By Emily Landau — (Emily is the editorial assistant at the OHS Canada magazine)
Work role overload is creating stress among a growing number of health care professionals, notes a report released in January.
Defining role overload as “having too many responsibilities and too little time in which to attend to them,” the review cites some of the contributing factors as understaffing, competing priorities (both at work and at home) and the organizational culture of the health care system. The last necessitates urgency, thereby making it difficult for health care providers to say “no” to any given task.
“You’ve got people who care and who are working in a life-and-death kind of environment,” notes Linda Duxbury, Ph. D., one of the report’s authors and a professor at Carleton University’s Sprott School of Business in Ottawa. “If a nurse or a doctor [is] asked to stay late and [they] don’t, there could be significant consequences,” Dr. Duxbury says.
The investigation, funded by Ontario’s Workplace Safety and Insurance Board (WSIB) in Toronto, represents the first detailed research project examining the causes and effects of role overload. The decision to focus on health care follows findings in Dr. Duxbury’s 2001 study on work-life balance that indicated overload had increased more among health care workers than employees in any other sector over the previous decade.
In the latest review, four hospitals in the Ottawa area and almost 1,400 of their employees took part in focus groups, surveys and interviews. Results show that 57 per cent of employees are experiencing high levels of work role overload, with 59 per cent of respondents reporting high stress levels, 36 per cent citing high levels of depressed mood, and one in five pointing to poor physical health. To deal with the overload, more than half of those polled said they were cutting back on sleep, and almost one-fifth admitted to occasionally using prescription drugs or alcohol to take off the edge.
But employees are not alone in experiencing negative or stressful effects. Role overload is also taking a toll on organizations, especially in terms of absenteeism and presenteeism, which, in the context of the current study, Dr. Duxbury defines as attending work when sick.
Authors write that three-quarters of review respondents acknowledged the urgency of the health care system means they frequently come to work while ill, a response that contributes to reduced efficiency and performance.
Absenteeism is also a problem, with one in three health care workers admitting to frequently calling in sick because of emotional or physical fatigue. “They push themselves [until], rather than having taken one day off to recuperate at the beginning of a disease, they end up getting a lot sicker and having to take higher absenteeism,” says Dr. Duxbury.
Of course, role overload is not limited to four hospitals in the Ottawa area. HÃ´tel-Dieu Grace Hospital in Windsor, Ontario reports that staff members are also having to deal with the stress of the system’s organizational culture.
Over past decades, the health care sector has been constantly “asked to do more with a lot less,” says Kim Spirou, vice-president of the communications department at HÃ´tel-Dieu Grace. “That definitely adds to the stress of people trying to do the very best they can [and] provide optimal care to everyone. But when occupancy rates are at an all-time high and it’s every day, it gets harder and harder [for] staff to cope.”
To date, however, work demands have not manifested “in significant changes to our absentee rate,” she adds.
Linda Haslam-Stroud, president of the Ontario Nurses’ Association in Toronto, says she is not surprised by the findings in the recent review. “We’ve been saying for some time that the complexity and the intensity of the work have dramatically increased and, unfortunately, the appropriate staffing has not equalled the increase,” says Haslam-Stroud.
Dr. Duxbury recommends that health care employees facing work role overload put themselves first, make time for both their families and friends and get enough sleep. “As long as [they] keep trying to [do] it all, the system has no real incentive to change,” she suggests.
Both Haslam-Stroud and Dr. Duxbury agree that Ontario should review its current funding formula to help relieve the staffing crisis in hospitals. Until that happens, though, Dr. Duxbury emphasizes that health care workers need to be made aware of work role overload.
“[It] is a forgotten construct. We just haven’t looked at it,” she says. “We talk about stress and mental health, but what causes those issues? It’s being overwhelmed.”
There are a number of articles out there from very good references such as the OHS Canada magazine. The above article is excellent and contains pertinent information dealing with different sectors in the workforce and different career challenges. Emily Landau has completed an amazing work with great attention to detail. Her research was thorough and her suggestions right to the point.
The issues in the ‘Healthcare’ sector will continue as long as those in power continue to ignore the current state of affairs. Since healthcare costs are on the rise, the government needs to review the data and reduce the workloads of our medical people. The reduction of stress alone can reduce a large chunk of the healthcare costs. There should be a review of the current hiring practices. The number of cases is going up but the staff numbers are not.
The nursing associations are attempting to get the word out to attempt a change at the grassroots level. The health care employee needs to put themselves first. The problem is that they will continue to work the outrageous hours if asked.
This must stop!
Emily’s article will certainly contribute to the wakeup call.
Remember — In Ontario, “ALL Accidents are Preventable”
‘Work’ and ‘Play’ safe.
Daniel L. Beal
CHSEP – Foundation Level
VP & Senior Trainer