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chapter 13 | Work-Related Stress and Burnout 199 CikguOnline
table 13-1
Stress Continuum
Eustress Distress Severe Distress
Psychological Fear/excitement Feelings of uneasiness, appre- Burnout
hension, sadness, depression, Emotional exhaustion/
pessimism, listlessness depersonalization and
Lack of self-esteem disengagement
Increased level of arousal/ Isolation
mental acuity
Negative attitude
Increased use of alcohol/
smoking/drugs
Decreased interest in sexual
activity
Procrastination/unable to
complete tasks
Physiological Autonomic nervous system Prolonged elevated blood Clinical hypertension
response: increased blood pressure/pulse Coronary artery disease
pressure/heart rate; Indigestion Gastric disorders
increased metabolic rate; Bowel disturbances
release of cortisol; quicker Menstrual problems
reaction times Weight gain or loss
Reduced immunity
Fatigue/low energy
Poor sleep habits
Headache
Trembling hands, fingers, body
Dry mouth and throat
Individual response Adaptive Varies among individuals but Varies among individuals but
Increased alertness usually maladaptive usually severely maladaptive,
Focus totally on the situation Absenteeism possible life-threatening
Able to respond to changes Apathy
quickly Cynicism
Callousness Defensiveness
Energized for fight or flight
preparation
Adapted from Martin, K. (May 1993). To cope with stress. Nursing 93, 39–41, with permission; Goliszek, A. (1992). Sixty-Six Second Stress Management: The
Quickest Way to Relax and Ease Anxiety. Far Hills, N.J.: New Horizon; and McVicar, A. (2003). Workplace stress in nursing: A literature review. Journal of
Advanced Nursing, 44(6), 633–642.

She was afraid that she would miss something “good stress” or “bad stress”? Lenson identified
important and that the patient would die during seven factors:
the admission. The more experienced nurses
1. People can exert a high level of control over the
seemed to handle each admission with ease, even
outcomes of good stresses. With bad stresses,
when the patient’s physical condition was severely
there is little or no control.
compromised.
2. Positive feelings are experienced in processing
Selye also differentiated between “good”stress and good stress. With bad stress, negative or
“bad” stress. In 1974, Selye stated: “Stress is the ambivalent feelings occur.
spice of life. Since stress is associated with all 3. Good stress helps achieve positive goals. No
types of activity, we could not avoid most of it desirable outcomes occur with bad stress.
only by never doing anything” (Lenson, 2001, 4. There is a feeling of eagerness when anticipat-
p. 5). Good stress can push people to perform bet- ing the work that needs to be done to process
ter and accomplish more. What makes an event the good stressors.