Wellness for Managers Avoiding Burn Out: Costs, Implications and Preventions

Wellness for Managers Avoiding Burn Out
Costs, Implications and Preventions

M. Ron Eslinger, CAPT,USN, Retired,
CRNA, APN, MA, BCH,
Healthy Visions Wellness Center
Oak Ridge, TN
www.eslinger.net

It all depends on how we look at things and not how they are themselves. – Carl Jung
In this simple statement we can surmise that our perceptions are truths that our minds and bodies respond to. We determine our perceptions by choice. However, choices are influenced by past experiences so therefore our reality is either corrupted or enhanced by our thoughts of past experiences. There fore, by controlling our thoughts we control over our body’s response to stress and wellness. The purpose of this presentation is to explore nursing and management in the following list and outline ways to decrease stress and promote wellness in order to create a healthy work environment.

The most stressful jobs
1. Teaching
2. Nursing
3. Management
4. Other professionals
5. Social workers
6. Road transport
7. Police and prison officers
Source: HSE

Hidden Cost of Stress
Annually, $26 billion are paid out in disability claims related to stress. Other conditions that result from occupational stress incur health care costs that are compounded by the cost of lost work time.

• 4% of all work hours are lost to absenteeism, which costs millions of dollars annually.
• Heart disease is related to the loss of 135 million workdays each year.
• Alcoholism costs U.S. industry approximately $20 billion each year.
• Mental illnesses such as depression -- which can result from workplace stress -- cost the U.S. economy about $30 million each year.

Absenteeism According to the American Stress Institute, “Stress is America’s number 1 health problem.” Stress may be singularly responsible for loss of productivity in the workplace today. Last year the American workforce lost 550,000,000 days to absenteeism. On an average workday, an estimated one million workers do not make it to work due to stress.

Job Stress
It is estimated that job stress cost Americans more than $300 billion annually due to diminished productivity, absenteeism, and employee turnover, medical, legal and insurance fees. It is also projected that 60 to 80% of all work related accidents are due to stress. Some of the most noted e.g., the Three Mile Island nuclear incident and the Exxon Valdez oil disaster have cost billions in clean up efforts alone, to say nothing of the devastating environmental damage. 40% of worker turnover is due to stress alone and last year employers spent more than $150 billion in worker compensation claims.

Illness
• The average back and neck pain case costs business and industry $24,000 annually.
• Up to 90% of all visits to primary care physicians are for stress-related complaints.
• Up to 80% of industrial accidents are due to stress.
• Over 50% of lost work days are stress-related.
• 14% of all workers say stress caused them to quit or change jobs in the previous two years.

Other Hidden Cost of Stress
Perhaps the biggest cost of occupational stress, and the one, which is most difficult to calculate, is the effect of errors made by workers who are impaired but still working. The industrial accidents caused by on-the-job stress -- which account for 75-85% of all accidents, are estimated to cost American companies $32 billion annually. While other estimates suggest that annually over 2 million workers suffer disabling injuries, and 15,000 people lose their lives, due to work-related accidents.

Toni Knott, MS, CSPP-Fresno, “Health and Executive Magazine,” claims 6.5 million sick days are being taken every year as a result of stress.

STRESS REDUCTION
Introduction Why participate in a stress management program?
1. You will feel and look better
2. You will think more clearly
3. You’ll be less irritable
4. You’ll get more positive recognition
5. You’ll accomplish more
6. You’ll sense inner peace
7. You’ll become more patient
8. You’ll be more promotable
9. You’ll sleep better
10. You’ll contribute to others’ well being

The number one cause of stress. Stress is any change that you must adapt to. CHANGE – Change is constant which means stress is constant so the way one adapts is the measure of good and/or bad stress. What type of changes have you experienced over the last 24 months? Your experiences come from four basic sources:

1. Environmental Stressors
2. Social Stressors
3. Physiological Stressors
4. Your thoughts

Thoughts become reality so therefore stinking thinking, toxic tongues all words words become things so you can be hung by the tongue or savedby the tongue because you are what you think you are.

Internal Causes of stress and burn out
• Emotions
• Decisions
• Chemical
• Physical

External Causes of stress and burn out
• Family situations
• Dealing with others
• Social or status change
• Environment and surroundings
• Work

How stress affects the body. Blood pressure; sleep habits, nervousness, and confusion. Whenever our bodies are stressed – whether the stress is real or imagined – our brains take over and respond. Stress, by the way, can come in many forms: an impending deadline, an inability to complete your work tasks, or even a verbal lashing from another person. Yet, the physiological response is basically the same.

Stressors are perceived by BRAIN, which activates the ADRENAL GLANDS, which release Adrenaline-related hormones into BLOODSTREAM

THE BODY RESPONDS TO STRESS with:
• Increased heart rate
• Elevated blood pressure
• Increased breathing rate (rapid and shallow)
• Release of stored energy from liver into bloodstream
• Dilation of pupils to let in more light
• Heightening of senses
• Tensing of muscles for movement or protection
• Shutdown of digestive processes; blood diverted to muscles and brain
• Constriction of blood flow to extremities
• Perspiring

How stress reduction works:
It changes our perception. By changing the way we perceive a given situation, we change the way we respond to it. Changing perception does not mean that the problem is not real, but it does mean we take control of how a tragedy affects us. Every behavior is reward driven, even if the reward is negative. Therefore, one must find the WIIFM – What’s in it for me reward in order to have the motivation to change a behavior.

Setting boundaries: When dealing with the sexes women like to talk about their problems which are OK and allows them to flush their system of the frustrations that accompany these stressors. That is until they tell the problem to a man, usually their spouse. Unfortunately men are blessed with the fixit syndrome. So they before the story is even completed are already in the fixit mode, which now adds to the stressor and frustration to the female/spouse. A double bind has been created – she wants to talk about the problem. He wants to fix it. Now her stress is magnified because she didn’t wanted fixed in the first place and he is now frustrated because he can’t figure out why she told him if she didn’t want it fixed.

So think about this: If you consider how hard it is to change yourself. Then you must consider how hard it is to change others or to fix their problems. Just listening is a wonderful gift that few possess.
In Summery - the following is a great way to start reduction reducing your stress

Ten Ways to Cut Down on Stress
1. Talk it out. Get support from family and friends.
2. Exercise regularly.
3. Avoid false guilt.
4. Set realistic goals and priorities.
5. Avoid perfectionism.
6. Keep a sense of humor.
7. Hang loose. Set aside idle time to relax every day.
8. Live by the calendar, not the stopwatch.
9. Avoid overindulging in drugs, alcohol, caffeine, and nicotine.
10. Think positively

The five steps for stress reduction.
1. Progressive relaxation.
2. Create a positive visualization.
3. Create kinesthetic sensations that go along with the visualization.
4. Establish a positive anchor to hold on to the relaxed, positive sensations.
5. Rehearse using the anchor.

Everyone experiences relaxation differently. The key is to relax to the best of your ability at this moment in time. List some of the items that might enhance, or interfere with relaxation.
How to enhance the relaxation response

• Quiet place
• Positive self talk
• Biorhythmic music
• Day dreaming
• Taking a walk References: "Employee Burnout:America's Newest Epidemic" (Northwestern National Life);
  "Job Stress: The 20th Century Disease" (UN International Labor Organization);
  "Mitchum Report on Stress in the '90's."
  
  Proper abdominal breathing. Which very few people know how to do. Rather than thinking about taking a deep breath which usually expresses itself as throwing out the chest, lifting the shoulders and tensing the neck. This is a very tense and pain producing way to take a deep breath.
  
  Do this: Blow your stomach out like blowing up a balloon. This will drop the diaphragm down and automatically pull into the lungs a deep breath. This will get more air into the two lower lobes of the lungs. The two lower lobes of the lungs are highly vascular and will get more oxygen into the cells of the body, which greatly helps decrease stress.
  The importance of practicing once or twice a day.
  
  Self-talk affects stress. To create a positive affirmation the following are necessary and examples are given.
  The affirmation must be:
  
• Realistic
• Believable
• Measurable
• Positive
• Presence tense
• Rewardable
• Simple EXERCISE Exercise is the most widely recommended form of treatment for relieving the effects of stress and depression. Exercise increases endorphin release along with melatonin and serotonin production. It helps level out blood glucose and focuses the attention to create a meditative hypnotic state some call getting in the zone. Exercise helps us sleep better in itself creates a more relaxed being.
  
  Listed are some statements from prominent publications:
  
  THINK STRESS CONTROL
  Skipping breakfast is a bad idea. Starting your day on an empty stomach results in DECREASED ATTENTION and POOR PERFORMANCE. Even if your breakfast consists of something sweet or fatty, which is common, it can still help you get a better start on your workday. It is also true that breakfast eaters are leaner, have lower blood pressure, eat less throughout the day, and are in better health than those who skip the most important meal of the day.
  SOURCE: NEW ENGLAND JOURNAL OF MEDICINE
  
  People who begin weight training in their 40’s and 50’s can be stronger at 60 than they were at 20. A physically fit middle-age person can have more strength and endurance than a 25 year old.
  SOURCE: CHICAGO TRIBUNE
  
  One new study found that regular workouts during middle age could halve the risk of colon cancer.
  SOURCE: JOURNAL OF NATIONAL CANCER INSTITUTE
  
  Scientists have now proven a link between stress and illness. Being under stress and feeling a loss of control can almost double your chances of catching a cold by lowering your resistance to infection.
  SOURCE: NEW ENGLAND JOURNAL OF MEDICINE
  
  Workers who suffer the least job stress are those who feel in charge of their workloads, who are firmly committed to their work, and who thrive on challenges.
  SOURCE: STUDY AT YALE UNIVERSITY
  
  These are the most stressful jobs: customer service personnel, complaint resolution personnel, secretaries and office workers, inner city high school teachers, police officers, air traffic controllers, medical interns, waiters and waitresses.
  SOURCE: AMERICAN INSTITUTE OF STRESS