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  1. Identify potential stressors in the workplace
  1. How does the body respond to stress physiologically?
  1. How does the body respond to stress psychologically?
  1. Identify potential long-term effects of stress on health
  1. Discuss the strategies/services available in health that can help the nurse manage stress
  1. Provide a brief outline of self-care techniques including:
  1. Impact of exercise, diet and nutrition
  2. Work life balance strategies
  3. Complementary and alternative health options
  1. Describe three (3) stressors that may result in grief or loss.
  1. Identify the potential sources of stress form the following situations, and briefly discuss how you would manage your stress in the situations identified:
  1. complex medical situation
  2. stressful working conditions/incident
  1. Describe how you would manage a situation where a staff member is “behaving badly” toward you.
  1. Review the workplace rights according to the Fair Work Act. Identify what is considered unlawful for a worker under the Fair Work Act.

What is Workplace Stress?

Workplace stress is defined as the harmful emotional and physical response which can occur when there is a conflict between the work demands on the employees and the employee's amount of control over those demands. Some of the potential stressors at the workplace include lack or inadequate appreciation, inadequate time to finish a task when the skills do not match the requirements of the job. Role conflict, that is, numerous managers or supervisors (Thompson, 2010), too many jobs or conflicting demands of a job, underpromotion, threats of harassment, violence, lack or inadequate trust and non-participation in the decision-making process (Melnick, 2013).  

Stress is a psychological and biological response experienced in the body on encountering a threat which individuals have no resources to deal with (Giudice et al. 2018). Severe and sudden stress normally produces increased breathing, increasing heart rate, releasing of glucose by the liver for energy, digestive activity is reduced as one usually does not feel hungry. In the rapid breathing and heartbeats, an individual’s body increases respiration rate as well as the heartbeat to provide oxygen and energy to the body which will be required to aid in the rapid response to the threat (Wiggert, Wilhelm, Nakajima & al’Absi, 2016).  Flushed or pale skin is also observed during stress, and it occurs because, at the start of the stress, the blood flow to the surface of the body is limited while blood flow to the brain, muscles, arms, and legs are increased (Pusch, Bentz, Becker & Navara, 2018). A person who stressed will tremble since the muscles become tense as well as ready for action. The tension usually results in shaking or trembling.

When a situation is considered by the body as stressful, the hypothalamus in the brain is activated. In response to a stressful condition, the sympathetic nervous of the body is activated because of the quick release of the hormones. The sympathetic nervous system of the body stimulates adrenaline glands which further triggers catecholamine (noradrenaline and adrenaline) to be released. The release of catecholamine leads to an increase in the rate of heartbeat, the rate of breathing as well as blood pressure.  It takes about 22 to 60 minutes for the body to resume normalcy after the threat is gone. Hypothalamus is in charge of the response to stress. During stress, signals are normally sent to adrenal medulla and pituitary glands which produces flight or fight response through the Sympathomedullary Pathway (Gunnar & Adam, 2012). On the other hand, long term stress is normally controlled by the Hypothalamic-Pituitary-Adrenal (HPA) system (Kirk, Xie, Steyn, Grattan & Bunn, 2017).

Triggers of Workplace Stress

A little stress normally is not something an individual should worry or be concerned. However, regular and chronic stress can lead to or exacerbate numerous negative health problems (Barbee, 2012). Such problems include mental health issues like personality disorder, depression and anxiety, cardiovascular diseases like high blood pressure, stroke, heart attacks, abnormal heart rhythms and heart diseases, menstrual problems, overweight and other eating disorders, sexual dysfunction like premature ejaculation and impotence in men as well as loss of sexual urge or desire in both women and men. Hair and skin problems like psoriasis, permanent hair loss, eczema, and acne. Gastrointestinal problems like ulcerative colitis, irritable colon, GERD, and gastritis (Panda, 2014).  

For nurses to take care of the patients, they need to take care of themselves too effectively. When nurses are well rested, healthy and safe in their workplace, they tend to have more life, and their impact on the patient outcome improves as well as the quality care provided. Job stress can be challenging, and nurses are not left behind. Nurses are believed to work in an environment which drains emotions with long and tedious workloads (King, Singh, Bernard, Merianos & Vidourek, 2012). Thus, nurses also end up feeling stressed out and overwhelmed daily. Nevertheless, as a buildup of stress significantly affects the mood as well as work performance of individuals, nurses are required to be aware of the various techniques that they can apply to manage and resume their work with a stable and healthy mindset (Shariatkhah, Farajzadeh & Khazaee, 2017). It is key to note that prevention and management of workplace stress are important and should be given much priority for all the emp0loyers and employees as it negatively impacts on the economy. One of the best technique nurses can apply to reduce or prevent stress is taking breaks during workday, self-calming and even communicating with a colleague has been known to manage and prevent stress. Nurses are highly encouraged to use realistic dreams and goals. Even though numerous patients, as well as doctors, rely on nurses for daily care and cooperation, they should only take on jobs they can handle to avoid burning out and being overwhelmed by heavy loads of work. Nurses should also practice relaxation techniques in their workplaces. It is key to note that every individual has various preferences for what calms him or her down. Spending time with friends or family, listening to music, and coloring are some of the methods used by individuals to calm themselves down. Thus, the right and effective relaxation technique are key in helping an individual reduce or manage build-up of stress.

Effects of Workplace Stress

When individual encounter stress, his or her nervous system as well as the adrenalin gland send signals to the entire body to aid in clear cognitive thinking and ready for any physical action or response. Eating a well-balanced diet and little will keep the body’s metabolism ticking and reduces the troughs and peaks in levels of energy. One is encouraged to take breakfast even though he or she may not feel hungry (Cora?, 2010). Taking breakfast aids to kickstart the body metabolism for the day as well as stabilize the level of blood sugar which have the potential to reduce stress. One is also advised to eat fruits and vegetables and focus on foods rich in vitamin C and B as well as magnesium (Miedziun & Czaba?a, 2015). Caffeine which is mostly found in tea, some soft drinks and chocolate and coffee may have negative impacts on the body if consumed in high quantities. Taking substitutes of caffeine is key in reducing or preventing stress. Exercise helps in reducing the built-up pressure in the blood cells, thus, preventing and managing pressure (Li et al. 2019). Even a gentle exercise has the potential to reduce pressure when combined with a healthier diet.

  1. Work-life balance strategies

In the era where the personal and professional demands in our lives normally compete and collide, we regularly wish and long for more balance. In the professional world, work-life balance is a common request or plea of overwhelmed and overworked employees. However, a perfect life can never exist and can only be found in utopia and looking after it only leads to dissatisfaction and frustrations. To reduce pressure at the workplace, one needs to have flexible job hours, alternate working hours as well as part-time work which has been proven to increase job or work satisfaction, higher motivation, productivity and reduce stress. Employers are also encouraged to implement better and effective work-life balance strategies like promoting technology options which can help with the daily tasks. An employee is also advised to have ample time with the family members. The time spent with the family will relieve pressure from the muscles and ensure that he or she reduces the impact of stress. Spending time with family or friends also ensures that you can confide in such a person.

  1. Complementary and alternative health options to stress include anger management and depression management. Anger and depression which are the physical and psychological symptoms must be managed to reduce or prevent stress. Depression can lead one to committing or doing negative or suicidal activities in his or her life.

The three stressors that can lead to death or grief include loss of loved ones, being sacked at your workplace and promiscuous partner. Most of the mentioned stressors can lead to depression in one’s life with the resultant repercussion being severe.

Strategies for Managing Workplace Stress

  1. Misdiagnosis in the medical department is one of the stressors which can cause depression. I managed to talk to my healthcare provider who did everything to salvage the situation. Misdiagnosis is one of the mistakes happening in most healthcare ecnters. However, if discovers that he or she has been misdiagnosed, he or she can suffer from chronic or acute depression depending on the intensity of the misdiagnosis.
  2. Meeting the deadline of a project in the workplace is a source of stress. To prevent myself suffering from stress, I planned and did my work in time (Pignata, Boyd, Winefield & Provis, 2017).

If a colleague at the workplace is behaving badly towards me especially sexual harassment or intimidation, I would avoid him or her or report him or her to the relevant authority. If the situation persists, I will resign from my post.

From the fair work act, it is considered unlawful to harass or intimidate a colleague sexually. Persistent and continuous sexual harassment and intimidation can negatively affect the relationship between the employer and employee and employee-employee relationship.

The two situations that made me feel stressed in my clinical place was intimidation from my supervisors and tedious workload.

  1. On a scale of 1-10, I can rate my condition at that time at 6. I was averagely stressed due to the acts of my supervisor.
  2. I felt that I would not look for a job in that facility again if both my supervisors are still in that center.
  3. Emotionally I felt depressed and overwhelmed with anger and rage at the supervisors. My self-esteem dropped as I felt that I was not good enough among my peers. Physically, looked distraught and out-of-my mind. I did not feel like eating as I did not feel angry.

Source of stress

Stress triggers

Strategies to manage stress and self-care technique

From the supervisor

Intimidation (Pestonjee & Pandey, 2013). 

Report to the relevant authority

Share your experience with close people (Bernstein & Amacom, 2014). 

Supervisor

Excessive workload to be done within a short and limited deadline

Finish on time

Stop procrastination

 

References

Barbee, A. (2012). Everything You Need to Know About Stress Management. [Newmarket, Ont.]: BrainMass Inc. 

Bernstein, A., & Amacom. (2014). Stress Less. Achieve More: Simple Ways to Turn Pressure into a Positive Force in Your Life. New York: AMACOM.

Cora?, G. (2010). ExecutiveHealth.com’s Leading Under Pressure?: Strategies to Avoid Burnout, Increase Energy, and Improve Your Well-being. Pompton Plains, N.J.: Career Press. 

Giudice, M. D., Buck, C. L., Chaby, L. E., Gormally, B. M., Taff, C. C., Vitousek, M. N., … Wada, H. (2018). What Is Stress? A Systems Perspective. Integrative & Comparative Biology, 58(6), 1019–1032. https://doi.org/10.1093/icb/icy114

Gunnar, M. R., & Adam, E. K. (2012). The Hypothalamic-Pituitary-Adrenocortical System and Emotion: Current Wisdom and Future Directions. Monographs of the Society for Research in Child Development, 77(2), 109–119. https://doi.org/10.1111/j.1540-5834.2011.00669.x

King, K. A., Singh, M., Bernard, A., Merianos, A. L., & Vidourek, R. A. (2012). Employing the Health Belief Model to Examine Stress Management among College Students. American Journal of Health Studies, 27(4), 192–203. 

Kirk, S. E., Xie, T. Y., Steyn, F. J., Grattan, D. R., & Bunn, S. J. (2017). Restraint stress increases prolactin-mediated phosphorylation of signal transducer and activator of transcription 5 in the hypothalamus and adrenal cortex in the male mouse. Journal of Neuroendocrinology, 29(6), 1–N.PAG. https://doi.org/10.1111/jne.12477

Li, H., Shi, Y., Xing, Z., Li, Y., Wang, S., Ying, J., … Zhao, M. (2019). The effectiveness of aromatherapy and massage on stress management in nurses: A systematic review. Journal of Clinical Nursing, 28(3/4), 372–385. https://doi.org/10.1111/jocn.14596

Melnick, S. (2013). Success Under Stress: Powerful Tools for Staying Calm, Confident, and Productive When the Pressure’s On. New York: AMACOM. 

Miedziun, P., & Czaba?a, J. C. (2015). Stress Management Techniques. Archives of Psychiatry & Psychotherapy, 17(4), 23–30. https://doi.org/10.12740/APP/61082

Panda, S. (2014). Stress and health: Symptoms and techniques of psychotherapeutic management. Indian Journal of Positive Psychology, 5(4), 516–520.

Pestonjee, D. M., & Pandey, S. C. (2013). Stress and Work: Perspectives on Understanding and Managing Stress. New Delhi: Sage Publications Pvt. Ltd. 

Pignata, S., Boyd, C. M., Winefield, A. H., & Provis, C. (2017). Interventions: Employees’ Perceptions of What Reduces Stress. BioMed Research International, 2017, 1–12. https://doi.org/10.1155/2017/3919080

Pusch, E. A., Bentz, A. B., Becker, D. J., & Navara, K. J. (2018). Behavioral phenotype predicts physiological responses to chronic stress in proactive and reactive birds. General & Comparative Endocrinology, 255, 71–77. https://doi.org/10.1016/j.ygcen.2017.10.008

Shariatkhah, J., Farajzadeh, Z., & Khazaee, K. (2017). The Effects of Cognitive-Behavioral Stress Management on Nurses’ Job Stress. Iranian Journal of Nursing & Midwifery Research, 22(5), 398–402. https://doi.org/10.4103/1735-9066.215683

Thompson, H. L. (2010). The Stress Effect: Why Smart Leaders Make Dumb Decisions--And What to Do About It (Vol. 1st ed). San Francisco, Calif: Jossey-Bass.

Wiggert, N., Wilhelm, F. H., Nakajima, M., & al’Absi, M. (2016). Chronic Smoking, Trait Anxiety, and the Physiological Response to Stress. Substance Use & Misuse, 51(12), 1619–1628. https://doi.org/10.1080/10826084.2016.1191511

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