Daffernee Morris

Professor Reynolds

ENGL 1201

11 April 2021

Healthcare Workers and Stress: Techniques and Strategies to Help them Cope.

Heartbreaking stories of healthcare workers who have had the misfortune of

having to deal with a dying patient attributes to their stress on the job. This particular

nurse had the privilege of caring for a patient who was 75 years old. He was in the

hospital and he was alone. The only person he had by his side was his nurse, and her

name was Ryan. She was decked out in full PPE. She tried to make him comfortable

while she used her iPad so he could speak with his family before he died. Afterwards,

she cried. She had lost another patient (Hoffman). For support, she contacted a doctor

who was the director of the support program at her place of employment. (Hoffman).

She told her that she just could not pretend that she was okay. She had just had a

traumatic experience (Hoffman). Headaches, anxiety, burnout, and stress are some

words that describe the mental and physical toll that a person in healthcare may

experience There are resources available but, what are those resources, how can they

help, are there some better than others, and why are there not more resources

available.
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The healthcare field is by far one of the most challenging and stressful fields in

the workforce. This is especially true due to the on-going pandemic the world is

currently experiencing. Stress management and coping strategies are important for

healthcare workers to deal with the day-to-day stresses they may incur.

According to Healthcare Finance, a survey was conducted where healthcare

workers indicated that they were indeed stressed and experienced anxiety (Lagasse).

Over 1,000 healthcare workers were asked how stressed out they were (Lagasse). The

responses were overwhelming. The results were that, over 90% experienced stress,

over 80% experienced anxiety, over 70% experienced frustration, exhaustion, burnout

and were overwhelmed (Lagasse).

The above study listed different challenges those in healthcare may face that can

have a direct impact on their stress. There are resources available but how does one go

about utilizing them. First and foremost, one must figure out why they are feeling

stressed out. You must recognize why you are feeling the way you are. You must be

specific, and then focus on that issue. Is it because of workload or is there something

else you cannot pinpoint? Are you having a hard time with guilt and what many

professionals call compassion fatigue? The list goes on and on. The reality is that you

must identify what exactly is your problem. In the article “Stress-management Tips for

Healthcare Workers” the author states “You have to recognize the problem to make the

change and not fix it with a band aid” (LeClaire).

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Graph 1: The overall prevalence of psychiatric disorders and burnout syndrome among the studied groups

The above graph shows the prevalence of anxiety, and burnout as well as other

psychological issues that contribute to stress in the healthcare field. So how do

healthcare workers deal with their stress and anxiety (Ahmed). There is not a magic

wand that one can wave and make everything okay. If that were possible individuals

would not need therapy, resources, or any kind of support. There are many ways that

individuals in healthcare can cope with stress in their workplaces. These stress and

coping mechanisms vary. Some of those include support groups, self-care techniques,

preventative measures and being able to educate yourself on how to deal with stress.

There have been studies performed on just how stress and anxiety affect those,

especially in healthcare. For example, a study was conducted on 218 Italian healthcare

workers during the lockdown. Once the results of the study were revealed, it showed

that the participants had indeed different ranges of stress and anxiety (Bonanno). The

outcome of the study revealed that depression, anxiety, and stress was experienced
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anywhere from 8 percent to slightly over 9 percent. It also revealed that these

symptoms were common to serious (Bonanno). In another study, when compared to

men, the women had a higher level of anxiety and stress than men (Conti, et. al). They

also had higher somatization symptoms, as well the need for psychological care. In the

study if a healthcare worker lost a patient, this also contributed to the high levels of

stress in comparison to others who had not (Conti, et. al). Somatization is the way the

body manifests stress. These studies show how stress has an adverse effect of those in

the healthcare field.

According to the article in HealthLink BC there are many different coping

strategies, and some are considered better than others. There are strategies that are

considered positive and there are also strategies that are considered negative. When

negative and positive coping responses were compared, negative coping mechanisms

made stress worse because it just added more stress. Whereas positive coping

strategies were more beneficial to the individual because they contributed to the person

working on their issues. Positive strategies were thought to be overall the best and most

productive (Common Coping responses for Stress).

“The negative coping strategies include being critical of yourself. These types of

strategies are counterproductive and provide no benefit to a doctor or a nurse who is

already stressed and filled with anxiety. Some examples of this include downing

yourself, nervous activities such as nail biting, exhibiting violent behavior or engaging in

activities that are not healthy for your body. These types of strategies are not productive

and does nothing to help the individual to deal with the stress they are having

(“Common Coping responses for Stress”).

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On the other hand, there are strategies that are positive and are thought to be a

better way of coping. The positive coping strategies include taking time out of your day

to unwind to your favorite song, going outside to play catch with your dog, or

participating in your favorite hobby, such as reading, or painting (Common Coping

responses for Stress). Some other positive strategies may include attending a church

service, just relaxing, or rejuvenating your body by doing some exercise to take your

mind off the stressful activities of your normal workday (Common Coping responses for

Stress). The positive strategies previously listed is not conducive for all people, a

person should find what works for them (Common Coping responses for Stress).

Although we have discussed some strategies a person can use individually, lets discuss

a resource that healthcare individuals can use with the help of a professional or in a

group setting. That resource is support groups. Support groups are sessions that are

done in an environment with more than one person and each person is supported by

the group with encouragement, advice, and a listening ear.

In the article written by Jonathan Kozowyk, he wrote about how the stress of the

pandemic specifically, took its toll on its employees. Realizing the importance of taking

care of their employees they created a task force to deal with those issues. This task

force created a virtual support group that allowed not only the healthcare workers, but

their families to access the resources (Kozowyk). When someone is experiencing

stress, it is important that they have support from others so it can strengthen them

during that time (Cherry).

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Support groups were important resources for individuals because they helped to

reduce depression, and the inability to cope. Support groups were chosen more often

over therapy sessions because it gave people more of a sense of belonging. Support

groups are more attractive because they are usually cheaper than going to therapy.

Therapy is usually more expensive, and many times insurance does not include that

cost in the benefit (Mahtani). On the other hand, support groups are cheaper, and some

provide services at no cost (Mahtani). Support groups helped individuals learn how to

manage their anxiety.

In addition to the techniques mentioned above there is also a very personal

technique that allows the person to focus on themselves and put themselves first. This

technique is self-care. Self-care is a very important technique for those in the healthcare

field to remember to apply. So, what do we mean by self-care and how does one go

about incorporating this into their daily or weekly routine? When an individual practices

self-care they consciously take their mental health in their own hands which includes

their health mentally, physically, as well as emotionally (Scott). Choosing the right one is

important to maintain your over well-being. A person who eats right, gets enough

exercise, gets adequate sleep, and how much one focuses on their physical well-being

are ways to exhibit how well one is in tune with themselves. (Cherry). Social self-care

refers to maintaining social relationships. Are you going out with friends? Are you

making sure that you are spending quality time with your family? Mental self-care refers

to keeping you mind busy with positive things. This can include working fun puzzles or

reading a book. Spiritual self-care is having a connection with God, attending church,

and praying. If a person has a strong sense religion or if they practice spirituality the
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according the research one’s health is better (Scott). Lastly, there is emotional self-care.

How are you taking care of yourself emotionally? How are you dealing with feelings of

anxiety, depression, suicidal thoughts, etc. If an individual engages in activities that

allow them to communicate how they feel, they are inclined to experience better

emotional self-care (Scott).

Because healthcare is such a busy and demanding field on your time, there are

also some resources that will allow you access help at the tips of your fingers. There are

many apps that have been designed or created to address the very issue of stress. One

popular app is called Headspace. Headspace is an app that includes meditation, sleep,

and movement exercises (Goodwin). The Headspace app also includes articles that can

be accessed that addresses topics from meditation, and sleep, to healthy living. Another

app that would be beneficial to an individual in healthcare dealing with stress is

Pasha80. This app allows specifically individuals in the healthcare field to reach out to

each other and access different resources for their needs (Daley). More importantly, it

acknowledges the importance of a holistic approach (Daley). In addition to the above

app’s, there are an abundance of other app’s that healthcare workers can use to

manage their stress. There were five different app’s that were chosen by a physician

specifically for those working in healthcare (Hackethal). One of those app’s was

Headspace, as well as, My Well-Being Index, Provider Resilience, Calm and Relax

Melodies.

The next form of therapy that may be beneficial is not one that has been around

as much as the more traditional forms of therapy. Pet therapy is a popular program that
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is being used as a therapeutic way for individuals to reduce stress. It involves a trained

dog or other type of animal with a trained handler. So, how does this help those in

healthcare? It turns out that there is credible information to prove that this type of

therapy is very helpful. One study found that when therapy dogs were used, the nurse’s

who were evaluated in the studies levels of cortisol fell (International Journal of

Environmental Research and Public Health). Cortisol is a stress hormone for the body,

and it controls your frame of mind, your motivation, and how much you worry about

things (Cassoobhoy). The study was performed on 22 nurses working in a hospital in

the Czech Republic. The nurses were surveyed on three different conditions. The end

results of the survey revealed that the nurses had lower levels of stress when they were

with animals trained in pet therapy (Machova). Buckeye Paws was a program

implemented by the Ohio State University to help their staff members after dealing with

stressful situations. In this program the Universities goal was to be able to give staff

members an outlet, and way they could step back from their stressful jobs (Henry).

These two programs or studies show how pets are beneficial to employees who are

dealing with stress.

There are also holistic approaches to dealing with stress in healthcare. Many

healthcare workers as well as some healthcare employers have turned to this

alternative therapy instead of going the traditional route. Holistic therapy looks at a way

to support the whole person and not just the mental aspect of stress. When a person

seeks the holistic route, they are looking for support that will address other areas of their

body. For example, their physical well-being is important. Holistic alternatives are

becoming popular for those who would like to take a different approach, and there are
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more hospitals and facilities who are offering this as an alternative (Sullivan). A

surprising and amazing part of holistic therapy that was used to reduce stress and

anxiety in healthcare workers is acupuncture. Auricular Acupuncture is a type of therapy

that focuses on the individual’s ears. This is done by focusing on specific points one the

ear. There have been studies that have shown that this type of therapy is helpful and

successful in reducing stress in this field (Breakey). Although the use of acupuncture is

traditionally done in setting with just the individual, this type of acupuncture is attractive

because it could be done in group settings (Landgren). The person can move around

versus having to lie still as in traditional acupuncture, and it was considered to be less

stressful for a healthcare worker who already have a high level of stress and anxiety

(Sullivan).

While some may seek help outside the workplace for their stress, there is a

resource that is overlooked many times by employees, including those in healthcare.

The EAP Program, or the Employee Assistance Program is a program that if offered

through an individual’s employer. Although some may feel hesitant to use this program

due to privacy, it could be a great option for those experiencing stress. This resource

has been important for healthcare workers especially during the pandemic. It has a

wealth of information and provides beneficial information for those who are struggling

(Halpern).

Why are there not more resources available for healthcare workers? It is not that

the support is not there, but one particular factor plays into why it is perceived there are

not enough resources. There are factors that prevent healthcare workers from seeking
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out help. One of those is the social stigma regarding the subject. About a third of

Americans are concerned that they will be judged if it is known that they are seeking

help for mental health. Americans have also not been truthful about receiving these

services (Burwell, et. al.). It would be difficult for a person who is working the fast-paced

field of healthcare with co-workers who seem to be doing a great job at handling the

stress and anxiety of the job to have to seek help. This could be a deterrent for

someone who is already emotionally and physically drained and really needs

assistance.

In conclusion, there is a wealth of resources available for those who need them

in this highly stressful field. One resource does not always fit the needs of everyone.

There are some that are considered to be more effective than others. There was no real

clear reason as to why there were not more resources available, but it does appear that

the resources are out there and available if needed. Many of the resources are helpful

however, an individual must seek out and find what works for them. That may not be an

easy task when you are already overwhelmed. You must take that first step in getting

help. After all, you cannot fix something if you do not acknowledge and recognize the

problem.
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Works Cited

Ahmed, A.S. et. al. “Prevalence and Predictors of Burnout Syndrome, Post-Traumatic

Stress Disorder, Depression, and Anxiety in Nursing Staff in Various

Departments.” Middle East Curr Psychiatry 27, 36 (2020).

www.mecp.springeropen.com/articles/10.1186/s43045-020-00044-x#citeas.

Accessed 11 April 2021.

Bonanno, George. “Depression, Anxiety, and Stress Among Healthcare Workers During

the COVD-19 Outbreak and Relationships with Expressive Flexibility and Context

Sensitivity”, Frontiers in Psychology, Vol. 11, 2021. Assessed 28 March 2021.

Breakey, Suellen, “Auricular Acupuncture to Relieve Healthcare Workers’ Stress and

Anxiety”,

www.journals.lww.com/dccnjournal/fulltext/2014/05000/auricular_acupuncture_to

_relieve_health_care.9.aspx#:~:text=Studies%20have%20suggested%20that

%20auricular,providing%20compassionate%20care%20to%20patients.

Accessed 14 April 2021.

Burwell, Joy, et. al.“New Study Reveals Lack of Access as Root Cause for Mental

Health Crisis In America”, www.thenationalcouncil.org/press-releases/new-study-

reveals-lack-of-access-as-root-cause-for-mental-health-crisis-in-america/, 10

October 2018. Accessed 27 March 2021.

Cassoobhoy, Arefa.” What is Cortisol”, www.webmd.com/a-to-z guides/what-is-

cortisol,13 Webmd, December 2020. Accessed 28 March 2021.

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Cherry, Kendra. “How Social support Contributes to Psychological Health”

www.verywellmind.com/social-support-for-psychological-health-4119970,

Verywell Mind, 14 April 2020. Accessed 26 March 2021.

“Common Coping Responses to Stress”, www.healthlinkbc.ca/health-topics/ta5463, 16

December 2019. Accessed 26 March 2021.

Conti, Chiara, et.al, “Fragile Heroes: The Psychological Impact of COVID-19 Pandemic

on Healthcare Workers in Italy”, 2020, 15,11, 17p. Assessed 28 March 2021.

Daley, Beth. “Pasha80: A New App Helps Frontline COVID-19 Frontline Workers with

Mental Health”, www.theconversation.com/pasha-80-a-new-app-helps-covid-19-

frontline-workers-with-mental-health-145868, 9 September 2020.

Goodwin, Jazmin. “Health and Wellness Apps Offer Free Services to Help Those

Coping with Coronavirus”, www.usatoday.com/story/tech/2020/03/21/health-and-

wellness-apps-offer-freebies-coping-coronavirus/2892085001/, USA Today, 21

March 2020. Accessed 27 March 2021.

Hackethal, Veronica, “Top 5 Stress-relief & Well-being Apps for COVID-19 Healthcare

Providers”, www.patientcareonline.com/view/top-5-stress-relief-well-being-apps-

covid-19-healthcare-providers, November 29, 2020. Accessed 8, April 2021.

Halpern, Madeline, “Improving Workplace Mental Health Through EAP Usage”,

www.mhanational.org/blog/improving-workplace-mental-health-through-eap-

usage, Mental Health America. Accessed 27 March 2021.

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“Healthcare workers suffer from PTSD and Burnout during COVID 19”

www.ohsonline.com/Articles/2020/05/19/Healthcare-Workers-Suffer-from-PTSD-

and-Burnout-During-COVID19.aspx?Page=3, May 19, 2020. Accessed 26 March

2021.

Henry, Megan, “Buckeye Paws Program Helps Wexner Healthcare Workers Destress”,

www.dispatch.com/story/lifestyle/2021/01/02/buckeye-paws-program-helps-

wexner-healthcare-workers-de-stress/3880724001/, January 2, 2021. Accessed

8 April 2021.

Hoffman, Jan, “I Can’t Turn My Brain Off” PTSD and Burnout Threaten Healthcare

Workers”, www.nytimes.com/2020/05/16/health/coronavirus-ptsd-medical-

workers.html, The New York Times, May 16, 2020. Accessed 26 March 2021.

Kozowyk, Jonathan. “Providing Mental Health Support to Frontline Healthcare Workers

During the Pandemic”. News Hub, www.nyulangone.org/news/providing-mental-

health-support-frontline-healthcare-workers-during-pandemic Accessed 24 March

2021.

Lagasse, Jeff, “Healthcare Workers Experiencing Burnout, stress due to COVID-19

Pandemic”, www.healthcarefinancenews.com/news/healthcare-workers-

experiencing-burnout-stress-due-covid-19-pandemic#:~:text=The%20responses

%20collected%20from%20the,75%25%20said%20they%20were

%20overwhelmed., 8 December 2020. Accessed 27 March 2021.

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Landgren,Kajsa. “Auricular Acupuncture”. https://www.sciencedirect.com/topics/medicine-and-

dentistry/auricularacupuncture#:~:text=Group%20treatment,of%20sitting%2C%20fully

%20dressed%20patients. Accessed 14, April 2021.

LeClaire, Jennifer “Stress-management tips for healthcare workers”. Monster,

www.monster.com/career-advice/article/stress-management-tips-in-healthcare.

Accessed 24 March 2021.

Machova, Christyna, et.al, “Canine-Assisted Therapy Improves Well-being in Nurses”,

www.ncbi.nlm.nih.gov/pmc/articles/PMC6801790/ 16 International Journal of

Environmental Research and Public Health. (19) October 2019. Accessed 28

March 2021.

Mahtani, NIkhita. www.huffpost.com/entry/support-group-therapy-

benefits_l_5d273b04e4b0cfb59601aa41, Huffpost, 11 July 2019. Accessed 27

March 2021.

Scott, Elizabeth. “5 Self-care Practices for Every Area of Your Life”,

www.verywellmind.com/self-care-strategies-overall-stress-reduction-3144729,

Verywell Mind, 03 August 2020. Accessed 26 March 2021.

Sullivan, Katie. “Hospitals try Holistic Approach to Treat Docs Stress, Burnout”

www.fiercehealthcare.com/healthcare/hospitals-try-holistic-approach-to-treat-

docs-stress-burnout, December 03, 2013. Accessed 10 April 2021.