Features of stress in healthcare professionals

Back, 2016Dobson, 2021Meier, 2001Riley, 2004Turner, 2011

Emotional stress can be a significant problem for healthcare professionals. Stress can have adverse effects on work performance, job satisfaction and personal health and wellbeing. It can also compromise the care of patients and their families and carers.

It is impossible to avoid the sadness and distress of patients and their families as they face death. Healthcare professionals may experience emotional reactions to the limitations of medical care and treatment, to advancing disease and death, and to the demands these inevitably place on patients, their families and on healthcare professionals themselves. Dealing with prognostic uncertainty and breaking bad news to patients and families can be difficult. Prolonged contact with traumatised and distressed individuals can result in compassion fatigue, a state of exhaustion and stress associated with a decreased ability to empathiseBaqeas, 2021Cocker, 2016.

The background and personal characteristics of some patients and families may elicit more stress than others. For example, a healthcare professional may experience more stress if the circumstances of the patient’s illness resonates with the healthcare professional’s own life experience (eg similar age or background). Dealing with complex ethical dilemmas can also be stressful (eg when there is conflict about care decisions within the team, or between the team and a patient or family). Factors related to the professional and the work environment that can contribute to stress or burnout are summarised in Factors that increase the risk of stress and burnout in healthcare professionals.

Table 1. Factors that increase the risk of stress and burnout in healthcare professionals

Healthcare professional factors

inadequate training for the role and tasks

limited or absent personal supports

difficulty setting boundaries (role and responsibilities, patient-provider relationships)

younger age

engaged full-time in caregiving

high self-expectations

stressful personal life events, especially when cumulative and without adaptation or resolution

history of depressive or other psychiatric disorder

propensity to self-medicate for stress symptoms, including excessive alcohol use

Work environment factors

work overload

ambiguity of role

lack of job control or flexibility

lack of supportive working relationships or networks with other healthcare professionals

ineffective teamwork with inadequate communication, conflict about goals of care, or lack of leadership

administrative problems due to inadequate resourcing or poor management

periods with multiple complex or especially demanding clinical problems to manage