August FY20

[sarahrollison]

This month's journal club is presented by Kelsie Johnson. She chose an excellent article that explores the incidence and impact of job-related stressors for CRNAs. The article discusses coping mechanisms for job-related stress, as well as how our daily stressors can affect our interpersonal relationships with coworkers. 

Here is a link to the article.

Questions to engage in discussion:
1. Do you agree with the stressors this article has identified to be true in your life/practice?
2. What are some of your ideas/suggestions that you have to decrease the identified stressors? How can we make things better?

[aileen mendez]

hi there
very good article
I agree with the stress list in the article and believe we could each add more. We need to appreciate all the hard work we do for our patients and families every day. All day we are giving of ourselves, kind and vigilant and work at 100%.  It is physically and mentally exhausting.  I come home some days and need to nap before going to bed!
I think having close friends at work who you know truly care for you as a person and who you can count on to help you out or with a favor is my biggest joy.
I also think ideas like the sunshine club by Darolyn is a very nice way to show appreciation with a personal touch.
A good company cares for their workers, who are then able to care for their customers/patients as best as they can.
aileen 

[Jessica Switzman]

Another pertent article that identifies job stresses that I are true in life and practice. Stress is unavoidable but with supportive colleagues, administrators and family we can navigate stress and learn to build resilience. Caring for ourselves with proper nutrition, sleep, exercise and carving out time for being silly are essential in order to deal with daily stressors

[LarSharVeA Bailey]

I certainly agree with the article and the identified stressors. The article provides an excellent presentation of the subjective CRNA experience; I could not relate more.
There are some stressors that can not be avoided i.e. those related to patient safety and the vigilance required to deliver the excellent care that CRNAs do. However,
facility wide treatment of CRNAs and interpersonal relations can certainly be improved. It is my belief that emphasis on the strict requirement for professional, respectful
communication and interaction should start from the top. Considering all of the esoteric knowledge that we have swift command of and all the difficult cases we manage seamlessly
everyday, it is really not that hard, nonetheless, it remains a choice.

[Jennifer Hannon]

Well, I'll follow the eloquent LarSharVeA and I agree, there is absolutely a choice. There are many stressors here at the Hop. I hope relationships and culture will improve as it is an indirect job stressor that we shouldn't have to focus our vigilance and time on.

I try not to take things home. The beauty of report is knowing the helm is now in the hands of someone else. I say a positive prayer/vibe for the patient and go home. We are a team and through Darolyn's sunshine fund and social events we unite, learn more about each other and strengthen as a team.


PS. The "I'm not a robot" is a huge stressor!! How many crosswalks, nope fire hydrants, nope bicycles Do I have to click to post this?

[Moishe Mayer]

This is a great article that I agree with all the points mentioned that can add to stressors in a CRNA's daily routine. Open communication with appropriate validation is of paramount importance. It is very frustrating when I feel that I cannot provide optimal anesthesia administration according to my style. Poor communication and constant invalidation can really get into one's head to constantly question their decisions.

[Jocelyn Datud]

Thank you for this article. The article validated some of the experiences that I encountered. It is helpful to know that other CRNA's are feeling stressed out too and that we are not alone in this experience. We have a big responsibility in the OR. Once we wheel our patient in the OR, we have this responsibility to bring them back to their families- which is definitely a huge deal. This itself is very stressful. Hence, it is imperative to know how to manage stress. Having supportive and helpful colleagues and administrative personnel is the key. If we see that we are appreciated and supported, we in return will work harder for the group. Also, having a break from work and being able to enjoy your life outside work also helps in rejuvenating our energy.

[Patricia Brissett]

This article speaks volumes! I am certainly going to share it with the SRNAs that will soon be our colleagues. My key take away point was self evaluation and acknowledging that I am not alone. If I may quote, "Anesthesia is a constantly changing field". As mentioned by others before me, find the balance and maintaining open lines of communication are key.

[Katya]

1. Thank you for interesting article. We all can relate to stressors mentioned in article. I agree with Lasharvee that some stressors are unavoidable and some can be avoided.
2. To reduce my personal stress I listen to audiobooks on a way home from work and go to gym or just for a walk to clear up my head.

[Ben Waldbaum]

1. For the most part, yes. Production pressure, lack of staff, long days, reduction of amount of staff allowed off, challenging cases.
2. Increase the pay at the institution to enable recruitment and retention. This would translate to better OR staffing, more breaks, ability to schedule vacation days.

[jkim54]

1. The stressors discussed in this article ring very true to what I experience in our own practice. I appreciated that the issue of work space was also brought to light as a stressor. How many times has an OR room been renovated or re-configured and it seems obvious that anesthesia has been an afterthought to the redesign? This is just one of many instances when it seems as if we are merely an incidental part of caring for the patient, of which we are most certainly not.

2. Lack of staff is currently a major stressor - we need to hire more CRNAs and take more aggressive measures to promote this - whether it be increase in pay, retention incentives, etc. We are not a dime a dozen. We perform a wonderful service to our patients and should be valued as such.

[Jessica Hadley]

1. I agree with the stressors that were identified in this article. Specifically; Production pressure, interpersonal relationships, challenging cases/patients, and staffing shortage are stressors that I most identify with.

2. There are some stressors which are inherent to the role and can't be modified eg. patient comorbidities. Modifiable factors can include adequate staffing, rewarding staff for managing a very stressful environment e.g. bonus, call offs when overstaffed. Personal stress reduction techniques I employ are podcasts, books on CD to and from work, exercise, cooking, and playing with my kiddos.

[Christine Velarde]

1. I agree that there is a push to do as many cases as possible, finishing up on time to avoid overtime of staff. I think this increased production can stress us out and make us feel like robots rather than health care providers. If it becomes too stressful I'll ask the team to slow it down until I'm ready-otherwise mistakes will be made.
2. A stressful work environment should not be brought home and affect their life. We should go do some relaxation: go to the gym -yoga, cook or bake

[Wai-Ling Lo]

1. Although it's a small study, it did highlight the most common stressors that I encounter daily such as overtime, production pressure, complex interpersonal relationships, environmental stressors (such as lack of equipment and supplies...) and acuity of cases. I guess these things are universal.

2. I agree with the recommendation that one should separate work from person life to keep our sanity. A supportive leadership and collaborative interdisciplinary team will definitely help to create a less stressful working environment. Engage in relaxing hobbies and leisure activities during my free time can also help me to reduce stress level.

[Soo-Ok Kim]

All the stressors mentioned in this article are relevant in the stressor at our work place, varies in degrees. Some stress factors are given and not modifiable. Most of times, those are not big factors make me stressful. The main stress is coming from interpersonal relationship in practice; attending, surgeon and OR staff. If I have great team members to work with complicated cases, that day is not so bad.
Several other stressors are short staff, unable to change schedule as needed including vac/sick time, and politics at work mentioned in article.

It is very important to have dependable and good friends at work who share similar work ethics and life value in general. I have a friend who is willing to cover me for 2hrs on her day off for me to go to class. This makes me feel appreciative and I will do the same thing to my colleagues when needed. I also attended RISE program when the event happened in OR with great feeling. I highly support using that if staff needs.

One of things, I hope, to make it better at work is to recognize our daily hard work with kind words to one another.
The big institution like this tends to overlook the each individual employee like us, not a very few top, make a big difference every day.

The article picked the interesting sample group with rather seasoned practitioner with majority of diploma level education in rural hospital 15yrs ago. I wonder what kind of findings we will find in JHH setting.
Thank you for the article. soo-ok kim