Abstract
Stress in healthcare can affect the professionals’ well-being (emotionally and physically) by curbing their efficiency and negatively impacting their overall quality of life. This paper aims to investigate the impact that work environment stress can have on employees, organizational performance, and the delivery of patient care. The research will first identify and explore the different types of stress in a healthcare environment. This will be followed by a discussion on why stress in such an environment may be more pressing than in other industries. The paper also aims to examine employee burnout due to stress and how it affects the delivery of care. This will be achieved through the use of theory and existing literature. Finally, the paper will look into best practices that can alleviate the adverse effects of stress in the workplace and examine how managers should behave to ensure employees experience less stress on the job.
Introduction
Every workplace environment faces its share of daily challenges. In such an era of rapid globalization, technological development, and intense industrialization, employees are expected to work more intensely and deliver more successfully. Workplace stress can result from various factors, and some professions experience much more stress than others. However, in the healthcare profession, where expectations are high and working hours are long, employees are more prone to occupational stress (Salari et al., 2020). The healthcare profession is among the topmost stressful institutions since it is one of the professions that involve human contact and rapid decision-making skills with decisions that can bring about a severe effect.
In the healthcare environment, workers are exposed to burnout conditions and stress that may impact their well-being. Burnout can best be described by the job demand-resources model, which is usually used to predict the well-being of employees. According to this model, when the demand is high, the employees’ performance starts to decline (Adil & Baig, 2018). This is because job demands comprise of certain factors like time pressure which reduces the energy and health of the employees, causing low performance.
Therefore, the job demand-resource model illustrates that when there is too much pressure on the employees, they start to wear out. The situation becomes extreme when there are few resources to assist the employees (Adil & Baig, 2018). As such, during the Covid 19 pandemic, most health workers have experienced burnout conditions and stress. A lot of employees were cut off from work hence becoming unemployed. Due to this, the health workers who remained had the burden of ensuring things ran smoothly, thus influencing burnout and stress. This paper aims to look into stress and employee burnout in healthcare and its impact based on recent literature and existing theory.
Stress
When a person experiences stress, it is a response of the body towards a particular action or anything that requires attention. Stress can be defined as any condition that influences emotional, physical, or psychological strain (Starc, 2018). It is inevitable, and anyone can get it no matter the age. However, the difference in well-being after stress arises in how the person handles it. Whether it is good or bad depends on how it affects the well-being of the person. Stress that is considered reasonable is less destructive towards a person’s health, and it is short-term. However, the other stress that is regarded as bad is long-term. In this situation, the body does not receive a signal to return to normal. People with long-term stress may experience symptoms such as headaches.
Types of Stress
When a person is experiencing stress, the body reacts by flushing hormones to prepare the systems to avoid it (Freshwater, 2020). This is an uncontrollable response that is referred to as freeze or fight-or-flight. The American Psychological Association categorizes stress into three groups, acute, episodic, and chronic stress (Freshwater, 2020). These types of stress have their symptoms, characteristics, treatment, and duration approaches. Therefore, when treating them, the approach will be different.
Acute Stress
It is the most common type of stress and occurs in a short period. Those who experience it think of an adverse event that has happened to them or is about to occur (Freshwater, 2020). For example, a person in an argument may experience acute stress as they think about the negative thoughts that might arise from the conflict. Acute stress may also be caused by thinking about an upcoming deadline (Freshwater, 2020). In healthcare, nurses may experience this type of stress when they are under pressure. Providing quality services to the patient is the top priority, but some cases require fast thinking to save the patient from dying. For instance, a patient who has come out of surgery may start experiencing symptoms like seizures, and it might become severe to the point where the patient may develop abnormal posturing. At this point, the nurse ought to be quick to diagnose and administer the correct medicine or call a pediatrician to assess the patient. However, since the nurse is working under pressure, acute stress may arise. According to Freshwater (2020), the most common signs a person with acute stress may show are transient muscular distress, emotional distress, and a transient stomach. Therefore, acute stress has less impact on a person’s well-being as it can be managed.
Episodic Acute Stress
This kind of stress is known for frequently occurring in a person’s daily activities. They are acute stresses but occur many times, thus the word episodic (Freshwater, 2020). A health practitioner who has episodic acute stress is always in a rush and feels pressure due to their roles within the hospital. Any individual who experiences episodes of acute stress lives a life of crisis. Certain personalities are associated with episodic acute stress, including Type A personality and the Worrier (Freshwater, 2020). Type A personality is a person who exhibits the drive to be competitive, and they are always aggressive and impatient. In the other personality, the person is constantly stressed due to the many worries triggered by the surroundings. Such as asking themselves what if something bad were to happen.
Chronic Stress
Compared to the other types of stress, this can be classified as advanced. Chronic stress is the most harmful, and if left untreated for a long time, it can severely impact a person’s health (Freshwater, 2020). The stress sets in when individuals see no hope of fixing the challenge they face or are in a poor working environment. In healthcare, this type of nursing can be observed when the health practitioner is frequently pushed to the edge such that everything they do gets undermined or it does not work, such as operating on patients, but they keep on dying. People with chronic stress experience a change in their behavior that is had to change (Freshwater, 2020). Therefore, it causes the person to be vulnerable to stress and its effect regardless of its intensity. In cases where a person may have chronic stress, they may experience some symptoms as the other types of stress, but the additional symptoms are suicide, violence, or heart attacks.
Stress in Healthcare
Stress in healthcare is more important than any other profession because a nation depends highly on its healthcare system to improve mortality rates and the well-being of the people. The US has realized this and spent most of its funding on healthcare. Compared to other developed countries, the US emerges as the leading in spending its GDP on improving its health care system (Martin et al., 2017). As such, this has made the US have one of the best medical services for its people.
Certain factors make stress in a healthcare environment more critical than in other industries. They vary from professional hierarchy, gender, personalities, and ethnicity, among others. In the professional hierarchy of healthcare, the different professionals within the hospital are dependent (Alenezi et al., 2018). This suggests that, for the patient to get better, all professionals play a role in providing the services. Unlike other industries, their professional hierarchy is independent, meaning the company’s CEO can leave the work to the subordinates like the managers to ensure the job is done (Alenezi et al., 2018). This puts healthcare stress as a crucial matter because if the nurses, surgeons, or doctors are under stress, work will not be done, hence endangering the patients’ health.
Also, personality is an essential factor in determining the importance of focusing on stress in healthcare more than in other industries. This is because personality in other sectors can not affect their services as much as it would in healthcare service (Alenezi et al., 2018). Employees in other industries who exhibit personalities that affect their services when stressed can be demoted or moved to another section of the organization where they cannot limit the progress of the business. However, in healthcare services, personality matters even when the health practitioners are under stress (Alenezi et al., 2018). A stressed doctor who has arrogant when stressed cannot offer services to the patient because the patients might refuse to share their problems due to the arrogance they see.
Sources of Stress
Several factors could bring about stress in the healthcare profession. According to Alenezi et al. (2018), the ICU nursing staff reported that dealing with death is their first source of stress. On the other hand, workload and sufficient manning are reported to be the most significant source of stress for nurses working in surgical departments. However, stress is a complicated phenomenon; thus, it is hard for one to be too decisive and confident regarding stress sources. On the contrary, what should be taken into account is the individual and what they perceive to be stressful. Among some of the factors that could contribute to workplace-related stress include the stressful nature of the profession. The healthcare profession can burden the employees ‘ emotional state when combined with the patient’s demands, psychological quests, and ethical dilemmas. In addition to this, workplace tensions and anxiety, lack of support from colleagues, administration-related factors, and individual characteristics of the employee could also be a source of stress. For instance, during pandemic periods like the Coronavirus pandemic, healthcare professionals’ sources of stress included the anxiety of getting the virus and prolonged working hours (Çelmeçe & Menekay, 2020). These sources of stress act accumulatively on the individual, leading to psychological, physical, and behavioral reactions. Feddeh and Darawad’s (2020) study also confirms that maladministration, poor working conditions, deadlines, prolonged working hours, interpersonal relationships, and conflict are the top sources of workplace stress. These are but a few of the existing sources of stress.
Effect of Employee Burnout on Health Care Services
As noted earlier, health practitioners are crucial to maintaining the well-being of patients. As such, any amount of stress may jeopardize their efficiency in service delivery. In Starc’s (2018) research, a test was conducted to determine whether stress can affect a nurse’s performance, and the findings showed a correlation between the two. The findings showed that, in stressful situations, nurses lose focus, they become unmotivated, and find themselves in conflicts within the workplace. Additionally, having too much stress within the workplace diminishes productivity, increases injuries and poor judgment, and makes nurses insensitive about the patients’ needs (Sultana et al., 2020). Furthermore, as discovered in Starc’s (2018) research, stress creates a problem for nurses where they engage in drug abuse to fix their issues but make the situation worse. This concern makes stress a significant problem towards nurses’ work in providing health care services.
In order to fix the stresses experienced by employees in their workplace, certain approaches may be relevant. Among these include the interactional model of stress, which demonstrates that individuals’ perception of the stressor is the most critical factor (Tement et al., 2020). According to the model, a person undergoes stages of stress. These stages escalate due to the person’s experience with the stressor, control, coping ability, and reappraisal (Tement et al., 2020). As such, if a person experience stress, its effect will depend on how the same stressor had previously affected them. If the stress can be handled, it will not progress, but if the person cannot take it, it continues to the next stage, which requires the person to cope with the situation. The basic idea of this model is that a person’s stress can be mitigated through how they perceive the stress. For instance, whether it is life-threatening or not, thus, their perception will aid how they will get help for efficiency.
Best Practices to Alleviate the Negative Effects of Stress in the Workplace
Just like any other work environment, stress is inevitable in the healthcare industry. A study by Salari et al. (2020) suggests that doctors prefer stress coping strategies geared towards direct problem management through a positive approach and solution. To be specific, the study indicates that male doctors prefer solving the issue while women prefer using an emotion-centered coping strategy. On the other hand, nurses tend to use problem-centered techniques linked to good mental health regarding stress management at work. When an organization goes above and beyond to help its employees reduce stress, they are more likely to feel good about their well-being and quality of life (Feddeh & Darawad, 2020). Reducing stress in the workplace will bring about benefits to the employees, patients, and the entire healthcare facility. There exist several best practices that help in alleviating the adverse effects of stress in the workplace. Among the methods available to lessen the negative effects of stress in the workplace include;
Creating a Positive Work Culture
The work environment has a significant impact on employees’ well-being, mainly because they spend approximately one-third of their lives working. Therefore, a great way to reduce stress and its negative impacts are to create a positive work culture. This can include practices such as team bonding activities or something as simple as a welcome lunch culture for new employees (Feddeh & Darawad, 2020). A positive work culture also includes highlighting the positive impact that employees are bringing to the organization. For example, recognizing the great work employees are doing and encouraging an open-door policy such that employees feel comfortable voicing their concerns.
Practice Healthy Habits at Work
Another way to reduce stress in healthcare workers is to practice healthy habits while at work. This includes promoting habits such as group meditation, yoga, and walks with workmates. Physical and mental relaxation have been proven to reduce stress in healthcare workers. Therefore, promoting practices like this will enable employees to manage and relieve their work. It will also help in creating a positive environment for them to share and talk about their issues. Through such practices, employees will be encouraged to turn to their co-workers for support whenever they are stressed out (Salari et al., 2020). Thus, reducing the adverse effects that may result from stress. In addition to this, stocking the break room and fridge with healthy and fresh produce for lunch meetings is another healthy work practice. Through such practices, a robust support system is built for employees, which can help buffer them from the negative effects of workplace stress.
Streamlining Stressful Tasks
Another stress-reducing activity is streamlining stressful aspects of the healthcare job so that healthcare workers can do what brought them to the profession; taking care of patients. One way to achieve this is to implement an automated software, for example, for administrators and frontline staff to help them reduce the amount of time they spend on stressful and time-consuming tasks (Giga et al., 2018). In this case, the software will help organize on-call schedules and make communication with physicians more efficient. By so doing, the employees’ work stress will be reduced, enabling them to focus on other tasks assigned to them.
Leadership Practices
Aside from the workload, the stress in the workplace flows down from the decisions at the top. Therefore, to reduce and control stress, healthcare organization leaders need to work constantly to monitor the employees’ stress levels. This can be achieved through leading by example, including healthily managing one’s own stress and avoiding the emittance of any unnecessary tension in the workplace. In addition to this, the leaders should also practice regular communication and transparency to the employees as well as reassuring them that their efforts are recognized (Alenezi et al., 2018). Another healthy leadership practice is to show employees what a healthy work-life balance looks like by discussing how to spend downtime. In this case, managers should also ensure that they do not request deadlines that require the overworking of employees.
Conclusion
Since the outbreak of COVID-19, the prevalence of depression, anxiety, and stress within healthcare workers has increased. Stress is considered a pressing issue in the healthcare profession as this is a profession responsible for human life. Therefore, stress can compromise the professional’s ability to provide quality care to the patients or, even worse, lead to the death of patients and compromise the entire organization’s performance. In addition to this, the stress in this profession can lead to employee burnout and affect the employee’s well-being. However, as a manager and an organization, several steps can be taken to reduce the adverse effects of stress and promote stress-reducing activities. Failure to take measures to control stress, in this case, will lead to the failure of the entire healthcare system.
References
Adil, M. S., & Baig, M. (2018). Impact of job demands-resources model on burnout and employee’s well-being: Evidence from the pharmaceutical organisations of Karachi. IIMB Management Review, 30(2), 119-133.
Alenezi, A. M., Aboshaiqah, A., & Baker, O. (2018). Work‐related stress among nursing staff working in government hospitals and primary health care centres. International Journal of Nursing Practice, 24(5), e12676..
Çelmeçe, N., & Menekay, M. (2020). The effect of stress, anxiety and burnout levels of healthcare professionals caring for COVID-19 patients on their quality of life. Frontiers in Psychology, 11, 3329.
Feddeh, S. A., & Darawad, M. W. (2020). Correlates to work-related stress of newly-graduated nurses in critical care units. International Journal of Caring Sciences, 13(1), 507-516.
Freshwater, S. (2020). 3 types of stress and health hazards. Shawna Freshwater, PhD.
Giga, S. I., Fletcher, I. J., Sgourakis, G., Mulvaney, C. A., & Vrkljan, B. H. (2018). Organisational level interventions for reducing occupational stress in healthcare workers. The Cochrane Database of Systematic Reviews, 2018(4). Web.
Martin, A. B., Hartman, M., Washington, B., Catlin, A., National Health Expenditure Accounts Team. (2017). National health spending: Faster growth in 2015 as coverage expands and utilization increases. Health Affairs, 36(1), 166-176.
Salari, N., Khazaie, H., Hosseinian-Far, A., Khaledi-Paveh, B., Kazeminia, M., Mohammadi, M.,… & Eskandari, S. (2020). The prevalence of stress, anxiety and depression within frontline healthcare workers caring for COVID-19 patients: A systematic review and meta-regression. Human Resources for Health, 18(1), 1-14.
Starc, J. (2018). Stress factors among nurses at the primary and secondary level of public sector health care: The case of Slovenia. Open access Macedonian journal of medical sciences, 6(2), 416.
Sultana, A., Sharma, R., Hossain, M. M., Bhattacharya, S., & Purohit, N. (2020). Burnout among healthcare providers during COVID-19 pandemic: Challenges and evidence-based interventions.
Tement, S., Plohl, N., Horvat, M., Musil, B., Jakus, G., & Sodnik, J. (2020). Driving demands, stress reactivity and driving behavior: An interactional approach. Transportation research part F: traffic psychology and behavior, 69, 80-90.
