Management In Nursing Ch 15 Stress & Time Management

Front 1

A nurse manager has a 24-hour responsibility for supervision

Back 1

Nurse manager

Front 2

_______ is the body’s non specific response/ reactions to any demands

Back 2

STRESS

Front 3

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)

Back 3

Effects of Stress

Front 4

Certain amount of stress is essential to sustain life

Back 4

Stress essential

Front 5

Moderate amounts serve as stimuli to performace

Back 5

Stress stimulates

Front 6

6. Overpowering stress can cause a person to respond in a maladaptive physiological or psychological manner.

Back 6

Overpowering stress

Front 7

degree of ability to accommodate= state of equilibrium

Back 7

Degree of stress

Front 8

Experience of stress is subjective and individualized

Back 8

stress is individualized

Front 9

Poor performance and low motivation results from a degree of stress that is not stimulating enough, lack of interests, apathy, boredom.

Back 9

Poor performance and low motivation

Front 10

Alarm reaction – mobilization of resources to confront threat
Resistance Stage- increase in energy consumption
Exhaustion – depletion of the body’s energy reserves

Back 10

STAGES IN STRESS RESPONSE

Front 11

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

Back 11

CAUSES OF STRESS
Organizational factors

Front 12

Physical environments –noise levels, lightings, tigh quarters, poorly organized work environments and lack of equipments

Back 12

CAUSES OF STRESS
Organizational factors

Front 13

Manager’s behavior – authoritarian and punitive supervisory behavior (Participative management in contrast reduces stress).

Back 13

CAUSES OF STRESS
Organizational factors

Front 14

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).

Back 14

CAUSES OF STRESS
Organizational factors

Front 15

Managed care, cost containment, creation of integrated organizations and downsizing

Back 15

CAUSES OF STRESS
Organizational factors

Front 16

New technology, increased expectations from patients and their families, liability concerns competition associated with efficiency among health care providers

Back 16

CAUSES OF STRESS
Organizational factors

Front 17

Strained interpersonal relationships within the nursing profession and between other professions ( medical and administrative)

Back 17

CAUSES OF STRESS
Interpersonal factors

Front 18

Interdisciplinary difficulties – example a therapists or radiology dept. expect patient to be ready in such and such time or cancellation of procedures

Back 18

CAUSES OF STRESS
Interpersonal factors

Front 19

Interactions between physicians and nurses

Back 19

CAUSES OF STRESS
Interpersonal factors

Front 20

Need to fulfill multiple roles (nurse, mother, husband).-conflict bet family roles and professional roles

Back 20

CAUSES OF STRESS
Interpersonal factors

Front 21

Changes throughout life such as marriage, pregnancy or purchasing a new home

Back 21

CAUSES OF STRESS
Individual factors – rate of life change

Front 22

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

Back 22

CAUSES OF STRESS
Individual factors – rate of life change

Front 23

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

Back 23

view of stress

Front 24

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.

Back 24

view of stress

Front 25

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

Back 25

view of stress

Front 26

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

Back 26

SOURCES OF STRESS IN THE WORKPLACE
Necessitating

Front 27

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

Back 27

SOURCES OF STRESS IN THE WORKPLACE
Low skill recognition

Front 28

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).

Back 28

SOURCES OF STRESS IN THE WORKPLACE
Reality shock

Front 29

Stress can also result from incongruence between one’s expectations for performance and one’s perception of the resulting performance (intrarole conflict).

Back 29

SOURCES OF STRESS IN THE WORKPLACE
intrarole shock

Front 30

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.

Back 30

SOURCES OF STRESS IN THE WORKPLACE
Interrole conflict

Front 31

Role ambiguity is the frustration that results from unclear expectations for one’s performance.

Back 31

Sources of stress
Role ambiguity

Front 32

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

Back 32

Sources of stress

Front 33

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

Back 33

CONSEQUENCES OF STRESS

Front 34

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.

Back 34

Key to handling stress

Front 35

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

Back 35

PERSONAL METHODS FOR MANAGING STRESS

Front 36

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.

Back 36

Role definitions

Front 37

If there is a role conflict or ambiguity, it is important to confront others by pointing out conflicting messages

Back 37

Role conflict

Front 38

ONE LOST HOUR A DAY EVERYDAY FOR A YEAR RESULTS IN 260 HOURS OF WASTE, or 6.5 WEEKS OF MISSED OPPORTUNITY ANNUALL

Back 38

Toll of stress on work place

Front 39

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

Back 39

Burnout

Front 40

Burnout is a combination of physical fatigue, emotional exhaustion and cognitive weariness

Back 40

Burnout

Front 41

The results of employee stress are INCREASED ABSENTEEISM AND TURNOVER.

Back 41

Increased absenteeism and turnover

Front 42

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

Back 42

Job Performance

Front 43

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

Back 43

ORGANIZATIONAL METHODS FOR MANAGING STRESS

Front 44

Time waster is something that prevents a person from accomplishing the job or achieving the goal

Back 44

Time Waster

Front 45

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.

Back 45

TIME WASTERS AND HOW TO MINIMIZE THEM

Front 46

Goals provide directions and vision for actions as well as timeline in which activities will be accomplished

Back 46

IMPORTANCE OF IDENTIFYING GOALS AND SETTING PRIORITIES

Front 47

SHORT-TERM GOALS should be set for the next 6-12 months but need to be related to long-term goals

Back 47

Short term goals

Front 48

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

Back 48

PRINCIPLES OF TIME MANAGEMENT
Goal setting

Front 49

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

Back 49

PRINCIPLES OF TIME MANAGEMENT
Time analysis

Front 50

Priority determination (Setting priorities)-identifying activities as:

Back 50

PRINCIPLES OF TIME MANAGEMENT
Priority determination

Front 51

a)Urgent and important – must be completed

Back 51

PRINCIPLES OF TIME MANAGEMENT
Setting priorities

Front 52

b)Important but not urgent-are activities that make the difference between carrer progression or maintaining the status quo

Back 52

PRINCIPLES OF TIME MANAGEMENT
Setting priorities

Front 53

c)Urgent not important

Back 53

PRINCIPLES OF TIME MANAGEMENT
Setting priorities

Front 54

d)Busy work-compiling new charts for future patient admissions

Back 54

PRINCIPLES OF TIME MANAGEMENT
Setting priorities

Front 55

e)Wasted time- sitting by the phone waiting for return calls

Back 55

PRINCIPLES OF TIME MANAGEMENT
Setting priorities

Front 56

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

Back 56

PRINCIPLES OF TIME MANAGEMENT
Daily planning

Front 57

Delegation – involves assigning tasks, determining expected results and granting authority to the individual expected to accomplish these tasks

Back 57

PRINCIPLES OF TIME MANAGEMENT
Delegation

Front 58

Interruption control-keeping an interruption log (who,nature, when,how long. What topic discussed, importance of topic and time-saving actions taken

Back 58

PRINCIPLES OF TIME MANAGEMENT
Interruption

Front 59

Evaluation

Back 59

PRINCIPLES OF TIME MANAGEMENT
Evaluation

Front 60

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

Back 60

Sources of Interruption

Front 61

Written communicationcan be minimized by planning and scheduling paperwork, sorting, delegating, writing effectively and using an effective filing system

Back 61

Writtten communications being minimized

Front 62

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)

Back 62

Dop-ins

Front 63

The key to using time management techniques is to respect one’s own time as well as that of thers.

Back 63

Time Management