Healthcare professionals should take steps to manage their stress and prevent it from negatively affecting job performance, emotional well-being and health.
Krystal M. Lewis, PhD, explains how stress affects the body and shares insights on how healthcare professionals can manage the stress they experience in their professional and personal lives.
Q: What is stress and how does it affect the body?
A: Stress is a normal part of life. There are two different types of stress: acute stress, which is short-term, and chronic stress, which occurs over time. Stress can become a chronic condition if left unchecked. Both types of stress involve physical, mental, and emotional responses to stimuli that require change or adjustment. These responses can be triggered by changes in the immediate environment, such as loud or alarming noises, aggressive behavior, perceived threats, or specific thoughts related to the stressors—for example, if you feel like you can’t handle the situation, fear negative outcomes, or fear the unknown. The body’s defenses kick in to protect against the threat.
Stress causes the body to flood the bloodstream with hormones, such as cortisol, epinephrine, and norepinephrine. These hormones prepare the body to escape or confront danger through specific reactions, such as increased blood pressure, changes in muscles, increased heart rate, and increased breathing. This is often referred to as the fight-or-flight response.
There are positive aspects to our bodies being in this state of alertness. We are more alert and ready to respond, and more engaged in the present moment. As a result, stress can help improve overall performance. But there is a sweet spot for determining what level of stress is good for you. How you respond to the challenges of situations will determine the effects of stress on your overall health.
Q: What are the symptoms of unrelieved or chronic stress?
A: Stress is experienced differently by each person, but there are general symptoms. The physical effects of chronic stress include becoming hot or sweating a lot, body aches, headaches or stomachaches, pain in the extremities that feels like they are tingling or having muscle spasms. Some emotional reactions may include feeling irritable or suddenly angry, fatigued, restless, sad or anxious. Neurological changes include difficulty concentrating and forgetfulness. Stress-related behaviors may include having more outbursts or using drugs and alcohol, changes in appetite, crying and other behaviors that show you are feeling stress. Feelings of stress and the impact on overall health tend to increase in tandem with the number of stressors experienced.
Q: What are the main triggers of stress?
A: Common sources of stress are routine personal experiences or major life events, such as moving or getting married, relationship events, pregnancy, miscarriage, death—many of the different things we can experience.
Stress can also be a result of systemic problems, such as inequality in the socioeconomic determinants of health. This can mean living in poverty or lacking basic resources such as food or shelter, not having access to adequate health care, and generally experiencing racism or unfair treatment. Some people suffer chronic stress after an accident, abuse, or some other life-threatening experience.
Q: What additional stressors do healthcare professionals face?
A: Working in healthcare can be physically and emotionally demanding in normal times, and even more so during a public health crisis. In addition to caring for patients with complex health conditions, healthcare professionals may have limited access to adequate equipment, funding challenges, difficulties in interpersonal relationships with colleagues, and inadequately staffed workplaces, requiring them to work long hours. There is also the risk of exposure to infectious and hazardous substances. And, more generally, there is the stress of dealing with patients who are very sick and possibly dying.
Not only do healthcare professionals have to worry about their patients and work issues, they are also human beings and can experience stress in their personal lives. The result is that they may experience some of the same adverse effects of stress as other people.
Q: Why is it important for healthcare professionals to monitor their stress levels?
A: For assistants in any profession, but especially in healthcare, it is extremely important to manage stress levels as they can negatively impact decision-making ability, reduce overall performance and contribute to errors. The more overwhelmed and anxious we feel, the less likely we are to have access to the prefrontal cortex, which is the area of the brain that supports rational thinking, problem-solving and decision-making. If we are feeling stressed, if we are in a constant state of alert and anxiety, the sympathetic nervous system is activated, which causes the flood of physical symptoms I mentioned earlier. These affect the ability to act rationally and logically, which in turn affects our ability to make good decisions.
Q: What strategies can healthcare professionals use to manage their stress levels?
A: Start by simply being aware of the physical and emotional signs of stress. Pay attention to how your body is talking to you: if you have physical symptoms, if you feel fatigued or overwhelmed, if your muscles ache, if you get sick more often, or if you are irritable.
It’s important to know your own stress response and address symptoms right away. It’s easy to ignore stress and let things pile up, but that’s counterproductive and can ultimately affect your overall effectiveness. So, it’s best to identify the stressors in your life, learn to take breaks, and manage physical or emotional symptoms.
It’s also important to identify and address conditions that cause stress. This may involve talking to coworkers or management, looking for ways to reduce responsibilities or workload if you feel overwhelmed, or asking for help at home.
Self-care is important. It’s not just about engaging in pleasurable activities, but also about choosing healthy responses to stress. It’s helpful to have a list of healthy, adaptive coping strategies that work for you and help relieve stress. This can be exercise, such as yoga, cooking, and eating a good diet – healthy choices and the occasional sweet treat, too.
Q: How effectively are healthcare professionals managing stress in these stressful times?
A: Some people are very good at setting boundaries when it comes to self-care, but, especially during this pandemic, I’ve seen many more healthcare professionals taking on more tasks than they normally would, working longer hours and overexerting themselves for the good of humanity. In talking to people and seeing my own patients who work in the medical field, I’m aware that many of them are simply burned out. What they’ve lost along the way is the importance of taking care of themselves.
Q: What do you say to health professionals to remind them of the importance of managing stress?
A: It’s like when you fly, in an emergency you have to put on your own oxygen mask before you can help other people. In your workplace, it’s taking those five minutes to sit down somewhere and take a break, making sure you’re resting, or bringing snacks to work to eat properly. Managing stress doesn’t mean you have to take a day off and go to the beach. If you have to be at work, be aware of the little moments you can take for yourself, so you can keep going.
Much of my clinical time is spent developing strategies with patients – what are the small steps they can take to manage their overall stress level and mental health, so that they can continue to help others? I work a lot with people on cognitive restructuring – helping them identify ways of thinking that are not productive and replacing those thoughts with more adaptive and helpful thoughts. For healthcare professionals, there may be times when they focus on how they messed up or feel like they are not doing enough. It is helpful to highlight how this thinking affects how they feel and their behaviours – when they are stressed, their thoughts are more negative and maybe even anxious. I try to help them identify helpful thought patterns and reflective self-talk, so that they can manage stress a little better and increase their overall self-compassion.
