The onset of summer, with its promise of free time and vacations may seem like a strange time to bring up the issue of work-related stress, but the time is actually very appropriate. You might say it’s summertime and the livin’ ain’t easy. I have noticed a trend over the past couple of decades where people have less and less time away from work.
Technology such as cell phones and email has made it possible to work even while on a tropical vacation, so the expectation is that you will be available because you can be. In recent years in particular, with the advent of Wi-Fi in hotel rooms, text message access no matter where you are, and telecommuting across time zones, it has become harder and harder to separate out work and life. I have seen an increase, both in my patients and in my personal life with friends, family, and acquaintances, of anxiety, panic, stress-related medical symptoms, and the like that, for many, seems to be a consequence of too little downtime.
My father came home at 6pm. He worked a pretty steady 9-5 schedule, on the subway at 8am, off the subway at 6pm, dinner on the table. I’m sure that those above him in the executive suite worked more, but that was a choice they made. Your average white-collar worker 30 or 40 years ago could work 9-5 and not fear losing his job for his laziness or not getting a promotion he deserved. My father’s sister married a doctor, and he worked varied and long hours at times, but again, it was his choice to become a physician, and the payoff for his hard work was a house that boasted six bathrooms and a panoramic view of Brooklyn, Manhattan, and New Jersey. He drove fancy German cars and lived in financial security, providing future financial stability for his three children as well.
Problem is, today, the physicians don’t get compensated as well for their troubles, and it’s not just internists and executives who are expected to be constantly on the clock—it’s paralegals, clerks, accountants, entry-level workers, data analysts—anyone who wants to rise up the ranks is expected, from Day One to work through lunch, read email on weekends, carry a Blackberry, and be otherwise constantly connected to work. Call in sick? No, just take an aspirin and work from home, don’t lose the sick day. Take a vacation? Yes, but be available for that conference call that’s too important to miss. Take a day off and pay the price when there is double the work the next day when you return.
Being a pretty Type-A person myself I learned long ago that my sanity depended on making time for peace and quiet. That can mean regular hikes in the Rockefeller Preserve with my dog before starting my work day, having separate phone numbers and emails so I can choose when to be on the clock (e.g., responding to work communications), and when to go into “off-duty” mode. This doesn’t always work out neatly, as patients can have emergencies at any time, or I may have a busy period where I’m overwhelmed with work with little free time for myself. But if most of the time I can leave work at work and have time away, I’m better with my patients since I’ve had the time I need to recharge and maybe even start to “miss” work. A vacation is not a vacation if I’m working, and I’m of more value if I return feeling refreshed and like I’ve missed the process of working with people and interacting. If I feel like I’ve been on the clock 24 hours a day then I am not going to do my best work. That’s true of everyone.
Anxiety counseling can be an effective tool in addressing the negative effects of workplace stress, by providing individuals with the tools and techniques to manage their symptoms, and ultimately improve their overall mental well-being.
The climate today says that if you want to get ahead you have to work more and more hours, often to the point of physical exhaustion. One patient of mine often worked past midnight before leaving for a new job. One friend falls asleep at her computer with regularity. I lost a very good friend in the World Trade Center attacks. He worked in finance and was expected to put in very long hours in order to get promotions and raises. Even though his compensation didn’t reflect his exhaustion, he continued to do what he had to, hoping for his compensation to catch up to his efforts. Then a plane flew into his building, killing thousands of people. And while some people took a lesson from that day and decided to reassess what’s important, changing careers, spending more time with family, and the like, the culture as a whole moved into a work-work-work climate where people check emails before even getting out of bed. I admit, I sometimes do this too.
In the healthcare industry this is especially true, as hospitals are trying to run on minimal insurance reimbursements. (I’ve written before about the lack of increase in insurance payments to doctors and facilities.) Nurses work without breaks because there are not enough of them. Good nursing shoes are important to them, even for sitting nurses! Radiologists are expected to read twice the scans they used to in the same work day. I don’t know too many psychologists who have secretaries as we used to, since with stagnant reimbursement rates we can’t afford to pay them. So I do it all—phone calls, scheduling, billing, mailing, etc., as well as what I was trained to do—patient care. When I supervise interns and post-doc fellows in a clinic setting the stress of “billable hours” is prevalent. When I was in their shoes I never worried about how many patients I saw in a week and how many billable hours that translated to; my main job was to learn, and we had ample time for supervision and didactics.
Today the students are stressed before they even start working. This is not to say my internship was easy or that I never took work home; I’d be lying. However, there were enough hours in the day to complete my work, even if I caught up on a few things over the weekend. I’ve supervised students who literally took months to write reports, not out of laziness or refusal to bring work home, but because they needed to sleep once in awhile. I recently spoke to a local school district which shall remain nameless. The district was out of compliance with a child’s evaluations and paperwork because so many psychologist positions had been cut and people were asked to do double the work. Not only is this impossible, it’s bad for everyone.
So, how can we deal with the world as it is? It’s not going to change overnight, and we may be stuck with these demands for good due to a global workforce that requires people to work through different time zones and the expectation that things will be done in a nanosecond. But even so, there are ways to handle the high expectations.
• Make downtime for yourself. Whatever that means. Read a book, turn off your phone, take a walk and leave your phone at home. Simply go out for lunch. Whether you can spare a half hour or a whole day, make it time off and keep it that way
• Set limits with your bosses. Be willing to work extra if that is going to lead to rewards and compensation, but let them know what you can and cannot do. Work late on certain days and leave on time on other days. Agree to work only certain weekends if necessary for a project. Explain to your boss that you will be more efficient if you are not exhausted. This approach may or may not work, and no one should jeopardize the job they have, but it can’t hurt to start a dialogue. At one job I had I was asked to log my duties day by day for a few weeks to determine if the position was given enough time. It was determined that in order to provide all we had hoped to provide we needed to allocate more hours to the position. Win-win for everyone. I got more hours at work, and the school had a psychologist who was willing and able to provide more than the bare bones mandated services.
• Keep work and personal emails and cell phones separate. Of course I send work-related emails late at night or first thing in the morning. But I can check for anything urgent, send a message if needed, and then shut down “work” for whatever time I need to, be that overnight so I can sleep, or a few hours so I can address my own real-life needs.
• I can’t stress enough how important it is to exercise. Studies prove that even a short walk a few times a week eases anxiety. A slump in my exercise routine makes me feel lousy. This long, horrible winter we had turned me into an unhappy slug and it showed in my mood and energy level. Whether I hit the Rockefeller Preserve for an hour, or workout at the gym, or get on my bike, getting the blood flowing has healing properties. I’m lucky that I can walk to my office, so even on busy days where I may not have had time for a workout I can at least get in a ten minute walk to and from work. The ten minutes at 9 p.m. is particularly valuable as I get to stretch my legs, breathe fresh air, and regroup after a long day.
• Take that paid time off! Most jobs provide for sick or vacation days, and many people get through the year without taking any. Choose a time where you can comfortably stay home (not when a deadline looms) and simply call in sick or take a personal day. And then really make it a day off. Pack your day with fun activities or do nothing, but don’t do work. Plan for a long weekend from time to time, or simply grab a mental health day when you can, but a day off here and there for a float therapy or any activity that helps reduce stress can recharge your batteries. And that week vacation you may take—don’t even think about work while you’re off!
•Finally, if you find that work stress has become prolonged and there’s no relief in sight, you may need to reassess your job or career and/or seek counseling and support to decide what strategies will work for you.
