A biological reaction to any internal or external stimulus that can disturb an organism's homeostasis (a steady state)
stress
2 contingencies that place individuals working in health care organizations at risk of stress and burnout
work structure and workload
[Stress contingency] Differs in health organizations because typically shift-based and non-routine
(staff shortage)
work structure
[Stress contingency] Must multi-task continually as they make decisions and perform job responsibilities (often have urgent consequences); interact with many different stakeholders
workload
[Stress contingency] Caregivers bear witness to the complex array of feelings that patients and their families experience in times of illness
emotional
3 sources of stress in health organizations
role stressors
emotional labor stressors
organizational stressors
5 role stressors
role overload
role conflict
role ambiguity
lack of role control or autonomy
lack of participation in decision making
[Role stressor] Having too many and/or too difficult work responsibilities within a given role; asked to do too much
role overload
Role overload has been identified as a leading cause of ____________ and ________________ among healthcare workers
stress and burnout
[Role stressor] Clash between two or more competing and/or divergent roles; feeling like you are being pulled in different directions
role conflict
[Role stressor] The uncertainty that exists about specific role requirements and expectations (it is not clear what your role is)
role ambiguity
[Role stressor] Due to managed care physicians feel like they do not have role autonomy anymore; can cause stress particularly on physicians because they feel as though they can no longer make the best healthcare decisions
lack of role control or autonomy
[Role stressor] Feeling like you cannot make decisions in an organization
lack of participation in decision making
How feelings can produce significant stress in a health organization; some jobs require you to display a particular emotion
emotional labor
With emotional labor, it is extremely stressful when your displays on the _____________ do NOT match how you are on the ______________
outside; inside
When negative emotions (depression, anger, sadness) spread to others; problem for healthcare providers (ex: caring for a patient that is depressed, can spread to the healthcare provider and compromise their performance)
emotional contagion
2 major organizational stressors
work-life overlap and managed care
Says that inevitably, work lives and social lives will overlap
work-life overlap
3 parts of work-life overlap
work-life spillover
work-life conflict
lack of control over work hours/schedule
In work-life overlap, when aspects of a person's personal life overflow into work life and vice versa
work-life spillover
In work-life overlap, when personal and work interests compete, leading an individual to attempt to balance work and home life responsibilities (spillover becomes negative and we feel pulled in different directions)
work-life conflict
Can create stressors for physicians; much more paperwork, must get permission prior to treatment/recommending a treatment; much more rules to follow in order to keep costs down
(Physicians lack autonomy is making healthcare decisions = which causes stress
managed care
Multidimensional; "wearing out" or "gradual erosion" experienced by a person suffering from long-term and often chronic occupational stress
burnout
3 dimensions/variables to measure burnout
reduced personal accomplishment
depersonalization
emotional exhaustion
[Dimension of burnout] When people believe they cannot make progress in or achieve job responsibilities; leave job at the end of the day feeling worthless and unproductive; causes negative self-esteem
reduced personal accomplishment
[Dimension of burnout] Occurs when you are so burned out, you no longer see people as distinct individuals (become numb to people)
depersonalization
[Dimension of burnout] Most predominant dimension; when a person feels wrung out or used up emotionally because of day-to-day role
emotional exhaustion
Burnout can be recognized in 4 different symptoms/signs
physical, behavioral, emotional, work-related
[Sign of burnout] Twitching, problems sleeping, low energy and weariness, prone to illness
physical
[Sign of burnout] Acting up (not acting normal), dehumanization of patients, reduced communication with colleagues and patients, aggressive interactions with others
behavioral
[Sign of burnout] Outburst of emotion (anger, sadness), depressed mood, apprehensive/worried
emotional
[Sign of burnout] High turnover, late for work, reduced/ineffective job performance, absenteeism (missing work a lot)
work-related
Burnout poses significant threats to caregivers and negatively influences
caregiver communication
The consequences of burnout can have many _____________ and ______________ health problems that affect quality of life
physical and mental
Burnout can effect caregiver communication- making them less _________________ and ________________ to other's needs
empathetic and responsive
There is strong link between burnout and
depression
Burnout has the potential to cause high __________________- which can have large financial costs and human costs
turnover
Illness Low Org ID
Self-esteem Low Productivity
Anxiety Poor performance
Communication deficits Poor quality of care
Depression Absenteeism
Turnover Low Pat. Satis.
Job dissatisfaction
consequences of burnout
Models and theories provide explanations of how the the
social world works
Kathy Miller's Model of Empathy, Communication, and Burnout (1988) gives an explanation for how to ___________ and/or _______________ burnout
prevent; mitigate
As burnout increases, occupational commitment goes _________
As burnout decreases, occupational commitment goes __________
down; up
Being able to say the right thing at the right time, to make someone else feel better
communicative responsiveness
As communicative responsiveness increases, burnout goes ___________ & occupational commitment goes up
down
As communicative responsiveness decreases, burnout goes _________ & occupational commitment goes down
up
As emotional contagion _________________, communicative responsiveness goes down- burnout increases- occupational commitment decreases)
increases
Feeling for (NOT mirroring negative emotions); detached concern, while not allowing negative emotions to spread
empathic concern
According to Miller's model, to decrease burnout you must increase ______________________ and decrease __________________________; and learn how to be more communicatively responsive
empathic concern; emotional contagion
Another way you can decrease burnout is through
social support
Social support =
helpful relationships
Interactions that reduce perceptions of ambiguity and helps foster a sense of control over stressors
socially supportive communication
3 forms of social support
instrumental, informational, emotional
[Form of social support] When someone helps us physically or gives use something tangible (like money or restructuring job tasks); visible assistance
instrumental
[Form of social support] The provision of knowledge, data, advice to reduce and/or buffer a person's stress; advice or knowledge you can give to someone in order to help them
informational
[Form of social support] The display of care and concern in the form of showing encouragement or empathy; communicate affection/caring as a way of helping someone else
emotional
Research shows that _______________ social support is the most effective
emotional
Individuals tend to seek and receive _______________ types of supportive communication simultaneously
multiple
Relationships and social support are important in healthcare organizations because they provide
socially supportive communication
2 major types of relationships that are important for social support in health organizations
supervisor-subordinate and peers
Relationship that is a source of social support- formal reporting structures (ex: nurse manager to staff nurse; dentist to dental hygienist); those in leadership positions often have knowledge that can help their subordinates cope with/manage stress
supervisor-subordinate
Relationship that is a source of social support- (friends, other employees) lateral or parallel relationships between employees that lack a formal reporting authority; others that work in shared organizational setting
peers
2 functions of social support
1. Functions to __________ or ____________ health workers from stress and burnout
2. Functions in helping with or ________________ stress and burnout
buffer or shield; managing
Outcomes of social support
organizational commitment
intent to remain
identification
increased job satisfaction
reduced emotional exhaustion
better job control and performance
As workplace stressors increase - burnout ______________ - work satisfaction variables ________________
increase; decrease
As burnout decreases- _________________________ variables increase
work satisfaction