Dealing with occupational stress in the ED
Tuesday, October 18, 2016
Occupational stress is ubiquitous in the workplace today, and it presents major challenges to health and safety on the jobsite. Emergency departments are notoriously high-pressure environments, but health scientists have never established the specific organizational stressors that affect workers in the ED.
However, a new literature review in Emergency Medical Journal investigated occupational stress in the emergency department.
All doctors, nurses and other healthcare professionals bear the responsibility of affecting the lives, health and well-being of patients and their families with their decisions and judgments. Those working in the ED have the extra burden of making split-second, life-saving decisions several times each day. In this regard, medical professionals in the ED carry an especially high risk for occupational stress.
Increased workloads, human suffering, overtime, shift work and hostile work environments contribute to occupational stress, which is a major hazard for many workers inside the ED. Acute stress from occupational pressure can lead to headaches, gastric upset, sleep disorders and chronic illness. It can also contribute to psychological and behavioral problems that range from anxiety to substance abuse, which increases the risk for poor care for patients.
Another recent study, published in May, explored the effects of occupational stress on nurses' caring behaviors. That study of 246 nurses in Greece found that contact with death, patients and families, conflicts with supervisors, and uncertainty regarding treatments caused high stress.
The researchers found these stresses negatively affected caring behaviors of the nurses, and could negatively affect the physical and mental health of nurses in high-stress occupations. The newer study, however, gives a wider view of occupational stress in the ED.
Researchers from the Sheffield Occupational Health Service and Emergency Department at Northern General Hospital in Sheffield, England, conducted a systematic review of literature examining occupational stress in the ED, its relationship to adverse health outcomes and interventions to alleviate this stress.
The scientists also performed a narrative review of various factors contributing to occupational stress. All articles written in English, Spanish or French were eligible for inclusion in the review. They used a modified version of the Newcastle-Ottawa Scale to grade study quality. In all, 25 full-text articles were eligible for inclusion. Two of the articles were low quality, two were high quality, and the rest were of moderate quality.
Many of the articles discuss high demand and low job control as contributing to occupational stress in the ED. Other studies show how insufficient support in the workplace, poor balance of effort to reward, and organizational injustice play a role in the development of occupational stress in emergency workers.
Only one peer-reviewed journal, which evaluated a stress reduction program in ED workers, even mentioned intervention.
The authors of the study hoped their review would provide a guide to developing interventions targeting the origins of stress in the ED. The review suggests exploring and implementing interventions that give workers more control over their jobs, reduce demand, boost support from managers, improve working relationships and reward workers for their efforts.
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