Transcript Work-Related Stress and Burnout

Work-Related Stress and
Burnout
Reality Shock
Objectives
Identify signs of stress, reality shock, and
burnout
 Describe the impact of stress and
burnout on the individual and the rest of
the team
 Identify resources in place specific to
INTEGRIS Health

Transitions in Nursing
What
are transitions?
 Passages/changes
from one situation,
condition or state to another over time
 Types




Developmental
Situational
Health-Illness
Organizational
Sources of Stress for the New
Graduate Nurse





Moving into a new group
Expectations of
competence
Ideals vs. Reality
They are the RN
Loss of trusted
relationships with
classmates
Reality Shock
“ unsettling and/or
jarring experience
resulting from wide
disparity between
what was expected
and what the real
situation turns out to
be.”
Reality Shock and New Graduate
Nurses
New graduates often feel a conflict over
professional goals or values and the
values and goals in place at work.
The work setting goals are often
embedded in the culture of the
organization.
Stages of Reality Shock:
Honeymoon Phase






Thrilled with completing
school
Excited about finally
being a nurse
High energy euphoria.
Wants to become learn
everything at once.
Excitement that distorts
perceptions
Frequently short lived
Preceptor’s Role During the
“Honeymoon”
Harness the new nurse’s enthusiasm for
learning new skills and routines by
helping the new grad stay grounded.
 Be realistic without being negative
 Assist the new employee integrate into
the workplace culture

Shock Phase

Experiences
frustration and
disappointment in
new role
 Perceives conflicting
values between
school and work
 General negativity
about role.
Shock and Rejection






Excessive fear and
mistrust
Physical exhaustion
Feelings of failure
Hypercritical attitude
Physical symptoms
Tend to bond to
people with like
attitudes
Effects of Stress
Stress is assessed on
4 levels:
 Environmental
 Social
 Physiological
 Psychological
Ineffective Ways to Cope
Abandon professional goals – will
eliminate conflict, but leaves you
dissatisfied
 Give up professional ideals
 Disengage – work for just the paycheck
 Leave the profession

Preceptor’s Role During Shock
Phase
Offer support by being a good listener
 Offer an objective point of view by:
acknowledging negative but emphasizing
positives
 Encourage new staff to verbalize ideas
for improvement
 Educate other staff about what to expect
in shock phase

Effective Ways to Cope
Build a professional identity
 Engage in the organization
 Communicate effectively
 Seek out feedback often
 Develop a support network
 Identify a mentor

Emotional Intelligence





Know and manage your
own emotions
Motivate your new
graduate by setting
small achievable goals
Help with organizational
skills
Be open to other points
of view
Be readily available and
open
Recovery Phase




Beginning to re-discover
a sense of humor
Decreased physical
signs of stress
Increased ability to
objectively view work
and the environment
Can distinguish between
effective and ineffective
behaviors
Preceptor Role During Recovery

Continue to emphasize positive

Support the new graduate’s suggestions
for improvement

Encourage participation in unit-based
council, staff meeting, etc.
Unsuccessful Recovery

Job hopping
 Limited involvement
with co-workers and
the organization
 Complain but rarely
offer suggestions
and refuse to help
solve problems
Resolution Phase
Seeing a resolution to previous conflicts
 Understands and/or accepts role in both
the work environment and workplace
culture
 Behavior appropriate for situation

Differences in expectations
To cope with reality, you must recognize that:
 Expectations are often distortions of reality,
which can lead to disappointment
 To be successful in nursing, you must fit
yourself into the work, not fit the work to suit
your demands
 The way you perceive events on the job will
influence how you feel about your work
Expectations

Your mental attitude will influence
whether your work is a pleasant or
unpleasant experience.

Feelings of helplessness and
powerlessness cause frustration and job
stress.
Warning Signs of Stress


Apathy
Anxiety
 Irritability
 Reacting in the extreme
 Smoking/drinking
 Eating “comfort foods”
 Tardiness or
absenteeism
 Chronic ailments or
repeated bouts of illness
 Relationship problems
 exhaustion
Burnout

The ultimate end of
job related stress

Often attributed to
the nurse’s inability
to deliver what is
perceived as ideal
care.
Stages of Burnout

High expectation and
idealism
 Early job
dissatisfaction;
pessimism
 Withdrawal and
isolation
 Irreversible
detachment and loss
of interest
Beating Burnout
A-B-C’s of Stress management
 Awareness – be honest when signs appear
 Belief – help new graduates develop
confidence in their abilities
 Commitment – be committed to helping the
new graduate recognize and reduce stress
 Don’t forget your own stress!
Physical Health Management





Get plenty of sleep
Take breaks
Practice relaxation
techniques: deep
breaths, stretching
Exercise
Eat healthy
Mental Health Management

Realize that new
nurses own their
thoughts, attitudes,
and values
 Set realistic
expectations
 Laugh
 Provide social
support
Traditional View of Conflict

Conflict is BAD

It’s adversarial

It’s a Win – Lose
proposition: if I win,
you have to lose and
if you win I have lost
Typical Self-Talk about Conflict
There is nothing that I can do about
it.”
 “I wish it will all disappear when I
wake up tomorrow”
 “He’s always been this way and as
long as I have to deal with him
nothing will change.”
 “It would feel so good to kick her ***.”

Why Do people Fall Into the Conflict
Mode?
They’re just ‘doing their job”
 This method has always worked for them
in the past.
 They don’t think they are difficult ( and
they can prove it!!!!)
 They don’t have the skills to resolve or
handle conflict.

What’s Really Behind Conflict








Fear
Differences in values and beliefs
Differences over facts
Differing view of the priorities
Differences over methods
Competition for resources
Competition for power
Simple misunderstanding (poor communication)
Conflicts in Nursing

Conflicts that can occur are often
rooted in trying to balance
institutional interests, “client”
interests, and personal interests of
the individuals involved. Some
complicating factors are:

-Distribution of costs and benefits.
Those who benefit
from resolution may not be the same
people who pay the costs

-Perceptions of problems. People
tend to blame others for causing the
problem

-Speed of the action. Some will
want change to take place more
quickly than others
What are your options?
Do Nothing
 Walk Away/Turn the “Other Cheek”
 Change Your Attitude
 Change Your Behavior to resolve the
conflict
 Changing their behavior is NOT an
option!

Dealing with Difficulty
Remember that the only one you can
change is you;
 you can become the “skilled” person
 Become Confident, remain Calm, be
Comfortable
 Act or respond rather than react
How to Handle Conflict
1.
2.
3.
Know your limits and boundaries: What
actions/promises are you authorized
and willing to take?
What can you tolerate?
What pushes the “difficult’ person’s
button? Realize that once it’s been pushed,
conflict management skills are likely to be
ineffective.
Diffusing Anger

Stay clam yourself
( breath!!!)
 Create emotional
distance: ask yourself if
there is any value in
what they other person
is saying
 Listen for information
and ignore the emotion
Prepare an Effective Response
“Time out!. I hear what you are saying,
but you need to slow down.”
 “ Give me a chance to respond. This is
what I hear you saying.”
 I need to interrupt you to let you know
that yelling is distracting, and makes it
hard for me to listen to your information,’

Remember
You can’t change them; you can only
change yourself.
 Change the environment. If certain
settings usually trigger responses,
change the scene. Meet for lunch or in a
non-threatening setting.
 Show you understand; summarize and
ask questions.

The single best anger diffusing
technique:
Apologize!
……..even if you are not sure you did what
the other person thinks you did, it can
diffuse the situation.
When emotions aren’t high, you can
approach that person to work on a
solution.
Practice Good communication Skills
Be positive
 Be direct, but non confrontational
 Have access to facts
 Be aware of body language, tone of
voice, eye contact
 Use appropriate timing
 Let the person know that you share the
same goal.

Remember that usually there are rarely
absolute rights and wrongs
 Don’t judge
 Don’t accept fighting as acceptable;
excuse yourself if the other person
cannot gain control of themselves
 Work on not letting others push your
buttons
