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  1. 1.    Stress and anxiety are basic to life, no matter how wealthy, powerful; good working and happy- mild stress can be stimulating, motivating and sometimes even desirable. The word stress derived from English word. Originally it was used in physics and it is meant an external pressure , tension , load of an object. It was conceived as pressure from environment , then as strain within the person. The term stress was introduced in medicine in 1949by Canadian Endocrinologist Hans Selye he described stress as the body’s adjustment to new circumstances , and the bodys stereotypical and non specific response to environmental stimuli.
  2. 2. Definition Stress is a state manifested by a specific syndrome which consist of all the non specificaly induced changes within a biological system . by Hans seyle Stress is mind and body’s response or reaction to a real or imagined threat, event or change. A physical or psychological stimulus that can produce mental tension or physiological reactions that may lead to illness."
  3. 3. LEVELS OF STRESS Two types of stress- Eustress or positive stress - Distress or negative stress Eustress or positive stress occurs when the level of stress is high enough to motivate to move into action to get things accomplished. Distress or negative stress occurs when level of stress is either too high or too low and body and/or mind begin to respond negatively to the stressors.
  5. 5.  When we experience a stressful event or perceive something to be stressful psychological changes occur in the body. This experience or perception disrupts body’s normal balance and immediately body begins to respond to the stressor(s) as effectively as possible
  6. 6. During this stage body tries to cope or adapt to the stressors by beginning a process of repairing any damage the stressor has caused..
  7. 7. EXHAUSTION STAGE • • During this stage the stressor is not being managed effectively and the body and mind are not able to repair the damage.
  8. 8. CAUSES OF STRESS • • • • • At work place At Organizational Level At Personal Level Inter personal factors Individual factors
  9. 9. Workplace stressors of staff nurses • • • • • • • • • • Workload Inadequate staff cover Relationship with other clinical staff Leadership and management style lack of adequate supervisory support Coping with emotional needs of patients and their families poor patient diagnosis Death and dying Shift working Lack of reward
  10. 10. At Organisational Level • • • • Technical – emergence of new technologies Strategic – globalization, privatization, take-overs, Competition Increasing urbanization
  11. 11. At Personal Level Life events Entries & exits to the family Change in job Daily events Unexciting but tight routine Struggle of day to day life Social support Economic, physical & emotional support from friends, family & others
  12. 12. Inter personal factors • Interpersonal relationship within the nursing profession and between other professions • Shorter stay for patients • Supervision of assistive personnel • Interdisciplinary conflict
  13. 13. Individual factors • Marriage • Pregnancy • Purchasing a new home
  14. 14. COMMON SYMPTOMS OF STRESS Insomnia  Fatigue  Depression  Irritability  Anger  Hopelessness  Change in appetite
  15. 15. Physiological indicators The physiological signs and symptoms of stress result from activation of sympathetic and neuro- endocrine systems of body.  Pupils dilate to increase visual perception  Sweat production increases  Heart rate and cardiac output increases  Skin is pallid due to peripheral blood vessel constriction  Mouth may be dry  Urine output decreases  Blood sugar increases
  16. 16. Psychologic indicators The manifestations: of stress includes- anxiety, fear, anger, depression and unconscious ego defense mechanism. Anxiety: state of mental uneasiness, apprehension, dread or feeling of helpness. It can be experienced at conscious, subconscious or unconscious level. Fear: it is an emotion/ feeling of apprehension aroused by impending or seeming danger, pain or threat. Depression: it is an extreme feeling of sadness, despair, lack of worth or emptiness. Unconscious ego defense mechanism: it is a Psychologic adaptive mechanism developing as the personality attempts to defend itself and alay inner tensions
  17. 17. Cognitive indicators problem solving: the person assesses the situation or problem analyzes, chose alternatives, carries out selected alternatives and evaluates. Structuring: arrangement/ manipulation of a situation so that threatening events does not occur. Self control: assuming a manner and facial expression that conveys a sense of being in control or in change. Suppression: willfully putting a thought or feeling out of mind. Day dreaming: unfulfilled wishes and desires are imagined as fulfilled or a threatening experience is re worked or re played so that it ends differently from reality
  18. 18. BIBLIOGRAPHY • Sullivan Elanor J , Decker Philip J . Effective leadership and management in nursing. Addison Wesley; 1997 • Barret jean. Ward management and teaching . New Delhi , Konark publishers; 1994 • Ann R L . Basic concepts of psychiatric mental health nursing. 7th edition. Philadelphia . Lippincott ;1997
  19. 19. • C. Adey: “Stress: Who cares?”, in Nursing Times, Vol. 28, 1987, pp. 52-53. • J.T. Bailey, S.M. Steffen and J.W. Grout: “The stress audit: Identifying the stressors of ICU • nursing”, in Journal of Nursing Education, Vol. 19, 1980, pp. 15-25 •