Home How to Deal with Stress in a Healthcare Setting

How to Deal with Stress in a Healthcare Setting

Gary R. Simonds

Featuring expert advice from Gary R. Simonds

Whether you’re a healthcare manager of a small clinic, the head of a surgical department, or a hospital administrator, you have a great deal of responsibility. You need to wear many hats and accommodate the needs of numerous people, including staff, outside agencies, your superiors, and even the public.

Learning to watch for stressful situations and how they affect you is important for supporting your mental health. While there are general recommendations for reducing stress that apply to nearly everyone, in this article we identify specific stress triggers for people in healthcare leadership positions—and how to deal with them.

Stress Triggers and How to Manage Them  

Being a leader in a healthcare setting comes with a unique set of pressures that stem from both working in healthcare and being in charge.

Dr. Gary Simonds was Chief of Neurosurgery at the Virginia Tech Carilion School of Medicine and the Carilion Clinic for 16 years. He shares the stressors related to being a healthcare manager—both from his experience and that of others—as well as self-care strategies for addressing each one.

Lack of Control

Why It’s Stressful

“You may possess a leadership title,” says Dr. Simonds, “but it’s not the Army, no one has to ‘follow orders.’ You can influence behavior but you certainly can’t control it.” He points out that getting all the members of a team to work in the same direction can be stressful since inevitably some team members will want to do things their own ways.

You may also become frustrated when your visions and goals don’t align with those of your institution. “This becomes particularly challenging when you may have more knowledge or insight into a situation than do those who are opposed, or when morality may play a role in your concerns,” says Dr. Simonds.

How to Cope

Accepting that you can’t control everything is obviously important, but there are other helpful measures you can take. Simonds recommends trying to find the positive in difficult situations. “Celebrate the diversity of your team and encourage discourse and difference in opinion,” he says. “Be willing to re-evaluate and course-correct.”

To encourage input from team members, Simonds recommends that you “Create frameworks within which your teams are encouraged to be creative and proactive on how they implement action and achieved goals.”

“In the end,” he summarizes, “you have to approach a leadership position as a leader, not a controller. Control is rigid. Leadership is flexible. Seek leadership, not control.”

In the end, you have to approach a leadership position as a leader, not a controller. Control is rigid. Leadership is flexible. Seek leadership, not control.

Patient Welfare

Why It’s Stressful

Patient welfare should always be the top priority in a healthcare facility—and usually, it is. However, Dr. Simonds points out that “inevitably individual, systemic, external actions may risk compromising ideal patient care. This ratchets up the stress level instantaneously.” In other cases, there may not be agreement on what quality care means or what baseline standards should be followed.

How to Cope

Although you can’t control external factors involving patient welfare, you can control how you address issues of patient care within your own jurisdiction. This starts with regularly soliciting opinions about ways patients might be better served and making sure concerns are addressed early and taken seriously. Simonds says, “Forgive yourself for failings but take each failing seriously and hold an administrative morbidity and mortality review to understand how to better handle similar situations.”

Your mindset is also important. Simonds recommends that you “Frame all major decisions and directives in how they 1) affect patient care, 2) affect your team, 3) affect your system.” At the same time, he says, you need to remind yourself “that you are working towards excellence but not perfection.”

Forgive yourself for failings but take each failing seriously and hold an administrative morbidity and mortality review to understand how to better handle similar situations.

External Regulations and Mandates

Why It’s Stressful

External pressures can come from the government, regulatory boards, insurance companies, lawyers, quality control teams, and so many other organizations or individuals. Not only does compliance with these entities require action on your part, but it can also affect your staff’s productivity and methods of care. “You often are at the sharp end of the spear bringing this to the day to day functionality of the team,” Simonds says. “Teams chafe at and fight change every step of the way if it is not perceived as being helpful to the patient or lightening their own workloads.”

How to Cope

While you can’t get rid of such regulation, you can try to make dealing with it less complicated. “Seek support in improving processes and implementation of various mandates and policies,” says Simonds. “Re-visit various sore points and assess improvement of implantation and adaptation.” You won’t be able to make a complete overhaul of the processes for dealing with compliance, so instead focus on the ones that can be improved more easily.

You also need to address your team and their possible negative reactions. Be as transparent as you can be. “The better they understand things, the more they realize that the actions of the system and senior leadership are not arbitrary or evil but are necessary for the system’s solvency,” says Simonds. Solicit ideas and suggestions from your team about how to improve processes. As with your own approach, help them focus on issues and processes that they are more likely to be able to affect.

Teams chafe at and fight change every step of the way if it is not perceived as being helpful to the patient or lightening their own workloads.

Performance Issues

Why It’s Stressful

Managing others can be rewarding and satisfying, but it also comes with challenges and stressors. You will routinely need to address conflicts, performance issues, and behavioral problems. “This is infinitely time consuming and energy depleting,” says Dr. Simonds. “Often…blame and hostility are transferred onto leadership. It is challenging to project forbearance when one is taking heavy personal fire.”

How to Cope

It’s essential to address employee issues right away. Taking a “wait-and-see” attitude can result in escalation, anger, and more conflict. You can often resolve problems effectively without hurt feelings if you deal with them when they first arise.

However, not all issues can be resolved easily. Dr. Simonds emphasizes that you must deal with problems objectively, rather than getting emotionally involved. He suggests the following: “Try to depersonalize and objectively evaluate. Investigate the context, actively look for mitigating circumstances. Hear all sides. Solicit viewpoints. Be careful of reacting rather than processing. Take account of your own emotional response to a situation—if escalated, step away, seek calm and rationality.”

It’s also important to manage problems, not punish them. “Don’t just admonish team members for behaviors/actions—establish methodologies and resources for their remediation,” Simonds says. “Ultimately, be fair. Never administer discipline unequally predicated on favor/friendship.”

Finally, recognize that you can’t control your staff’s behavior—you can only guide it. If a situation becomes serious, don’t feel that you’ve failed if you need to call in outside resources.

Don’t just admonish team members for behaviors/actions—establish methodologies and resources for their remediation.

Time Management

Why It’s Stressful

You likely know the difficulties of trying to find time to address every aspect of your job effectively. You’ve probably experienced the stress of working on one thing while worrying about the next thing you have to do. It’s particularly frustrating when the amount of time you spend on a task doesn’t seem to be proportional to the value of the outcome.

Meetings in particular can be a source of stress and frustration. As Simonds points out, “One massive black hole of time is meetings. The time investment is astronomical and thus exquisitely stressful—every minute you are trapped in meetings is a minute that you can’t be present on the front lines, or working with middle managers, or addressing team member concerns, or strategic planning, etc.”

How to Cope

You can find many resources about effective time management—for example, prioritizing activities, grouping similar tasks together, and blocking off certain times of the day to tackle specific jobs.

Although you may be tempted to skip some of your many meetings, Dr. Simonds says that this is a mistake. “Being present is a key component to effective leadership,” he advises. “Meetings are extremely important in terms of internal networking and presence even if they accomplish nothing—attend as many as are feasible but it is ok to prioritize some out of the schedule in busy weeks.”

Even though your time is limited, it’s important to be accessible to your team members and interact with them regularly. However, remember that you do not have to be available all the time. Don’t be shy about closing your door if you need to. Just let your staff know what a closed door means and that you are still available for true emergencies.

Meetings are extremely important in terms of internal networking and presence even if they accomplish nothing—attend as many as are feasible but it is ok to prioritize some out of the schedule in busy weeks.

Loneliness

Why It’s Stressful

“Being a leader is exquisitely lonely,” points out Dr. Simonds. “You are considered one of ‘them’ by your team. True friendship and openness is quite difficult to establish and maintain with anyone below you, and frankly, above you.” It can be particularly tough if you used to be part of the team but got promoted to managing them. Relationships change, and friendships can end.

Your responsibilities can also isolate you. Your decisions and actions may not always be popular, and this resistance can make you feel alone in your efforts.

How to Cope

First of all, realize that you are not the only person in a management position who feels lonely. It’s a very real issue among people in leadership, and thus not something you should consider to be your own personal weakness.

Dr. Simonds recommends that those in leadership positions find people at work they can relate to. “They don’t have to be in a similar position, but it often helps,” he says. “Take a few minutes out of a morning and have a cup of coffee—compare notes, commiserate, share management tips. Better yet, connect with such people regularly with an open discussion meeting at or after work.”

In addition, Dr. Simonds stresses that you should “put effort and care” into your non-work relationships. It’s easy to take these relationships for granted and not nourish them or use them for your own nourishment. “Don’t be afraid to occasionally connect with them even during the workday and certainly on return home,” he says. Share with them that you sometimes feel isolated in your position. Don’t dwell on it, but help them understand that this feeling can sometimes affect your relationship with them.

Being a leader is exquisitely lonely. You are considered one of ‘them’ by your team.

Meet the Expert

Gary R. Simonds

Gary R. Simonds, MD, MHCDS

Gary R. Simonds, MD, MHCDS, is a former army neurosurgeon who created and ran the neurosurgery department and residency training program at the Virginia Tech Carilion School of Medicine and the Carilion Clinic until his retirement in 2019. He was responsible for all related functions of the program, including financial oversight, behavioral remediation, hiring and firing, integration with other system entities (including the medical school), patient relations, morbidity and mortality review, and more. He remains a professor at the Virginia Tech Carilion School of Medicine and the Virginia Tech School of Neuroscience.

Of principal interest throughout his career has been the promotion of wellness in healthcare workers, an interest that led him to a partnership with Wayne Sotile, Ph.D., a world expert in the field. Together they have written several books: Thriving in Healthcare: A Positive Approach to Reclaim Balance and Avoid Burnout in Your Busy Life, The Thriving Physician: How to Avoid Burnout by Choosing Resilience Throughout Your Medical Career, and Building Resilience in Neurosurgical Residents.