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chapter 13 | Work-Related Stress and Burnout 201 CikguOnline
shocks of bad experiences, the affirmations of good current strengths, weaknesses, opportunities, and
experiences, constructive evaluation, knowledge of threats. Where do you see yourself in 1 year? 5
the unit routine,and priorities of school versus work years? How will you fit yourself into your work to
(Godinez, Schweiger, Gruver, & Ryan, 1999; meet your goals?
Heslop, 2001). 3. The way you perceive events on the job will
Well-supervised orientation programs are very influence how you feel about your work. Your
helpful for newly licensed nurses. In this era of the attitude will affect whether work is a pleasant or
nursing shortage, the orientation program may be unpleasant experience. Health care is not easy.
cut short and the new nurse required to function on Sick people can be cranky and demanding. Health-
his or her own very quickly. One way to minimize care agencies continue to want to do more with less.
initial work stress is to ask questions about the ori- How you perceive your contribution to the health-
entation program: How long will it be? Whom will care system will definitely influence your reality.
I be working with? When will I be on my own? 4. Feelings of helplessness and powerlessness at
What happens if at the end of the orientation I still work cause frustration and unrelieved job
need more assistance? stress. If you go to work every day feeling that
you do not make a difference, it is time to
Differences in Expectations reevaluate your position and your goals.
The enthusiasm and eagerness of the first new job
What are these differences in expectations?
quickly disappear as reality sets in. Regardless of
Kramer (1981), who studied reality shock for
the career one chooses, there is no perfect job. The
many years, found a number of them, which are
problem begins when reality and expectations col-
listed in Table 13-3.
lide. After 2 or 3 months, the new nurse begins to
Ideally, health care should be comprehensive. It
experience a formal separation from being a stu-
should meet not only all of a patient’s needs but
dent and embraces the professional reality of the
also be delivered in a way that considers the patient
nursing role. To cope with reality, several facts of
as a whole person, a member of a particular family
work life need to be recognized (Goliszek, 1992,
that has certain unique characteristics and needs,
pp. 36, 46):
and a member of a particular community. Most
health-care professionals, however, are not
1. Expectations are usually distortions of reality.
employed to provide comprehensive, holistic care.
Unless you accept this and react positively, you
Instead, they are asked to give medications, provide
will go through life experiencing disappoint-
counseling, make home visits, or prepare someone
ment. As a student, you had only two or three
for surgery, but rarely to do all these things. These
patients to care for, and you are very surprised to
tasks are divided among different people, each a
hear on your first full day of orientation that you
specialist, for the sake of efficiency rather than con-
have five patients. Although you did hear the nurses
tinuity or effectiveness.
talking about their caseload while you were a stu-
dent, you expected to continue to have two or three
patients for at least the next 4 months.
table 13-3
2. To some extent, you need to fit yourself into
your work, not fit the work to suit your needs Professional Ideals and Work Realities
or demands. Having a positive attitude helps to Professional Ideals Work Realities
maintain flexibility and a sense of humor. Your Comprehensive, holistic Mechanistic, fragmented care
first position is at a physician’s office. The physi- care
cian is ready to retire, and his patient load is Emphasis on quality of Emphasis on efficiency
care
dwindling. You wanted to apply for a position in
Explicit expectations Implicit (unstated) expectations
acute care, but you have a very active social life
Balanced, frequent Intermittent, often negative
and did not want to work weekends. The current
feedback feedback
position is not very challenging, and you are con-
Assignments that
cerned that you might be unemployed soon. You
“make sense”
are starting to miss the acute care environment.
Adapted from Kramer, M. (January 27–28, 1981). Coping with reality
Go back to your SWOT analysis. Evaluate your shock. Workshop presented at Jackson Memorial Hospital, Miami, Fla.