STRESS COMPASSION FATIGUE BURNOUT Health Care Stress Workshop March 30,

Task 1 Create a consensus definition of “burnout” in health care professionals working with residents who have Alzheimer’s disease and related dementias? Work with the people around you and be prepared to present your definition to other participants in the workshop. 2

Task 2 Compare the definition that you created with those of other participants and with the definition described by the workshop leader. 3

Burnout A syndrome linked to the emotional strains experienced at work. The most widely accepted conceptualization originates from the work of Maslach and Jackson (1986). An ongoing emotional state, typically characterized by the three dimensions of emotional exhaustion, depersonalization and reduced personal accomplishment. 4

FEELINGS OF BEING EMOTIONALLY OVERWHELMED AT WORK AND HAVING DEPLETED ENERGY LEVELS Emotional Exhaustion 5

A MECHANISM WHICH DEVELOPS IN ORDER TO ENABLE A PERSON TO COPE WITH THE EMOTIONAL EXHAUSTION. THUS, THE HELPING PROFESSIONAL DEVELOPS NEGATIVE AND INDIFFERENT ATTITUDES TOWARDS THOSE THEY CARE FOR. Depersonalization 6

A DECLINE IN FEELINGS OF COMPETENCE AND PERSONAL ACHIEVEMENT Reduced Personal Accomplishment 7

WHAT IS IT? 8 Compassion Fatigue

9 Caring too much can hurt. When caregivers focus on others without practicing self-care, destructive behaviors can surface. Apathy, isolation, bottled up emotions and substance abuse head a long list of symptoms associated with the secondary traumatic stress disorder now labeled: Compassion Fatigue

Task 3 List the most common situations that are associated with stress when working with residents with dementia and their families. Work with the people around you and be prepared to present your list to other participants in the workshop. 10

Task 4 Compare the list that you created with those of other participants and with the list provided by the workshop leader. 11

Workplace Stress The National Institute for Occupational Safety and Health (NIOSH) defines workplace stress as "the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the worker." 12

13

Job Stressors (general) Job or task demands (work load, task control, role ambiguity) Organizational factors (interpersonal relations, management practices) Financial and economic factors Conflict between work and family roles and responsibilities Training and career development issues (opportunity for growth or promotion) Organizational climate (management commitment to core values, communication styles, etc.) 14

Common Stressors for HCWs Inadequate staffing levels Long work hours Shift work Role ambiguity Exposure to infectious and hazardous substances 15

Studies on Nurse Stress - 1 Work overload Time pressure Lack of social support at work (especially from supervisors, head nurses, and higher management) Exposure to infectious diseases Needle stick injuries 16

Studies on Nurse Stress - 2 Exposure to work-related violence or threats Sleep deprivation Role ambiguity and conflict Understaffing Career development issues Dealing with difficult or seriously ill patients 17

Task 5 List the approaches that you currently use to cope with the stresses of working with residents with dementia and their families. Work with the people around you and be prepared to present your list to other participants in the workshop. 18

Task 6 Compare the list that you created with those of other participants and with the list provided by the workshop leader. 19

ORGANIZATIONAL CHANGE INTERVENTION AND STRESS MANAGEMENT INTERVENTION How can stress be controlled in the workplace? 20

Organizational Change Intervention Ensure that workload in line with workers’ capabilities and resources Clearly define workers’ roles and responsibilities Give workers opportunities to participate in decisions and actions affecting their jobs Improve communication Reduce uncertainty about career development and future employment prospects Provide opportunities for social interaction among workers 21

Common Characteristics of Successful Organizational Interventions Involving workers at all stages of the intervention Providing workers with the authority to develop, implement, and evaluate the intervention Significant commitment from top management and buy-in from middle management An organizational culture that supports stress interventions Periodic evaluations of the stress intervention 22

Worker-focused interventions may include one or more of the following: Training in coping strategies Progressive relaxation Biofeedback Cognitive-behavioral techniques Time management Interpersonal skills Stress Management Intervention 23

24

Also… Another type of intervention that has shown promise for reducing stress among health care workers is innovative coping, or the development and application by workers of strategies like changes in work methods or skill development to reduce excessive demands. 25

26