Some Occupational or Work Environments that have unusual forms of stress. Hospices and Hospice-related duties is one. In a society with an increasing aging population, Hospice Workers perform the vital function of addressing the needs of terminally ill patients. Working in such facilities or performing such duties can have an emotional impact on the worker.
There has been a number of articles which have discussed the emotional concerns of these workers.
There are multiple issues that relate to why Hospice Workers experience stress.
This article will discuss the nature of Hospice Work, why such employment is stressful, and what a Hospice Worker can do in the event that the work-related stress becomes disabling.
What is a Hospice?
Hospices are health care facilities which provide care to those who are facing the end of their life. They provide services to ensure that the patients’ physical, emotional, and spiritual needs are met during this period.
These facilities can involve multiple disciplines, can be face-paced, and can involve transitioning caseloads.
What Are The Difficulties When Working at a Hospice?
There are a number of difficulties with Hospices. There is the difficulties of dealing with the emotional support needed for both families and the patients who are facing death. There is the difficulties with heavy caseload. There is the administrative, agency and institution, requirements in these facilities which can be a source of stress.
24-7 Care
“The hospice system provides 24-7 support and includes rapid response teams who cover nights and weekends. Even though other hospice workers have taken over providing care to that patient, the feeling of caring doesn’t stop.” Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto, Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.
Note: Graveyard and Rotating Shifts have been known to cause medical problems irrespective of the fact that it involves Hospice Work.
Heavy Caseload
“Caseloads are widely different by role due to the nature of the work, with social workers and chaplains carrying larger numbers of patients than nurses and aides. Despite these differences, many of the challenges reported were remarkably similar. Workload is intense; often there is not time for lunch (unless while driving) or even to use the bathroom. Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto, Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.
Note: Stress from heavy caseload should not be considered as a “good faith personnel action.”
Different Roles
“Different roles reported different challenges. Many of the hospice worker roles are salaried, officially paid and expect to work 40 h per week, but often ending up putting in additional hours without additional compensation. Managers are also salaried but have less expectation of “only” working 40 h. On the other hand, aides are paid overtime when they work more than 8 h, but are discouraged from doing so. These differences led to different pressures.”. Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto, Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.
Note: Some of these Role Issues may involve issues of “good faith personnel action” which may give rise to a defense to a workers’ compensation claim.
Communication
“Communication problems may also contribute to the chaotic nature of many workdays. Interdisciplinary teams, by definition, means different roles, responsibilities, and vocabularies, all caring for the same patients, usually in separate visits or calls. Such complexity can result in unanticipated communication problems as indicated by the following nurse’s example: Hospice Employees’ Perceptions of Their Work Environment: A Focus Group Perspective, Rebecca H. Lehto, Int. J. Environ. Res. Public Health 2020, 17(17), 6147; https://doi.org/10.3390/ijerph17176147 Received: 30 June 2020 / Revised: 13 August 2020 / Accepted: 17 August 2020 / Published: 24 August 2020.
Note: Some of these communication difficulties may involve issues of “good faith personnel action” which may give rise to a defense to a workers’ compensation claim.
What are the Consequences of The Difficulties of Working in a Hospice Environment?
The consequences of such employment is Occupational Burnout as well as Secondary Traumatic Stress.
What is Occupational Burnout?
“Job (occupational) burnout is defined as a prolonged response to job stressors, encompassing exhaustion, cynicism, and inefficacy (Maslach, Schaufeli, & Leiter, 2001); however, a more recent definition includes exhaustion and disengagement (Demerouti, Bakker, Vardakou, & Kantas, 2003; Demerouti, Mostert, & Bakker, 2010). Exhaustion, in this sense, refers to being drained of physical, cognitive and emotional energy as a result of exposure to job demands, while disengagement is interpreted as distancing oneself from work and possessing a negative attitude toward work-related objects and tasks. Job burnout is associated with depletion of energy and personal resources, which makes it an important factor in the process of health impairment (Basińska & Gruszczyńska, 2017). Burnout can cause the individual to be susceptible to other negative consequences of experienced stress, including posttraumatic stress disorder (PTSD) or secondary traumatic stress.” Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnout. Psychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421
What is Secondary Traumatic Stress?
Secondary Traumatic Stress “is characterized primarily by symptoms of intrusion (returning thoughts, dreams related to trauma), avoidance (an effort to get rid of emotions, thoughts associated with traumatic event) and hyperarousal (increased vigilance, anxiety, and impatience; Bride, Robinson, Yegidis, & Figley, 2004 Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnout. Psychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421
What is Compassion Fatigue?
In one article, it noted that “It is important to mention that the consequence of secondary exposure to trauma at work is also called compassion fatigue (Figley, 2002), which indicates that STS bears some similarity to burnout syndrome, especially to emotional exhaustion. According to Figley (1995) STS appears as a complex state of dysfunction and exhaustion in which emotional distress and suffering experienced by trauma victims is taken on by the helpers.” Ogińska-Bulik, N., & Michalska, P. (2020). Psychological resilience and secondary traumatic stress in nurses working with terminally ill patients—The mediating role of job burnout. Psychological Services. Advance online publication. https://dx.doi.org/10.1037/ser0000421
What are the Problems for Hospice Workers?
From the studies, as noted above, it would appear that the stress is two-fold. There is the stress from performing the job and there is the stress from dealing with the administration of the facilities. Thus, both the work, and the work-setting can be injurious to the worker on an emotional level.
If a Hospice Worker is Having Emotional Problems, What Should They Do? What Are the Concerns?
First, they should seek medical assistance. This can include utilizing an Employee Assistance Program if one is available. A workers’ compensation claim may be considered. Before doing so, an analysis should be done with respect to whether the worker will meet the threshold requirements for proving up a claim. Consultation with an attorney is recommended. Some of the threshold issues may involve the length of employment, outside stressors, and whether there has been good faith non-discriminatory personnel action.
What If I Need Legal Advice?
If you would like a free consultation concerning any workers’ compensation case, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. They have been helping people in Central and Southern California deal with their worker’s compensation cases for 28 years. Contact us today for more information.
