Stressful jobs in the world
Being a nurse is one of the most stressful jobs in the world. Other professions may lay claim to this but personally I do believe that when it comes to the prevalence of stress, nothing beats nurses. For nurses, stress usually come from various sources which may include conflict with supervisors and coworkers, lack of support from allied staff, nature of workload, and dealing with the chronic illness, dying and death and the emotional needs of family members (Gray-Toft & Anderson 1981).
Stress is brought about by stressful events or conditions that threaten the well-being of a person; this may be traumatic events, controllability and predictability of situations and internal conflicts (Atkinson, et. al. , 1996). When we are faced with stress our body reacts with the fight or flight response. The sympathetic nervous system causes increased heart rate, elevated blood pressure, dilated pupils and the release of extra sugar from the liver. The adrenal-corticol system causes the release of adrenocorticotropic hormone which stimulates the release of cortisol in the blood.
These reactions prepare the body to fight the stressor or flee from it, when chronically aroused these physiological responses can cause wear and tear on the body (Hamberger & Lohr, 1984). Acute levels of stress may result to a number of psychological and physiological reactions. The most common response to a stressor is anxiety, wherein the individual feels apprehension, tension and fear in varying degrees. Another common reaction to stressful situation is anger, which may lead to aggression. Studies have shown that children who become angry exhibit aggressive behavior when they experience frustration (Atkinson, et. al. , 1996),
fortunately adults often express their anger verbally than to direct blows. On the other hand, stressful events may also lead to apathy and depression. The individual may withdraw from normal functioning and succumb to depression. Aside from the emotional reactions to stress, people also suffer from cognitive impairments when faced with serious stressors. They may find it hard to concentrate and to organize their thoughts logically, may be distracted and hence performance on tasks may deteriorate. Stress can also affect our health by leading us to engage in behaviors that undermine the body’s ability to fight off disease.
When we are feeling stressed we often do not take proper care of ourselves, we often rely on coffee to keep us awake during shifts and eat fast food because we are pressed for time. We do not have time to exercise and may even indulge in habits like smoking and drinking to help us cope with the stress. Thus, keeping stress to a manageable level may be in the best interest of everyone concerned especially in work settings. As a nurse the top three causes of stress for me is work overload, role ambiguity and interpersonal relationships.
A nurse is overworked more often than not. The demands of the job are quite high and all consuming, both professionally and personally. During a days shift, a nurse would be witness to and experience the full range of emotions from a near miracle of saving a patient to the grief of the death of a patient and yet we are asked to be composed and alert at all times. We are responsible for so many things in a given day and sometimes do not even have time to rest, even with the tasks assigned to us, we must be cheerful, friendly and
accommodating. In the course of fulfilling our duties we are asked to respond to patients’ needs, doctor’s needs and the needs of other medical workers. Everyday we are faced with the same tasks that even the most dedicated and committed nurse may suffer from job burnout. Most nurses are stressed by not being able to identify and set parameters as to what their roles are in the health services, is it providing healthcare to patients only, is it to assist doctors, or is it to arrange staffing and shifting of nurses.
Based on the characteristics of stressors, role ambiguity is characterized by lack of controllability and predictability. Research has demonstrated that our perception of the controllability of events is important to our assessment of their stressfulness, and likewise, being able to predict the occurrence of stressful events reduces the severity of the stress. By role ambiguity, a nurse may be a carer in an hour and be a receptionist the next. Not being able to have control of our work and duties and not being able to have a regular and predictable job nature increases our stress.
I have to e always on my feet because I do not know what will be required of me next, thus each day when I start my shift I am anxious and tense and ultimately affects my performance and my work relationships. A nurse is required to interact with all kinds of people, the well and the sick, the doctors and the specialists, the visitors and family members of patients and even the police and detectives. But the nurse usually establishes relationships with other nurses and doctors and aids.
But because of the highly tense and stressful nature of hospital work, interpersonal relationships are not given much importance, doctor’s order nurses around, supervisors reprimand nurses all the time and even nurses themselves are short tempered and often angry with each other. A pleasant work environment and positive interpersonal relationships with coworkers are often indicators of a happy workplace. Which is the opposite of nurses work environment, thus without the benefit of positive work relationships and support systems, relating with other people has become stressful.
Moreover, nurses are assigned to different shifts thus making it more difficult to maintain close interpersonal relationships or even to maintain friendships. The hospital management has recognized the implications of working in a stressful environment and hence has taken steps to help employees cope with the stress and develop better ways of managing stress (Dewe, 1987). First, we have employee counselors who are available for counseling.
Anyone who feels the need to share their problems and concerns can set an appointment with the counselor and hopefully can help the employee manage stress better. Then there are department workshops that teach us how to deal with the demands of the job, to discover new hobbies and relaxation techniques. It has been found that people who control their physiological or emotional responses through relaxations can lessen the effect of stress. The department staffs are encouraged to form a support group to serve as a venue to share experiences and lend emotional support.
It has been found that support group members showed lower levels of emotional distress and learned how to control their stress and emotional difficulties (Spiegel, 1991). Awareness sessions of the signs of stress and burn out are also given periodically to help employees identify the early signs of stress so as have more control over it. When people are able to identify the kinds of stressful situations they are more able to devise measures to deal with it. However, what was not emphasized in al the information campaigns
about stress was how normal people deal with it as there are different coping strategies, what was emphasized was how we should do it. I believe that it is important that we be able to identify what current strategies we employ and whether it is good or not. The management emphasizes problem-focused strategies wherein we are trained to take active steps to solve our problems and anxiety by confronting our stressors. However, most of us try to cope with stress through emotion-focused strategies by using avoidance, repression and or projections which is not beneficial in the long run.
Aside from these measures, management also tries to make the work environment better and pleasant to work in. Lounges are provided with simple amenities for use when employees are on break time; there are certain rules and regulations to provide a semblance of order and predictability in the hospital although it is not followed to the letter. Additional fringe benefits are offered to keep employees happy like salary adjustments, paid vacation leaves and even opportunities for further studies.
Effective coping with occupational stress is however a joint effort, the person concerned should take care of his/her self through proper exercise, diet, a realistic outlook in life, being able to respond to pressure well and even to seek and offer moral support to others. For the organization, they should help employees deal with stress and burn out by making sure that workloads are commensurate to worker’s resources and capabilities. They should also be able to define clearly the work responsibilities of nurses in particular and by giving nurses tasks that would give them the opportunity to become empowered and make decisions as well as to
encourage initiative and to give praise for a job well done. The administration also could delineate the lines of communication, give incentives like job security, and pay increases and promotions. Most importantly, it should not condone sexual discrimination, violence and harassment and strongly protect employees’ rights (Tankha, 2006). Even if these components seem to be idealistic and unreachable, nevertheless, it would probably be best for everyone.
Atkinson, R. , Atkinson, R. , Smith, E. , Bem, D. , & Hoeksema, S. (1996). Hilgard’s Introduction to Psychology 12th ed. New York; Harcourt BraceDewe, P. (1987). New Zealand Ministers of Religion: Sources of stress at work. Work and Stress, 1, 351-363. Gray-Toft, P. & Anderson, T. G. (1981). The nursing stress scale: Development of an instrument. Journal of Behavioural Assessment, 3, 11-23. Hamberger, L. & Lohr, J. (1984). Stress and Stress Management: Research and Application. New York; Springer Spiegel, D. (1991). Mind matters; Effects of group support on cancer patients. Journal of NIH Research, 3, 61-63 Tankha, G. (2006). A comparative study of role stress in government and private hospital nurses. Journal of Health Management, 8 (1): 11 – 22.