Building Resiliency to Better Building Resiliency to Better Manage Occupational StressManage Occupational Stress

S. Joshua Kenton, Psy.D.S. Joshua Kenton, Psy.D.

LCDR USNLCDR USN

Staff Clinical PsychologistStaff Clinical Psychologist

Naval Medical Center, San DiegoNaval Medical Center, San Diego

Work Related Stress

• Unreasonable demands for performance

• Lack of interpersonal communication between the employer and the employees

• Lack of interpersonal relationship among the

employees • The fear of losing one's job/job insecurity

• Long working hours • Less time to spend with the family • Under utilization of skills

Psychological Symptoms

•Mood swings

•Anxiety

•Depression

• Irritability

• Poor decision makingPoor decision making

•Lack of concentration

Physical Symptoms

•Suppression of immunity resulting in infection

•Headaches

• Increased appetite leading to weight gain.

•Sleeplessness

•Loss of sexual drive

•Memory disturbances

Behaviors you may Behaviors you may display…display…

• Change in friendsChange in friends

• WithdrawalWithdrawal

• Changes in Changes in appetiteappetite

• Inability to restInability to rest

• PacingPacing

• Change in sexual Change in sexual functioningfunctioning

• Increased Alcohol Increased Alcohol consumptionconsumption

• Emotional Emotional outburstsoutbursts

• Erratic movementsErratic movements

• Change in speech Change in speech patternspatterns

A beliefs injury Due to conflict

between moral/ethical beliefs and current experiences

INNER INNER CONFLICTCONFLICT

INNER INNER CONFLICTCONFLICT

A fatigue injury Due to the

accumulation of stress over time

Wear &Wear & TearTear

Wear &Wear & TearTear

A grief injury Due to loss by

death or separation of people who are cared about

LOSSLOSSLOSSLOSS

Stress Injury Sources:Stress Injury Sources:

Impact

A trauma injuryDue to events provoking terror, helplessness, horror, shock

Intense or Prolonged StressIntense or Prolonged Stress

Facing decision about balancing Pt. care with Self-Care

Feeling disillusioned

INNER INNER CONFLICTCONFLICT

INNER INNER CONFLICTCONFLICT

Long shifts Frequent

Deployments Staffing

shortages, and changes; PCS

Wear &Wear & TearTear

Wear &Wear & TearTear

Loss by death of critical care pts. suicide, etc.

Loss of job/role, relationships, etc.

LOSSLOSSLOSSLOSS

Stress Injury Sources:Stress Injury Sources:

ImpactImpact

ER Trauma Care Psychiatric Emergencies ResponseICU, NICU, etc

Common Examples in Common Examples in Healthcare SettingHealthcare Setting

““Fit & FocusedFit & Focused”” Well-trained and qualifiedWell-trained and qualified Positive command climatePositive command climate High moraleHigh morale Strong cohesionStrong cohesion Good order and disciplineGood order and discipline Clear sense of missionClear sense of mission Exhibits ethical and moral Exhibits ethical and moral

behaviorbehavior Balanced & healthy Balanced & healthy relationshipsrelationships

READY READY

READYREACTINGINJURED ILLHEALTHY

GREEN ZONE

READYREACTINGINJURED ILL

REACTINGREACTING Anxious, irritable, sadAnxious, irritable, sad Poor concentrationPoor concentration Trouble sleeping, Trouble sleeping, fatiguedfatigued Changes in appetiteChanges in appetite Apathy, loss of interestApathy, loss of interest Negative, pessimisticNegative, pessimistic Increased interpersonal Increased interpersonal

conflictconflictPoor decision-makingPoor decision-making

RECOGNIZING STRESS REACTION

INJUREDREADYREACTING ILL

INJUREDINJURED

Poor emotional control Poor emotional control Major sleep difficulties Major sleep difficulties Guilt, shame, fearGuilt, shame, fearLoss of interestLoss of interestDisruption of moral Disruption of moral

valuesvaluesSubstance AbuseSubstance AbuseDecreased confidenceDecreased confidencePoor moralePoor moraleFamily disruptionFamily disruption

RECOGNIZING STRESS INJURY

READYREACTINGINJURED ILL

ILL

• Chronic and severe distress

• Substance dependence

• Major disruptions of sleep, appetite, mood

• Significant problems at work

• Panic, rage, guilt, and shame

• Symptoms that persist or get worse over time

• Injuries that don’t heal without help

• Family/relationship violence or abuse

RECOGNIZING STRESS ILLNESS

What Doesn’t Help

•Using alcohol or drugs

•Violence or conflict

•Overeating/restricting diet

•Working too much

•Blaming others

•Withdrawing from pleasant activities

Building, Maintaining and Building, Maintaining and Restoring Your ResiliencyRestoring Your Resiliency

• Create small goals

• Stay in the here and now

• Don’t run from the problem/Keep things in perspective

• Maintain an outlook of hope

• More fun

• Rely on good relationships

• Exercise

• Breathing/Relaxation

Conclusion

•Managing stress takes practice

•Be preventative

•Stay in the Green/Yellow

•Look out for each other

•Know when to get professional help.