Measurement and management of stress in health professionals working with advanced cancer patients

Abstract Staff working with advanced cancer patients may experience considerable stress but there have been few attempts to measure such stress systematically. This paper presents preliminary studies of staff stress in two cancer centers. Nurses in an active treatment cancer hospital were found to focus on problems with dying patients as a displacement for their feelings of personal inadequacy in stressful situations. Major problems with the work situation and with staff communications were cited just as often as problems in watching patients suffer and die. A series of discussion groups lasting eight sessions was held with the nurses to facilitate communication with other staff and patients to promote understanding of the problems of dealing with life-threatening illnesses and death. Staff on a newly opened palliative care unit were found to experience only slightly less stress than a group of newly widowed women. While the stress decreased over time, indications are that some staff working in newly developed hospice units may be at considerable risk. Stress among physicians has been observed (although not measured) in a number of oncology settings. The difficulties inherent in being an oncologist in an institutions where research is a major goal are discussed and recommendations are made to decrease some of the stress being experienced.