preventing stress and burnout in employee health ... · burnout a long-term high level of stress...

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Preventing Stress and Preventing Stress and Burnout in Employee Health & Burnout in Employee Health &

Wellness PractitionersWellness Practitioners

The Public Service Employee Health and Wellness Indaba VIThe Public Service Employee Health and Wellness Indaba VIbyby

Rhulani MakhubelaRhulani Makhubela99thth October 2006October 2006

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OutlineOutlineStressStress–– Common stressors for EH & W PractitionersCommon stressors for EH & W Practitioners–– Consequences of stressConsequences of stress

BurnoutBurnout–– Contributing factorsContributing factors–– Symptoms of burnoutSymptoms of burnout–– InterInter--relationship of stress and burnoutrelationship of stress and burnout

Prevention of Stress and BurnoutPrevention of Stress and Burnout–– IndividualIndividual–– GroupGroup–– Organisation Organisation

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Stress Stress

One of the greatest challenges to balancing One of the greatest challenges to balancing work and home life is job demands work and home life is job demands ––demands that include demands that include ““time pressures and time pressures and deadlines, long hours, unclear or conflicting deadlines, long hours, unclear or conflicting duties, having too much responsibility, or duties, having too much responsibility, or work that is too tiring or boringwork that is too tiring or boring””

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Common Stressors for EH&W Common Stressors for EH&W PractitionersPractitioners

Excessively high clients to practitioner ratioExcessively high clients to practitioner ratioLack of time outs for a temporary breatherLack of time outs for a temporary breatherExcessive and continuous direct contact with clientsExcessive and continuous direct contact with clientsLimited access to a socialLimited access to a social--professional support systemprofessional support systemLimited time and place to share personal feelings with Limited time and place to share personal feelings with colleaguescolleaguesInadequate training for working with peopleInadequate training for working with peopleInadequate coping strategiesInadequate coping strategiesRepetitive single tasksRepetitive single tasksProblems without solutionsProblems without solutionsTime pressures and demandsTime pressures and demands

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Consequences of StressConsequences of Stress

Physical:Physical:–– Stress can cause headaches, irritable bowel Stress can cause headaches, irritable bowel

syndrome and diarrhoea, eating disorder, syndrome and diarrhoea, eating disorder, allergies, insomnia, backaches, frequent cold allergies, insomnia, backaches, frequent cold and fatigue to diseases such as hypertension, and fatigue to diseases such as hypertension, asthma, diabetes, heart ailments.asthma, diabetes, heart ailments.

–– It can also affect eating patterns, as well as It can also affect eating patterns, as well as reduce immunity levels, leaving individuals reduce immunity levels, leaving individuals vulnerable to colds and other illnesses.vulnerable to colds and other illnesses.

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Psychological:Psychological:–– tiredness and irritability tiredness and irritability –– reduced quality of work reduced quality of work –– indecisiveness and poor judgement indecisiveness and poor judgement –– loss of sense of humour loss of sense of humour –– poor timekeepingpoor timekeeping–– Other symptoms include; insomnia, loss of mental Other symptoms include; insomnia, loss of mental

concentration, anxiety, absenteeism, depression, concentration, anxiety, absenteeism, depression, substance abuse, extreme anger and frustration, and substance abuse, extreme anger and frustration, and family conflictsfamily conflicts

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Organisational:Organisational:–– a fall in productivitya fall in productivity–– arguments and disputes between staffarguments and disputes between staff-- i.e. poor i.e. poor

workplace relationsworkplace relations–– general absenteeism general absenteeism –– an increase in mistakes which may in turn lead an increase in mistakes which may in turn lead

to more complaints/ more grievances from to more complaints/ more grievances from clientsclients

–– greater staff turnover greater staff turnover

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StressStress

Tackling workTackling work--related stress is essential to related stress is essential to ensure the wellensure the well--being of both employer and being of both employer and employees and safeguard organisational employees and safeguard organisational performanceperformanceWhen stress is NOT addressed, it can lead When stress is NOT addressed, it can lead to burnout and this can have serious to burnout and this can have serious debilitatingdebilitating effectseffects

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BurnoutBurnout

A longA long--term high level of stress can lead to term high level of stress can lead to burnout. Burnout is a descriptive rather than burnout. Burnout is a descriptive rather than a medical term, but when it occurs an a medical term, but when it occurs an individual may experience a variety of individual may experience a variety of symptoms. symptoms. Burnout is a process that occurs when one Burnout is a process that occurs when one perceives a discrepancy between work input perceives a discrepancy between work input and the output that was expected from work.and the output that was expected from work.

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BurnoutBurnout

Burnout is described as the mental and Burnout is described as the mental and physical exhaustion that results from long physical exhaustion that results from long term stress, overwork, and the unhealthy term stress, overwork, and the unhealthy condition of spreading yourself too thin. This condition of spreading yourself too thin. This often happens when demands often exceed often happens when demands often exceed abilities.abilities.

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BurnoutBurnout

There is increasing recognition that workers There is increasing recognition that workers in health and human services fields often in health and human services fields often experience high levels of workexperience high levels of work--related related demands and stressors; and are hence demands and stressors; and are hence particularly vulnerable to the experience of particularly vulnerable to the experience of stress and burnout.stress and burnout.

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BurnoutBurnout

In recent years, burnout has become a well In recent years, burnout has become a well known problem in the human service known problem in the human service professions. A number of researchers have professions. A number of researchers have indicated that burnout is mentally and indicated that burnout is mentally and physically debilitating for workers, costly to physically debilitating for workers, costly to institutions and agencies, and harmful to institutions and agencies, and harmful to clients.clients.

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BurnoutBurnout-- Contributing FactorsContributing Factors

Lack of space and privacy in work environmentLack of space and privacy in work environmentLack of an effective voice in decisions that affect Lack of an effective voice in decisions that affect the practitioners and their workthe practitioners and their workToo little autonomy or responsibilityToo little autonomy or responsibilityLack of scope for initiativeLack of scope for initiativeInadequate training, skills and preparation for the Inadequate training, skills and preparation for the workworkLack of clarity about what the practitioner is Lack of clarity about what the practitioner is expected to doexpected to doLack of referral mechanismsLack of referral mechanismsFear of HIV infectionFear of HIV infection

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Chronic Responsibility SyndromeChronic Responsibility Syndrome

Chronic Responsibility Syndrome is a kind Chronic Responsibility Syndrome is a kind of burnout where people get mentally and of burnout where people get mentally and physically exhausted from their workload. physically exhausted from their workload. The symptom is often described as "there's The symptom is often described as "there's simply too much work to do, and no one simply too much work to do, and no one else can do it but me". Typically it will occur else can do it but me". Typically it will occur in hard working, hard driven people, who in hard working, hard driven people, who become emotionally, psychologically or become emotionally, psychologically or physically exhaustedphysically exhausted

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Chronic Responsibility SyndromeChronic Responsibility Syndrome

“Of course, we are good, hard working and intelligent and they are a bad, ugly bunch of idiots!”

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BurnoutBurnout

Strong sense of commitmentStrong sense of commitmentHigh work demandsHigh work demandsLack of supportLack of supportLimited resourcesLimited resourcesClientClient--related issuesrelated issuesBoredom/overworkedBoredom/overworked

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Symptoms of BurnoutSymptoms of Burnout

Physical SymptomsPhysical Symptoms–– HeadachesHeadaches–– Digestive problemsDigestive problems–– Sleep deprivationSleep deprivation–– HeartburnHeartburn–– Chronic back painChronic back pain–– Other muscle tensions Other muscle tensions –– Loss of appetiteLoss of appetite–– Weight gain Weight gain

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Symptoms of BurnoutSymptoms of BurnoutEmotional SymptomsEmotional Symptoms–– DepressionDepression–– Increased angerIncreased anger–– Emotional exhaustionEmotional exhaustion–– FatigueFatigue–– Increased anxietyIncreased anxiety–– Preoccupation with death and dyingPreoccupation with death and dying–– Low selfLow self--esteemesteem–– ApathyApathy–– Isolation and withdrawalIsolation and withdrawal–– Memory lossMemory loss

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InterInter--relationshiprelationship

Stress

Burnout

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Prevention of Stress & BurnoutPrevention of Stress & Burnout

Three Levels identified:Three Levels identified:Individual

GroupOrganisation

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VisionVision

To be world class Employee Health & To be world class Employee Health & Wellness Practitioners with service delivery Wellness Practitioners with service delivery excellence where people can attain a excellence where people can attain a balanced quality of life and find reward in all balanced quality of life and find reward in all our services.our services.

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ThereforeTherefore

If we are to achieve this vision, we need to If we are to achieve this vision, we need to work very hard to avoid burnout, increase work very hard to avoid burnout, increase job satisfaction, and provide quality services job satisfaction, and provide quality services to clients.to clients.This will positively impact on organisational This will positively impact on organisational effectiveness and thereby improving service effectiveness and thereby improving service delivery.delivery.

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IndividualIndividualA Practitioner needs to stay sharp, sensitive, inA Practitioner needs to stay sharp, sensitive, in--tune, and responsive. tune, and responsive. Individual therapy, like a support group, provides Individual therapy, like a support group, provides an antidote to isolation, loss of meaning or an antidote to isolation, loss of meaning or autonomy, or low selfautonomy, or low self--esteem.esteem.Practitioners will find it useful to attend to their Practitioners will find it useful to attend to their emotional lives through their own therapyemotional lives through their own therapyTherapy should not be seen as a red flag, but Therapy should not be seen as a red flag, but rather as a resource for staying centered and rather as a resource for staying centered and connected to the self, enabling one to relate to connected to the self, enabling one to relate to his/her clients with more empathy and insight.his/her clients with more empathy and insight.

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IndividualIndividual

NonNon--Professional Activities e.g. relaxation Professional Activities e.g. relaxation techniques techniques Practitioners may benefit from reserving significant Practitioners may benefit from reserving significant time for activities such as: time for activities such as: –– sports, meditation, films, reading, or attending theatre. sports, meditation, films, reading, or attending theatre.

Vacations that are not related to professional Vacations that are not related to professional activities should be scheduled, whether these will activities should be scheduled, whether these will be taken with the family, with friends, or alone.be taken with the family, with friends, or alone.Personal relationships with people outside the field Personal relationships with people outside the field are part of an essential nonare part of an essential non--therapy focus. therapy focus.

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GroupGroupGroups offer the opportunity for practitioners Groups offer the opportunity for practitioners to learn more about selfto learn more about self--care and to engage care and to engage in meaningful interaction with others.in meaningful interaction with others.Discussing cases with colleagues will bring Discussing cases with colleagues will bring different perspective to the intervention.different perspective to the intervention.Attending workshops would broaden the Attending workshops would broaden the knowledge base and improve approach to knowledge base and improve approach to internvention.internvention.

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GroupGroup

Group venting and sharing, with Group venting and sharing, with professional orchestration, both challenges professional orchestration, both challenges and facilitates individuals and systems to and facilitates individuals and systems to grapple with the difficult cases.grapple with the difficult cases.Productive and efficient sharing of Productive and efficient sharing of information and ideas is criticalinformation and ideas is critical-- this this includes sharing information about new includes sharing information about new developments in the field and also serving developments in the field and also serving as a group supervision session.as a group supervision session.

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Learn to appreciate feedbackLearn to appreciate feedback

Feedback is very important for personal and Feedback is very important for personal and professional growth; being defensive robs professional growth; being defensive robs one of an opportunity for selfone of an opportunity for self--exploration!exploration!

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OrganisationalOrganisational

Carrying out a stress audit is one of the best Carrying out a stress audit is one of the best ways to find out whether stress is a problem ways to find out whether stress is a problem among EH & W practitioners.among EH & W practitioners.A stress audit involves talking to staff A stress audit involves talking to staff ––either individually or in groups either individually or in groups –– to find out to find out where there may be problems. where there may be problems. Conversations can be relatively informalConversations can be relatively informal

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Comprehensive employeeComprehensive employee--support networksupport networkCreate an atmosphere that promotes health Create an atmosphere that promotes health among EH & W practitioners.among EH & W practitioners.Create job diversity to avoid performing repetitive Create job diversity to avoid performing repetitive taskstasksKeep EH & W practitioners involved. Keep EH & W practitioners involved. Recognise and reward EH & W practitioners for Recognise and reward EH & W practitioners for their accomplishments and contributions.their accomplishments and contributions.Stress management is not a luxury.Stress management is not a luxury.

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Strengthening the capacity of the individual Strengthening the capacity of the individual to cope with the duties and responsibilities to cope with the duties and responsibilities of the role.of the role.Ensuring that the working conditions, Ensuring that the working conditions, practices and policies of care programmes practices and policies of care programmes offer a supportive environment to offer a supportive environment to practitioners and are not causes of stress in practitioners and are not causes of stress in themselves.themselves.

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Operational Performance Operational Performance –– looking at the looking at the knowledge & skills of EH & W Practitionersknowledge & skills of EH & W PractitionersProject PerformanceProject Performance-- identifying which projects identifying which projects can be rendered.can be rendered.Risk & ComplianceRisk & Compliance-- issues of ethical compliance.issues of ethical compliance.Talent ManagementTalent Management-- further development of further development of Practitioners, attracting and retaining talented Practitioners, attracting and retaining talented practitioners.practitioners.Financial PerformanceFinancial Performance-- Return on InvestmentReturn on Investment

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MentoringMentoring

One way to decrease isolation and to enhance One way to decrease isolation and to enhance overall supportiveness is to engage in mentoring. overall supportiveness is to engage in mentoring. It makes us feel good to offer our support and the It makes us feel good to offer our support and the wisdom we've gained to those with less wisdom we've gained to those with less experience.experience.Even seasoned professionals will sometimes Even seasoned professionals will sometimes benefit from being mentored. The complexity of benefit from being mentored. The complexity of clients and the problems they face can be clients and the problems they face can be enormous. Having a trusted mentor for peer enormous. Having a trusted mentor for peer review can greatly enhance overall satisfaction review can greatly enhance overall satisfaction and confidence in own job performance. and confidence in own job performance.

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Approach to PreventionApproach to Prevention

EH & W PractitionerEH & W Practitioner Group SupervisionIndividualActivities

Organisational Support

Mentoring

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ConclusionConclusionThe most encompassing way to think about avoiding burnout is The most encompassing way to think about avoiding burnout is through creating a balance in one's life.through creating a balance in one's life.BBe aware of the effects that stress may have upon you.e aware of the effects that stress may have upon you.AAdjust work in order to get time to fulfil your personal and profdjust work in order to get time to fulfil your personal and professional essional commitments as well. commitments as well. LLaugh! A sense of humour plays an important role in relieving straugh! A sense of humour plays an important role in relieving stress.ess.AAttend workshops or other programmes you might not have previouslttend workshops or other programmes you might not have previously y considered going to and absorb information to enhance your considered going to and absorb information to enhance your communication and management skills. communication and management skills. NNutrition, exercise, meditation and yoga can help you maintain/obutrition, exercise, meditation and yoga can help you maintain/obtain tain good health, and provide an outlet for stress.good health, and provide an outlet for stress.CCommunicating effectively with staff members, colleagues, clientsommunicating effectively with staff members, colleagues, clients, , family members and friends can decrease stress in your life.family members and friends can decrease stress in your life.EEstablish a support system if you are feeling stressed or burned stablish a support system if you are feeling stressed or burned outout

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