INVITED ARTICLES

STRESS AMONG HEALTH PROFESSIONALS: NEED FOR RESILIENCY

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Volume 2 Issue 4 April, 2012

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. 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.
To start with, getting into the medical education is like passing through the proverbial eye of the needle. Trainings are long and tedious.

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, sleep deprivation, repeated exposure to emotionally charged situations, dealing with difficult patients, conflicts with other staffs and the expectation of the society at large.

The doctor is still perceived as a very comfortable person in our society and expectations are usually high financially and otherwise. Inability to ‘meet up’ may constitute a significant stress factor in some physicians. Hostile job environment, administrative ineptitude bureaucratic bottlenecks, unavailable/obsolete equipments, unsecured future, delays in promotion and inappropriate capacity utilization can make the job situation very frustrating. This could be compounded in our environment by denied holidays and lack of manpower. Stress creates 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. 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.

Several factors determine whether an individual experience stress at work or other situations – Subjects perception of the situation, past experience, personality, social support.

Managing stress requires the utilization of basic resiliency skills. 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 the ability of people to return to normal by bouncing back from the ups and downs of life. An optimistic attitude is one of hopeful expectation for positive results. It is this optimistic attitude that pulls resilient people through hard times and puts them back into shape.

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, 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. Lastly, the medical curriculum should include courses on stress management.

Stress is not what happens to us. It’s our response to what happens and response is something we can choose!

Dr Anil Kakunje MBBS, DPM (NIMHANS), MD
Assistant Professor of Psychiatry,Yenepoya Medical College,Mangalore
Email: anilpsychiatry@yahoo.co.in