Stress and Time Management

• Week 5 focuses on managing stress and time.
• The major goal is to learn how to manage stress and lack of time.
• It can be helpful to reflect on current stressors by writing ALL of them down, what has been stressing you over the last 2 weeks whether it's personal or professional, be as specific as possible.

Sources of Stress

• Changes, pressure, lack of control, conflict, school, and daily frustrations can be sources of stress.

Stress Overview

• Stress is a normal part of life.
• The inability to cope with stress can trigger mental health symptoms.
• Stress can be emotional, behavioral, or a physical response to an event.
• New situations and illnesses can cause stress.
• Some stress (eustress) can be beneficial in accomplishing tasks.
• The event or situation that causes stress is called a stressor.

Effects of Stress

• Stress affects the whole person.
• Physical effects of stress may include cancer and fear
• Emotional effects of stress may include divorce and anger
• Intellectual effects of stress on cognition may include final exams and leaving school
• Social effects of stress may include moving to a new country
• Spiritual effects of stress include death of a loved one and abandoning faith.
• Major stressors include changes (positive or negative), emotional pressure, conflict, school, traffic in urban centers, and lack of control.

Responses to Stress

• Responses to stress depend on gender, age, culture, perception of personal control, availability of social support, cognitive awareness, health, temperament, personality, past experience, the number of stressors, and the nature/severity/duration of the stressor.
• People can display physical, emotional, and behavioral responses to stress.

Acute Stress

• Acute stress is short in duration.
• Acute stress symptoms include changes in vital signs (pulse, respiration, BP), "butterflies" in the stomach, dry mouth, sweaty palms, sore muscles, perspiration, GI problems, urinary frequency, changes in sleeping/eating patterns, and weight/appetite changes.

Chronic Stress

• Chronic stress is ongoing.
• Chronic stress symptoms include chronic headache, mood swings, anxiety, substance abuse, memory disturbances, weakening of the immune system, cardiovascular disease, bowel disorders, decreased sexual drive, and sleeplessness.
• Emotional/behavioral effects of stress include anxiety, depression, anger, worry, fear, irritability, and the onset of mental health symptoms.
• Further emotional/behavioral effects of stress include loss of self-esteem, fatigue, dissatisfaction, forgetfulness, poor concentration, smoking, drinking, and emotional outbursts.

Burnout

• If coping mechanisms related to chronic stress are unsuccessful, burnout can occur.
• Burnout is a state of physical, emotional, and mental exhaustion.
• Those who experience burnout feel discouraged, negative, and powerless.

Defense Mechanisms

• Defense mechanisms are behaviors used to separate from unpleasant events, actions, or thoughts.
• Psychological strategies may help put distance between oneself and threats or unwanted feelings like guilt or shame.
• Defense mechanisms are generally not under a person's conscious control and are a normal part of psychological development.
• Identifying defense mechanisms used by oneself and others can improve understanding of what bothers them.
• It's important to observe and report these signs of stress to a nurse or social worker for patient assessment.

Types of Defense Mechanisms

• Conversion changes an emotion into a physical symptom.
• Denial refuses to accept an unpleasant or threatening reality.
• Displacement involves unconsciously directing emotions toward a safe person/thing instead of the source.
• Projection assigns one's feelings to someone or something else.
• Rationalization makes excuses while ignoring the real reason.
• Reaction formation masters anxiety-producing emotions by exaggerating the opposing tendency.
• Regression reverts to earlier behaviors.
• Repression keeps unpleasant thoughts/experiences from the conscious mind.

PSW Role in Stress Management

• Recognize common responses to stress in clients.
• Tell your supervisor when you notice a client showing signs of stress.
• It is important to observe and report clients' behavior, it is not within the scope of practice to diagnose clients or use defense mechanisms.
• Be familiar with terms used to understand what they means when giving care to clients.

Managing Stress

• Develop self-awareness to recognize stress.
• Take care of your needs; think positively and don't let minor stressors become major ones.
• Assert yourself and never agree to more than you can handle.
• Seek help and support from others, practice calming exercises, and accept what you cannot change.
• Understand the effects of social media on your mood.

Signs of Burnout

• Signs include being more critical or sarcastic, changes in sleep habits/appetite, dragging oneself to work and self-medicating e.g food, drugs, and alcohol.
• Other signs include less patience with others, trouble getting projects started.

Experiencing Burnout

• Do not ignore it, it is important, talk to your supervisor, doctor, or employee assistance program.
• Take time to recover, keep an open mind and consider your opinions.
• When colleagues are suffering burnout, it is important to acknowledge and recognize the severity of it, and confirm what they tell you.

Self-Soothing Coping Strategies

• Self-soothing coping strategies involve one or more of the five senses (touch, taste, smell, sight, & sound)
• Touch. Soaking in a warm bath, massage, sunlight, stretching, swimming, comfortable clothes, and playing with animal.
• Taste. Eating a comforting or healthy meal, sipping herbal tea, slowly sucking on hard candy.
• Smell. Shopping for flowers, smelling lavender, lighting candles, fresh air.
• Sight. Watching a funny movie/show, reading a good book, looking at pictures of loved ones/vacations, watching the clouds.
• Sound. Listening to relaxing music, singing, saying positive statements, playing a musical instrument.
• Focus completely on the task at hand being mindful and bring your attention back if you're distracted.

Time Management

• The purpose is to reduce stress, organize self, and be safe.
• It has its uses throughout work and recreation.
• The benefits include better work habits, effective care for clients.
• Use it personally and professionally.
• It is the ability to to use one's time effectively or productively, especially at work, identify your priorities to stay focused on what's important to you.

Principles of Time Management

• Each activity should bring you closer to your goals.
• Break large tasks into smaller pieces and tackle unpleasant/small tasks first.
• The Pomodoro Technique and taking breaks is important.
• You should also change different kinds of activities.
• Remember to leave some time for unexpected tasks
• Refer to the document in this week's BB shell

Pomodoro Technique

• A method for staying focused and mentally fresh by:
• Step 1: Pick a task
• Step 2: Set a 25-minute timer
• Step 3: Work till the timer goes off
• Step 4: Take a 5 minute break
• Step 5: After 4 pomodoros, take 15-30 minute break.

Pros and Cons of Time Management

• Benefits are there is a better task management, higher productivity, lower stress levels, better work-life balance
• Cons come in the form of missed deadlines, poor quality work, higher stress levels, work imbalance, and lead to a burnout.
• Ask yourself if you are using it Personally, as a student, and as a PSW

Personal Life and Managing Time

• Most days begin with some struggling to wake up, rushing to work or school, coming back home tired, where is family time? What brings you joy?
• Don't let work define you, make clear boundaries outside of work and you can live a fulfilling life. You can follow the following guides:
• 1. Plan the day
• 2. Learn to say no
• 3. Wake up early
• 4. Delegate effectively
• 5. Turn off work mode
• 6. Indulge in hobbies
• 7. Take a vacation
• 8. Pay attention to your body

College Time Management

• Three big time management issues for students:
• Planning: Not having a realistic plan, or no plan at all, to manage time
• Procrastination: Avoidance of starting some tasks
• Perfectionism: Aiming to get things "perfect" which causes tasks to stack up.
• It is good to get into the habit or arriving to your shift early, by reading all the reports, handover sheets, settling you mind, and organizing tasks before the hustle and bustle if your shift.
• Whether its a tick box, a to-do list, or a Grid, making a note allows you to clearly see what tasks you needs to accomplish. When adding time estimates prevent spending way too much time one specific task and then neglecting all the others that must be done.
• When task are listed in order of what needs to be done, the tasks will be prioritized, you can then delegate if needed.
• There may be new unexpected tasks that are not on your list, then they are probably not the est uses of your time, and you should possibly say no.

Keeping Track of PSW Work

• POP: A personal organizational plan will be given more context in another course as well in semester II and carry into future.

Staying Organized as PSW

• Follow assignment sheet/care plan and remember needs/priorities as well a schedule.
• It is important to know what needs to be done at a specific time
• With that in mind it is important to be flexible and be ready to adapt in response to clients needs as each one differs depending on age, culture and health.
• Starting with the things that MUST be done, and to not get sidetracked is the key.
• Using notes and system of reminders helps a lot,
• Setting your goals using your specific needs will help you achieve more.
• Remember to get equipment ready beforehand and put thing away properly after.

SMART Goal Approach

• S = Specific. Define the goal as much as possible with no ambiguous language.
• W = Who, What, Where, When, Why, Which
• M = Measurable. From and to, can the progress and results be measured? "How Much, how many. how will i know when my goal is accomplished"
• A = Attainable. How, is the goal reason enough ro be and how will it become accomplished, not to out of reach or performance.
• R = Relevant. Is this goal worthwhile and will meet your needs? Will this goal line up well with others you are hoping to establish.
• T = Timely. A time limit to establish a sense of urgency and prompt to have better time management.
• This should include specific goals, measurable, achievable, realistic and time goal.

For the SMART Goal

• For stress management *it = be a part of the assignment
• For time management by having personal deadlines and staying accountable as a student and PSW

Decision Making

• Important for a PSW to decide what is the correct manner to help some one, what can be done correctly and ethically.
• To make decision it rely on the focus and involvement, where a clear mind ready to adapt in response to clients needs as they can be highly different.

To make the task list from work

• 0700 AM would involve waking and proving care, noticing any physical hinderances or anomalies.
• 0745 you would transport them to the dining room for breakfast and record how much they ate
• 0840 you would see them for toilet runs.

Problem Solving

• Identify and analyze the problem (supervise when in doubt ask for help)
• Be sure to note anything that can effect health by reading them, to make the solutions effective, be sure there is help in a plan that must be followed

Conflict Resolution and Problem Solving

• Conflict resolution and problem-solving are important skills
• Conflicts with classmates, professors, and other students may arise, which requires good decisions
• After graduation, daily problems and conflict may occur with colleagues, management, clients, and family

Conflict

• Conflict is a fight, battle, or struggle, especially a prolonged one
• Conflict can be a quarrel, involving conflicts between parties
• It is discord of action, feeling, or effect and antagonism or opposition; a conflict of ideas
• Conflict is incompatibility or interference, such as a conflict in the schedule

Problems

• A problem is any question or matter involving doubt, uncertainty, or difficulty
• A problem is a question proposed for solution or discussion, like a math problem

Problem Solving Process

• Problem-solving involves identifying the problem, analyzing it, finding a solution, and creating a plan to implement that solution
• The nursing process (ADPIE) is used, including Assess, Diagnose, Plan, Implement, and Evaluate

Steps to Identify the Problem

• Determine if it is a situation you should get involved in
• Determine if you can be part of the positive outcome
• Determine if it is an emergency that requires immediate attention

Steps to Analyze the Problem

• Consider whether you need assistance to solve the problem and consult your supervisor if needed
• Check if the problem is within your scope of practice
• Communication, asking questions for clarification, and active listening (verbal/nonverbal) are involved

When to Consult a Supervisor

• Consult a supervisor if there is an emergency
• Consult a supervisor if you observe a change in the client’s condition or normal functioning
• Consult a supervisor if you believe the client’s safety is at risk
• Consult a supervisor if a problem involving medications exists
• Consult a supervisor if the client asks about their diagnosis, condition, or treatment plans
• Consult a supervisor if the client or family member wants you to do something against the care plan
• Consult a supervisor if you have a conflict with a client or family member
• Consult a supervisor if a question or problem arises and you need help to deal with it

Steps to Find a Solution

• Think of as many solutions as possible using critical thinking
• Decide which solution is the safest and promotes best practice

Making a Plan

• This may involve creativity, while remembering to be safe

Steps for Evaluation

• Checking on the efficacy of your problem-solving is crucial
• Ensure best practices when reporting client issues

Conflict Resolution

• First reflect on how you usually deal with conflict to learn how to deal with conflict
• Consider how you normally deal with conflict and if you are aggressive, passive, or assertive
• Consider how conflict makes you feel and whether you have experienced a lot of conflict in your life

Reasons for Conflict

• Conflict can be caused by pain, points of view, bad behavior (bullying, harassment, gossip), poor communication (misunderstandings, lack of communication), and more

PSW Role in Conflict

• Determine if the conflict is something you are responsible for
• Decide if you can solve the conflict on your own (within your scope of practice and employer policies), or if you need to contact your supervisor for support

Examples of Conflict in the PSW World

• An employer wants you to work more days/hours than you are able
• Your manager informs you the PSW taking over is sick, and asks you to stay to pick up your child at daycare
• Your client instructs you to leave the room because they "don't like your kind"
• Other conflict examples arise when a fellow PSW spreads rumors that you are a drug dealer

Resolving Conflict

• Clarify what the conflict is using your words
• Determine the purpose of trying to resolve the conflict with the other person
• Discuss ways to reach those goals and determine if there are barriers
• Agreedupon strategies will be chosen to resolve the conflict
• Ensure clarity on each person’s role in the resolution
• Learn when/where your supervisor should get involved

Managing Conflict

• Approach the person with whom you have a conflict and request to speak with them privately
• Maintain politeness and professionalism
• Explain the problem and what is bothering you, providing facts and describing specific behaviors, focusing on the issue, not the person
• Listen to the person’s response without interruption
• Identify ways to resolve the problem, offering your thoughts and asking for the other person’s ideas
• Implement the solutions and review the situation as needed
• Consult your supervisor privately, explaining the situation and asking for advice with facts and specific examples if you are unable to resolve the conflict

Considerations When Dealing With others

• When working with clients, families, co-workers, and supervisors, remember:
• Depending on culture, family, or situation, others may deny or downplay the problem
• Taking action could cause displeasure or resolution reluctance
• Some want to blame others
• Some may not respond verbally at all

Seek Supervisor Support

• It is important to seek support from your supervisor, who may have more knowledge of the background of your client or co-worker, as well as provide information and guidance

Conflict Resolution Resources

• GBC offers crisis/conflict management and intervention courses
• Crisis Prevention and Intervention training (online) is available
• College of Nurses of Ontario Practice Standard has guidelines related to conflict