psy_stress
Table of Contents
stress
see also:
- viewing images of nature changes brain responses to painful stimuli and reduces pain (go camping!) 1)
Government and professional body resources
- are you a doctor or medical student and need to see a doctor confidentially?
- Anxiety Disorders Assoc. of Vic. (AdaVic): ph: 03-9853-8089
introduction:
- the term “stress” was popularised in 1950's by Hans Selye, an Austrian-born Canadian physician. Prior to this the usual phrase used was “under strain”.
- in engineering terms, strain is a measure of the extent to which a body is deformed when it is subjected to stress, while stress is the force exerted on a body that tends to cause it to deform.
- in response to Selye, psychologists developed tables of what were asserted to be highly stressful events, such as death of a spouse, being sacked from a job, moving house, getting a divorce, etc.
- everyone experiences stress, but of itself it does not cause emotional distress:
- athletes inflict force upon themselves in order to change their form - they voluntarily subject themselves to stress with enthusiasm & commitment, in the expectation of improving performances - they call it training.
- an environmental stress may generate emotional distress or it could be used as the challenge that strengthens us.
- nevertheless, like athletes who over-train, excessive stress for our level of coping will tend to result in exhaustion, conflict, frustration, anxiety & depression.
- extreme emotionally stressful events may lead to delayed post-traumatic stress syndrome in susceptible people.
- how doctors manage stress is often dependent on their personality2)
red flags suggestive of burnout
- Cognitive rigidity
- Difficulty with ambiguity
- Problems with setting boundaries
- Inability to forgive oneself or blaming others
- Irritability or sarcasm
- Feeling of emotionally exhausted
- A sense of depersonalisation (cynical and detached)
- Muscle tension/headaches
stressors confronting ED doctors:
- emotionally stressful patient situations (eg. death of a child)
- pressure to work beyond your abilities
- lack of support from senior staff or inpatient units
- insufficient time to further develop your abilities
- pressure to work when not physically well
- lack of adequate staffing to cover sick leave
- generalised job dissatisfaction & distress
- lack of the expected rewards of appreciation and approval from peers, management and patients
- imbalance between work, family life and fun
- checking work emails when off duty increases stress and impairs sleep
- inability to cope with work levels or poor patient care levels:
- exit block - this is soul destroying as, regardless of clinical skill, you are unable to practice medicine to your own standards
- persistent excessive patient workloads resulting in excessive waiting times & patient dissatisfaction
- poor inpatient support - delay in having patients reviewed or admitted
- inadequate facilities to deal with patient load or conditions
- presence of poorly performing peers
- inadequate change management
- perception of inadequate support or abilities of management ED or hospital
- anxieties related to:
- ability to perform - risk of making judgement errors or procedural complications
- risk of needlestick injury or exposure to other illnesses such as TB
- risk of exam failure for those sitting exams
- acceptance by peers
- professional nihilism
- for example the negative views on the current medical profession and the commodification of doctors - see here
- existential crisis:
risk factors for psychiatric illness in Australian doctors
- having a current medicolegal matter
- not taking a holiday in the previous year
- working long hours
- type of specialty
- having personality traits of neuroticism and introversion.
- see 3)
risk factors for ethanol abuse in Australian doctors
- male
- being Australian-trained
- being between 40 and 49 years of age
- having personality traits of neuroticism and extroversion
- failing to meet Continuing Medical Education requirements
- being a solo practitioner
- see 4)
other references and other resources:
- Towards longevity in emergency medicine. Chris Curry. Emergency Medicine (2002) 14, 102-5.
psy_stress.txt · Last modified: 2025/03/14 00:02 by gary1