Causes of Stress in Healthcare and How to Cope
The journal article The Prevalence of Compassion Fatigue and Burnout among Healthcare Professionals in Intensive Care Units: A Systematic Review by Margo van Mol, Erwin Kompanje, Dominique Benoit, Jan Bakker, and Marjan Nijkamp is a review article regarding the topic of stress and caregiver burnout as well as its causes and coping solutions. The article purpose is to raise public awareness on recognizing occupational stressors as well as regulating the stress response to prevent detrimental consequences of emotional distress.
The topic of widespread stress and burnout among healthcare professionals, particularly ICU professionals, is an important topic to be addressed because the consequences of the wellbeing and burnout of a caregiver are associated with patient safety issues. Two research studies out of 40 selected publications, including over 14,000 participants, reported that compassion fatigue was predominant in 40 percent of intensive care unit (ICU) professional study participants, and burnout was reported up to 70 percent of research participants (Van Mol, Kompanje, Benoit, Bakker, & Nikkamp, 2015).
The vast prevalence of this issue indicates that the problem must be addressed through institutional intervention in order to provide an efficient platform that renders quality patient care.
First, the article provides a recap of stress factors including a feeling of a lack of professional achievement, depersonalization of the profession, and the compassion fatigue due to the daily exposure to traumatic and distressing situations of patients. Common stressors in the healthcare profession include emotional exhaustion, perceptions of inadequate professional achievement, and lack of individual recognition within the profession (Van Mol et al.
, 2015). The review article reveals additional research studies that validate that common stressors in the healthcare field include the number of hours of work, the salary that does not correlate with the weight of job responsibilities, an unsupportive and judgmental atmosphere, including threats of employment termination, professional liability issues, and the hierarchical nature of the organization structure (Van Mol et al., 2015). Other causes of stress cited by nurses include the unmanageable patient to nurse ratio, lack of material resources, and poor technical conditions (Van Mol et al., 2015).
Secondly, the article explores the biopsychosocial factors that influence the stress level and stress response mechanisms. For example, the article literature research findings reveal that stress can trigger or exacerbate physical symptoms, such as headaches, sleep disturbances, lower back pain, and gastric ulcers, as well as mental symptoms, including irritability, reduced concentration, and feelings of depression (Van Mol et al., 2015). Excessive occupational stress can lead to behaviors of withdrawal such as poor attendance and a rusting of skills if the employee quits his or her job prematurely (Val Mol et al., 2015). Emotional burnout can lead to decreased concentration and clarity, leading to potential errors that may jeopardize the quality of care given to patients as well as the therapeutic communication patterns between the caregiver and patient or patient families.
Thirdly, preventive measures to occupational burnout with the overall purpose of ensuring patient safety include improving communication skills with the patients and families to reduce conflict or misunderstanding, implementing stress management sessions to staff to increase self-awareness, and teaching meditation techniques to healthcare professionals. Coping mechanisms for stress and burnout in the healthcare community include changing work schedules that fits the healthcare worker, offering classes on coping with occupational stress, expanding communication skills, and implementing relaxation techniques (Van Mol et al., 2015). The authors conclusion is that stress and burnout is epidemic in the healthcare professional community and that it is essential to use social and personal resources to cope with stress on a both physiological and psychological level in order to maximize professional effectiveness and build rapport with patients (Van Mol et al., 2015). Although these literature findings have been published, healthcare institutions are yet to implement these theoretical findings into practice, particularly in intensive care unit settings.
The content on the effects of stress on the brain structure and function covered in the review article is consistent with that of the course reading. According to the review article, compassion fatigue is defined as a state of physical or psychological distress in caregivers induced by firsthand or secondary traumatic stress (STS) resulting from prolonged involvement with a traumatized person (Van Mol et al., 2015). This definition goes hand in hand with the textbook definition of distress, or stress that adversely affects health and daily functioning (Pinal & Barnes, 2018). Clinical manifestations of Burnout Syndrome include emotions of indifference, hopelessness, pessimism, boredom, and disorientation, and a loss of focus (Van Mol et al., 2015). When the demands of the profession exceed the resources available, stress is triggered, and the sensory overload can result in confusion and a lack of organization and clarity. The issue of the adverse effects of stress in terms of the quality of performance of job-related tasks is further expanded in the textbook on the chapter titled Biopsychology of Emotion, Stress, and Health in the context of the long-term physiological reaction to stressors (Pinal & Barnes, 2018). Physiologically, stress causes a decrease in dendritic branching necessary for neural synapse and fluidity of brain function (Pinal & Barnes, 2018). Gray matter in the prefrontal cortex of the brain is responsible for decision-making and problem-solving, whereas the white matter is made of fatty white myelin sheath composed of axons that send signals to regions in the brain to communicate information. Chronic stress results in overproduction of myelin that can cause permanent chemical imbalance in the gray and white matter of the brain. Stress also decreases the regeneration of nerve cells to replace old ones to maintain optimal function, thereby impacting performance within the job (Pinal & Barnes, 2018). That is, a socially stressful incident can destroy the new neurons in the brains hippocampus, the site of neurogenesis associated with memory, emotion, and learning. Consequently, stress can result in shrinkage in parts of the brain that regulate emotions, memory, and metabolism. The potential behavioral manifestations of these physiological changes are emotional outbursts and increased medical errors due to lapses in memory. While research has shown that mild stress tends to improve memory to an extent, excessive long-term stress can result in impaired judgment, decreased concentration or focus, and decreased memory as a result of fatigue and sensory overload. Furthermore, cytokines released as a reaction to stressors, such as infection or disease, causes an inflammatory response (Pinal & Barnes, 2015). While the short-term release of cytokines can strengthen the bodys immune system against infection, long-term release of cytokines can lead to diseases such as major depression, posttraumatic stress disorder, and cancer (Pinal & Barnes, 2018). The MyPsychLab activity video on the topic of stress discusses coping mechanisms of stress, including meditation, focusing on the sensation of breathing and the present moment, and adopting a nonjudgmental approach towards the surrounding environment. These suggestions are parallel to the recommendations for coping with stress in the article, including relaxation techniques, staff educational seminars on stress management, as well as a focus on improvement in communication patterns through using an open-minded approach to situations.
In conclusion, the article titled The Prevalence of Compassion Fatigue and Burnout among Healthcare Professionals in Intensive Care Units: A Systematic Review is an evaluation of literature that probes into the pervasive biopsychosocial phenomena of compassion fatigue, burnout, and secondary traumatic stress in the intensive care unit healthcare community. Effects of emotional distress include both physical and psychological manifestations. Physical symptoms include headaches, disruptions in sleeping patterns, low back pain, and stomach ulcers, whereas psychological symptoms include feelings of depression, decreased concentration, impaired judgment, and irritability. Preventive strategies include a change in work schedule, educational programs for stress management, therapeutic communication skill development, and relaxation techniques. By effectively identifying the triggers and causes of stress, one can apply appropriate measures to successfully manage the response to inevitable stressors in the workplace as well as reset both ones lifestyle and mindset to minimize stressful situations. Ultimately, the goal of stress management is to ensure patient safety and quality of care through addressing the impediment of occupational stress in the healthcare professional.
Pinal, J. & Barnes, S. (2018). Biopsychology Tenth Edition. New York: Pearson.
Van Mol, M., Kompanje, E., Benoit, D., Bakker, J., and Nijkamp, M (2015). The Prevalence of
Compassion Fatigue and Burnout among Healthcare Professionals in Intensive Care Units: A Systematic Review. Retrieved from