Stressors of Being in the Medical Field

This article is the fifth part of a multi-part series of hazards within the medical field. Catch up on parts one, two, three, and four.

Work stress can lead to poor mental and physical health. Mental health includes psychological, emotional, and social well-being and affects how we feel, think, and act.

Medicine is one of the most stress-filled occupations. For example, between 300 and 400 physicians each year commit suicide. And the burnout rate for physicians is the highest of nearly every occupation, about double that for attorneys.

And even before the pandemic, working conditions in the medical field have always been challenging for healthcare workers. Work in healthcare often involves intensely stressful and emotional situations in caring for those who are sick, exposure to human suffering and death, and pressures from relationships with the patient, family members, and employers.

Factors that may increase work-related stress in a hospital setting include lack of control over the work environment, excessive workload demands, lack of support, inadequate or insufficient resources to accomplish the assigned work, or a feeling that optimal care is not being provided.  

Shift Work

Because a large portion of the healthcare industry is concerned with caring for patients staying in a hospital overnight or for extended periods, shift work is deemed necessary.

Shift work includes any shift that differs from the traditional eight-hour work schedule between 7:00 a.m. and 5:00 p.m. Shift work includes night or evening shifts, extended work days, extended work weeks, and rotating or permanent off-hour shifts. 

But, the night shift is one of the most frequent reasons for disrupting circadian rhythms, causing significant alterations in sleep and biological functions that can affect physical and psychological well-being and negatively impact work performance. 

Additionally, extended work hours are associated with job performance issues, absenteeism, accidents, and issues related to individual workers’ health and safety, endometrial, breast, and possibly colorectal cancer, peptic ulcers, myocardial infarction, and obesity among nurses.

For example, one study found that nurses engaged in rotating night shifts were statistically significantly younger, more frequently single, and had Bachelor’s and Master's degrees in nursing. They reported the lowest mean score in job satisfaction, quality, and quantity of sleep with more frequent chronic fatigue and psychological and cardiovascular symptoms than the day shift workers.

Violence

According to occupational health researchers, workplace violence is one of the most complex and dangerous occupational hazards facing nurses working in today’s healthcare environment. OSHA defines workplace violence as “violent acts, including physical assaults and threats of assault, directed toward persons at work or on duty.”

Healthcare has increased anticipation of violence due to several factors: a patient population under the influence of intoxicants such as drugs and alcohol, metabolic disorders, trauma, psychosis, personality disorders, etc. 

Additionally, the hospital is open 24 hours, seven days a week, giving a compromised patient population easy access to the facility and its staff. Personal and organizational stressors affecting the patient, the family, and the healthcare worker put the worker at increased risk for violence. 

Areas of particular concern in hospitals are the emergency department, psychiatric units, and critical care areas.

The Emergency Nurses Association’s violence surveillance study in 2009-2010 revealed that patients and relatives of patients perpetrated 97.1% of physical violence in the emergency department.

Exposure to violence has short-term and long-term effects, including anxiety, life disturbances, increased absenteeism, poor work quality, and leaving the profession.