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63 Cards in this Set

  • Front
  • Back
A nurse manager has a 24-hour responsibility for supervision
Nurse manager
_______ is the body’s non specific response/ reactions to any demands
STRESS
According to Selye, the body’s wear and tear results from its response to normal stressors. The rate and intensity of damage INCREASE when an organism experiences greater stress than it is capable of accommodating. He maintains that the physiological response IS THE SAME whether the stressor is POSITVE
( enstress) or NEGATIVE
( distress)
Effects of Stress
Certain amount of stress is essential to sustain life
Stress essential
Moderate amounts serve as stimuli to performace
Stress stimulates
6. Overpowering stress can cause a person to respond in a maladaptive physiological or psychological manner.
Overpowering stress
degree of ability to accommodate= state of equilibrium
Degree of stress
Experience of stress is subjective and individualized
stress is individualized
Poor performance and low motivation results from a degree of stress that is not stimulating enough, lack of interests, apathy, boredom.
Poor performance and low motivation
Alarm reaction – mobilization of resources to confront threat
Resistance Stage- increase in energy consumption
Exhaustion – depletion of the body’s energy reserves
STAGES IN STRESS RESPONSE
Job-related – task overload, conflicting tasks, inability to do tasks assigned because of lack of preparation or experience and unclear or insufficient informations regarding the assignments
CAUSES OF STRESS
Organizational factors
Physical environments –noise levels, lightings, tigh quarters, poorly organized work environments and lack of equipments
CAUSES OF STRESS
Organizational factors
Manager’s behavior – authoritarian and punitive supervisory behavior (Participative management in contrast reduces stress).
CAUSES OF STRESS
Organizational factors
Organizational norms and expectations that CONFLICT with an individuals needs – understaffing and high vacancy levels, job insecurity due to organizational restructuring, staff working with UAPs, more acutely ill patients ( very stressfull by nature).
CAUSES OF STRESS
Organizational factors
Managed care, cost containment, creation of integrated organizations and downsizing
CAUSES OF STRESS
Organizational factors
New technology, increased expectations from patients and their families, liability concerns competition associated with efficiency among health care providers
CAUSES OF STRESS
Organizational factors
Strained interpersonal relationships within the nursing profession and between other professions ( medical and administrative)
CAUSES OF STRESS
Interpersonal factors
Interdisciplinary difficulties – example a therapists or radiology dept. expect patient to be ready in such and such time or cancellation of procedures
CAUSES OF STRESS
Interpersonal factors
Interactions between physicians and nurses
CAUSES OF STRESS
Interpersonal factors
Need to fulfill multiple roles (nurse, mother, husband).-conflict bet family roles and professional roles
CAUSES OF STRESS
Interpersonal factors
Changes throughout life such as marriage, pregnancy or purchasing a new home
CAUSES OF STRESS
Individual factors – rate of life change
Deficiency focusing is the habit of focusing on the negatives at the expense of the positive. It leads to an increased sense of threat and a diminished sense of optimism, immobilizing individuals and limiting their ability to solve problems
CAUSES OF STRESS
Individual factors – rate of life change
Individuals who believe that their life is controlled largely by events external to themselves often perceive less stress and are likely to react negatively to surrounding events
view of stress
Those who perceives factors as being internal react more negatively to situations that are beyond control. They are more proactive to situations within their control and engage in positive coping behaviors to change the environment and reduce stress on themselves.
view of stress
Managers can reduce the physiological pressure through ensuring that nurses receive adequate rests and work breaks, rotating staff only between 2 shifts and never schedule “double backs:” (working 8 hours, off 8 hours, working
view of stress
Necessitating is the belief that it is imperative or necessary that a particular task be done by a specific person; it is a belief structure that limits choice. Nurses are prone to this type of thinking
SOURCES OF STRESS IN THE WORKPLACE
Necessitating
Low skill recognition – tendency not to recognize the role one-own’s ability has played in producing one’s successes; it affects both managers and staff when they face something unfamiliar. Example are the newly grads RNS
SOURCES OF STRESS IN THE WORKPLACE
Low skill recognition
Reality shock is the stress, surprise and disequilibrium experienced when shifting from a familiar culture into whose values and sanctions are different. ( e.g. from school culture to work culture).
SOURCES OF STRESS IN THE WORKPLACE
Reality shock
Stress can also result from incongruence between one’s expectations for performance and one’s perception of the resulting performance (intrarole conflict).
SOURCES OF STRESS IN THE WORKPLACE
intrarole shock
Interrole conflict can be a source of stress; it is a conflict resulting form incongruence between the different roles an individual might play such as doing a job and directing others to do the job. Conflict between the roles of nurse manager and as a nurse.
SOURCES OF STRESS IN THE WORKPLACE
Interrole conflict
Role ambiguity is the frustration that results from unclear expectations for one’s performance.
Sources of stress
Role ambiguity
Role underload and underutilization Being underutilized or not having much responsibility may be seen as stressful by a person who is a high-achiever or who has a high self-esteem
Sources of stress
Undue, prolonged anxiety , phobias or a persistent state of fear or free-floating anxiety
Depression
Abrupt changes in mood and behavior (erratic)Perfectionism
Physical illness – peptic ulcer, arthritis, colitis, hypertension, MI and migraine headaches
CONSEQUENCES OF STRESS
To manage stressing factors effectively and keep stress levels that enhance one’s performance rather than deplete energy, the key is to develop some resiliency. To accomplish this requires a comprehensive approach to manage stress which involves planning, time and energy.
Key to handling stress
Recognize stressors in the environment and control them
• Caring for yourself thru diet and exercise and adequate sleep
• Developing effective mental habits
–role definition,
– improved time
management,
–relaxation
• Developing of interpersonal skills
• Nurturing social supports
PERSONAL METHODS FOR MANAGING STRESS
Role definition involves clarifying roles and attempting to integrate or tie together the various roles individuals play. It may also involves renegotiation of roles in an attempt to lessen overload.
Role definitions
If there is a role conflict or ambiguity, it is important to confront others by pointing out conflicting messages
Role conflict
ONE LOST HOUR A DAY EVERYDAY FOR A YEAR RESULTS IN 260 HOURS OF WASTE, or 6.5 WEEKS OF MISSED OPPORTUNITY ANNUALL
Toll of stress on work place
BURNOUT – refers to the perception that an individual has used up all available energy to perform the job and feels that he or she doen’t have enough energy to complete the tasks
Burnout
Burnout is a combination of physical fatigue, emotional exhaustion and cognitive weariness
Burnout
The results of employee stress are INCREASED ABSENTEEISM AND TURNOVER.
Increased absenteeism and turnover
JOB PERFORMANCE suffers during times of high stress, so much energy and attention are needed to manage the stress that little energy is available for performance
Job Performance
Proper matching of the job with the applicant during the selection and hiring process
•Skills training- promotes better performance and less turnover
•Developing a program of job enrichment to match individual goals and desires- increases autonomy and participation
•Greater participation in decisions- increases job commitment and reduces stress
•Communication and social support- open upward and downward communication; team building encourages staff to build a network of support with each other
•Policies that reduce the stress of shift work such as reducing number of hours in the night shifts, weekend and holiday work assignments and providing adequate opportunities for breaks and meals
ORGANIZATIONAL METHODS FOR MANAGING STRESS
Time waster is something that prevents a person from accomplishing the job or achieving the goal
Time Waster
Interruptions such as telephone calls and drop-in visitors
•Meetings, both scheduled and unscheduled
•Lack of clear-cut goals, objectives and priorities
•Lack of daily and weekly plans
•Lack of personal organization and self discipline
•Lack of knowledge about how one spends one time
•Failure to delegate, working on routine tasks
•Ineffective communications
•Waiting for others, not using transition time effectively
•Inability to say NO.
TIME WASTERS AND HOW TO MINIMIZE THEM
Goals provide directions and vision for actions as well as timeline in which activities will be accomplished
IMPORTANCE OF IDENTIFYING GOALS AND SETTING PRIORITIES
SHORT-TERM GOALS should be set for the next 6-12 months but need to be related to long-term goals
Short term goals
Goal setting helps to relate current behavior, activities or operations to the organizations or individuals long-range goals; Goals should be measurable, realistic and achievable goals
PRINCIPLES OF TIME MANAGEMENT
Goal setting
Time analysis – identify how time is being used and to determine whether time use is appropriate to the manager’s role. TIME LOGS kept in intervals of 30-60 minutes are useful in analyzing the actual time spent on various activities
PRINCIPLES OF TIME MANAGEMENT
Time analysis
Priority determination (Setting priorities)-identifying activities as:
PRINCIPLES OF TIME MANAGEMENT
Priority determination
a)Urgent and important – must be completed
PRINCIPLES OF TIME MANAGEMENT
Setting priorities
b)Important but not urgent-are activities that make the difference between carrer progression or maintaining the status quo
PRINCIPLES OF TIME MANAGEMENT
Setting priorities
c)Urgent not important
PRINCIPLES OF TIME MANAGEMENT
Setting priorities
d)Busy work-compiling new charts for future patient admissions
PRINCIPLES OF TIME MANAGEMENT
Setting priorities
e)Wasted time- sitting by the phone waiting for return calls
PRINCIPLES OF TIME MANAGEMENT
Setting priorities
Daily planning- prepare a to do list by workday or work week; flexibility is a major consideration; focus is not on activities and events but rather on the outcomes that can be achieved in the time available
PRINCIPLES OF TIME MANAGEMENT
Daily planning
Delegation – involves assigning tasks, determining expected results and granting authority to the individual expected to accomplish these tasks
PRINCIPLES OF TIME MANAGEMENT
Delegation
Interruption control-keeping an interruption log (who,nature, when,how long. What topic discussed, importance of topic and time-saving actions taken
PRINCIPLES OF TIME MANAGEMENT
Interruption
Evaluation
PRINCIPLES OF TIME MANAGEMENT
Evaluation
Telephone calls are a major source of interruption. They can be controlled by minimizing small talk, planning calls, setting aside time for calls, stating preferred call times and using voice-mail
Sources of Interruption
Written communicationcan be minimized by planning and scheduling paperwork, sorting, delegating, writing effectively and using an effective filing system
Writtten communications being minimized
Drop-in visitors can be controlled by meeting visitors outside the office, keep visits short,encourage appointments, keep staff informed and arrange furniture to discouraged unscheduled visitors ( turn desk 90 0r even 180-degrees from the door minimizes potential eye contact)
Dop-ins
The key to using time management techniques is to respect one’s own time as well as that of thers.
Time Management