Stress in work teams

Introduction

In this work we will deal with the topic: « Stress in work teams «. Our objective through this presentation is to develop this problem that is so present today in a way that can clearly understand what stress is, how it is presented, how it influences the actions and results of teamwork and how we can treat it and eradicate it if possible.

In all the work we take as a base the bibliography used in the "Driving Teams" chair, trying to draw our own conclusions from the interrelation of the latter with the vast bibliography that can be found on the subject of this monograph.

Stress is one of the great problems of our time, many specialists believe that it is the result of a society where existence has become a constant and endless struggle for the career of being the best, earning more money and the obsessed intention of being almost perfect. Always and every minute we live in a fight against time which has created a human being with a great internal conflict, constantly facing daily pressures and problems, it is not so difficult to understand that our organism has sought a way to adapt and defend against this reality.

Stress is generally taken as an individual problem, but it goes without saying that given the need to interact with other people, as happens in a work team, the stress of one member can affect everyone else, it is understandable that a nervous person, tense and unwilling to cooperate, as happens with people who are victims of this problem, may have consequences on the team's performance and results. Given this, taking into account that our objective is to lead effective teams or integrate effective teams, we cannot forget that stress is a very common problem in our time, that we have to know how to detect it, understand it and solve it. We will try to find a way to these actions in this work.

As a guide for the reader we can highlight that we will develop the topic starting with the explanation of the problem of stress, exposing definitions and characteristics, then we will treat the causes that provoke it, we will specifically touch the consequences of stress in work teams, we will expose some methodologies of treatment and finally we will include the whole topic through the development of a practical case that we chose from which we found particularly exemplary of the entire analysis and that it could be a good element to achieve a better understanding.

What is stress?

Then, as the first point of this work, we find it essential to explain the meaning of the term stress. There is a lot of bibliography that refers to this topic, but we found it interesting, as a generic definition, the following:

"It is the general term that is applied to the pressures that people experience in life"

We found that many specialists make a difference between physical and emotional stress, being able to find these separately or be correlated. Physical stress is characterized by presenting hormonal discharges, tightening the muscles and interfering with the body's ability to resist diseases. But stress often affects not only our body, but also our thoughts and feelings, becoming a very important factor in the development of depression, anxiety and other psychological problems. The long-term effects of stress can be devastating, as we can recover from a bad day, but it can be very difficult to endure continuous stress.

We can say then that over time the human organism has created a set of physical and psychological responses to threatening or dangerous situations. In this way, when the human being feels threatened, he tightens the muscles, accelerates the heart rate, increases the segregation of adrenaline, the mind becomes "alert", and activates a set of adaptive responses learned over time (General System of adaptation). When these responses are made in harmony, respecting the physiological and psychological parameters of the individual, it is adequate in relation to the demand and the energy provided by the General Adaptation System is consumed biologically and physically, we adopt the concept of "stress" or "stress" positive".When, on the other hand, the responses have been insufficient or exaggerated in relation to demand, "distress" or "overemphasis" occurs due to its permanence (chronicity) or its intensity (acute response). We in this work will always refer to negative stress.

The fact that the human organism presents this action behavior in situations of danger is normal, but currently the human being lives within a society where daily, he encounters threatening and dangerous situations (economic problems, lack of work, labor problems, family problems, etc.) and therefore the body is in a constant state of alert. This creates that the adaptive responses created by the organism appear every day, and that in many cases this is the normal way of life.

On the other hand, if we apply the concept of stress to the workplace it would be defined as:

« The perceived imbalance between professional demands and people's ability to carry them out «

In this presentation we will refer to stress in work teams, but we can highlight in general that stress is practically inevitable in many tasks. However, individual differences show the existence of a wide variety of reactions to the problem; a task considered interesting by a person can produce in other high levels of anguish. When pressure builds up, as we highlighted earlier, it can cause adverse stress to a person's emotions, mental processes, and physical condition. When stress becomes excessive, people develop various symptoms that can harm their job performance and health, and even put their ability to cope with the environment at risk.

Causes of stress

Next we will carry out a general development of the causes of stress in the workplace.

The conditions that tend to cause this problem are called stress agents and include all those situations capable of triggering the process of adaptation to environmental demands or demands. Although a single agent can cause too much, usually several of them combine in the pressures of a team member to develop stress.

We can say that the main sources of stress in employees are divided into organizational factors and the non-work environment. These causes are pointed out in the following figure, which shows that individual differences between employees can cause, as mentioned above, that some of them respond to such agents with positive pressure (which stimulates them), while others experience negative stress (which detracts from your efforts). As a result, constructive or destructive consequences can occur for both the company and the employee. These effects can be short-term and disappear quickly, or last a long time. Thus, to control stress, firms often start by examining their work-related causes.

Models of causes, types and consequences of stress

We can highlight two types of stress in the first place:

Episodic, which occurs due to a particular event (a dismissal, for example) Chronic, which can occur when the person is subjected to the following situations:
- Inadequate work environment. Work overload. Altered biological rhythms. Very important responsibilities and decisions. Slow and monotonous stimulation. Inadequate work conditions.

On the other hand, we find it interesting to highlight a classification of stressors based on whether they are extra-organizational or intra-organizational.

1. Extraorganizational stressors

Extra-organizational stressors are those that arise outside the scope of the company. They understand the family, political, social and economic factors that affect the individual. Although recent studies suggest that the incidence of work stressors on family and spousal life is greater, we cannot fail to mention the interrelation between work and home life or social life.

The inadequate home-work interconnection generates psychological conflicts and mental fatigue, lack of motivation and decreased productivity, as well as a deterioration of the conjugal and family relationship.

There is no doubt that organizational or intraorganizational problems or stressors, that is, those that occur within the workplace, affect the personal life of the subject, causing household difficulties, which as they increase are later potentiated, generating a subsequent stress that is carried again. to the workplace and generates difficulties in job performance, thus producing a vicious circle of mutual feedback.

2. Intraorganizational stressors (from the work environment)

We must bear in mind the fact that people invest a large part of their time in their work, finding a substantial part of their identity and personal gratification in their tasks. However, these considerations are not always adequately valued by companies, or even by workers themselves.

We believe that there are stressors that are more evident in a team situation than in individual work, but that at the same time teamwork can decrease the degree of stress produced by certain stressors. Likewise, it is worth clarifying that it will depend on the activity, although there are generic stressors, there are certain activities that, due to their characteristics, expose individuals in a particular way and different from others.

We can group organizational stressors into four types:

Physical environment stressors; Individual level stressors; Group level stressors; Organizational stressors.

A) Stressors of the physical environment

We can highlight the following

Lack of light or very bright light; Excessive or intermittent noise; Vibrations; Polluted air; High or low temperature; Inadequate infrastructure

These factors require a double adaptation, both physical and psychological.

B) Individual level stressors

Such are considered to be:

Work overload; Role conflicts; Discrepancies with career goals. Alteration of biological rhythms.

1) Work overload: This represents excessive assignments of activities to a worker. The overload or stress due to overstimulation can be objective or subjective, according to the assessment and characteristics of the people. Exerting important responsibilities, that is, for example, responsibility for the task or the decisions of others, is considered workload. These people usually have more stress, smoke more, have higher pressure and increased cholesterol levels than those who only take responsibility for objects or for carrying out their own tasks.

The overload generates dissatisfaction, tension, a decrease in self-esteem, a feeling of threat, tachycardia, an increase in cholesterol, the consumption of nicotine and other addictions, to try to respond to the excess demand.

2) Role conflict: it occurs for an employee when a person in his work environment communicates certain expectations of how he should behave, and this expectation makes it difficult or impossible to fulfill others.

There are different types of role conflicts:

Intra-plaintiff: It is when the supervisor or a person who directs, communicates incompatible and inconsistent expectations with each other Inter-plaintiff: It occurs when two or more people communicate incompatible role expectations Person-role conflict: When there is an incompatibility between the values of an individual or their beliefs and expectations. Inter-role conflict: It happens when the requirements of a role are incompatible by the same person. Role Ambiguity: It happens when there is adequate information about the expected role. Such information is unclear and confusing about the role's expectations (behaviors), as well as when there is confusion as to what behaviors the subject has to satisfy the role's expectations and little certainty about the consequences of certain role-behaviors.

3) Discrepancies with career goals: Discrepancies and doubts about the individual's career or profession are caused by lack of job security, doubts about promotions and legitimate frustrated ambitions. Dissatisfaction regarding the discrepancies between aspirations and achievements leads to anxiety and frustration, depression and stress, especially between the ages of 40 and 50.

It is common that in addition to a poor quality of work performance we find addictions such as alcohol, drugs, coffee, tobacco, etc.

It is necessary to clarify that the concept of role is taken as the way in which the function is carried out.

4) Alteration of biological rhythms: It is the stress that occurs when altering the biological constants determined by the heart rate determined in turn by hormonal secretions, sleep cycles and metabolic rhythm. It requires a high adaptive effort, generating irritability, decreased concentration, sleep disorders, fatigue, anxiety, in addition to causing changes in social, marital and sexual life. It comes in:

Night Workers; Airline Pilots and Air Hostesses; Air Traffic Controllers; Health Personnel; Security Personnel; Transportation Workers; Diplomats; Professional Athletes.

C) Group level stressors

The following are included as stressors at group levels:

Lack of cohesion among team members; Intra-team conflicts; Inter-team conflicts; Inadequate team support.

A team is a set of people who perform a task to achieve a result. One organization may adopt teamwork as a fairly widespread "mode" of work these days, causing many others to adopt it as a "fad", producing this lack of conviction and support from the hierarchical level that the results are not really expected (in the opinion of the author Fainstein)

D) Organizational stressors

They include:

Organizational climate; Management styles; Technology; Job designs and characteristics; Non-rational deadlines; Control of computer systems; Slow and monotonous stimulation.

1) Climate of the organization: An organization has a character, a particular atmosphere typical of its productive scheme. This climate conditions the behavior of the individuals that comprise it, but its assessment is difficult to achieve, since its measurement lacks scientific rigor. It can be a tense climate, relaxed, cordial or not, and so on. All this produces different levels of stress in individuals, depending on the susceptibility or vulnerability that each one has.

2) Management styles: They can be determined by rigid and impersonal structures, by inadequate supervision or information, by the impossibility of participating in decisions, etc.

3) Technology: The availability with which the organization equips its employees with the necessary elements for their action, as well as training in the use of the respective technology, will be highly stressful. Resources must be in accordance with labor requirements and demands.

4) Job designs and characteristics: They allow motivation for progress within the work organization.

5) Non-rational deadlines: It does not require more detail to describe the impact produced by the establishment of unattainable goals at the times set for it. Especially in work teams where time is a fundamental factor for their realization.

6) Control of computer systems: When the members of the organization, objectively or subjectively, do not dominate or control the computer systems that are used, situations of anxiety and stress are generated that decrease efficiency.

7) Slow and monotonous stimulation: It is stress by underestimation. It is produced by the lack of normal and physiological stimulation of the senses and thought. It occurs, for example, in routine, automated work that does not allow for creativity and independent thinking, in cases such as the following:

Slow and monotonous work chain. Abrupt retirement. Excessively quiet holidays. Lack of work.

Companies, organizations and institutions are areas where individuals spend most of their time in a waking state. Prevention in this area must be essential on the part of the authorities or hierarchies, within the task of caring for the health of individuals and the area where their work is carried out.

As a conclusion to this point, we can say that if we were to propose an organizational model to prevent stress, it would be necessary to investigate extra-organizational and intra-organizational factors, the latter containing those at the group, individual and organizational level that affect or have an impact on the individual's capacity, creativity and independent thinking.

On the following sheet we present a table as a synthesis of the effects of stress.

Emotional effects	Anxiety
Aggression
Apathy
Boredom
Depression
Fatigue
Feelings of guilt
Shame
Irritability
Bad mood
Sadness
Low self-esteem
Tension
Nervousness
Loneliness
Effects on thinking	Inability to make decisions
Inability to concentrate
Frequent forgetting
Critical hypersensitivity
Mental blocks

How stress affects the work teams

From the analyzed material, the reduction in efficiency arises as the main consequence of stress in work teams. We will face this issue seeing it from Fainstein's position in which, the team is such at the time of the action and it is at that moment when the stress suffered by any of the team members, affects him. While the effectiveness aims to meet the objectives and the efficiency to meet them in the best possible way, we observe that the effects of stress will be greater in results-oriented teams, fundamentally when they are in contact with other people and looking for complex results, needing high precision.

Related to the reduction in effectiveness we find low concentration to carry out team tasks as another consequence of stress. Faced with the development of tasks, low concentration is a trigger for errors and even work accidents that lead to inefficiency. A stressed person can be characterized by physical and mental fatigue that make them become more careless, less foresight and less attentive in the development of tasks. The rest of the team needs that member and an oversight can harm them.

Low satisfaction at work and activity receptors is another of the repercussions of stress. We will begin by analyzing what happens in work teams in contact with people.

Facing stressed team members, tasks are not performed properly. As we have previously mentioned, efficacy is reduced by tiredness, poor memory, poor predisposition to attention and a bad mood. People demanding the team's activity generate a series of expectations regarding what they want to receive, producing, when not covered, a wide gap between the care received and the expected one, causing high levels of dissatisfaction or low satisfaction.

Looking at it from the team's perspective, stressed members often bring their problems and concerns to the rest of the team, lowering the level of performance, causing low satisfaction of the members during and after seeing the team's results. That is, the process-oriented teams are less satisfied by the low performance of the stressed members' tasks, and in the result-oriented teams, satisfaction is reduced when the expected results differ greatly from the real ones.

Another very notable consequence is the high rate of absenteeism from stressed members. This can be given by prescription when stress has already been triggered, therefore physical and mental rest and rest are recommended. Also absenteeism can be caused by those who are about to get sick or by the rest of the team when the work environment becomes dense or conflictive.

Quoting Peter Senge in his book The Fifth Discipline, we can clearly see the attitude of absenteeism as a form of defensive routine against the fear or complication of facing a work environment with risk, tension or conflict. Faced with this, many people often do not attend work as a way to avoid facing these conditions once more, postponing the search for a solution to this problem.

For many people, it is easier to absent themselves to deal with the problem and see how they could cope with it through a kind of learning.

Related to efficacy and absenteeism, we emphasize that stress often leads people to the consumption of alcohol, drugs and tranquilizers as a means of escape and reducing the effects of the disease. Here we again mention these loopholes as defensive routines that generate a high impact on the team. Many times the members are afraid to comment that they are sick due to the reaction of their colleagues and of society or their fear of seeing that they are sick. Therefore, it is very common that they go to means that conceal the disease for a longer time.

The demoralization of the team is another consequence, by which the stressed person loses concentration and activities are not carried out effectively. Factors such as low wages, high layoffs, complaints from everyone who expects the team's results or activities, work stoppages, union problems, overwork, lack of resources, lack of infrastructure, late payment of wages, not only increase the possibility of stress but it lowers the spirit of the team. This can be due to the powerlessness to face situations that go beyond what they can handle.

This, in turn, generates a lack of interest in the job until it suffers from a lack of professional performance in the case of professional teams. Those teams that need the knowledge of other members and co-creation often do not feel fulfilled as a professional, frustrating their expectations.

Negative thinking of stressed people and high levels of self-indulgence affect the team during action. Referring to the different roles that can appear in a team, we can find an individual role that is not a contribution to development as a team and is that of the "help seeker". This person can divert the interests of the group so that it is attended and listened to.

On the other hand, stress leads to a bad mood and the adoption of roles of aggressors. The bad mood often leads to out of place responses, greater sensitivity and to lean towards the role of aggressors or opponents who harm the team a lot by showing the interest in satisfying their personal needs, leaving aside the alignment with the team. In general, there are often rivalries and discussions that lead to the search for the culprits of errors rather than the search for solutions to what has already been done. We emphasize that these aggressive behaviors are very little adaptive and can generate interpersonal conflicts that in turn can become other stressors. This aggressiveness in our opinion acts directly on communication. Articulating element,It generates and can unlock conflicts and it is through this that the knowledge that allows to develop reliability among team members is shown. Fundamental element to achieve the team's objectives. (Following Fainstein's thought)

Another of the most notable consequences of stress is decreased cooperation. This from the point of view of E. Pichón Riviere, is a fundamental element for the team's action.

This statement constitutes a first approximation to what are the negative consequences of stress in work teams, but we must not lose sight of the fact that stress in small doses can produce positive effects, such as growth and learning, development of resources and professional skills.

Methods to prevent stress

There are different methods to remedy stress in work teams and also to prevent it. Depending on the characteristics of each team and the organizational level it is in, methods may emerge that suit their style. We will mention some general and some particular tools:

Prior to a prevention program, it is essential to support the higher levels in the case of work teams. From this, the establishment and the resources to carry out programs and objectives are achieved.

The formation of round tables for debate and communication is one of the possible tools. Through these tables, people can treat the stress issue, its causes, symptoms and how it affects the team, being able to detect people with this symptomatology and seek help from the team. Communication is fundamental in this aspect and the freedom to express how they feel in the team manages to remedy anguish, tension, feeling support from others. This tool is mentioned under the name of peer solidarity.

Through the meetings, it is possible to obtain an extra knowledge that is developed as a team. For this we mentioned that it is not necessarily important to reach a friendly relationship between the members, but with greater communication and trust, great results are already achieved for the prevention of stress.

Regular talks, meetings before and after teamwork work as a stimulus to less uncertainty and as a prevention of anxiety and tension that can trigger stress. It is vitally important to promote opinions during teamwork, to say no in front of tasks that are known in advance to be difficult to fulfill and that generate excess responsibility and greater pressure on the members.

On the other hand, we need the good will of the team members to recognize themselves with the disease, preventing it from falling into denial.

It is also important to conduct training sessions on the subject and ensure the commitment of the entire team to try to find a solution. With the help of professionals and applying it to each individual team, ways can be found to prevent and improve.

From the point of view of the management of labor organizations, we will mention some tools that, through their application, allow preventing stress in the members of the different teams that compose it.

Job rotation, multidisciplinary team building, and task diversification help prevent stress in teams with routine problems and mental and physical fatigue. It is essential to develop more stimulating roles that congratulate, reward, negotiate, and allow opinions to be expressed within the team to reduce pressure and motivate members even when the conditions for carrying out the tasks are complex or difficult to bear. Such is the case of the work teams belonging to public organizations, needy schools, and public hospitals that often work with minimal resources, allowing to reduce tensions by stimulating each of the members.

Faced with roles of aggressors or contradiction, chats and the help of a good driver can help reduce a discussion work environment for one who seeks solutions to problems and not the culprits.

We observe that in companies in our country there are methodologies that help prevent stress. Some of them were not specifically implemented for this reason, but by achieving a better team relationship, by allowing the distraction and discharge of tensions in individuals, it contributes to their prevention:

Adoption of activities to stimulate interpersonal ties, motivating its employees to participate in different sports disciplines organized by the company. The disciplines can be varied (soccer, tennis, paddle, chess, fishing, etc.)

The activities can be organized by the HR department or in the case of important organizations, they are in charge of the employees' Mutual or the union organization.

In them, the employee can experience various roles that he cannot develop during his work in the work team, helping the team to unite, a greater integration of team members through informality and allowing the discharge of perceived tensions within or out of work.

Certain organizations install gymnasiums within companies on some floor of the building or in another place to which the members of the organization can attend as an extra benefit and method to relieve tension.

Others point to the possession of a fifth or weekend club or the execution of different agreements with organizations where the employee may carry out recreational activities.

Carrying out weekend tourism, guided tours, recreation and leisure activities are other methodologies.

Free psychological attention, different interviews organized by the company, by the social services or by the mutual employee are methods applied by an important National Bank, alarmed by the absence of its employees (tellers) caused by the high degree of stress, deciding to This will provide free psychological support to those who request it.

These premises were obtained from inquiries made to employees in charge of the HR department, employee of various sectors, belonging to various multinational companies.

On the other hand, there is a proposal that is based on the effective administration of time as a reducer of stress levels, considering it as an irreplaceable resource that does not recover, the main cause of stress. For this, it takes concepts from the systemic approach.

Knowing how to manage time well implies achieving objectives, productivity and efficiency and does not allow the decline of people and, consequently, of the organizations of which they are part due to stress. On the contrary, as the bad use of time produces stress, higher costs, less organization, less time for individual use, the objectives are not met, work is done on the urgent, long-term strategies are lost sight of the situation.

This proposal highlights the importance of planning, delegating, organizing, «learning to work as a team». This team building allows the delegation and distribution of tasks among the various members, which makes them have the possibility to excel, develop skills, participate and feel responsible for successes and failures, thus increasing commitment to the team's task and cohesion.

This methodology aims to value the work of others, respect the human being and build an organizational culture of continuous learning, and above all, "learn to work as a team." Which must be interdisciplinary in order to achieve a vision of the whole.

To manage time well and avoid stress, there must be good coordination of teamwork, taking into account the following:

Clarity of objectives: make them known by allowing and promoting participation, synergy of human resources must be created. Set deadlines for achieving the objectives; plan correctly in time and form of the work to follow. Plan human and material resources: to achieve a shared vision of the organization's objectives, values and missions, developing excellence and learning, this is achieved when there is a real union of people within the organization. Control from the outset the resources, tasks, management of individuals. But it must be a control that although continuous and permanent, is based on respect for the other.

It is clear that each work team will have its own methodologies depending on the complexity of the tasks, the style of the team, and the personal characteristics of its members, the socio-economic, political, and legal context. We believe that the context influences a lot of people who can contract stress, taking it to the work team and having an impact on it.

This process of converting human and material resources must begin with personal mastery, which means enhancing our abilities, breaking with isolation, enhancing our talents.

All these transformations must be carried out within a systemic framework without losing sight of the environment that surrounds us, this leads us to deepen and share the individual vision with others to achieve the objectives, values and missions, not only of the company, but of the individuals that form it.

On the other hand, through teamwork and "team learning", an efficient change is achieved in our mental models, achieving a greater perception of reality and integrating ourselves through it through a shared vision, to achieve the development of excellence and through dialogue and commitment to achieve personal growth.

We decided to take from this article only the premises on which we agreed, such as good time management and teamwork, considering them applicable in any organization.

In conclusion, we note that in companies where particular attention is paid to the factors exposed, it is possible to observe increasing levels of productivity and / or decreased costs. Although this proposal is not of general conviction.

We consider it essential to reduce stressors a correct assessment and evaluation of stressors, causes, conditioning factors and those situations that affect the conflict.

The ILO argues that companies that help their employees cope with stress and carefully reorganize the work environment based on human skills and aspirations "are more likely to achieve competitive advantages.

Stress in Health Workers

From the development of the case of stress in health workers, we intend to exemplify the topics that we have been discussing up to now as a way to achieve a complete and global understanding of the topic of stress in work teams.

We chose this type of activity because it highlights in a very particular way the problems that we are dealing with, and although it is not possible to reflect some phenomena that in this example are visualized to any other work team, there are many of them that serve us perfectly to observe how stress influences the actions of a team.

Health professionals suffer serious problems regarding their physical and mental health as a result of the exercise of their work and a special case is that of those who work in emergencies. They get sick from homework and the work environment, not only from viruses, bacteria, or genetic fingerprints, but also from the environment around them.

On the other hand, while the opportunity to work with people is an intrinsic positive feature of the job, professionals dealing with people, such as doctors and teachers, top the list of professional occupations with the highest job stress. Therefore, we intend to demonstrate that maintaining a direct clinical relationship with patients is a significant occupational factor that causes consequences.

Based on research, the association between the characteristics of the health team's work (specialty, patient severity, length of service, hierarchical employment status, number of guards and degree of participation in teaching) was determined and its relationship with habits and dependent variables (satisfaction, job stress and quality of life); To all this was added the decrease in the effectiveness of the professional.

Psychiatry plays an important role not only in the care of individual clinical cases but also in the investigation and prevention of chronic occupational stress of health personnel, a phenomenon that in the USA was called Burn-out or psychological attrition syndrome in professionals who provide "human services", who have no gratification or recognition. It is associated with higher rates of divorce, suicide, job change, alcohol and drug abuse, as well as lower life expectancies, and has significant repercussions at the institutional level and a decrease in healthcare effectiveness (poorer quality of services provided, low patient satisfaction and non-compliance by them with medical prescriptions.

It is important to highlight the fact that the greater exposure to human suffering, due to working with sick people, produces interpersonal stress that reduces levels of job satisfaction, at the same time that for others, job satisfaction experiences can neutralize stress at work. The quality of interpersonal relationships between members of healthcare teams (social support at work) will mediate experiences of job satisfaction and occupational stress, as well as the quality of life of the doctor.

Both situational variables (job characteristics) and individual demographic and personality differences are associated with different levels of satisfaction, occupational stress and the doctor's standard of living within a multifactorial model.

The characteristics of medical work and its relationship with toxic consumption habits have been studied, analyzing the cognitive processes that stimulate these disease behaviors, allowing preventive intervention programs to be launched.

The specific consequences of stress in emergency teams are demoralization of its members depending on the type and complexity of the task to be performed, decreased performance, emotional exhaustion, pessimism and self-medication. It seems that the traumatic events caused by medical emergencies cause health professionals to generate mechanisms such as avoidance of the task or state of tension and alert from the moment of admission to the hospital.

According to a series of studies, the specific causes that cause stress on the health teams (including obviously the emergency teams) are the work overload, the lack of financial gratification (depending on the type of institution to which they belong), hyperexigence, and the "frustrating mental pathology" generated by patient deaths and the responsibilities assumed.

This here we find a synthesis of how stress affects a specific work team such as health teams, especially in emergencies. Next, we will present an interview to a member of a team of these characteristics that will allow us to deepen and understand how stress affected her and her team.

Interview

Through the following interview, we intend to show how stress affects work teams and the particular analysis of emergency surgery teams. The idea is to apply not only the concepts seen in the Driving team work in a particular team but also to see how a member feels and how it affects the pressures on it and on the work team.

To achieve greater sincerity, we decided not to publish his name or the institution where he works, targeting only his work team and how he feels about it. During his career he has passed through various teams from which he obtained not only work experience but different consequences and especially stress.

Until a few months ago, he worked in daily surgery teams characterized by overwork, reaching an uncountable number of operations per day. She currently belongs to an emergency team, so according to her, she is calmer and with less pressure. Next we will see the questions.

1. What is your profession?

I am a surgical instrumentation, for 9 years

2. What work team are you part of?

Currently I carry out tasks as a surgical instrumentation in a surgical team on the night shift in the emergency room. I am part of three different work teams that I attend four times a week. I always worked with pediatric surgery.

3. How is your work team made up?

In general, the surgical work teams vary according to the complexity of the operations and the case, but it generally consists of:

A surgeon A second or third assistant or up to a fourth assistant depending on the type of surgery A surgical Instrumenter A Circulator (nurse or Instructor who assists the room) Anesthesiologist (sometimes with an anesthesiologist technician)

Sometimes you need a hemotherapy technician, or a perfusionist, cardiologist, etc. Within each healthcare center there are several specialties and each specialty may or may not have a work team. In my case I identified with some specialties (trauma, gastro, laparoscopic surgery). I was also rotating equipment and specialties (urology, orl, neurosurgery, general surgery, etc.).

4. What situations give you the most pressure at work?

I get more pressure from HIV positive patients, since the work team must take precautionary measures to avoid possible infection. In our work, there is management of sharps elements in contact with blood from the infected patient.

These precautionary measures are standardized.

I am also under pressure from terminal patients, for example with Cancer, patients with very high risk of life during surgery.

5. Is your work characterized by work overload?

Yes, for two reasons. One because as it is a public hospital, there is a greater demand for the number of people who do not have social work and another because when someone is absent from the team, the activities have to be replaced, increasing our work.

6. Who is the team leader?

The surgeon is the leader and the one who leads the team.

7. Do any of your current teams have a leader other than the surgeon?

None.

8. What degree of commitment is there to the team and its tasks?

The commitment is maximum. We need everyone to carry out surgery. On the other hand, legally there is a degree of responsibility that varies according to each activity on the patient. The maximum responsibility falls on the surgeon.

Cooperation must be between us and I really believe that it occurs.

9. What effects cause a good and a bad result?

A good result for the team causes satisfaction, but a bad result can cause low spirits, anguish, often needing medication and / or therapy.

10. How is communication during surgery?

If the type of surgery requires concentration and precision, there is no other topic than that. If it is of little complexity (eg local anesthesia) we can talk calmly about any other topic, even many times we talk to the patient to reassure him a little more.

11. Is there communication before or after an operation on the equipment?

Usually the Anesthesiologist and the Surgeon speak before entering an operation but usually I do not participate. I participated in some previous talk but very few times.

12. Were there any discussions during an operation?

Yes, sometimes it happens but for reasons of the surgery itself, not for personal problems that are brought to the site. Personal problems are usually dealt with outside of work or at least outside the operation site. Likewise, discussions can occur due to organizational problems.

13. Do you have the necessary resources for the team?

We generally have resources but it depends on surgery, what we lack is infrastructure.

14. Do you consider that there is stress in your computers? What produces it?

Yes, many colleagues are stressed. I think that bad organization generates a lot of stress, at least it is what affects me.

15. Do you know what the consequences of stress were?

Yes, many colleagues had stomach problems, migraines, heart problems, skin problems, Uveitis (eye problems), high blood pressure, tiredness, another lack of sleep.

There were two cases of death from heart attack caused by stress.

16. How do you think stress affects the team?

I believe that stress affects the way we work more than the results. The results are achieved but the work climate is very affected. In situations of pressure we tire twice.

17. Do your work team or institution you work for have any anti-stress methodology planned?

No, we don't have any. Some colleagues go to psychologists.

18. Have you ever suffered stress from work? What consequences did it have?

Yes, due to problems such as poor organization, I get stressed having a lot of tiredness, cervical contractures, mood changes, and arrhythmia. But now that I'm in the guards, I feel calmer, although there is still some work overload.

19. Is there absenteeism due to stress?

Yes, many colleagues miss due to stress, and that creates problems for us by increasing the number of tasks we have to do. Likewise when someone is absent they usually have a replacement.

20. How do you replace a team member?

You can replace other people, we also have the necessary instruction that each surgery specialist gives us to know how to act if any member is absent.

21. How is your mood compared to an operation?

Complexity depends.

I take it as normal and I was never afraid before or during an operation. I believe that faith is my great support.

22. Are the tasks you perform routine?

No, it depends on each operation, even though they are operations of the same type, each patient is different and being in the emergency room, any type of case can occur. Now many cases of family violence are being seen, fights on the street.

23. Do you think there is contention in the equipment?

I think not, but it's not something that worries me either. On the other hand we all know each other but there is no friendly relationship with my colleagues.

24. Has any member of your team at that time ever felt so pressured that you wanted to leave the operation and leave?

No one can actually leave an operation. That is abandonment of the patient and is punishable by law, what you can do is call an assistant to accompany you.

25. Have you thought, for the same reasons, of leaving your profession at any time?

Well, stop participating in surgery, yes, that happened to me once due to overwork, but that does not mean that I would have continued working in the health field, for example, as a social worker.

Conclusions of the interview

We can see in the interview that some of the members have suffered or are currently suffering stress from a series of causes such as the lack of basic infrastructure, overload of work, life-threatening situations, lack of organization, high commitment to the task and the work environment.

On the other hand, we observed a notorious lack of communication, although the interviewee did not perceive it as clearly as the other stressors. However, the lack of communication according to everything seen in this work is an important factor that we should not neglect.

It is important to highlight the fact that this establishment to which it belongs does not have stress prevention and / or treatment methodologies despite dedicating itself to health. This in turn is related to the situation of any public hospital since they do not have the extra monetary resources to take over the treatment of professionals.

However, the interviewee finds in her work factors that can act, in many cases, as dissociators of stress, such as the variety of tasks they perform. During the interview, she made reference to her story within daily work teams in the same establishment that were often oriented towards a specialty. The number of surgeries he attended was so many that due to this, among others, he ended up becoming a victim of the disease. Now that she carries out the same activity but in an emergency team, the work overload decreased a little and the tasks are much less routine since they are totally contingent on the situation that arises. This brought her many benefits since her stress level currently decreased.

In our opinion, it is very important that the institution insists with the request for resources and infrastructure that they need to be able to make changes in the physical working conditions with which health workers perform, since, as we saw, this is a basic stressor.

It is essential that physicians can count on the confidence of the upper line, which in turn is supported by the medical team's pattern of conduct, also of trust, and an emphasis on the feeling of belonging.

Communication and prevention can be developed through round tables, training courses, stress information days and meetings of the whole team before and after the development of the tasks.

We cannot downplay what the interviewee calls "lack of organization" in an emergency. Despite the fact that she stressed that it does not always occur, she considers it as a stressful factor and that it generates difficulties for them to carry out the work. Pre-setting tasks prevents problems from who should perform each task and prevents "clearing" of functions from occurring without anyone taking responsibility.

It is positive that each institution has professionals who treat team members or who are at least available to them in case they need it. It is very common that many doctors do not consider that they need psychological help and they create methods to avoid stress themselves. Some rely on religious faith either in an extra-organizational way or within the healthcare center, since priests can often be found helping to cope with complicated situations such as the death of a patient during an operation. Others play sports to relieve tension while others have different hobbies.

Finally, through the interview and all the analysis of the work, we can see that if stress is not treated in time, it can lead to the extreme loss of life, as in the case of the interviewee of two professionals who died from unemployment. cardio-respiratory due to stress.

The ideal situation would be to find a formal method of prevention and treatment that can be applied in health facilities to care for their professionals. This would improve their physical and mental health and consequently the effectiveness and efficiency of the teams they are part of.

Final conclusion

We understand that teamwork is a modality that produces many benefits, both in results for the organization and in learning new skills for the members, but it also has its conflicts from the fact that not all people are equal and do not respond to In the same way before the facts, and for many people having to work as a team creates extra tensions, high levels of pressure and demand that can be stressful, so we believe that it is necessary to start the team's activity taking into account this reality, and establishing mechanisms of work that contains guidelines to reduce stress levels.

We think it is essential to highlight that the topic we are dealing with in this work is very current, and therefore we cannot fail to mention its relationship with the reality we live in.

Through this research we were able to observe that the incidence of mental health problems is increasing, to the point that one in ten workers suffers from depression, anxiety, stress or tiredness, which in some cases leads to unemployment and hospitalization.

We see that stress is a problem that is directly linked to the reality of the labor market and the economic situation in which we are immersed.

On the other hand, it seemed important to us to highlight the fact that when we started this research we found a great deal of material on work stress, but very little on work team stress. From this reality, we had to start a team's own production, from which we believe that very interesting conclusions emerged. We think that perhaps not having found specific material is related to the reality that we could observe: there are very few companies that expose stress treatment methodologies in work teams, since this is generally taken as an individual problem, and this it is even more evident if we narrow the analysis to our country.

On the other hand, we find another phenomenon, that of "canned methodologies", we could observe that many times the subject is treated in a very general way, not taking into account the differences that may exist between people, or between organizations, being these fundamental at the time of facing any prevention or treatment plan. Furthermore, we felt that in several cases stress treatment emerged as a business for some institutions, rather than as an honest end.

We see that some employers are aware of the relationship between health and productivity, and are improving their management strategies by developing and implementing programs to treat this problem.

Meanwhile, we highlight that in Argentina, the Superintendency of Occupational Risks indicates that "diseases related to mental health are not considered professional diseases, they are not included in the List of Professional Diseases."

In our country there is still very little awareness that the workplace can be psychologically ill and, at the same time, it represents an opportunity to improve mental health or solve problems.

Even with difficulties, several countries pose different scenarios as mentioned above, here, instead, companies have the wrong perception of the subject: they believe that if an employee has difficulties it is easy to replace him, and that in any case there is coverage for his Health. This is a passive response to problems.

Finally, we would like to highlight the fact that any attempt to deal with the problem of stress, both in work teams and in the workplace in general, must not only be carried out by companies, but a social framework is also necessary. and legal that supports these efforts.

Bibliography

Human Behavior at Work (Tenth Edition) - Keith Davis, John W. Newstrom - Ed. Mc Graw Hill. Managing Effective Teams - Héctor N. Fainstein - Macchi Editions. The Fifth Discipline. The art and practice of organization open to learning - Peter Senge - Ed. Juan Garnica SA, Barcelona, Spain 1992. Report 00/37 - ILO. Paradigms of the 21st century: Time and stress management in smart organizations - Silvia E. Poggi, Bachelor of Administration (National University of Luján) and professor of Administration at UNL - Magazine High Management. Labor Stress - Dr. Oscar E. Slipak. Magazine Health Consultant - 2nd. Fortnight of July 2000.www.lector.net «Overcoming stress» - Web Pagewww.estreslaboral.comwww.ccoo.es/istas/ip/foro1c.htm - "Repetitive work and stress" - Salvador Moncada - Director of the Center for Occupational Health - Municipal Institute of Public Health of Barcelona. www.negocios.com.ar - "When work is not health"