4. 


Stress and anxiety are basic to life, no matter how wealthy,
powerful; good working and happy- mild stress can be
stimulating, motivating and sometimes even desirable.
The word stress derived from English word. Originally it was
used in physics and it is meant an external pressure , tension ,
load of an object. It was conceived as pressure from
environment , then as strain within the person.
The term stress was introduced in medicine in 1949by
Canadian Endocrinologist Hans Selye he described stress as the
body’s adjustment to new circumstances , and the bodys
stereotypical and non specific response to environmental
stimuli.

5. Definition
Stress is a state manifested by a specific syndrome
which consist of all the non specificaly induced changes
within a biological system .
by Hans seyle
Stress is mind and body’s response or reaction to a real
or imagined threat, event or change.
A physical or psychological stimulus that can produce
mental tension or physiological reactions that may lead
to illness."

6. LEVELS OF STRESS
Two types of stress- Eustress or positive stress
- Distress or negative stress
Eustress or positive stress occurs when the
level of stress is high enough to motivate to move
into action to get things accomplished.
Distress or negative stress occurs when level of
stress is either too high or too low and body and/or
mind begin to respond negatively to the stressors.

7. STAGES OF STRESS

8. 
When we experience a stressful event or
perceive something to be stressful psychological
changes occur in the body. This experience or
perception disrupts body’s normal balance and
immediately body begins to respond to the
stressor(s) as effectively as possible

9. During this stage body tries to cope or adapt to the
stressors by beginning a process of repairing any damage
the stressor has caused..

10. EXHAUSTION STAGE
•
• During this stage the stressor is not
being managed effectively and the body
and mind are not able to repair the
damage.

11. CAUSES OF
STRESS
•
•
•
•
•
At work place
At Organizational Level
At Personal Level
Inter personal factors
Individual factors

12. Workplace stressors of staff
nurses
•
•
•
•
•
•
•
•
•
•
Workload
Inadequate staff cover
Relationship with other clinical staff
Leadership and management style
lack of adequate supervisory support
Coping with emotional needs of patients and their families
poor patient diagnosis
Death and dying
Shift working
Lack of reward

13. At Organisational Level
•
•
•
•
Technical – emergence of new technologies
Strategic – globalization, privatization, take-overs,
Competition
Increasing urbanization

14. At Personal Level
Life events
Entries & exits to the family
Change in job
Daily events
Unexciting but tight routine
Struggle of day to day life
Social support
Economic, physical & emotional
support from friends, family &
others

15. Inter personal factors
• Interpersonal relationship within the nursing
profession and between other professions
• Shorter stay for patients
• Supervision of assistive personnel
• Interdisciplinary conflict

16. Individual factors
• Marriage
• Pregnancy
• Purchasing a new home

17. COMMON SYMPTOMS OF STRESS
Insomnia
 Fatigue
 Depression
 Irritability
 Anger
 Hopelessness
 Change in appetite

19. Physiological indicators
The physiological signs and symptoms of stress result from
activation of sympathetic and neuro- endocrine systems of
body.
 Pupils dilate to increase visual perception
 Sweat production increases
 Heart rate and cardiac output increases
 Skin is pallid due to peripheral blood vessel constriction
 Mouth may be dry
 Urine output decreases
 Blood sugar increases

20. Psychologic indicators
The manifestations: of stress includes- anxiety, fear, anger, depression
and unconscious ego defense mechanism.
Anxiety: state of mental uneasiness, apprehension, dread or
feeling of helpness. It can be experienced at conscious,
subconscious or unconscious level.
Fear: it is an emotion/ feeling of apprehension aroused by
impending or seeming danger, pain or threat.
Depression: it is an extreme feeling of sadness, despair,
lack of worth or emptiness.
Unconscious ego defense mechanism: it is a Psychologic
adaptive mechanism developing as the personality attempts
to defend itself and alay inner tensions

21. Cognitive indicators
problem solving: the person assesses the situation or problem analyzes,
chose alternatives, carries out selected alternatives and evaluates.
Structuring: arrangement/ manipulation of a situation so that
threatening events does not occur.
Self control: assuming a manner and facial expression that conveys a
sense of being in control or in change.
Suppression: willfully putting a thought or feeling out of mind.
Day dreaming: unfulfilled wishes and desires are imagined as fulfilled or a
threatening experience is re worked or re played so that it ends differently
from reality

24. BIBLIOGRAPHY
• Sullivan Elanor J , Decker Philip J . Effective
leadership and management in nursing.
Addison Wesley; 1997
• Barret jean. Ward management and teaching .
New Delhi , Konark publishers; 1994
• Ann R L . Basic concepts of psychiatric mental
health nursing. 7th edition. Philadelphia .
Lippincott ;1997

25. • C. Adey: “Stress: Who cares?”, in Nursing
Times, Vol. 28, 1987, pp. 52-53.
• J.T. Bailey, S.M. Steffen and J.W. Grout: “The
stress audit: Identifying the stressors of ICU
• nursing”, in Journal of Nursing Education, Vol.
19, 1980, pp. 15-25
•

26. MEDITATE
GAIN INNER BALACE