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chapter 13 | Work-Related Stress and Burnout 207 CikguOnline
main causes of the shortage are individuals not ABCs of Stress Management
entering the profession and nurses leaving. As dis-
Frances Johnston (1994) suggested using the
cussed, one reason for leaving is burnout. A recent
ABCs of stress management (awareness, belief, and
study of 106 nurses demonstrated that the three
commitment) in order to have as constructive a
dimensions of burnout (emotional exhaustion,
response to stress as possible (Box 13-2).
depersonalization, and personal accomplishment)
were correlated with work excitement. Work Awareness
excitement is defined as “personal enthusiasm
How do you know that you are under stress and
and commitment for work evidenced by creativi-
may be beginning to burn out? The key is being
ty, receptivity to learning, and ability to see
honest with yourself. Asking yourself the questions
opportunity in everyday situations (Sadovich,
in Box 13-3 and answering them honestly is one
2005, p. 91). Work excitement factors include:
way to assess your personal risk. To analyze your
work arrangements, variable work experiences,
responses to stress further, you may also want to
the work environment, and growth and develop-
answer the questions in Box 13-4. The answers to
ment opportunities. As you pursue your nursing
these questions require some thought. You do not
career, consider looking for positions that support
have to share your answers with others unless you
a favorable work environment.
want to, but you do need to be completely honest
with yourself when you answer them or the exercise
A Buffer Against Burnout
will not be worth the time spent on it.Try to deter-
The idea that personal hardiness provides a buffer
mine the sources of your stress (Goliszek, 1992):
against burnout has been explored in recent years.
Hardiness includes the following: ■ Is it the time of day you do the activity?
■ Is it the reason you do the activity?
■ A sense of personal control rather than power-
■ Is it the way you do the activity?
lessness
■ Is it the amount of time you need to do the activity?
■ Commitment to work and life’s activities rather
than alienation Another suggestion is to keep a stress diary. People
■ Seeing life’s demands and changes as challenges often have “flash points” that send stress levels sky-
rather than as threats rocketing. Keeping a stress diary often helps in
identifying these triggers. Identify the date, time,
The hardiness that comes from having this perspec-
situation, scale (on a scale from 1 to 10), symptoms,
tive leads to the use of adaptive coping responses,
reaction, and efficiency (on a scale from 1 to 10,
such as optimism, effective use of support systems,
how well did you cope with this stressor?). What
and healthy lifestyle habits (Duquette, Sandhu, &
was your reaction? Did you solve the problem, qui-
Beaudet, 1994; Nowak & Pentkowski, 1994). In
etly seethe, or become reactionary? After 2 weeks,
addition, letting go of guilt, fear of change, and
analyze the diary, and reflect on where and when
the self-blaming, “wallowing-in-the-problem” syn-
your highest stress levels occured. Keep your stress
drome will help you buffer yourself against burnout
diary for as long as you think necessary in order to
(Lenson, 2001).
identify personal stress triggers and patterns of
Ask yourself, “What can I possibly do as a new
behavior (Bruce, 2007).
graduate? I don’t even have a job yet, let alone
understand the politics of health-care organiza-
tions.”It is never too early to understand yourself— box 13-2
what triggers stressful situations for you, how you ABCs of Stress Management
respond to stress, and how you manage it.
Become Aware of your own responses to stress and the
consequences of too much stress.
Stress Management Believe that you can change your perspective and your
behavior.
Although you cannot always control the demands Commit yourself to take action to prevent conflicts that
placed on you, you can learn to manage your reac- cause stress, to learn techniques that help you cope in
tions to them and to make healthy lifestyle choices situations over which you have no control, and to understand
that you can choose how to react in stressful situations.
that better prepare you to meet those demands.