Sunday, August 14, 2011

How to Tame Stress in the Workplace

For years incivility in the workplace has grown to worrisome proportions. The large majority of workers have fallen victim to rudeness and increased stress on the job. The impact on the business and individuals is measurable with potentially devastating economic and personal loss. It is widely accepted that it is linked to broader changes in our culture. The source of the rudeness was more commonly coworkers rather than clients. There are ways to encourage trust and respect in professional relationships at every level.

The definition of incivility is rude behavior lacking respect or politeness. We have long understood that cooperation is necessary in any relationship whether personal, professional, or family. All these relationships are built on trust and respect. Civility is simply how people work and live together cooperatively. Some would say that it has been key to the strength of our culture cutting across social class, economics and other forms of bias. Research shows that incivility occurs very frequently in the workplace. Low level negative behavior can be childish requests or accusations about lack of knowledge. More intense actions such as being left out of a key meeting, having your credibility undermined in front of others or extra work assigned because of inaction by others, even yelling or shouting are not uncommon. Unfortunately these behaviors are much more common than any violence in the workplace, yet can be very devastating.

How does this affect workers? The stress created in the workplace profoundly affects the overall productivity of any business and the health of individual workers. Increasing demands of the economy and technology have created increased productivity with less people. However the stress on the individual worker has increased. Most companies have overlooked the value and importance of professional civility. Much of the negative behavior occurs without organizational awareness. Some companies may even feel they don't have time "to be nice". The reality is they cannot afford to ignore effective communication cultivating professional relationships among their staff. The effects of stress on personal health have been widely accepted for over 50 years. The more stress a person experiences the more likely they are to get sick. The vulnerability to illness can last for a couple years after the stress has past. The unhealthy effects pertain to infectious diseases, chronic illness including mental and emotional side effects.

A model of workers who are valued for their effort and information yields greater productivity. When there is proper training in the specifics of the job, effective respectful communication, and encouraging value of all team members, the workplace is more comfortable and accomplishes more. Although people need to be compensated fairly the most common reason people leave a job is because of lack of respect and inappropriate treatment. With a better working atmosphere there is less turnover of staff and greater loyalty to the organization and its mission. Cultivating a professional atmosphere means trust that your coworkers are doing their best. Look for the strengths in each other and compliment those traits. Have and expect a clear process for communication and feedback available to everyone that is done in a manner with respect for all team members. No one person can accomplish the mission without the contributions of all the team members. Recognize someone for their help and support. Appreciation and validating the individual remains a very strong motivator at home or work. With a little help from our friends, we can lead healthy, happy, more productive lives.

Monday, August 1, 2011

Paid Sick Leave

Four in every ten workers have no paid sick leave. This single phenomenon has a major impact on public health. The Center for Disease Control (CDC) has identified paid sick leave as one of the three most important ways to reduce the spread of illness in the community along with hand washing and proper food handling. Paid time off from work allows an individual to seek medical attention, recover from injury or illness faster, and tend to a sick child or adult family member without threatening family economic security.

Paid sick leave promotes better public health by eliminating the spread of illness when sick workers are on the job. They are clearly less productive, make more mistakes and are incapable of sustaining high quality services. Research shows that illness is frequently spread by contact in the workplace from worker to worker throughout all industries. This is particularly poignant in service industries in particular food services where both workers and customers are at risk. One in six Americans get food related illnesses resulting in 125,000 hospitalizations and 3,000 deaths each year. At least 20% of these cases are traced back to a sick food worker.

Most people who do not have paid sick leave are in lower paid or part-time jobs where no benefits are provided. The short-term economic impact of time-loss from the job makes people come to work when they are sick. They cannot afford to take care of a sick child or get them to a health care provider. Children are more likely go to school sick creating additional negative health impacts in the community. There is an economic and social impact on family income, child's education and school performance. The CDC recommends keeping children home for 24 hours after a fever subsides in order to limit the spread of disease and allow adequate time for recovery. Research confirms that sick children improve faster with a parent present. Adults recover faster when they are able to get access to health care and adequate rest. Return to work in less time and lives that are more productive are the dividends.

Paid sick leave changes the dynamic in important ways. It promotes public health decreasing the spread of illness keeping workers and businesses healthy. The return on investment by any metric is a positive economic and social benefit that far outweighs the alternative. Three municipalities have passed mandatory sick leave standards including San Francisco, Milwaukee, and District of Columbia. After several years experience with minimum sick leave standards in place, two thirds of employers support them and tens of thousands of workers have benefited. Job growth has been enhanced in these same markets by having these benefit standards in place. National data shows workers who do have a sick leave benefit accrue on average 9 days a year, but only use 2 to 3 days a year. Fear that abuse of a sick leave benefit is simply unfounded. Companies that provide paid sick leave report higher morale, greater productivity and fewer employees who actually come to work sick.

The lack of paid sick leave is a serious public health problem with many economic and social implications. There are many existing models for sick leave and its associated benefits. Policies that promote a better balance between work and personal health result in better employee morale, less turnover and improved public health.

Update: Head Injuries Revisited

Head injuries in athletes resulting in concussions occur more frequently than previously thought.  We are learning more about the problem and the important consequences. Each year more than 300,000 athletes in the U.S. suffer some form of traumatic brain injury (TBI).  High school athletes comprise 60,000 of these injuries. The consequences vary a great deal but can be physical, emotional and intellectual.

TBI can result in short term symptoms as well as problems that are more serious which may not surface until several years later. What kind of problems develop depend on what portion of the brain is affected, the severity of the blow, the number of repeated blows to the head, preexisting conditions of the individual and personality traits of the injured person. The more blows to the head that occur, even small ones, increase the risk of for mental deficits. Significant head trauma to a football player occurs hundreds of times a week during practice and game experience. Exploring options for protective equipment in contact sports and teaching fundamental techniques in sports that can reduce head trauma are paramount to reducing the number of injuries and the serious consequences.

A 2000 study surveyed 1,090 former N.F.L. players and found more than 60 percent had suffered at least one concussion in their careers and 26 percent had three or more. Those who had concussions reported more problems with memory, concentration, speech impediments, headaches and other neurological problems than those who had not, the survey found. Considering these professional players spent many years coming up through the ranks as amateurs, the frequency of head trauma is likely under-reported. Other common problems are being discovered as we examine this challenge more closely. Depression, insomnia, attention deficit, personality changes occur more frequently among those who had even a single episode of head trauma. Long-term problems may take eight years or more to develop and become evident.

Immediate symptoms that require removal from sports activities include amnesia, poor balance, headaches, dizziness, or other neurologic deficits on exam regardless of how quickly they subside on the sidelines. It is widely accepted that symptoms of a concussion can reappear hours or days after the injury, indicating that the player had not healed from the initial blow. This requires strict guidelines that conservatively allow adequate time for healing to occur. This is challenging and unclear how much time is enough. A health care provider should be involved in examining and investigating these head injuries to insure the best outcome. Even one episode of head trauma makes the athlete at risk for serious consequences and more vulnerable for the next episode, which in many contact sports is inevitable.

Both professional and college sports authorities are changing their recommendations regarding contact sports. Reducing the numerous head blows by enforcing more practices where there is no contact. Research has shown the number of head blows during a college football season totals in the thousands to an individual player.  Many of these have forces comparable to driving a car into a concrete wall at 40 miles per hour. Teaching better techniques to reduce the head leading contact and providing better equipment can reduce the negative effects. Football helmet manufacturing and testing are not closely regulated. New helmet technology and better monitoring of equipment after repeated impact can reduce the consequences of head impact.

Repeated head trauma resulting in serious consequences of traumatic brain injury should be no surprise. We can do more to preserve and protect athletes of all ages. A concussion is a complicated problem that needs thorough initial evaluation. Seek medical attention for head injures even if they seem mild and no loss of consciousness. Severity of symptoms and initial imaging studies can detect serious problems early and be the reassuring basis for ongoing treatment.