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Can Work Stress Effect Your Personal Life or Might You PTSD

by Michael Mileski, DC, MPH, MHA, MSHEd, LNFA

Consider the environment in which you work.  If it is like most other certified nursing assistants (CNA) it is most likely somewhere in a residential care or long term care facility.  Some other aides might work in hospitals as well.  Understanding this allows us to see that you work in some of the most stressful environments that are offered in healthcare.  Further considering the job that the CNA has, where they do the bulk of the patient care in the environment, and are often hustling back and forth between patients, it is easy to see where stress comes from.  Throw a few regulatory logs on that fire, with some additional supervisor issues, and you have set yourself up to become a stressed out individual!

Understanding this stress level also allows you to take action to deal with it, before it deals with you.  Knowing how to handle yourself and how to decrease those stress levels is such an important skill for you to develop to maintain your own health, and that of your family as well.  We often hear to leave your personal life at the door when you come to work.  However, the opposite is entirely true as well.  You need to leave your work life at the door when you go home.

Can You Have PTSD Yourself?
This is a very true possibility.  Consider what you deal with on a daily basis at work, and what you have going on within your life as well.  We understand that caregivers have increased levels of stress in dealing with grief when patients die (Sanderson, Lobb, Mowll, Butow, McGowan, & Price, 2013). A 1967 study done by Holmes and Rahe drew conclusions of significant life events and applied a numeric value to each of them.  The study is officially called the Holmes and Rahe Social Readjustment Rating Scale (we more commonly refer to it as the Holmes and Rahe Stress Scale). These numeric values have been correlated to show a relationship between them and the risk for illness that a person is placing themselves at.  Table 2 shows the numeric values and correlations to illness.  For a person to ascertain their potential for illness, they would simply add up the numbers for a total value.
The entire scale looks at events across life, not just work, however the scale does have work related items within it to consider.  For our purposes here, the “life only” events have been removed and we are only considering “work related” events.  Considering the number here in Table 3, you can see how much of an influence work can have upon your stress level and your health.

As a certified nursing assistant, on a daily basis you deal with many of these work related listings which are part of Table 3.  However, consider death.  In fact, if we look at death it is listed three times in the Scale (Table 4).  Despite that “death of a resident” is not listed here, this is one of the most common things we come across in the workplace.  Many caregivers develop rich and meaningful relationships with their residents over the years.  When a death occurs, despite how long it was expected, or necessary, the stress still is of paramount concern.
It is important to understand that each of the above situations (and many more not discussed in this article) can have a very direct impact on stress levels for someone.  The above table only considers that which might happen at work, but the full Holmes and Rahe scale entails the rest of your life outside of work as well.

If you would like to take the entire “stress test” you can access a copy and instructions at www.dartmouth.edu/~eap/library/lifechangestresstest.pdf

Dealing with Stress

Understand that caregiver stress is a “real thing” and it is important for you to do things for yourself to help alleviate these symptoms.  If you know you have an issue with PTSD, there are professionals who can help you such as a therapist or psychologist.  Even if you do not have true PTSD, but you are having these kinds of symptoms, reach out to someone for help.  Quite often, your workplace might even have resources for you available to take advantage of.

Learning ways to relax outside of work, despite your own life, is another way to help with this.  Find time for YOU each day.  Find a hobby, exercise, dancing, or anything that gets your mind removed from work or your own situation and your body moving.  Everyone understands that you lift 300 pound patients all day at work, but that is NOT the same as working out.

Spirituality might hold the key for you as well to relaxing.  This can be more than simply going to church on Sundays.  Find some way to connect yourself to “a higher power” and you might be able to find some peace as well.  Consider meditation, breathing exercises, yoga, walking in the forest, sitting near a river or on the beach, or any other way that you could commune with your surroundings.  This becomes more about you being comfortable with yourself.  Find ways that work for you in this area, and that help to relax you overall.  When your health is at its optimal level, you can do more to help those who depend upon you, both at work and at home!


References
Holmes, T. H., & Rahe, R. H. (1967). The social readjustment rating scale. Journal of psychosomatic research, 11(2), 213-218.

Sanderson, C., Lobb, E. A., Mowll, J., Butow, P. N., McGowan, N., & Price, M. A. (2013). Signs of post-traumatic stress disorder in caregivers following an expected death: A qualitative study. Palliative medicine, 0269216313483663.

Dr. Mileski is an Assistant Professor at the Texas State University School of Health Administration, where he teaches courses in staff and supervisory management, patient care/satisfaction, long term care administration, and quality assurance. He can be reached at mileski@txstate.edu.