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Introduction

The Open University — Tue, 11 May 2021 10:18:23 GMT

This free course, The caring manager in health and social care, encourages you to think about how a leader or manager in the ‘caring professions’ can be, in short, more caring. It is made up of a series of four sections. The first section focuses on understanding stress and anxiety more generally. Then the second section, pressure, stress and you, invites you to examine how stress is impacting upon you on an individual level. The third section encourages you to explore the personal causes of stress, as these apply to you and also other people. Finally, the fourth section is focused on organisations, change and stress, as this applies to the health and social care sector.

This OpenLearn course is an adapted extract from the Open University course K318 Leading, managing, caring.

Learning outcomes

The Open University — Tue, 11 May 2021 10:18:23 GMT

After studying this course, you should be able to:

outline why it is important to be aware of stress in others and your own response to stress
describe how caring managers and leaders can respond appropriately to stress in others
identify the role of caring management or leadership in reducing stress when implementing change in health and social care.

1 Understanding stress and anxiety

The Open University — Tue, 11 May 2021 10:18:23 GMT

The primary focus of this first section is to explore an important question in the area of leading, managing and caring, specifically:

What causes stress and anxiety?

1.1 Stress in the context of health and social care settings

The Open University — Tue, 11 May 2021 10:18:23 GMT

Being in a health and social care setting, while rewarding, is potentially stressful and sometimes emotionally overwhelming, especially when decisions have to be made under time pressures, with limited resources available and within the seemingly constant process of change – often on a large scale. The dual imperatives behind this change have been the needs to cut costs and improve services, increasingly in the face of competition for scarce resources from the independent and not-for-profit sectors. Managing change is not only challenging in itself but also in terms of supporting others, individually and collectively, when they might be facing uncertain personal futures because of organisational changes (Harvey, Liddell and McMahon, 2009).

This free course has an implicit dimension of personal awareness raising – awareness of others’ stress and how this might impact on both them and potentially ourselves in the context of health and social care. While different people have different ways of responding to change, the very process of change itself is likely to increase symptoms of stress and anxiety for many. Therefore, particular attention will be paid to stress and change, the relationship between stress and organisational change, and ways in which management can lead with a caring face in the context of ongoing organisational change in health and social care.

1.2 Understanding stress and anxiety

The Open University — Tue, 11 May 2021 10:18:23 GMT

Caring management and leadership require a comprehensive understanding of stress and its effects. This first activity will help you gain this understanding.

Activity 1 What causes stress and anxiety?

Timing: Allow about 1 hour 30 minutes

Read Sections 1–3 (from the start up to the heading ‘4 Approaching change’ on p. 12) of the following reading: Caring through stress, anxiety and change. This covers many potential sources of stress for those in health and social care. As you read:

make a note of these sources in the box below
go through this list of sources and identify which ones you think you have experienced.

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Discussion

The sections that you read in the reading talk about the effects of stress, how stress is universal and how it is caused by a range of stressors in people’s private and working lives. It is often unforeseen and can also involve an intersection between our private and public lives. You may have noticed that you can also experience stress from things that are perceived as positive, such as moving to a new house, becoming a grandparent or starting a job that you really wanted.

All the sources of stress in the reading revolve around change – whether it is change in our personal lives or changes at an organisational and even global level. Management is yet another critical factor to take into consideration in any discussion of stress; poor management of stress can compound its effects.

While many of those working in health and social care are vulnerable to stress, as discussed in the reading, some groups are more vulnerable than others. Compassion fatigue was mentioned in relation to people in these roles. You will explore this in more depth in the next section.

2 Pressure, stress and you

The Open University — Tue, 11 May 2021 10:18:23 GMT

This second section explores two key areas, namely caring and compassion fatigue, which selected workers are at greater risk of. The second key area investigated is stress and resilience. In particular, how we can ‘bounce back’ from stressful or aversive experiences.

In this free course you have already been introduced to many of the pressures associated with working in health and social care. A good way to start to think about managing these pressures is to look at the effects on you and your own capacity to cope. This is what you will be doing in this second section. As you may already know, such personal awareness is one of the basic building blocks of caring management and leadership.

Activity 2 Caring and compassion fatigue

Timing: Allow about 45 minutes

Part A

Video 1 provides a very comprehensive outline of compassion fatigue. The presenter, Patricia, uses the term ‘caregivers’. This is often used in the international literature (particularly that from Canada and the United States) in relation to anyone who provides any form of care for others.

Watch the first instalment of Patricia giving a TEDx talk about compassion fatigue in caregiving. You will need to watch from the beginning up to 8:29 to complete this part.

If you have any problems watching or listening to this video, look at the following website, where there is plenty of useful information about compassion fatigue in caregiving in the section entitled ‘Compassion fatigue is a set of symptoms, not a disease’, and then consider the questions below.

Video 1 How to manage compassion fatigue in caregiving

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As you watch1, use this interpretation of the word ‘caregiver’ and think about the following questions. Make some notes about your thoughts.

What is compassion fatigue?
What sorts of symptoms do those who have compassion fatigue experience?

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Discussion

In her talk, Patricia uses an established definition of compassion fatigue:

A state experienced by those helping people or animals in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it can create a secondary traumatic stress for the helper.

(Figley, cited in Tedx, 2017, 04:40)

You may be struggling with the fact that Figley’s definition refers to helping animals as well as people. However, despite this anomaly, Patricia’s talk has much relevance for anyone with responsibility, in their personal life and/or their working life, for the wellbeing of others. Most notably, caring too much can be damaging. When caregivers focus on others without practising self-care, and don’t receive appropriate support from those around them or working with them, destructive behaviours can surface. Apathy, isolation, bottled-up emotions and substance abuse head a long list of symptoms associated with compassion fatigue.

Part B

Now watch the second instalment of Patricia’s TEDx talk below, from 8:29 to the end of the video.

Video 1 How to manage compassion fatigue in caregiving

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Make notes in response to the following questions:

What are the causes of compassion fatigue?
What can be done to alleviate the symptoms of compassion fatigue?

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Discussion

While the effects of compassion fatigue can cause pain and suffering, learning to recognise and manage its symptoms is the first step towards healing. With the right support and management, caregivers can achieve their goals, carry out their roles, stay well and live fulfilled lives.

A key and very important message in this short exploration of compassion fatigue is that those with responsibilities for others in health and social care not only need to know how to deal with stress in those they manage and/or care for, but also need to be aware of their own individual signs of compassion fatigue.

2.1 Individual responses

The Open University — Tue, 11 May 2021 10:18:23 GMT

Patricia (in the video in the previous section) talks about resilience in individuals’ responses to stress; different people are affected by stress and anxiety in different ways and are resilient or able to cope with these feelings to differing extents. This suggests that any consideration of stress should be contextualised within the specifics of the individual. This is what you will do in the next activity, by measuring your own levels of stress and assessing your resilience.

You might wonder how abstract things like stress levels and resilience can be quantified accurately. To complete this part of the activity, you will be using a ‘stress scale’ developed by psychiatrists Thomas Holmes and Richard Rahe. Holmes and Rahe surveyed a large sample of participants to help determine the stress impact of certain major life events. In 1967, they developed the Social Readjustment Rating Scale (SRRS) – more commonly known as the Holmes and Rahe Stress Scale – a list of 43 of what they deemed to be life’s most stressful events, each with a score to indicate the level of impact. The most stressful event on this scale has a score of 100, while the least stressful event has a score of 11. In the following activity, you will go through the inventory for yourself to get an idea of the level of stress that you may have encountered.

Activity 3 Stress and resilience

Timing: Allow about 1 hour 15 minutes

Part A

Use an internet search engine (e.g. Google or Bing) to locate an online version of the Holmes and Rahe inventory (Holmes and Rahe, 1967), and use it to measure your stress levels.

Simply go through each of the events that have happened to you in the last year and add up the score for each one. If you experienced the same event more than once, add the score again for each extra occurrence of the event to improve the accuracy of your score. For guidance, see the Holmes and Rahe Stress Scale information on the Mind Tools website. Once you have completed this, make a note of your results.

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Discussion

Answers will vary, because all our circumstances are different. For illustrative purposes two colleagues completed the Holmes and Rahe inventory. Colleague A had a score of 136, the change with the ‘most weight’ (i.e. item closest to the top of the list) was ‘Death of a close family member’, which is a stressful event. Given that these colleagues completed the inventory during the COVID-19 global pandemic it was not surprising that both had a ‘change in work hours or conditions’ and ‘change in number of family get together’. Colleague B scored 145 and noted ‘Marital separation’ was a significant stress for them. Both had scores in the ‘low’ stress range, even during the COVID-19 pandemic, with total scores below 150. Scores up to this threshold of 150 are still indicative of potential challenges that might require further support or assistance from others, even if this is informal from friends and family members.

There is advice for those using the inventory who wish to quantify their chances of experiencing stress. For example:

if a person has fewer than 150 life change units they have a low risk of illness.
150–299 life change units equates to a moderate risk of illness.
over 300 life change units means a person has a high risk of illness.

(The Mind Tools Content Team, no date)

As you will have found, measuring stress is not a science and people vary in their responses to the same situation. In helping others to develop their resilience, we should lead by example by being self-aware and emotionally intelligent in our relationships with others. Others’ wellbeing can be supported by adopting an honest, open manner and acknowledging the very personal way we all deal with stress and anxiety.

Part B

How resilient are you?

Complete the simple resilience test we have devised. Select the tick box next to any of the following statements that you feel apply to you. Completing the resilience test should give you a very rough estimate of how well you cope – being dependent, of course, on the honesty of your responses!

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Resilience test

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Discussion

Part A and Part B are both based on surveys, and while it is interesting to do them, you will appreciate that there is a subjective element in both and they may produce conflicting results leading to further questions! For example, you may have scored high in the first survey and high in the second, indicating that even though you may have had a number of major life events that are considered stressful, you perceive yourself as being resilient. This brings into question Holmes and Rahe’s estimates of your chances of suffering from stress and stress-related illness.

Whatever the differences between people – as discussed in the sections of the reading you read in Activity 1 – anyone can suffer from stress and anxiety because of personal and organisational factors. You will now look at these factors in Sections 3 and 4.

3 Personal causes of stress

The Open University — Tue, 11 May 2021 10:18:23 GMT

In this section you will be invited to complete four activities to encourage you to explore the personal causes of stress, as these apply to the ‘industry’ of health and social care, drawing on a case study. Specifically, the activities ‘It wasn’t like this before’, ‘Finding a way forward’, ‘The manager’s lot’ and ‘Time management’ primarily as these apply to the case study of Lakshmi and Angelique.

The stress that people are experiencing in their own lives can impact on them and their behaviour in a work situation. For the next few activities, you will be engaging with a case study about a woman called Lakshmi and her return to work following the death of her mother.

Box 1 Stress in the workplace: a health and social care case study

Lakshmi lives and works in Leicester and has been an Occupational Therapist for her local NHS Trust for 15 years. She has always enjoyed her job, gets on well with other team members and has a really good relationship with her manager, Angelique. She is married, has a teenage son and lives a short drive from the office. Her family lives nearby. Sadly, her mother died from cancer in 2019, only six months after her initial diagnosis. Following the death, Lakshmi took two weeks off work. Upon her return she had her back-to-work interview, during which Angelique suggested a phased return, but Lakshmi felt this was not needed. However, soon after she found that her usual love of work had changed.

The first activity involves listening to audio clips that feature Lakshmi and her manager, Angelique. They talk about what happened before and during the time when Lakshmi’s mother was dying, her subsequent death and the effect that this had on both Lakshmi’s feelings about work and her performance at work.

Activity 4 It wasn’t like this before

Timing: Allow about 30 minutes

Part A

Listen to the following two audio clips, during which Lakshmi and Angelique independently reflect on the situation from their own perspectives.

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Audio 1 Lakshmi’s perspective

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Transcript: Audio 1 Lakshmi’s perspective

Lakshmi

It was strange but I didn’t feel that shocked when my mother died; since her diagnosis six months ago we had all seen it coming. The Macmillan nurses were brilliant and helped us face reality with courage. My mother’s faith helped us both too. It was also touching that the neighbours and everyone at the temple were so supportive. It was comfort to me to know that my mother would be missed by other people in the community.

What was a shock to me was how I felt when I went back to work after my two weeks compassionate leave; my memory of the last six months were all black and white, as if the colour had been washed out of the world. I have always loved work – the feeling I could ‘make a difference’ helped me to get out of bed in the morning. I have found my work cathartic too, and it was a comfort to immerse myself in work during my mother’s final months. But when I got back to work everything was just so exhausting. I didn’t know what was going on – I began to fall behind not long after starting back and never seemed to have the energy to catch up again. When more work came I began to feel overwhelmed. Normally, I would have gone to Angelique right away but I just didn’t feeling normal and she didn’t want to be seen as a failure at work.

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Audio 1 Lakshmi’s perspective

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Audio 2 Angelique’s perspective

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Transcript: Audio 2 Angelique’s perspective

Angelique

When Lakshmi’s mother died, I thought that she had coped with her bereavement in a calm and emotionally mature manner. I really admired her for that however, about six months later, I just didn’t know what to make of Lakshmi and couldn’t understand what was going on. She used to be a manager’s dream – always bubbly and bright, a keen team member, and always as sharp as a knife when it came to her caseload. Now she seemed to be permanently sullen and irritable, uncharacteristically cynical in meetings and, at serious risk of losing her grip on her caseload. I had always been close to Lakshmi but felt like we were losing the relationship we once had.

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Audio 2 Angelique’s perspective

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What do you think could be causing Lakshmi’s behaviour? Make a list of possible causes.

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Discussion

High levels of stress, such as that caused by bereavement, can lead to burnout, a sense of loss of control, disengagement from work and, ultimately, ill health. Lakshmi had experienced the trauma of losing her mother and had also lost the sense of fulfilment from, and engagement with, work, which she used to enjoy. Employees who have a sense of engagement in what they do find that, instead of experiencing work as stressful and demanding, they look on it as a positive challenge which, in turn, enhances their wellbeing, involvement and efficacy. When they lose that engagement, they often go down an energy-depleting path which can quickly lead to a drop in performance, fatigue and even burnout (Seemann and Seemann, 2013; Strauss, Parker and O’Shea, 2017).

Part B

Now listen to Lakshmi talking about how her stress built up at work.

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Audio 3 Lakshmi’s build-up of stress

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Transcript: Audio 3 Lakshmi’s build-up of stress

Lakshmi

I felt so ashamed. I had promised to do a presentation on a project I had done to the team and had been given a month to work on the presentation. I’m not a procrastinator and it wasn’t that I didn’t want to; rather, I simple never seemed to have the energy to sit down and start. My heart just was not in it.

When it came to the week of the presentation, I hadn’t done it. Although I felt I was letting down Angelique. I kept thinking what did it matter anyway? The whole place just felt really negative these days; people didn’t seem to look out for each other anymore; everyone was so stressed trying to hold on to their jobs; Angelique was never around for us anymore. I just wanted to run away and hide.

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Audio 3 Lakshmi’s build-up of stress

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As you listen, think about the following questions:

Have you ever experienced feelings similar to Lakshmi’s?
Have you seen someone else go through similar emotions?
In such situations, what do you think helps the person concerned?

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Discussion

Such situations need to be handled sensitively; caring leaders and managers can draw on both management and leadership skills to develop a style of management that builds on their personal awareness to support staff, while simultaneously acknowledging their humanity and dealing sensitively with strong feelings. This kind of approach can play an important part in retaining staff, keeping morale high and enabling people to deal with the inevitable pressures of work in health and social care.

As the case study of Lakshmi and Angelique continues, you will see the importance of a caring approach to management.

3.1 Caring management of stress

The Open University — Tue, 11 May 2021 10:18:23 GMT

The audio clips in the next activity feature Lakshmi’s and Angelique’s accounts of how Angelique approached the situation to support Lakshmi.

Activity 5 Finding a way forward

Timing: Allow about 45 minutes

Part A

Listen to the following audio clip, where Angelique talks about how she thought of a possible way to help Lakshmi.

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Audio 4 How Angelique tries to help Lakshmi

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Transcript: Audio 4 How Angelique tries to help Lakshmi

Angelique

I recognised that Lakshmi was struggling with her workload and that she didn’t seem to be as organised as she used to be before her mother’s death, so I arranged a meeting to discuss the situation. I wondered if Lakshmi might benefit from developing her time-management skills. I first began to use the technique when I was studying and working, and had been amazed by the way it put me back in charge of my life at a time when I was under considerable stress. The great thing was that the idea of a work–life balance was built into planning and I thought this would help Lakshmi, but wasn’t sure how to broach the subject as Lakshmi was so prickly at the moment.

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Audio 4 How Angelique tries to help Lakshmi

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What do you think of Angelique’s approach to Lakshmi’s behaviour?

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Discussion

The build-up of stress in Lakshmi’s life meant she was managing her time badly, resulting in more anxiety for her and potentially putting recipients of care at risk as well. Angelique was drawing on her own experience and personal awareness of the benefits of good time management to help improve the situation. Although she could not control the wider circumstances of Lakshmi’s stress, she felt she could help Lakshmi develop her personal sense of control, or her ‘power-from-within’ (Wong, 2003). In choosing to identify a practical tool that might support Lakshmi, Angelique was leading by example. You may well disagree with Angelique’s approach and feel that she should have focused much more on providing Lakshmi with emotional support. In the next part of the activity, you will hear how Lakshmi reacted to Angelique’s suggestion.

Part B

Listen to the following audio clip from Lakshmi and then reflect on the questions below.

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Audio 5 Lakshmi’s feelings about the meeting

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Transcript: Audio 5 Lakshmi’s feelings about the meeting

Lakshmi

I dreaded the meeting that Angelique had arranged for days. I also felt she was getting at me and could feel myself getting angrier and angrier just before I went in. It was so strange how my feeling changes when I got in there – I had been feeling that Angelique had seemed so distant and out of reach recently but the way she spoke to me showed that she really cared and that she was trying to find a way to help me cope and manage my time. It felt like she was there for me.

It was then that the floodgates opened. I could not stop crying and I told her all about my husband’s redundancy, my son’s problems at school, my constant feeling of panic, and how isolated I felt at work when I used to love it. I told Angelique how I felt totally inadequate when I had to go home at the end of the day to support my family and she was always staying late, and never seemed to stop. I just didn’t have the energy for that.

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What do you think about Lakshmi’s responses and what she said?
How effective do you think Angelique’s solution of personal time management was in practice?
What else might Angelique have done?

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Discussion

Clearly, there was more going on in Lakshmi’s life than Angelique had realised.

Lakshmi’s transition after the death of her mother was being frustrated by other stressful factors in her life. There is a danger that, in their concern to support particular individuals, managers and leaders may either overlook or even try to downplay any associated stress factors in the wider context that may be relevant. In terms of caring management, this can be seen as lack of contextual awareness. Talking to Lakshmi about her time-management skills and giving her a practical tool certainly looks like the actions of a caring and proactive manager, but Lakshmi’s outburst focused on her personal emotions, feelings and problems.

As you have seen, people who feel engaged at work generally experience a greater sense of wellbeing and are therefore more able to cope with stress. While Lakshmi had personal problems outside work that were making her feel less able to cope in work, she also revealed to Angelique that something had changed in the workplace recently, which undermined the comfort she used to feel there. So, if Lakshmi felt happier at work, it could have helped her to cope better with what was going on in the rest of her life.

There are many different ways of dealing with stress and you may have come up with a different solution to help Lakshmi. It is also important for the manager, however, to consider their own stress. The next section deals with this issue.

3.2 What about the caring manager’s stress?

The Open University — Tue, 11 May 2021 10:18:23 GMT

As you have seen, everybody in health and social care is under increasing pressure, and even well-intentioned managers like Angelique can struggle to meet human needs as well as organisational needs. You will explore this further in the next activity.

Activity 6 The manager’s lot

Listen to the following audio clip, where Angelique talks about her experience managing and supporting Lakshmi in this situation.

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Audio 6 Angelique’s caring management

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Transcript: Audio 6 Angelique’s caring management

Angelique

I was desperate to manage Lakshmi in a caring way, but her lack of engagement with work was beginning to impact on the rest of the team and the targets they were working towards. Although I wanted to support Lakshmi as an individual, as a manager, I also had to keep my eye on the wider team and I was under pressure to make efficiency savings. I had been working later and later, and couldn’t remember the last time I had a weekend off. But I was in charge now, and wasn’t that how it was meant to be? Nobody else was going to do it!

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Audio 6 Angelique’s caring management

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What do you think Angelique should do?

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Discussion

It would seem that there is case for Angelique to develop her own self-awareness more in her role as a caring manager. Angelique had to keep her eye on the team (team awareness), their goals (goal awareness) and the organisational context (contextual awareness) as well. As her stress levels increase because of all the demands on her, managing the life crises, losses, transitions and uncertainties that are part of other people’s lives – and therefore also part of the manager’s lot – could result in compassion fatigue. This, in turn, would have a negative effect on her ability to provide caring management for those for whom she is responsible. Angelique could, therefore, have benefited from developing her personal awareness more reflectively – applying it to her own work–life balance and motivation, but recognising that other people will be different and hence have different needs and ways of coping.

An important message here is that effective management responses to work-based stress must involve personal awareness first and foremost. A manager can lead by example by managing their own wellbeing and encouraging this in others. Perhaps Angelique was focusing so much on helping Lakshmi develop her personal awareness that she was neglecting her own self-awareness wellbeing. Lakshmi had suggested to Angelique that she had difficulty living up to Angelique’s example, and this might have been undermining team morale for others as well.

Now that you have reflected on Lakshmi’s and Angelique’s experiences of stress in the workplace, you may be more aware of similar instances within your own formal and informal practice. The next section emphasises the importance of effective time management in reducing stress and will help you develop your approach to manage time better.

3.3 Time management really can help

The Open University — Tue, 11 May 2021 10:18:23 GMT

You can’t actually manage time. Time just is. All you can hope to do is manage yourself and what you do with your time.

(Evans, 2008, p. 1)

So far you have been concentrating on personal stress experienced by those in health and social care, whatever their position. Angelique had identified time management as an essential skill that helps to keep work under control, increase productivity and reduce stress. Effective time management can also help people complete their work tasks more efficiently, so they are able to have more quality time for relaxation, leisure, friends and family. Poor time management leads to frustration, lack of motivation and poor self-esteem, and it can even undermine health and wellbeing. People working in health and social care often care for highly vulnerable people. Good time management, therefore, is crucial to help ensure safety for yourself, the people you manage, recipients of care and those for whom you have caring responsibilities.

Time management is about more than writing a list of tasks; the keys to effective time management are goal awareness and personal awareness. You need to know what your important work tasks are (these may be related to your team and/or service) and consider the competing demands on your time and how to prioritise and delegate. You then need to be able to recognise your strengths and weaknesses and to find a way to manage yourself and your time better with this knowledge.

In the next activity, you can reflect on your own time management.

Activity 7 Time management

Timing: Allow about 15 minutes

We all have an appreciation of our abilities in terms of time management, how would you describe your time management abilities? For instance, is time management a strength of yours? What assists (or hinders) your time management skills?

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Discussion

Thinking about what you know about your own time management – what makes a difference? Is it taking regular breaks or practical tips. For example, some people find that breaking down big tasks into smaller ones is very helpful. In addition to turning off your email and phone whilst doing certain tasks (to assist you with your focus at work), you might have identified other ways of minimising interruptions, such as negotiating time with others around you. What leadership skills or other tools could you draw on to develop in this area? For example, do you find it hard to prioritise? Perhaps being clear about your own objectives would help. Now that you have thought a bit about your time management abilities you might find it useful to identify a couple of practical ways in which you could optimise your time while at work.

You have carried out a thorough exploration of how stress and anxiety can result from personal factors. It’s now time to look at the role of organisational factors in causing stress and anxiety.

4 Organisations, changes and stress

The Open University — Tue, 11 May 2021 10:18:23 GMT

This final section pertains to change and the stress linked to this in health and social care services. The key area of focus will be on making sense of and understanding change.

You saw an example of organisationally induced stress in Angelique in the case study in the previous section. You are going to take a closer look at the ways in which organisations can cause stress. Organisational change is everywhere in health and social care. As stress and anxiety are most likely to occur during times of transition and change, the focus will therefore be on change in organisations.

Before you go any further, you need to have a clear understanding of change and its implications. This activity focuses on another reading. It will help you to understand the pressures for change in health and social care contexts, as well as introducing some key ideas about change from organisational theory.

Activity 8 Understanding change

Timing: Allow about 1 hour

Read the rest of the reading (from the heading ‘4 Approaching change’ on p. 12 to the end): Caring through stress, anxiety and change.

As you read, make notes on what you think a caring approach to managing change, in whatever context, should embody.

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Discussion

As you will now appreciate, change impacts in different ways across health and social care, placing demands on all those involved.

While change can be challenging for families, recipients of care and frontline staff, those tasked with making changes happen can also face significant challenges. Several models for managing change have been developed. In terms of adopting a caring approach to managing change in any context, the reading shows that rather than being authoritarian, it is important to stay in what is referred to as the ‘caring approach’. The strategies for doing so include making people feel they are being listened to and engaging them in the changes, nurturing a collaborative climate, being emotionally aware, emphasising potential improvements that the changes can bring and enabling those affected to see the bigger picture.

5 Test your knowledge

The Open University — Tue, 11 May 2021 10:18:23 GMT

You will now have a chance to review what you’ve learned in this free course with an informal quiz.

Activity 9 Informal quiz

Timing: Allow about 30 minutes

1. Personal awareness is one of the basic building blocks of caring management and leadership. True or false?

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2. Tick which of the following are correct. Compassion fatigue:

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Discussion

Compassion fatigue is experienced by those helping people or animals in distress. It is an extreme state of tension and preoccupation with the suffering of those being helped, and can lead to a secondary traumatic stress in the helper or caregiver. Symptoms include apathy, isolation, bottled-up emotions and substance abuse. These can be alleviated with the right support and management.

3. Who developed the Social Readjustment Rating Scale (SRRS) or the ‘Stress Scale’ as it is more commonly known?

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Discussion

Thomas Holmes and Richard Rahe developed the Social Readjustment Rating Scale in 1967. Look back at the ‘Individual responses’ section to find out more.

4. Which statement is the most accurate?

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5. Imposed change has a number of effects on staff. Which of the following are the most common examples of these?

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Conclusion

The Open University — Tue, 11 May 2021 10:18:23 GMT

In this free course, The caring manager in health and social care, you have examined a range of causes of personal and organisational stress for all those working in health and social care. By virtue of its very nature, health and social care is potentially stressful for both formal and informal practitioners. Change is an underlying factor in many of these causes of stress. Resilience to stress and anxiety varies from individual to individual, which in turn means that individuals’ responses to stress vary. You have seen that, whatever the reaction and context, a caring approach to the management of both stress and change is paramount for the wellbeing of all those concerned.

Key points

In order to prevent the quality of care being compromised, if you have responsibilities for others in health and social care, you need to understand what causes stress in others, the different symptoms and how to deal with stress in those they manage and for whom they care.

Responding appropriately to the different ways stress manifests in others requires the development of a management style that incorporates contextual awareness and personal awareness (the personal awareness tool can help caring managers build their personal awareness).

Change in health and social care has a range of drivers and is an ongoing, recurring and complex process, but there is no blueprint or formula for making it work. When implementing change in health and social care, being a caring manager or leader requires an awareness of the relationship between stress and change.

This OpenLearn course is an adapted extract from the Open University course K318 Leading, managing, caring.

References

The Open University — Tue, 11 May 2021 10:18:23 GMT

Baloh, J., Zhu, X. and Ward, M.M. (2018) ‘Implementing team huddles in small rural hospitals: how does the Kotter model of change apply?’, Journal of Nursing Management, 26(5), pp. 571–578.

Chang, T.F. (2018) A mindfulness approach to stress management [Streaming video]. Available at: https://methods.sagepub.com/ video/ a-mindfulness-approach-to-stress-management (Accessed: 30 April 2021).

Cooper, C., Fletcher, B., Donaldson-Fielder, E., Wager, N. and Shipp, L. (2007) Handling stress [Streaming video]. Available at: https://methods.sagepub.com/ video/ handling-stress (Accessed: 30 April 2021).

Evans, C. (2008) Time management for dummies. Chichester: John Wiley and Sons Ltd.

Figley, C. (2013) Treating compassion fatigue. London: Brunner-Routledge.

Figley, C. (2017) ‘Compassion fatigue resilience’, in Seppälä, E.M., Simon-Thomas, E., Brown, S.L., Worline, M.C., Cameron, C.D. and Doty, J.R. (eds) The Oxford handbook of compassion fatigue. Oxford: Oxford University Press.

Harvey, S., Liddell, A. and McMahon, L. (2009) Windmill 2009: NHS response to the financial storm. London: The King’s Fund.

Holmes, T.H. and Rahe, R.H. (1967) ‘The social readjustment rating scale’, Journal of Psychosomatic Research, 11(2), pp. 213–218.

McNaughton-Cassill, M.E. (2014) Coping with stress. New York, NY: Momentum Press.

Mind Tools (no date) The Holmes and Rahe stress scale. Available at: https://www.mindtools.com/ pages/ article/ newTCS_82.htm (Accessed: 22 April 2021).

National Health Service (NHS) (no date) Every mind matters. Available at: https://www.nhs.uk/ oneyou/ every-mind-matters (Accessed: 22 April 2021).

Seemann, M. and Seemann, T. (2013) ‘New perspectives on employee motivation: balancing the big 4’, International Journal of Knowledge, Culture and Change Management, 13, pp. 1–7.

Strauss, K., Parker, S.K. and O'Shea, D. (2017) ‘When does proactivity have a cost? Motivation at work moderates the effects of proactive work behavior on employee job strain’, Journal of Vocational Behavior, 100, pp. 15–26.

Tedx (2017) How to manage compassion fatigue in caregiving. 7 February. Available at: https://www.youtube.com/ watch?v=7keppA8XRas (Accessed: 22 April 2021).

Togetherall (2020) Get support. Take control. Feel better. Available at: https://togetherall.com/ en-gb/ (Accessed: 22 April 2021).

Wallbank, S. and Hatton, S. (2011) ‘Reducing burnout and stress: the effectiveness of clinical supervision’, Community Practitioner, 84(7), pp. 31–35.

Wong, K-F. (2003) ‘Empowerment as a panacea for poverty – old wine in new bottles? Reflections on the World Bank’s conception of power’, Progress in Development Studies, 3(4), pp. 307–322.

Acknowledgements

The Open University — Tue, 11 May 2021 10:18:23 GMT

This free course was written by Mathijs Lucassen, based on materials developed by Mary Larkin.

Except for third party materials and otherwise stated (see terms and conditions), this content is made available under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Licence.

The material acknowledged below is Proprietary and used under licence (not subject to Creative Commons Licence). Grateful acknowledgement is made to the following sources for permission to reproduce material in this free course:

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