Pearls of wisdom: using the single case study or ‘gem’ to identify strategies for mediating stress and work-life imbalance in healthcare staff

Abstract

Background The growing levels of stress and work-life imbalance reported in contemporary health and social care arenas in the UK can be linked to the neoliberal principles driving performance and intensification in the workforce. These pressures are an area of concern in terms of staff health and wellbeing and the impact of these on the care and compassion of patients/service users. Aims This paper reports on a single case study that was part of a wider interpretative phenomenological analysis (IPA) that aimed to explore the levels of stress and work-life imbalance experienced by occupational therapists working in health and social-care sectors in Wales in the UK. Methods Interpretative phenomenological analysis was used as both an approach and tool of analysis. The use of the single case study and gem as a tool in IPA to pique interest and promote further investigation is also explicated. Results Identified four key strategies that underpinned an approach to mediating stress and work-life balance for staff in the workplace. These were: a sense of choice and autonomy over workloads and decision-making; congruence with family values; supportive workplace attitudes and expectations of others; and finally, that the ability to reconcile conflicts i.e. integrate or harmonise them with personal values, as opposed to holding a sense of compromise marked by concession or loss, can address cognitive and emotional dissonance. Conclusions The existing constructs to support the health and wellbeing of staff in health and social-care settings are ineffective. These strategies offer tools to address this and successfully promote a sense of personal integrity and meaning in life. In turn, this can achieve and sustain a more resilient workforce providing the positive energy needed to be caring and compassionate in their practice.

Perceived stress, self-compassion and job burnout in nurses: the moderating role of self-compassion

“…Therefore, the perception of a stressful situation is more important than objective measures of the stressors and can influence a person's performance (Abdollahi et al, 2014;Wang et al, 2020). Among members of the medical team, nurses experience high levels of stress (Clouston, 2019). For example, they may engage in more work-related stressors, such as long work hours, lack sufficient staff to patient care, be physically or verbally abused by patients and their relatives, be emotionally affected by the death of patients, experience conflict with other medical team members, and lack necessary financial and emotional support (Faraji et al, 2012;Purcell et al, 2011).…”

Commentary: The relationship between workplace violence, emotional exhaustion, job satisfaction and turnover intention among nurses during the COVID-19 pandemic

“…Emotional exhaustion, stress and fears of raising concerns, are all, as my own work clearly attests, commonly reported issues in healthcare staff that impact on, not only job satisfaction, turnover and emotional exhaustion, but overall life balance, wellbeing and meaning in life (Clouston, 2014, 2015, 2019). Whilst the influence of the latter three factors is not mooted in the introduction and conceptual development sections of the paper, the authors do mention work–life balance in the findings and conclusion of their study.…”

“…For example, job satisfaction was found to have a partial mediating effect on the relationship between emotional exhaustion and turnover intention, that is, the presence of emotional exhaustion was correlated with job dissatisfaction and a higher rate of turnover intention. This would suggest that if workloads were reduced, staff were supported, and critically, a cultural change was implemented, that put care and wellbeing before productivity and outcomes in the health workplace, then this would reduce these factors (Clouston, 2015, 2019). Although cultural determinants are not a strong factor in the paper, the authors do, as mentioned previously, indicate the need for meeting personal and organisational needs both morally and materially.…”