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OJHAS Vol. 10, Issue 1:
(Jan-Mar 2011) |
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| Stress Among Health
Care Professionals - The Need for Resiliency |
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Anil Kakunje,
Asst. Professor, Dept of Psychiatry, Yenepoya Medical College
Deralakatte, Mangalore - 575018, India |
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Address for Correspondence |
Asst. Professor,
Dept of Psychiatry,
Yenepoya Medical College,
Deralakatte,
Mangalore - 575018, India.
E-mail:
anilpsychiatry@yahoo.co.in |
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Kakunje A. Stress Among Health
Care Professionals - The Need for Resiliency. Online J Health Allied Scs.
2011;10(1):1 |
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Submitted: Apr 7,
2011; Accepted: Apr 12, 2011; Published: April 15, 2011 |
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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 –
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!
- Sharma E. Role Stress among doctors. Journal of Health Management.
April 2005;7(1):151-156.
Familoni OB.
An overview of stress in medical practice. Afr Health Sci. 2008;8(1):6–7.
Balch CM, Freischlag JA, Shanafelt TD.
Stress and Burnout Among Surgeons. Arch Surgery. Apr 2009;144(4):371-376.
Awakenings: Simple Solutions for
Life's Problems. Available at
http://www.lessonsforliving.com
Accessed on 05 April, 2011.
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
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