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Healthcare Wide Hazards

Stress in the Workplace
Stress in the Workplace.
Potential Hazard

Hospital work often requires coping with some of the most stressful situations found in any workplace. Hospital workers must deal with life-threatening injuries and illnesses complicated by overwork, understaffing, tight schedules, paperwork, intricate or malfunctioning equipment, complex hierarchies of authority and skills, dependent and demanding patients, and patient deaths; all of these contribute to stress.

Health Effects

Stress has been associated with loss of appetite, ulcers, mental disorder, migraines, difficulty in sleeping, emotional instability, disruption of social and family life, and the increased use of cigarettes, alcohol, and drugs. Stress can also affect worker attitudes and behavior. Some frequently reported consequences of stress among hospital workers are difficulties in communicating with very ill patients, maintaining pleasant relations with coworkers, and judging the seriousness of a potential emergency.

Possible Solutions

Some of the methods that have successfully reduced hospital worker stress and job dissatisfaction include:

  • Educate employees and management about job stress.

  • Address work-related stressors, such as inadequate work space, unreasonable work load, lack of readily available resources, inadequate and unsafe equipment.

  • Establish regular staff meetings and discussions to communicate feelings, gain support, and share innovative ideas.

  • Establish stress management programs.

  • Provide readily available counseling from a nonjudgmental source.

  • Provide flexibility and innovation by supervisors to create alternative job arrangements.

  • Provide adequate staffing.

  • Provide reasonable shift schedules for house staff to allow adequate time for sleep each day.

  • Provide group therapy for staff with particularly difficult professional problems such as dealing with cancer patients, chronic illness, and death.

  • Provide an organized and efficient work environment.

  • Recognize and take action on legitimate complaints regarding overbearing physicians and supervisors.

  • The use of individual approaches such as relaxation exercises and biofeedback to relieve symptoms of stress until the sources are identified and evaluated.

  • Provide frequent in-service educational sessions and other opportunities to improve skills and confidence.

  • Provide more flexibility and worker participation in scheduling (possibly a 10 hr, 4-day workweek).

  • Provide scheduled rotation of unit assignments.

  • Establish programs to address workplace stress, such as: Employee Assistance Programs (EAP), or Organizational Change Programs.

  • An employee assistance program (EAP) can improve the ability of workers to cope with difficult work situations. Stress management programs teach workers about the nature and sources of stress, the effects of stress on health, and personal skills to reduce stress-for example, time management or relaxation exercises.

  • EAPs also provide individual counseling for employees for both work and personal problems.

  • Organizational Change Programs change hospital policies and procedures to reduce organizational sources of stress.

    • This is done by bringing in a consultant to recommend ways to improve working conditions. This approach is the most direct way to reduce stress at work. It involves the identification of stressful aspects of work (e.g., excessive workload, conflicting expectations) and the design of strategies to reduce or eliminate the identified stressors. Some strategies include:

      • Ensure that the workload is in line with workers' capabilities and resources.

      • Design jobs to provide meaning, stimulation, and opportunities for workers to use their skills.

      • Clearly define workers' roles and responsibilities.

      • Give workers opportunities to participate in decisions and actions affecting their jobs.

Additional Information:

  • Stress...At Work. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 99-101, (1999).

  • Stress at Work. National Institute for Occupational Safety and Health (NIOSH) Workplace Safety and Health Topic.

  • Guidelines for Protecting the Safety and Health of Health Care Workers. US Department of Health and Human Services (DHHS), National Institute for Occupational Safety and Health (NIOSH) Publication No. 88-119, (1988, September).

  • Stress. Worksafe, Department of Commerce, Western Australia.

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