STRESS

MANAGEMENT

Rajesh Kumar Sharma

Asso Professor
HCN, SRHU
 INTRODUCTION:
• Stress has been defined in many different ways
over the years. The word stress is derived
from English word. Originally it was used in
physics and it meant an external pressure,
tension, load of an object (Newhouse and
Treven, 2005). It was conceived as pressure
from the environment, then as strain within
• The term stress was introduced in medicine in
1949 by Canadian endocrinologist – Hans Selye.
To him, stress is described as the body’s
adjustment to a new circumstance, and the body’s
stereotypical and non-specific response to
environmental stimuli that disrupt a personal
balance, and described also as a psychosomatic
mechanism to regulate and balance the tensions,
which means the perception and preparation of
the body to the specific loads.
• About one-third of workers reports high level
of stress and high level of stress are associated
with the substantial increase in health service
utilization.
• Additionally, periods of disability due to job
stress tends to be much longer then disability
periods for other occupational injuries and
illness.
• Stress affecting the nurse across the globe has
been convincingly documented in the literature
for more than 40 years, (Lazarus RS).
• Nurse’s environment includes an enclosed
atmosphere, time pressure, excessive noises,
no second chance, unpleasant sights and
sounds, and long standing hours.
 DEFINE STRESS:
Stress is the “non-specific response of the body

to any kind of demand made upon it”.

(Selye-1956)
 DEFINE STRESSOR:

Stressor is any person or situation that produces

anxiety response to the body.

A stressor is a chemical or biological agent,

environmental condition, external stimulus or an
event that causes stress to an individual.
DEFINE OCCUPATIONAL OR JOB
STRESS
Occupational or job stress is
defined as a tension arising in
a person that is related to the
demands of the persons role
or job (McVicar, 2003)
 KINDS OF STRESSORS:

 External stressors:

 Internal stressors:
 External stressors:
- Physical environment
- Social interaction with people
- Life events which you have no control
over (death in the family)
 Internal stressors:
- Personal lifestyle choice
- Personality traits
- Individual thought (negative, over
process analyzing, etc.)
 TYPES OF STRESS:

Stress is the ‘wear and tear’ our

experiences bodies as we adjust to our
continually
changing environment.

It has physical and emotional effects on us

and can create positive and negative feelings.
There are actually two types of stress;

A.Eustress

B.Distress
A. Eustress:
• Eustress is the positive stress that stimulates
a person to function better. This is called as
friendly stress or positive stress.
• It has a good influence on human in terms of
physical and mental ability.
• It acts in a positive for the individual and the
organization.

• It also provides the sense of urgency and

alertness needed to survival when confronting
threating situation.
 B. Distress

• Distress is a negative stress

that may cause illness.
• This is also called as harmful stress.

• Negative stress could be also

described as a burning out.
• It is a contributory factor in minor
condition such as headaches, insomnia,
ulcers, etc
 CLASSIFICATION OF STRESS:

Stress can be classified as ;

 Short term (acute) stress:

 Long term (chronic) stress:

Short term (acute) stress:
• Acute stress is the reaction to an immediate
threat, commonly known as fight or flight
response.
• The threat can be any situation that is
experienced, even subconsciously or falsely
as a danger.
• Common acute stress includes – noise,
crowding, isolation, hunger, danger, infection,
etc.
 Long term (chronic) stress:

• In day to day life persons faces different

stressful situations, which are not short, lived.
The stress becomes chronic when an
individual tries to suppress it.
Common chronic stressor includes;

 Ongoing highly pressured work

 long term relationship problems

 loneliness
 EFFECTS OF STRESS:

The effects of stress generally fall in categories

1. Short term effects of stress:

2. Long term effects of stress:

 Short term effects of stress:
1. Physical changes:

• Physical symptoms are usually triggered

by arousal of autonomic nervous system
and includes increase in heart rate and
blood pressure
2. Psychological changes :
- It includes lack of concentration,
- Muscle ache,
- Headache, and
- Insomnia.
- Loss of memory,
- Inability to make decision,
- Forgetfulness, and
- Confusion.
- Faster breathing,
3. Emotional changes:
- Emotional response may include
- Anxiety,
- Nervousness,
- Frustration,
- Anger,
- Irritability, and
4. Behavioral symptoms:
- Impact of stress also affects the behavior
and present as pacing,
- Fidgety movement,
- Nail biting,
- Smoking,
- Drinking, and

- Throwing things
 Long term effects of stress:
1. Behavioral changes:
- The affected person becomes victim of serious
behavioral disorder like.
- Fearfulness,
- Obesity.
- Alcoholism

- Drugs addiction
2. Physiological changes:
- The affected person become victim of serious
Physiological disorder, like
- Hypertension,
- Heart diseases
- Skin diseases
- Even cancer
3. Emotional changes:
- Chronic anxiety
- Depression.
- The affected person become victim of serious
Emotional disorder, like
- Fear and phobia
- Personality changes
- Mental disorder
4. Cognitive changes:
- The affected person become victim of serious
Cognitive disorder, like
- Memory problem
- Obsessive thoughts
- Sleep disorder
 STAGES OF STRESS

Hans Selye explained stress through GAS

(General Adaptation Syndrome), a way that the
body tries to keep balance. The GAS stages are;

1.The alarm reaction stage.

2.Stage of resistance.
3.Stage of exhaustion.
1. The alarm reaction stage:
- Alarm is the first stag.
- When the stressor is identified or realized, the
body’s stress response is a state of alarm.
- During this stage, adrenaline will be produced
in order to bring about the fight or flight
responses.
2. Stage of resistance
- Resistance is the second stage.
- If the stressor persist, it become necessary
to attempt some means of coping with the
stress.
- Although the body begins to try to adapt to the
strains or demands of the environment, the body
cannot keep this up indefinitely, so its resources
are gradually depleted.
3. Stage of exhaustion
- Exhaustion is the third stage and final stage in
the GAS model.
- At this point, all the body’s resources are
eventually depleted and body is unable to
maintain normal function.
• If stage three is extended, long term damage

may result as the capacity of gland,

specially the adrenal gland.

 STRESS MANAGEMENT:

• Stress management involves the use of the

coping strategies in response to stressful
situations. Coping strategies are adaptive when
they protect the individual from harm or
strengthen the individual’s ability to meet
challenging situation.
 Strategies of coping with stress;
a)Awareness;
- The initial step in managing stress in
awareness- to become aware of the factors that
create stress and the feeling associated with a
stressful response. As one can becomes aware
of stressors, he or she can omit, avoid, or
accept them.
b) Got organized;
- Coping with stress is all about planning. You
can plan to fall or plan to sucessed. Organized
time for work, family, hobbies, spiritual time,
time with friends and time alone, time for
exercise and time for relaxation
c) Visualized the best outcome;

• Coping with stress knows how to deal with a

stressful situation before it occurs. Rehearse
how you are going to handle it. Picture
yourself being successful in coping with stress
d) Don’t postpone action;
- One of the best strategies for coping with
stress is not to put off actions until tomorrow if
you can do it today. Coping with stress
become more difficult when you defer. Do
your least favorite chores first, followed by
rewards.
e) Be realistic;
- Set realistic goals. Emphasize quality over
quantity. Work at a leisurely pace, taking
breaks often.
f) Sleep, eat, and exercise;
- Coping with stress is all about treating your
body properly. Eat food that nourish you,
exercise and get plenty of sleep.
RELAXATION TECHNIQUES:
Be specific when exploring your options.
You might consider the following,
o Going to walk,
o Meeting with friends,
o Reading for pleasure,
o Listening to music,
o Taking a bath.
 Begin practicing relaxation techniques
like,
o Medication,-

o Deep breathing exercises,-

o Progressive muscles relaxation.
Deep breathing exercises,-
Sit or lie down comfortably, inhale slowly
through the nose and exhale through the
mouth. While inhaling place one hand
below the ribs.
• Allow that hand to extend outwards when
inhaled, let the hand fall back to its original
position when exhaled. Exhalation should
take twice as long as inhalation.
 Progressive muscles relaxation.

Muscles relaxation can be done in sitting or

lying down position.
• Each muscles group is tensed for 5 to 7
seconds and then relaxed for 20 to 30 seconds,
during which time the individual concentrates
on the difference in sensations between the
two conditions.
• Soft, slow background music may facilitate
relaxation.
 UNHEALTHY WAYS OF
COPING WITH
- Smoking STRESS

- Drinking too much

- Over eating or under eating

- Using pills or drugs to relax

- Sleeping to much
- Withdrawing friends, family,
and
from activities
- Zoning out for hours in front of the T.V
or computer.
- Taking your stress out on others (lashing
out, angry outbursts, physical violence)
 NURSE MANAGER’S ROLE IN
STRESS MANAGEMENT:

 Ensure that the workload is in line with nurses’

capabilities and resources.
 Clearly define the nurse’s role
and responsibility.
 Planned orientation programmes for the newly
joined staff.
 Give nurses the opportunities to participate in
decision making and actions in patients care.

• Improve the communications and

provide supportive environment
 Provide opportunities for social
interaction among the nurses.
 Organize group meeting to solve the problems.
 RESEARCH ARTICLES ON
STRESS MANAGEMENT

1. A Study On Stress Management Among

The Employees Of Nationalised Banks
 Harish Shukla and Ms.
Rachita Garg
(12/2013)
 ABSTRACT
•Banking, like other services, has become one of
the highly competitive sectors in India. The banking
organizations, since the beginning of this decade,
have been facing greater challenges in terms of
technological revolution, service diversification and
global banking. Stress is unavoidable on the part of
the employees as the systems, procedures;
techniques are getting complicated with the use of
advance technology. Every employee cannot cope
with such rapid Changes taking place in the jobs.
This will lead to arising of stress among
employees. An attempt has been made through
this research paper to know the reasons of stress
among the bank employees and the ways used by
employees to cope with the stress generated at
workplace. It is found that maximum number of
employees in banks remains in stress. Majority
of the employees try to find solution to relieve
them from stress.
• Also the measures are also suggested in
the paper to overcome stress that affects
their physical and mental health.
 Findings and Conclusion

Most of the employees fear with the fact that

lack quality in their work puts stress on them. It
is found that maximum number of employees in
banks remains in stress. 50% employees feel
that they are overloaded with work.
44% employees feel tensed due to their non-
achievement of their target of work. 38%
employees accepted that they will obey the order
of their boss by sacrificing their important
domestic function. It indicates fear and stress
among employees. 24% employees feel stress
due to their family related problems.
Half of the employees accepted that there is conflict
among the employees. It is a concern for
top
management. 48%employees feel that
Only
strategies used banks to manage stress
by
employees are effective. Majority of the employees
of
try to find solution to relieve them from stress.50%
employees use YOGA or other ways to relieve them
from stress. In spite of stress, majority of the
employees balance in their social life.
2. Studies on Stress Management: A Case Study
of Avatar Steel Industries, Chennai, India

oGeeta Kumari and K. M. Pandey

ABSTRACT
• In this work the analysis has been done on
stress management of Avtar steel industries,
Chennai.Asample size of 100 is taken for the
purpose of analysis made from primary and
secondary data. Out of the total sample most of
the respondents are male and many are
between 50 and above.
• Most of the respondents are under graduate
and have professional qualification. Most of
the respondents have 10-15 years of long
association with the organization.
Almost all the respondents are satisfied with the
physical and psychological working condition of
the organization, and only fewer respondents are
dissatisfied with the psychological working
condition of the organization.
The opinion about the training programs
conducted by the organization is almost better,
according to majority of the respondents.
 CONCLUSION:

About one-third of workers reports high level of

stress and high level of stress are associated with

the substantial increase in health service

utilization.
Additionally, periods of disability due to job
stress tends to be much longer then disability
periods for other occupational injuries and
illness. Stress is the “non-specific response of
the body to any kind of demand made upon it”.
SUMMERY:
 BIBLIOGRAPHY:
1. Principles And Practices Of Nursing Management And
Administration For B.Sc. And M.Sc. Nursing, Jogindar
Vati, JAYPEE Publication, Pg No: 532-535
2. A Guide To Mental Health And Psychiatric Nursing,
R.Shreevani, 3rd Edition, Pg No:259
3. Mental Health For Nursing, Lalit Batra, PEEPEE
Publishers, Pg No:31
4.Leadership And Nursing Care Management, Diane
L. Huber, Fourth Edition, Pg No: 131)
5.Text Book Of Psychiatric Nursing, Anbu.T, EMMESS
Publication, Pg No: 198, 200
6.Voice of Research, Vol. 2, Issue 3, December 2013.ht
tp://www.voiceofresearch.org/doc/Dec-2013/Dec-
2013_20..
7.International Journal of Innovation Management and
Technology, Vol. 2, No. 5, October 2011, By Geeta
Kumari and K. M. Pandey.
Thank
you….