Success Under Stress - Why It’s Important

to Help the Ones Who Help Us

Madison Harshaw
February 22, 2022

Intern/Mentor - GT
Dr. Kiehl
 Abstract

Stress has become a daily occurrence in many people’s lives and is more commonly a
factor in high-stress jobs such as nurses/physicians, air traffic controllers, and lawyers. While the
tasks needed to be done in these jobs are all in a wide range, the effects that the tasks have on the
mental and physical health of those performing them continue to decline. The effects of stress
can include headaches, maladaptive behaviors like binge-eating, smoking, attempting suicide,
and more. Along with these behaviors, if the stress is chronic and a common occurrence in
someone’s life, it can lead to more severe mental and physical complications such as depression,
liver failure, disturbance in the immune and sleep systems, and more. If these behaviors are
continued and the source of the problem is not fixed sooner rather than later it can cause
mistakes in people’s work which is dangerous because these occupations all handle the lives of
others. When these behaviors are noticed, they need to be addressed either with professional help
or time off from their work to make sure the behaviors do not progress into something worse that
could affect their job. The goal of this study is to show how important it is to spread awareness
about signs of stress like these maladaptive behaviors so mistakes can be prevented early. The
occupations that do have practices set in place have shown to be more effective for people’s
mental health than those without them. This paper explains why awareness and workplace
practices could help people’s mental and physical health as well as their jobs.
 Introduction

Some jobs carry more stress than others - the person who is controlling a plane with

approximately 200 people, administering someone's medicine with shifts that can sometimes last

24 hours, or keeping someone out of jail. This added stress can lead to insomnia, anxiety, and

reduced mental health and that is where mistakes are made. A physician or nurse could

administer the wrong drugs to a patient, an air traffic controller could struggle to keep planes on

the right paths, or a lawyer could make an error during a trial. These occupations have the ability

to change a person’s future. While stress may be useful in a flight or fight situation and help a

person into survival mode, it can be bad in a fast-paced, high-stress job where the pressure of

stress is constantly on someone. ‘Stress’ can look different for everyone, but when the effects

become severe in positions like an air traffic controller, physician/nurse, or a lawyer, it can

negatively affect those they help and that is why it is important to make sure they have the

support and resources they need to do their job safely, and not lead to self-destructive behaviors.

The goal of this paper is to examine the effects of stress on air traffic controllers,

physicians/nurses, and lawyers, and analyze how these burdens affect their health and overall

well-being. This paper will examine the effects of stress on these occupations and compare them

to when the people in these jobs have the resources and tactics they need to cope with the stress

levels of their jobs.

Background

Stress has always been mostly thought of in a negative connotation because of the effects

it can have on someone’s mood, physical and mental health, behaviors, and the overall quality of

their life. When someone has a full-time job that is high stress, the constant stress can take a big

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toll on their mental and physical health, which can lead to burnout. If the effects of stress go

untreated, destructive behaviors can occur. Destructive behaviors can include, nail-biting, binge

eating, attempting suicide, or drug abuse to relieve the stress. Since medical professionals such

as anesthesiologists have access to unlimited amounts of medicine, they can easily use drugs to

reduce their stress. While there has been research conducted on how to reduce stress in

someone's job/work life, burnout rates and stress levels continue to grow across high-stress jobs.

In February of 2015, a study in Psychiatric Services conducted on 120 clinicians participating in

a burnout intervention trial showed that more than half of them (58%) said burnout had a

negative impact on their work. It would reduce their patience, which would then reduce their

listening skills. In June of 2016, a post from the Harvard Health Blog came from Steven A.

Adelman, MD who stated that there was a possible connection between physician well-being and

safety issues such as the opioid epidemic because physicians are the ones to frequently prescribe

opioids (Anesthesia Business Consultants, 2016). Overprescribing opioids is an example of how

burnout can cause health care professionals to make mistakes in their job.

The constant increase of rising stress and burnout rates needs to be addressed sooner

rather than later. When someone experiences burnout, they are in a state of emotional or physical

exhaustion that hinders a person’s ability to feel a sense of personal accomplishment and they

may also have a loss of personal identity due to a reduced work ethic. A study conducted in 2010

with 150 male and female lawyers showed that many factors lead to job dissatisfaction such as

emotional exhaustion, competition, over-expectation, and depersonalization. There was

regression analysis conducted after which led to seeing that emotional exhaustion, stress from

clients, work underload, and economic position were the significant predictors of job

satisfaction, and 10% higher for females than males at 55%. It was seen that the stressors and

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burnout were higher for females than males. Personal accomplishment was also a component of

burnout within the professions and often characterized a person’s behavior and performance

within their workplace (Sharma, et al., 2010). Casey Green, a nurse at the height of the pandemic

expressed how stressful the pandemic has been on top of their usual work. So stressful that some

nurses have lost interest in their job and are quitting altogether (C. Green, personal

communication, January 12, 2022). This is why it's important to make sure the well-being of

people in high-stress jobs is maintained not only for themselves, but for the people they consult

and treat at their job, or the people whose lives are in their hands.

Body Under Stress

Understanding how stress affects the body physically can then help people understand

how these effects could harm someone with a high-stress job. Richard P. Sloan, a professor of

behavioral medicine at Columbia University Medical Center states that many physiological

responses can come from stress and everyone reacts differently to them. Sloan says that stress is

not bad because it can help us be engaged and work better (Wall Street Journal, 2019), and can

set panic in a dangerous situation, making you think about fight or flight. When the stressor is

non-life-threatening, stress can be a motivator; jobs such as physicians, air traffic controllers, and

lawyers may have causes where lives are at risk, so they need to avoid excess stress. Chronic

stress is what people need to avoid because of the negative effects on their health.

When someone is under stress, glands above the kidneys release hormones like

adrenaline which increase our rate, making us sweat and metabolize food differently. A person’s

immune system can go into overdrive which can cause inflammation-this response is meant to

protect us against infection. Sloan responds that this reaction is good, but as long as it doesn’t

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last past the time of stress. If our immune systems are overactive for too long, they can’t protect

us against a common cold or infectious disease-when we need our immune system the most

(Wall Street Journal, 2019). When the stress is long-term, your body never receives a clear signal

that it can return to performing its normal functions because your body is constantly in that mode

of protecting you from the threat. Chronic stress can disturb major body systems like the

immune, digestive, cardiovascular, sleep, and reproductive. Some may experience the

disturbance of those systems, or they may have headaches or sleeplessness (National Institute of

Mental Health, n.d.).

Ignoring signs of stress on the body can cause more harm as well. Green found that

during COVID-19 surges, her colleagues would start to lose their hair, lose weight rapidly, or

start smoking again even if they had previously quit and continued maladaptive behaviors that

weren’t previously acquired from stress. Many people in her workplace would also lose sleep

because they couldn’t leave work at work and relax at home. Casey stated that she would never

hear IV pumps and machines, but over the last year and a half she has gone home to sleep and

woke up feeling as though she was still at work. When at home, she felt as though she was never

away from work and could never fully relax. Robert Mark, a former air traffic controller,

remembered days when people would easily get upset with each other during a long shift

because of how closely they were together trying to do their jobs. Mark and his colleagues didn’t

always have 8-hour shifts which made the job even more difficult. Some groups of people would

open the towers in the mornings at 6 a.m., work until 2 p.m., then have to come back into work at

midnight. When people in his field lost sleep, they had trouble being focused on what they were

doing when they had little sleep before shifts.

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 How Job Conditions Have Harmed People

Many people will go into a field due to their interests, which is exactly how Green, Mark,

and Cheret, a family law attorney, got into their jobs. Casey Green always found herself wanting

to care for others and knew she was always going to go into a job for healthcare. Robert Mark

found air traffic control to be an exciting, fast-paced job that suited his personality. Jaime Cheret

found the interactive aspect between her and others to be enjoyable, but she also liked helping

others through tough times like when people go through a divorce or a custody battle. Even

though they all enjoyed the overviews of their jobs, the stress and conditions of their jobs have

outweighed the positives. Green injured her ankle in the first pandemic surge but couldn’t have

surgery due to COVID-19 and has been working on a hurt ankle. Since then, her ankle has gotten

much worse, and has needed surgery for a second time, but continued to work bedside due to

COVID surges. Both Green and Mark have gone to work before during times when they knew

they should be at home asleep or resting because they felt exhausted. Green sometimes goes into

work with fatigue because there was little to no staff and many patients needed care. The added

stress of the pandemic has caused many to put themselves aside for their jobs.

Legal professionals have to deal with large casework, demanding clients, tight deadlines,

and that can easily lead to the work-life balance being way off. With many working remotely, it's

harder to create boundaries in their job and burn out at an all-time high because of it (The

National Law Review, 2021). Cheret and her colleagues have also had a hard time with work-life

balance when their caseload piles up. After working an 8-10 hour shift at their job, some went

home to do more work. Many clients would call Cheret after hours and she had to learn not to

pick up the phone because she needed a break too (J. Cheret, personal communication, February

3, 2022).

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 During the 1980s, thousands of air traffic controllers went on strike due to the conditions

they were enduring for their jobs. Many were working over 10-hour shifts with very little pay

and couldn’t continue. The strike was seen as a violation of the law and Ronald Regan made an

announcement saying that if they did not report back to their jobs, they would be fired. The air

traffic controllers on strike wanted to stand up and raise awareness for what they were going

through, but it caused approximately 12,000 air traffic controllers to be fired. Robert Mark had

friends during the time of the strike who believed in the strike but Mark knew they could never

win against the government, so he continued to do his job and stayed quiet (R. Mark, personal

communication, January 21, 2022).

Home stress can carry from home to work and vice versa but can have severe

repercussions. 44-year-old Rajaee Shareef Black was an anesthetist nurse and filed a federal

lawsuit against the University of Maryland Medical System saying that he was fired wrongfully

in April of 2020. He was fired for exposing a doctor who was allegedly hiding drugs in his

locker and was seen as a whistleblower that other staff in the building no longer wanted to work

with. This left him to work as a regular nurse in a hospital in New York during the pandemic. In

2021, he shot and killed his ex-girlfriend in Baltimore, then traveled to Columbia, Maryland to

kill his ex-wife over a custody battle. He got his ex-girlfriend pregnant, and she didn't want him

to see his kids from his previous marriage. He and his ex-wife had been in the custody battle for

three years, and after taking their two lives, he took his own. This home stress had been piling on

him for three years without help, and it led him to murder two women and commit suicide

(TooFab, 2021).

Part of the reason many don’t receive help is because of the stigma around stress and

mental health today. Little to no physicians/nurses, air traffic controllers, and lawyers are left out

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when it comes to stress, anxiety, and/or grief in the overwhelming workplace environment, but

the COVID-19 pandemic has pushed many past their breaking point when it comes to mental

health. Disclosing mental health between colleagues is a risk to their careers; they can be marked

to go through a disclosure process to see if they are still capable of doing their jobs or not,

stopping them from receiving the help they need (Windsor, 2021).

What Can Be Done?

While many physicians/nurses understand the importance of taking care of yourself and

what stress can do to the mind and body, not every field has been taught what to do if they feel

they may be close to burnout, or what burnout looks like. At Green’s workplace, they have

buddy systems where they can ask colleagues for help with patients if they need breaks, or they

can walk off the floor if they need to mentally get away from their work. Cheret and Mark have

no practices set in place at their works and would just take a sick day so they could rest.

A survey of approximately 1,700 legal professionals conducted by legal charity LawCare

found that 69% of lawyers have experienced poor mental health in the past year. The survey also

found that 56% of the people who suffered had talked about the issues they were having at work.

Responders in the people being surveyed would not disclose their situation due to being afraid of

the stigma surrounding attaching to them, career implications, and the financial and reputational

consequences. Elizabeth Rimmer, CEO of LawCare said that this type of research is necessary to

show how any legal job is stressful, exhausting, anxiety-inducing, high burnout risk, and

practices in the workplace that undermine the mental health of legal professionals needs to

change. She wants research like this survey to be the things that get the change going. LawCare

has been big on providing workplace support measures like mental health policies, training, etc.

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These types of support and programs are great for personal development. Their goal is to work

towards making the legal workplace a psychologically safe and supportive place (The Law

Society Gazette, 2021), but policies and training should be a workplace goal for every field. No

one should have to feel ashamed of being stressed or that they would be judged for talking about

it either. When people are in dire need of help, stigma can be the main factor holding them back

from seeking the help they need, making the situation worse. McKinsey’s Center for Societal

Benefit through Healthcare conducted two surveys to understand why people weren’t reaching

out for help. 52% of people didn’t want others to find out about their mental illness, and 37%

didn’t want others to find out about their substance abuse. Approximately seven out of ten people

who took the survey said they have missed at least a day of work after feeling burnt out or

stressed. Many employers have focused on worker productivity and engagement, but not

reducing stigma, and yet 75% of them acknowledged there was stigma present in the workplace

(Coe, et al., 2021).

The maladaptive behaviors that occur because of stress and burnout have been studied as

well, and Yale University scientists believe that it can be found whether someone can cope with

their situation. The University conducted a study that identified brain patterns of people that have

‘resilient coping’ skills: healthy ways to cope with stress. They used functional magnetic

resonance imaging (fMRI) to measure localized changes in brain activation while someone is

under stress. The participants of the study were stressed and violent images to look at for 6

minutes each. Scientists also measured non-brain indicators of stress while they looked at the

images like heart rate and level of cortisol. The scans showed the scientists three main patterns,

the first being the brain’s regions known to signal the threat, monitor it, and process the threat or

potential threats to come. The second pattern was a circuit in the brain of increased activation of

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those areas then decreased activation -- the scientists believe this is the brain’s way of reducing

the stress when a threat appears. The last pattern is the one that helped scientists to predict who

could take control of their emotions and behaviors to stress, which was “described as

neuroflexibility in a circuit between the brain’s medial prefrontal cortex and forebrain regions,

including the ventral striatum, extended amygdala, and hippocampus, during sustained stress

exposure” (Genetic Engineering & Biotechnology News, 2016). The neuroflexibility was

believed to have been caused by the second pattern, the increased and decreased activation

circuit of the brain. Chronic stress damages the prefrontal cortex’s structure, connections, and

functions. The prefrontal cortex is also that part of the brain that is needed for main functions of

the body, like language, social, behavior, mood, attention, and also helps regulate a person’s

emotions. People who showed to not have this neuroflexibility reported binge drinking, anger

outburst, and maladaptive behaviors (stopping you from adapting to a new situation). This study

has shown that scientists may be able to predict who has resilient coping with the

neuroflexibility, or who is at risk for emotional problems or alcohol disorders in the future that

do not have that neuroflexibility.

Methods and Data Collection

Interviews were conducted among four participants: Casey Green, a pediatric nurse in the

Pediatric Cardiac Intense Care Unit at Johns Hopkins Hospital in Baltimore, Maryland, Robert

Mark, a former employee of the Federal Aviation Administaration, Jamie Cheret, a family law

attorney at the Law Offices of Ali K., and Steve Hochstein, a nurse anesthetist at the Sinai

Hosptial in Baltimore, Maryland. Each participant was chosen due to them having a career that

many consider to be ‘high-stress’ and have been working in their field for many years. There

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may not be any bias due to the topic of the interview being a universal experience and leaving

little room for bias on stress, but they each had their own experiences with it. These participants

gave great insight into the research topic as well as provide answers that left more questions to

think about like how their typical hours and work-life balance affect them and their jobs. The

COVID-19 pandemic was also brought up in all of their responses, mostly affecting Mrs. Green

and Mr. Hochstein as they work in the medical field. Since Robert Mark was formerly an air

traffic controller, he gave hindsight to his job. He worked through the air traffic controller strike

in 1981 and was able to tell me lots of information on the subject and how it affected him and his

friends who were also air traffic controllers at the time. The researcher first emailed people in the

medical, aviation, and law professions to assist with the project and give a better understanding

of how stress affected them. Overall, 4 interviews were conducted: two from the medical

profession, one from the aviation profession, and one from the law profession. Once the

interviewees contacted back, A Zoom meeting was set up for each interview. All of the

interviews lasted between thirty-forty minutes and the conversations were recorded on an IPad as

it was being conducted. After each interview, they transcribed them so the researcher could go

back and find trends that may not have been heard during the interview for data analysis. The

main focus of all interviews was to find similarities and differences between their jobs and how

the stress of their job affected them. See appendix A for interview questions.

Results and Data Analysis

Charts 1, 2, 3, and 4: Similarities

Chart 1:

Interviewer What led you to become a(n) [their occupation]?

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 Casey Green “I always found myself wanting to care for other people, so I always knew I
was going to do something in healthcare. I got a scholarship for nursing
school at Howard Community College when I graduated, so that tipped the
scales toward nursing for me. When I was in high school my chemistry
teacher knew someone who had just become a nurse anesthetist and was
telling me about it because she knew I was super interested in chemistry and
physics and nursing and medicine, like as a science. I have always found
those things super interesting.”

Robert Mark “I spent many years doing it and I was an air traffic controller in the US air
force during the Vietnam era. When I came out, I had a couple of jobs and
they were pretty boring and air traffic is a pretty exciting career. When I came
out they were hiring and about a year and a half later I was interviewed and
got the job.”

Jaime Cheret “I think it was always in the back of my mind that it was something that [her
father] kind of wanted to do that would be cool to pursue. Then for family
law, I definitely like the interactive aspect of family law that I’m dealing with
actual people as opposed to like contracts and paperwork most of the time. I
like feeling like I’m helping people through something difficult.”

Steve “I was working with a patient that had severe depression and needed
Hochstein electroconvulsive therapy treatment, I don't know if you're familiar with that,
but it's where they intentionally induce a seizure in a patient because It's been
shown that it has major effects in people that have depression that doesn't
respond to other treatments like medications. I take the patient to the
treatment, I accompanied them to the treatment, and I get talking with the
anesthesia provider, and I find out that they're not an anesthesiologist but a
nurse anesthetist. … I wanted things to be a little more hands-on and when I
found out that that was a role that was available, that got me interested and I
started learning a little bit more about that. The more I learned the more I
realize that it was amazing and it was exactly what I wanted to do.”

Chart 2:

Interviewer Were there practices set in place at your work when employees feel too
overwhelmed by their work?

Casey Green “We have the EAP (Employee Assistance Program), where there is a number
that you can call there, and you always have the charge nurses for support.

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 You also have your manager, but they aren’t always there, you have buddies.”

“We also have relaxation rooms which I’ve only been to twice, but it's like a
nice oasis with music and it’s like a little aromatherapy …”

“Just getting off the unit and taking a walk sometimes can be good for stress
and mental space”

Robert Mark “We made our own de-stressors because as a government employee you
earned like a day of vacation like every month or so and then so many hours
of sick leave every 2 weeks. After a while, when you worked there for 6, 8,
10 months, a year, you had a fair amount of sick time built up. There were
times when I just said my brain is scrambled and called in sick. We never told
them in those days that we were stressed out because if you’d done that, you
would have probably gotten fired. They weren’t patient with people who
couldn’t keep up, it’s much different now, but not in those days.”

Jaime Cheret “One thing that we do when we get stressed to try to work together a little is
co-workers and I will bounce ideas off of each other. Last Friday I had kind
of like a weird legal issue that was coming up for a trial on Monday and I
called this other lawyer in my office and I was like “Hey, like what would
you do if you had this set of facts?” and he came up with some awesome
ideas that because I was stressed maybe didn't occur to me …”

Steve “There are hotlines that we are encouraged to call if people feel that things
Hochstein are getting away from them and need help managing stress. There are hotlines
they can call, and they are completely anonymous, where they can reach out
and say that they are not in a good headspace.”

“That's where they would have to reach out to someone, you know, maybe a
counselor, just to get it off their chest. Generally, we do that with each other,
just by talking to each other, debriefing, and just processing things…”

Chart 3:

Interviewer Have you ever been trained to notice symptoms of burnout or stress levels?

Casey Green “... they make you do classes when you get higher to recognize burnout in
yourself and co-workers, and when I became a charge nurse it was a class I

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 had to go through to recognize burnout in my co-workers. It is a very stressful
job and if you’re going to reference people to the EAPs or recognize it in
others, then you kind of have to know, so I went through a continuing
education course and a professional development class at work for it.”

Robert Mark “No, uh uh. When we started, I don’t even think we called it stress.”

Jaime Cheret “Not really trained per se, no, I can’t say that I have.”

Steve “Yes. There were a couple of things in our training, our professional training,
Hochstein both in my undergraduate training and my post-graduate training, there were
different lectures we had talking about how to recognize if someone is under
the influence. Unfortunately, anesthesia providers around substances that are
easily abused … If you have an individual who abused medication as a way
to mitigate or manage stress or stressful situations, that individual may make
a bad decision relating to diverting medication that was meant for a patient or
to self-medicate. We're taught how to recognize if that’s happening, how to
recognize that in ourselves, the stress levels that are becoming unreasonably
high, and the negative impacts.”

Chart 4:

Interviewer Did you ever notice yourself bringing work home, like thinking about certain
situations that you experienced during the day?

Casey Green “For me, I’ve never been the person who heard IV poles and pumps at home,
and over the last year and a half, I’ve come home and woke up feeling like I
was not at home. It was more stressful than PTSD because it’s not like I’m
stressed to be at work, but it feels as though I’m never fully relaxed or away.”

Robert Mark “When it was a bad day you definitely couldn’t just walk away, get in the car,
and go home. You’d just want to be left alone.”

“You're bringing that home, you know, drinkers, a lot of drinkers in this
business, and that's how they kind of self-medicate to take themselves down
after work, so they’ll stop at the bar and have some booze and then go home.”

Jaime Cheret “I do try to mostly leave work to work and family stuff to family stuff.”

Steve “Yeah, a lot of times. There have been a lot of times when I would just

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 Hochstein process things and thought about interesting cases or cases where the patient
may not have survived, Really bad vehicle accident victims, Shooting,
stabbing victims oh, where you didn't expect them to survive but they pulled
through. I might just think about things to learn or lessons to pass on to the
students that we train, and those kinds of things.”

Interviewing people in a wide range of professions gave me good insight into how stress

and burnout can affect many jobs and individuals. The main research question being asked was

how stress affected people with high-stress jobs. When each participant was asked why they

went into the profession they did, they all responded similarly because the job fits their

personality best. They all wanted to help people, be in a fast-paced environment, and use their

brains regularly. Now after having years of experience in the job, when I interviewed them they

had similar and conflicting answers. Three out of four interviewees talked about having long

work hours. All participants also added that they and their colleagues had their own de-stressors

like taking walks and stepping away from work, talking about certain situations with colleagues,

or just taking a day off. What was not surprising to hear was that both the participants that work

in the medical profession have been trained to notice symptoms of stress in burnout in

themselves and colleagues, and they both had practices/policies set in place at their work in case

an employee gets too overwhelmed. What is harmful about this is that the other two participants,

one from the aviation field and the other from the law field, both had not been trained to

recognize stress or burnout or policies set in practice at their places of work for their employees.

Three out of four participants also reported mentally bringing home work, either thinking about a

situation that occurred during the day, or in Mrs. Green’s case, hearing IV poles and pumps at

home and she felt as though she couldn’t fully relax.

The abundant information that the researcher gathered from my interviewees reinforces

the researcher’s hypothesis which was that an excessive amount of stress on people can cause

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them to be overwhelmed or mentally exhausted. This is dangerous because, during the

COVID-19 pandemic, people in the medical field were terribly overwhelmed that many quit. The

pandemic did not just affect their field.

Discussion and Conclusion

The responses that the researcher received from the participants in my research highly

reinforced my hypothesis. Each participant has different tasks that they do in their job every day,

but there were many common trends in how the stress of the job affected them. In my secondary

research, many of the sources that I read containing information on how stress impacts bodily

functions were presented in the respondents’ answers. Every single participant brought up the

topic of sleep and how it had hindered their ability to do their job safely and efficiently. Erro may

have been present within the data which could have been due to the misinterpretation of the

questions by the participants. Each participant answered the questions relating to their

experiences and in their own way.

The two participants that did have policies or resources set in place at their work brought

up how many did not use them. This was how the researcher’s hypothesis was also supported. It

is imperative that increasing awareness of how to identify symptoms of stress and what they do

to people mentally and physically can help physicians/nurses, air traffic controllers, lawyers, and

others with high-stress jobs to intervene and reduce the problem of stress with stress-reducing

techniques/metal health resources before the stress impacts them and their career negatively. This

cannot be done until the stigma behind accepting that they do need help and receiving help is

addressed. Many don’t receive the help they need because they may not have the resources like

in two of the researcher’s participant's cases, don’t want others to know their situation, or don’t

want to look weak in front of peers because of the stigma around mental health. This was seen in

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my secondary research as well, In Rajaee Black’s case. He committed a double homicide and

then committed suicide because of home stress which did ultimately affect his work life and

never received help before the incident. Resources should not only be available to people in the

medical field because it relates to their field. Everyone in a high-stress job or a regular job should

have access to get help.

Levels of stress and burnout will continue to rise and those in the fields of air traffic

control, medicine, and law are all at risk for emotional and physical exhaustion. Their sense of

self-worth will decrease as they start to feel their work has no meaning anymore, and that is why

it is important to have supervision over those performing the jobs. When they have someone to

talk to or see that they need help they can receive it before the excessive stress leads to burnout

and they no longer sufficiently do their job. Researchers should continue to explore the positive

effects of stress-management programs for lawyers, but these techniques could also be applied in

air traffic control. Nurses and physicians have been taught to see the signs of stress and burnout

because it has been deemed ‘medical’, but information to help someone in mental and physical

distress needs to be taught to everybody.

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 Appendix A

Interview Questions

1) Job Behaviors
a) What led you to become a(n) [their occupation]?
b) What does a normal work schedule look like for you?
c) What part of your job do you consider to be the most stressful? Do you notice
when you start to feel too stressed? What symptoms did you notice?
d) Have you ever talked to a colleague about your personal life? Has a colleague
ever talked down to you, or talked to you differently after talking about personal
life?
e) How did you handle stressful situations at your job? What did you do for yourself
after navigating a stressful situation?
f) Do you think you and your colleagues are at a higher risk for negative health due
to your stress levels?
g) Have you ever noticed when too much stress occurs that people you worked with
start to make mistakes in their work?
h) Do you ever notice yourself putting yourself aside for your job?
i) Did you ever notice yourself bringing work home, like thinking about certain
situations that you experienced during the day?
j) What part of your job do you like the most?

2) Job Practices
a) Were there practices set in place at your work when employees feel too
overwhelmed by their work?
b) Have you ever noticed stress symptoms in your colleagues? Have you ever
noticed negative behaviors in your colleagues like poor sleeping habits,
irritability, etc? In yourself?
c) Have you ever been trained to notice symptoms of burnout or stress levels?

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