Work-Related Stress and Burnout Reality Shock

Objectives Identify 3 causes of stress Recognize the stages of reality shock Identify 3 effective coping mechanisms used to manage stress Identify resources in place specific to INTEGRIS Health

Sources of Stress for the New Graduate Nurse

Reality Shock “ unsettling and/or jarring experience resulting from wide disparity between what was expected and what the real situation turns out to be.”

Reality Shock and New Graduate Nurses New graduates often feel a conflict over professional goals or values and the values and goals in place at work. The work setting goals are often embedded in the culture of the organization.

Stages of Reality Shock: Honeymoon Phase Thrilled with completing school Excited about finally being a nurse High energy euphoria. Wants to become learn everything at once. Excitement that distorts perceptions Frequently short lived

Preceptor’s Role During the “Honeymoon” Harness the new nurse’s enthusiasm for learning new skills and routines by helping the new grad stay grounded. Be realistic without being negative Assist the new employee integrate into the workplace culture

Shock Phase Experiences frustration and disappointment in new role Perceives conflicting values between school and work General negativity about role.

Warning Signs of Stress Apathy Anxiety Irritability Reacting in the extreme Smoking/drinking Eating “comfort foods” Tardiness or absenteeism Chronic ailments or repeated bouts of illness Relationship problems exhaustion

Effects of Stress Stress is assessed on 4 levels: Environmental Social Physiological Psychological

Preceptor’s Role During Shock Phase Offer support by being a good listener Offer an objective point of view by: acknowledging negative but emphasizing positives Encourage new staff to verbalize ideas for improvement Educate other staff about what to expect in shock phase

Effective Ways to Cope Build a professional identity Engage in the organization Communicate effectively Seek out feedback often Develop a support network Identify a mentor

Ineffective Ways to Cope Abandon professional goals – will eliminate conflict, but leaves you dissatisfied Give up professional ideals Disengage – work for just the paycheck Leave the profession

Recovery Phase Beginning to re-discover a sense of humor Decreased physical signs of stress Increased ability to objectively view work and the environment Can distinguish between effective and ineffective behaviors

Preceptor Role During Recovery Continue to emphasize positive Support the new graduate’s suggestions for improvement Encourage participation in unit-based council, staff meeting, etc.

Unsuccessful Recovery Job hopping Limited involvement with co-workers and the organization Complain but rarely offer suggestions and refuse to help solve problems

Burnout The ultimate end of job related stress Often attributed to the nurse’s inability to deliver what is perceived as ideal care.

Beating Burnout A-B-C’s of Stress management Awareness – be honest when signs appear Belief – help new graduates develop confidence in their abilities Commitment – be committed to helping the new graduate recognize and reduce stress Don’t forget your own stress!

Physical Health Management Get plenty of sleep Take breaks Practice relaxation techniques: deep breaths, stretching Exercise Eat healthy

Mental Health Management Realize that new nurses own their thoughts, attitudes, and values Set realistic expectations Laugh Provide social support

Resolution Phase Seeing a resolution to previous conflicts Understands and/or accepts role in both the work environment and workplace culture Behavior appropriate for situation

Traditional View of Conflict Conflict is BAD It’s adversarial It’s a Win – Lose proposition: if I win, you have to lose and if you win I have lost

Why Do people Fall Into the Conflict Mode?

What’s Really Behind Conflict Fear Differences in values and beliefs Differences over facts Differing view of the priorities Differences over methods Competition for resources Competition for power Simple misunderstanding (poor communication)

What are your options?

Practice Good communication Skills Be positive Be direct, but non confrontational Have access to facts Be aware of body language, tone of voice, eye contact Use appropriate timing Let the person know that you share the same goal.

Dealing with Difficulty Remember that the only one you can change is you; you can become the “skilled” person Become Confident, remain Calm, be Comfortable Act or respond rather than react

Diffusing Anger

Prepare an Effective Response “Time out!. I hear what you are saying, but you need to slow down.” “ Give me a chance to respond. This is what I hear you saying.” I need to interrupt you to let you know that yelling is distracting, and makes it hard for me to listen to your information,’

The single best anger diffusing technique: Apologize! ……..even if you are not sure you did what the other person thinks you did, it can diffuse the situation. When emotions aren’t high, you can approach that person to work on a solution.