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Chill out: How to recognize the signs and symptoms of excessive occupational stress

September 14, 2012

By Darlene Leuschke and Sharon Alderson, Commission on Paraoptometric Certification

Picture this. It is back-to-school time and the office is packed. Children may be running amok in the office while others are crying. You are in the process of implementing electronic health records (EHRs) in the office, there are two emergency patients that must be seen and a co-worker has called in sick. Can you say STRESS?

It seems these days that everyone is stressed about something at home or at work and often in both places.

Workers in the health care industry are no exception. With the implementation of new methods of recordkeeping, coding and billing standards, and new regulations, it’s nearly impossible to avoid workplace stress.

Economic conditions over the past several years have also contributed greatly to workplace stress for many Americans as budget cuts and layoffs result in more demands being placed on the remaining staff. Fear and uncertainty about the future contribute to even higher levels of stress.

How is stress defined and why is it so bad? Stress is a biological or psychological reaction in your body to a perceived threat or aggression. This reaction is commonly known as the “fight or flight reaction” – a natural alarm that goes off in your body and results in an immediate and brief hormonal response.

When a threat or aggression is perceived, the adrenal gland releases a surge of hormones including adrenaline and cortisol into the bloodstream. Adrenaline increases the heart rate and energy level and elevates blood pressure. Cortisol is the primary stress hormone. It increases blood sugar in the bloodstream and improves the brain’s ability to utilize glucose. Cortisol also suppresses the responses and functioning of certain body systems during the perceived threat. Digestive, reproductive, and immune system responses are altered when these hormones are released into the bloodstream.

Once the perceived threat or aggression has passed, your heart rate and blood pressure drop, hormone levels subside, and your body returns to normal. At least that is how the body was designed to function.

However, the typical American is constantly bombarded with situations that we may perceive as threats or aggression.
Consequently, the body reacts more often and maintains the fight or flight reaction longer.

And while not everyone reacts to every situation in the same way, morning traffic, deadlines, increased patient load, financial worries, increased home or family responsibilities, catastrophic events, major life changes, small daily annoyances, all can be causes of stress.

Sustained or chronic stress is linked to many mental and physical problems including depression, anxiety, sleep disorders, memory impairment, cancer, coronary heart disease, digestive problems, obesity, arthritis, and immune deficiencies, to name a few.

Occupational stress has long been recognized as a significant cause of health problems, but what is causing so much stress in the health care workplace?

With the passage of the Accountable Care Act (ACA) and the implementation of EHRs in many health care facilities, the health care industry as a whole has been participating in a huge upheaval and is preparing for an onslaught of new patients as the ACA takes effect.

Estimates are that millions of new patients will be seen by the same or a decreased number of doctors in the United States.

Couple this increase in patient load with doctors and staff trying to learn new EHR systems, while maintaining compliance with HIPAA standards, establishing proof of “meaningful use,” decreased reimbursements, stringent enforcement of billing and coding procedures, and the need for more staff, and it’s easy to see why stress levels are soaring.

Employers and staff may be frustrated by staff reductions due to the struggling economy and increased responsibilities for the same or less pay.

This may lead to frustration, anger, fatigue, apathy, resentment, and anxiety.

These negative reactions cause stress and impact physical and emotional well-being.

Stress can undermine productivity goals as employees may find it difficult to concentrate on the task at hand, begin to make more mistakes, or start feeling overwhelmed and unable to meet deadlines or expectations. They may become irritable with colleagues or patients.

High levels of stress may also contribute to increased absenteeism and staff turnover.

Learn to recognize the signs and symptoms of excessive stress such as feeling anxious, irritable, or depressed.

Research has linked these negative emotions to heart disease when they are not managed.

Others signs of excessive stress might be loss of interest in work, general fatigue or problems sleeping, problems concentrating, headaches or muscle tension in the neck, shoulders, or back.

People may also display signs of distress outside of work by smoking, consuming too much alcohol, using drugs, and even by withdrawing from social or intimate contact with friends and family.

How stress is dealt with by employers and employees is the key to better overall health and productivity.

Employers can help staff manage stress by encouraging open communication, providing a confidential Employee Assistance Program, allowing frequent breaks during the day, and offering gym memberships as part of the benefits package.

Promote a more relaxed atmosphere by including staff in decisions that may affect their jobs and share information that will reduce anxiety about their future employment.

Hire additional staff if needed to keep the office running smoothly.

The best thing you can do for yourself is learn how to manage your own stress and health.

When you feel at your rope’s end, don’t go home and do the usual flop on the couch and try to block out the day.

The worst things to combine with stress are suppressing your emotions, overeating, lack of exercise, and smoking. People who suppress feelings of anxiety, anger, or fear have higher incidences of illness.

Release those emotions in a positive way through exercise. Endorphins released during exercise will help decrease cortisol (the stress hormone) levels. If you have a poor diet, make small changes until you achieve a healthier diet.

Drink in moderation and don’t use nicotine products. Smoking may seem like it has a calming effect during stress, but in reality nicotine is a stimulant. Smoking may actually increase anxiety and it greatly increases the risk of many types of cancers.

And finally, if the way you are managing stress is not working, change it and try something new. Buy a self-help book, take up a new hobby or sport, look at things from a different perspective, or seek professional help.

As Albert Einstein said, “Insanity is doing the same thing, over and over again, and expecting different results.”

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