Staff Stress Prevention & Management

1. Staff Stress Prevention & Management Reducing Burnout in Reproductive Health Agencies

2. John-Henry Pfifferling, Ph.D.Director, Center for Professional Well-BeingDurham, NC 27705 Disclosure: Dr. Pfifferling states that he does not have a financial interest in or other relationship with any commercial product named in this presentation.

3. Objectives • Identify stressors specific to family planning/reproductive health agencies • Describe traits of a “burnout proof” family planning/reproductive health organization • Demonstrate how staff stress management and prevention improves patient care.

4. What is Burnout?

5. Burnout is a Process • Discrepancies between the person and the job • Expectations clash with an imposing reality • Engagement with the job erodes • Grieving results from mismatch between “spirit” (core passion and purpose) and demands of work environment

6. Burnout is a Grief Syndrome • Presents as exhaustion, cynicism, and ineffectiveness • Positive emotions decrease; loss of enthusiasm and idealism • Usually experienced as personal imbalance; not recognized as unrealistic job demands • Symptoms can be emotional, physical & transpersonal/spiritual

7. Stressors in Family Planning/Reproductive Health Agencies

8. The Clientele • Inconsistent attendance • Underserved population issues • High risk teen illness & pregnancy • Continually seeking services for preventable consequences • Present disabling conditions that enhance poor sexual health choices • Lack of partner involvement/problematic relationships

9. Management/Employee Relationship • Conflicts and disagreements • Custom of triangulation • Unavailability of staff or management • Non-compliance with orders & assignments • Anxiety over inability to understand or follow “orders” • Disruptive or dramatic employee promoting ineffective planning, treatment or strategic actions • Lack of financial and emotional reward from supervisors • Competing responsibilities

10. Effects of Limited Funding • Continuous funding insecurity • “Bureau-pathology” • Small or poor space constraints • Reduces staff availability/positions • Information overload • Less professional development • Less staff/time = Task overload

11. Lack of Community Support • Negative image of clinic’s role/services • Reproductive health not integral part of health and wellness • Hard convincing electorate and community members of the global benefits of family planning & reproductive health • Outside practitioners not current on reproductive health protocols

12. Burnout Prevention

13. Burnout Proof Organizations 1. Acknowledge that the system can cause stress, not primarily the individual 2. Establish collective thinking and collaboration 3. Improve feedback processes • Regular & timely • Establish approachability • Be available for confidential feedback

14. Burnout proof organizations seek/offer training on … • Medical function stress management • Reality shock preparation • Creativity • Career evolution assistance • Burnout • Conflict management • Leadership • Team-building • Effective communication skills/assertiveness • “Juggling” responsibilities

15. Burnout proof organizations… 5. Accept chaos/perceptions of control 6. Reduce excess workload 7. Promote agency cohesiveness 8. Balance reward systems 9. Clarify expectations and issues 10. Promote & model congruent values; balance, loyalty, confidentiality, honesty, clarity

16. Burnout proof organizations… 11. Support mediation and conflict resolution 12. Offer creative exercises and retreats 13. Establish peer support & coaching groups 14. Conduct an ergonometric analyses

17. Burnout Proof Individuals 1. Accept chaos 2. Address any workaholic/perfectionism 3. Become a member in a community of caring 4. Accept “life is alright, no matter how things turn out” 5. Practice assertiveness 6. Make constructive feedback a lifelong learning principle

18. Burnout proof individuals… 7. Practice absolute self-care • Use affirmations • Practice relaxation • Seek counseling • Career • Spiritual • Mental Health See “Absolute Self-Care” Handout

19. In general… • Services for staff need to be non-stigmatized, available and used. • All staff learns and practices constructive feedback with patients and each other. See Constructive Feedback Handout • Feedback from services incorporated into quality of work life program.

20. Improving Client Care

21. Areas of Improvement • Clinic Efficacy • Improved feedback systems lead to productive work environments • Attendance improvements • Decrease human system errors = increased safety! • Interprovider communication = integrated care of patient

22. Improvements… • Compassion • Model constructive feedback to clients • Speak to self-care • Compliance --Staff willing to comply with collaboratively set goals --Mutual respect encourages follow-through

23. Burnout-proofing validates a commitment to the value of the scarce human resource: Care-giving professionals.

24. Recommended Reading • Alberti, Robert & Michael Emmons. Your Perfect Right. 2001. Impact. • “Burnout: Effectively Managing a Grief Syndrome,” in Being Well (Summer 2002), and Maslach and Reiter, The Truth about Burnout. Jossey-Bass, 1997. • Oriah Mountain Dreamer. The Invitation. 1999. • Redford and Virginia Williams. 1993. Anger Kills. Times Books. • Rubin, 2000. The ABC’s of Effective Feedback. Jossey-Bass.

25. Thank you for joining us today. John-Henry Pfifferling, Ph.D.Director, Center for Professional Well-BeingDurham, NC 27705 cpwb@mindspring.com 919-489-9167 Take care of yourselves!!