5. Impact of Stressors on the Worker and Taking Care of Self
Dr Sue Blair MBChB, MFOM
Consultant in Occupational Medicine;
NHS Fife

6. OHSAS NHS Fife’s OH service for 20 years
Small Medium sized Enterprises (SME)
Including various 3rd Sector Organisations
See staff from all job types
Pre-placement
Management referrals
Occupational Medicine for 20 years
NHS based but experience in many industries; 1500 cases a year; 80% are stress-related / neurosis
Context 1 in 3 families have a member suffering; 10% of UK adults will have symptoms in any given week
Understand about what causes occupational stress (and non-occupational stress)
Passionate about individual self care as the best resource available to combat the experience of stress

7. Stress Common Denominator in all Occupations
Prevalent in Caring Professions
Why?
Self Selection?
Empaths?
Experiences?

8. Occupational Stress – a definition
“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.”
‘Exposure to Stress; Occupational Hazards in Hospitals; CDC; NIOSH 2008’

9. We know it’s a stressful job

10. What’s the impact of stress (SAD)?
In one organisation, in a year:
50,000 hours lost to sickness absence in a year
40% is ‘stress, depression, anxiety’
Mixture of work/non work-related
=26 WTE staff off every day of the year across the whole service

11. w/r non -w/r?
MIXED PICTURE

12. In a Fife Organisation
670 days lost in Fife between January ‘15 and December ’15 due to ‘SAD’
= 4 (wte) off work due to SAD every single day in 2015
Majority of the workers were in roles where exposure to Trauma (physical and mental) was a daily occurrence
18% of total sickness absence

13. Occupational Health figures for the same organisation
January ’15 – December ’15 OHSAS received 89 referrals, 82 were seen
28 (34%) were coded as SAD
Of those, 12/28 (42%) were perceived as ‘work-related’ (so most not work-related!)

14. What we see in the worker:
PTSD
Bereavement –type reactions
Depression
Anxiety
Alcohol abuse

15. But also: Burnout / compassion fatigue
Interpersonal relationships/ loss of camaraderie
Anger / irritability / intolerance/ poor resilience
Poor patient experience/ complaints
Feelings of poor management support (perceptions)

16. Impact on: The organisation cost of absenteeism
Colleagues...shift cover, annoyance/ tolerance, extra pressure
Managers...extra work in absence mangt, shift cover
Wife...
Children...
Friends / hobbies...
Finances...

17. And of course:
Clients/ Patients

18. We know it’s a stressful job…what are we doing about it?
Downstream ‘aftercare’
Upstream ‘ prevention or self care’

19. Neuro-science has shown:
Professor of Medicine at Pennsylvania University, Michael Baime and Neuroscientist, Sara Lazar's from Harvard University have done research using brain scans and they have visually amazing representations to show meditation can actually change the size of key regions of our brain, changing how our brain actually works, improving our memory and making us more empathetic, compassionate, and resilient under stress
Her research showed a meditation group (as compared to a relaxation group) saw a significant increase in the density of grey matter in the hippocampus, important for learning and memory, an increase in the density of grey matter in the neural structures responsible for self awareness, compassion and introspection and a decrease in the density of the grey matter in the amygdala – the part of the brain associated for anxiety and stress.
According to Harvard research mindfulness also
Relieves / reduces stress, depression and anxiety
Lowers blood pressure
Improves chronic pain
Improves sleep
Improves resilience / capacity to deal with stressful situations
Improves the ability to form deeper connections with others (camaraderie, support etc)

20. Strong evidence from the UK
Government support: Mindful Nation UK: cited >500 peer reviewed articles on mindfulness and its beneficial effects
Mindfulness All Party Parliamentary Group; October 2015
recommends integration of Mindfulness across the Public Sector in Health/Education/ Workplaces/ Criminal Justice System
NHS based staff mindfulness programmes; helping staff with rumination; sleep disturbance; attendance; supporting colleagues; and having a transformational impact
Unique research project based in Ambulance Service staff in UK – one such pilot project showing sustainable positive benefits

21. Taking care of self
Mind/ body connection

22. Self compassion
Kirsten Neff
self-compassion.org