Psychological occupational health hazards of nurses

1. Occupational Health Hazards
- Psychological
Dr.Latha Venkatesan
Principal
Apollo College of Nursing, Chennai

4. Introduction
Throughout the world, nurses spend much of their
waking hours at work.
Work provides a number of benefits for the nursing
manpower, at the same time they face a variety of
hazards more importantly psychosocial.
They place an impact on health & safety of nurses
and the healthiness of organisation.

5. Nursing Empowerment – Perceived Needs And
Challenges – Study Findings
PROBLEM AREAS THAT NEED
NURSING EMPOWERMENT
10% 10%
27%
13%
7%
0%
5%
10%
15%
20%
25%
30%
INFORMATION
TECHNOLOGY
GROOMING PHYSICIAN
NURSE
INTERACTION
QUALITY
NURSING
EMPATHETIC
CARE

8. Study on Identification of Personal Sources of
Power among Nursing students
Percentage Distribution of Sources of Power Identified by
Nursing students.
21/01/2018

9. Occupational Stress &
Wellbeing of Nurses
Whilst a certain
amount of stress
can improve
performance &
motivation,
extreme stress
can have
negative effects
on health
Let us
understand the
link between
stress and ill
health in a three-
stage model of
the body’s
physiological
response to
stress

10. Three stage model of body’s
physiological response to stress
Alarm – Hypothalamic-pituitary-adrenal
system is activated. (Fight or Flight)
Resistance – An attempt to cope with a
prolonged stressor by maintenance of
high levels of arousal
Exhaustion – Here the defence systems
of the body become exhausted & health
effects occur. (e.g. High Blood pressure)

11. Twelve work stressors that
increases the risk for ill health
Time
pressure
Cognitive
demands
Emotional
demands
Hours of
work
Poorly
define work
roles
Conflict

12. -Cont..
Poorly
managed
change
Violence and
aggression
Lack of job
control
Lack of
supervisor
support
Organisational
injustice
Inadequate
reward &
recognition

13. Time Pressure
Refers to the requirement to work very
hard or very fast to meet key performance
indicators set for the task, or having
inadequate time to complete work.

14. Cognitive Demands
Affects psychological & physical well being &
results in performance decrements.
Tasks with high cognitive loads – requires
sustained concentration & high level decision
making (calculating & administering
paediatric drug doses)
Tasks with low cognitive loads –
Monotonous tasks with little variety (stock
taking)

15. Emotional Demands
False display of emotion,
such as happiness or
desire to please, even in
situations where the
work has induced anger.

16. Hours of Work
Long working hours and
Fatigue can lead to injuries
& near miss accidents at
work

17. Poorly Defined Work Roles
An unclear understanding of
performance requirements &
job responsibilties, frequent or
sudden changes in roles
(changing areas of work too
often)

18. Conflict
Work related Interpersonal
conflict contributes to
psychological disturbance.
Work place bullying &
harassment are interpersonal
stressors which can lead to
outcome of severe nature

19. Poorly Managed Change
Any organisational change is a work
stressor . There should be effective
systems to communicate & manage
change process.

20. Violence & Aggression
• Any act of physical/ psychological
violence, harassment, intimidation,
or threatening disruptive behavior
that occurs at the work site.
• It ranges from threats and verbal
abuse to physical assaults and
homicide.

22. Lack of Job Control
‘Skill discretion’ - refers
to how much variety
people get in their
work and how much
opportunity people get
to use their skills;

23. Lack of Supervisor support
• Social Support acts as a buffer in the stressor
strain relationship at working place
• Social support can be offered by either
supervisor or co-worker in the work place.
• Instrumental support – providing assistance to
solve problems (Advice)
• Emotional support – Listening empathetically

24. Organisational Injustice
Fairness at work or organisational justice
is a multifactorial concept
– Procedural Justice (fairness of procedures)
– Distributive Justice (fairness of decision
outcomes)
– Interactional Justice (fairness of interpersonal
treatment)
– Informational Justice (fairness of provision of
information).

25. Inadequate reward &
RecognitionThe Effort-Reward Imbalance
model (Siegrist, 1998) centres
on the concept of imbalance
between the effort that a worker
puts in and the rewards (e.g.
money, esteem and social
control) they gain.
Imbalances in this
area are linked to
negative effects on
self-esteem, self-
efficacy and health.

26. Risks for Work Related Stress

27. Psychosocial Hazards &
Organisational Outcome
Absenteeism Presenteeism

28. Other Organisational outcomes
Exposure to
psychological
hazards at work
include
Turn over/ attrition Team disharmony
Management time
spent dealing with
conflict

30. Remedies
Regular exercise is a stress reliever
Talk to an attentive listener
Choose foods that keep you going (Take more
fruits, vegetables & proteins). Limit Carbohydrate
Groom well

31. -Cont...
Don’t over commit yourself
Prioritizing & organising
activities in advance
Get enough sleep
Improve Communication
( Assertive)

32. Assertive Communication
Is the ability to communicate
opinions, thoughts, needs &
feelings in a direct , honest,
comfortable & appropriate manner.
Exercising your personal rights
without offending or denying the
rights of others.

33. Techniques of Assertive
Communication
Be direct, use a
firm but
pleasant tone
Learn to take
complements
Ask for
feedback
Stop
apologizing all
the time, accept
your faults
without apology

34. -Cont...
Feel free to
say ‘no’ or ‘I
don’t know
Think both of
you should
win any
situation
Don’t be self
depreciating
Be as
specific &
clear as
possible

36. Statements Yes No
I am comfortable meeting new people in social situations
I am able to say no without feeling guilty or anxious
I can express strong feelings such as anger, frustration or
disappointment
I can easily request help and information from others
I feel capable of learning new things and performing new tasks
I am able to acknowledge and take responsibility for my own
mistakes
I can discuss my beliefs without judging those who don’t agree with
me
I am able to express my honest opinions to others even if they don’t
agree
I tell others when their behaviour is not acceptable to me
I can speak confidently in group situations
I believe my needs are as important as those of others and should be
considered
I can assert my beliefs even when majority disagrees with me
I can express my anger or disappointment without blaming others
I am comfortable delegating tasks to others
I value my own experience and wisdom

37. Grievance Redressal
Committee
• Grievance Redressal cell / committee should be
formed in every hospital with a team of leaders
who would represent the various problems
battled by nurses.
• Traditionally, grievance redressal is handled
through letters & complaint forms (has very little
appeal)
• Currently , new internet – based approaches
used by the government & more by the private
institutions (pgportal)-India, TripAdvisor &
ActPlease.com

38. Constitution of Internal Complaints
Committee
• A Presiding officer - shall be a woman
employed at a senior level at work place. If
senior level woman is not available,
presiding officer shall be nominated from
administrative unit of the work place
• Not less than 2 members from among the
employees preferably committed to the
cause of women – i.e.,1 from NGO
committed to the cause

39. Sexual Harassment at work
place policy
• Employers are responsible for complying
with prohibition , prevention & redress of
workplace sexual harassment.
• This policy
– Prohibits unwelcome behaviour
– Champions prevention of workplace sexual
harassment through orientation, awareness &
sensitization sessions
– Provides a detailed framework for redress.

40. Conclusion
Risks to psychological health due to work
should be viewed in the same way as
other health and safety risks and a
commitment to prevention of work-related
stress should be included in an
organisation’s health and safety policies

41. Thank You