
* Government Policies
Sharma (2005) studied various variables primarily attributed to Government infrastructure and policies pertaining to doctors. He found that Inter role distance, Role stagnation due to financial constraints, Role overload due to lack of staff, role isolation, personal inadequacy, Role ambiguity, resource inadequacy and transfer policies were attributed to stress in physicians.
Since more than one of the factors may affect the physician at any given time the stress gets compounded and often complicated (Neufield et al, 1988). There is also a distinction between the training and education of the doctors and in real life scenario the job demands that are called for. During the period of education in the medical curriculum an individual physician has their focus to learn about the patho-physiology of diagnosis, text book mediated practice regulations while in the organizational level they are put on demands on communication skills, ethics and law in medical education rather than the medical education and academic / professional excellence(Glass et al, 1997). Apart from that administrative and financial regulations add to the stress of the physicians.
Stress and its Impact on Physicians
As with any other individuals the physical complications of stress namely insomnia, gastrointestinal problems, headaches, fatigue, hypertension, lowered immunity, menstruation irregularities and sexual dysfunction is also prevalent in the doctors. The adverse effects of stress not only affects the individual physician but also impacts the family, social life of that doctor and even their relation with the patients or colleagues in the health care set up (Crane, 1998).
Further it has been noted that stress has been associated with burnouts (Crane, 1998). This means an earlier challenging work which was meaningful and important to the life of a doctor had become unpleasant, unfulfilling and meaningless to the same person over a period of time. The bottom-line is that the energy turns out into exhaustion, previous involvements turns into cynicisms and the efficacy and performance of the doctors becomes ineffective over a period of time upon exposure to stressors. Depression and increased physical illness has been attributed to burnouts (Maslach et al, 2001) (McManus et al. 2002).
The phases of burnouts have increased malpractice suits in the healthcare setup to such an extent that various American Organizations are arranging for "Stress Reduction Seminars" as a liability prevention stra...