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5 Most Stressful Hospital Jobs

In truth, just about any job involving health care comes with stress. © marcogarrincha/iStockphoto
In truth, just about any job involving health care comes with stress. © marcogarrincha/iStockphoto

Irregular working hours, safety concerns, layovers and jet lag turned being a commercial airline pilot into the most stressful job in the U.S. in 2011. In 2012, enlisted soldiers and firefighters topped the list at No. 1 and No. 2, respectively. While it's easy to agree that pilots, soldiers and firefighters do have high-stress work, it seems surprising that chronically stressed-out surgeons don't always top these types of lists. Surgeons do report work-related stress — the career was ranked as the most stressful job of 2009, with high rates of burnout and suicide. But unlike workers in many other careers, they often don't see their work as a negative in their lives. Overwhelmingly, surgeons talk about their love for what they do, and how they couldn't imagine doing anything else.

In general, though, many things considered stressful among hospital workers are pretty similar to what stresses workers in other fields: Complaints including not enough pay (76 percent), an unreasonably high volume of work (70 percent), long hours at work (35 percent), bureaucracy (33 percent), in addition to having to deal with distressed and angry customers (33 percent) all fall into the top 10 job stressors [source: Saha et al]. This is chronic stress, the kind that makes you feel cynical and disillusioned about your work and robs you of your vitality and good health.

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Specifically, becoming involved in patients' emotional distress —called compassion fatigue — falls into the top five things that stress out almost half of health care workers [source: Saha et al]. While doctors may spend only a few minutes with each patient, nurses typically take care of the day-to-day patient management. Although the time nurses spend with patients is often considered lower than ideal, we do know that the more time a hospitalized patient spends with a nurse, the better outcome that patient will have [source: Landro]. Since Americans have considered nursing the No. 1 most-trusted profession for more than a decade, let's start with just how stressful it is to be a nurse (spoiler: very) [source: Campaign for Action].

Nurses often prioritize their patients’ well-being over their own needs, working long shifts without breaks. It’s no wonder that their stress levels run high. © AlexRaths/iStockphoto
Nurses often prioritize their patients’ well-being over their own needs, working long shifts without breaks. It’s no wonder that their stress levels run high. © AlexRaths/iStockphoto

Did you know that women have a 67 percent greater chance of having a heart attack when suffering from work-related stress? Considering that 90 percent of the nurses in the U.S. are female, it's worrisome that nurses report some of the highest rates of job burnout among medical professionals, including physicians, physician assistants, administrative staff and medical technicians [sources: CPS, Matthews, Chou et al.].

Compared to, well, everyone in the American workforce, hospital nurses are four times more likely to report job dissatisfaction [source: Aiken]. Nurses report the greatest work-related stress during times when they have more patients than they feel they can safely manage [source: AACN]. With each additional patient a nurse cares for, the patient's risk of death increases: The patient's risk of dying of a major complication rises by 7 percent, as does the patient's likelihood of dying within the first month after being admitted to the hospital [source: Mensik].

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While the perfect number of patients may differ slightly from unit to unit, a 1:4 nurse-to-patient ratio is associated with both good patient outcomes and lower burnout rates among nurses [source: Aiken].

Think dealing with medical claims paperwork is stressful? Imagine doing it all day long while also juggling confused or upset patients. © Minerva Studio/iStockphoto
Think dealing with medical claims paperwork is stressful? Imagine doing it all day long while also juggling confused or upset patients. © Minerva Studio/iStockphoto

Job growth for medical office managers in the U.S. is expected to grow 22 percent between 2010 and 2020 to meet the increasing demand of the country's aging population [source: CareerCast]. And while medical records technicians are considered to have one of the least stressful jobs in healthcare administration, those working in most other hospital administrative jobs report high rates of work-related burnout [source: Chou et al.]. Medical billing managers, for instance, work with providers, patients and insurers; they also submit claims and bill patients.

This becomes a complex and stressful job for a couple of reasons. It's entirely likely that you've had a moment of frustration or confusion when dealing with your own medical insurance. So consider that a medical billing specialist deals with the ins and outs of insurance companies and their coverage policies day-in and day-out.

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If that doesn't sound terribly stressful, add into the equation the fact that they also handle collecting on unpaid bills. Additionally, they review and appeal billing errors, claims-processing errors and denied claims. And they sort through all this paperwork and red tape while dealing with emotionally upset and possibly hostile patients and their relatives.

A physician assistant does almost all the same things as any general physician … all the while knowing that their decisions and assessments could be overturned. © Prykhodov/iStockphoto
A physician assistant does almost all the same things as any general physician … all the while knowing that their decisions and assessments could be overturned. © Prykhodov/iStockphoto

In the U.S., as chronic diseases increase and old age gets the best of the population, there's a growing need for many Americans to make frequent visits to their primary care doctor, but there's a problem: There's a shortage of physicians practicing general medicine. Physician assistants fill that need, at least to some degree. The role varies depending on which state we're talking about, but the primary focus is often to provide preventive care, diagnose and treat illnesses and injuries, and perform a lot of the same care as their supervising physician.

That's right: Despite doing all the heavy lifting in the way of patient care and getting to know each case, physician assistants don't have the authority to have the final say when it comes to their decisions. They evaluate, diagnose and treat patients, and they can prescribe medications, but they do all of that under the supervision of a physician or surgeon. That means that even after they do their workup, their superior may or may not agree with their diagnosis and treatment plan, and could toss all that work out the window. Combine that with the fact that some patients may not trust a physician assistant the way they would a doctor, and you can see how the stress would add up.

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Because their shifts run so long, some medical interns probably feel like they live at work.  © DeanDrobot/iStockphoto
Because their shifts run so long, some medical interns probably feel like they live at work. © DeanDrobot/iStockphoto

Medical interns, known also as first-year residents, are brand new physicians undergoing an intensive training period to learn clinical skills, from diagnosis and treatment to establishing appropriate bedside manner. While they learn to practice medicine, they may be a patient's primary physician during a hospital stay. And as they make their morning rounds, they may be suffering from both physical and emotional exhaustion.

Medical internships are a difficult. This is a transitional period in many ways: physically, emotionally, financially — and for some, spiritually. The depression rate among medical interns also runs high; the proportion of interns with symptoms of depression was found to rise from 3.9 percent before the internship to 25.7 percent during this difficult year [source: Nauert]. Medical interns are typically responsible for the evaluation and workup of up to five patients over a 24-hour period. Interns also are expected to be on call, working 36-hour shifts at the hospital in rotation with other medical interns [source: Johns Hopkins]. The long hours and little sleep are stressful in and of themselves, but interns are also responsible for teaching medical students.

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The doctor who serves as the lead for patient care experiences a tremendous amount of stress.  © nyul/iStockphoto
The doctor who serves as the lead for patient care experiences a tremendous amount of stress. © nyul/iStockphoto

Between 60 and 80 percent of accidents that happen on the clock take place because of workplace stress-related sleepiness [source: Health Advocate]. Job burnout not only leaves us feeling physically exhausted, but emotionally exhausted, too. It robs us of our work-life balance, and it can cause depersonalization and symptoms of depression, as well as a low sense of personal accomplishment. And in the hospital environment, job burnout contributes to preventable medical errors. It's estimated that as many as 440,000 patients die in America annually because of medical errors, making preventable medical harm the third cause of death behind cancer and heart disease [source: James].

Just being a physician in the U.S. means you're already more likely to experience job burnout than any other American worker. In fact, one out of two American doctors admit to suffering at least one symptom of work-related burnout [sources: Sifferlin , Shanafelt et al.]. And if you're a front-line physician — the lead doctor responsible for a patient's care — in emergency medicine, family medicine or general internal medicine, you're at the greatest risk for burnout, compared to the slower-paced work environment of, say, a pathologist [source: Shanafelt et al.].

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Author's Note: 5 Most Stressful Hospital Jobs

When you're stressed at work, it really seems to permeate your whole life, doesn't it? It impacts your physical health as well as your behavioral and psychological well-being. It can make you irritable. It can keep you up at night. And it can cause physical changes, such as high blood pressure and weight gain. In 2012, for instance, a study found more than half of nurses in the U.S. were obese, with those working long shifts and those working desk jobs most at risk of gaining weight. Job burnout is also associated with high levels of stress hormones, diabetes, disordered eating, heart disease, irritable bowel syndrome (IBS) and sleep disorders.

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