Building Resiliency to Better
Manage Occupational Stress
S. Joshua Kenton, Psy.D.
LCDR USN
Staff Clinical Psychologist
Naval Medical Center, San Diego
Work Related Stress
• Unreasonable demands for performance
• Lack of interpersonal communication between the
employer and the employees
• Lack of interpersonal relationship among the employees
• The fear of losing one's job/job insecurity
• Long working hours
• Less time to spend with the family
• Under utilization of skills
Psychological Symptoms
• Mood swings
• Anxiety
• Depression
• Irritability
• Poor decision making
• Lack of concentration
Physical Symptoms
• Suppression of immunity resulting in
infection
• Headaches
• Increased appetite leading to weight gain.
• Sleeplessness
• Loss of sexual drive
• Memory disturbances
Behaviors you may display…
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Change in friends
Withdrawal
Changes in appetite
Inability to rest
Pacing
Change in sexual
functioning
• Increased Alcohol
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consumption
Emotional outbursts
Erratic movements
Change in speech
patterns
Stress Injury Sources:
Intense or Prolonged Stress
Impact
A trauma
injury
Due to events
provoking terror,
helplessness,
horror, shock
Wear &
Tear
LOSS
INNER
CONFLICT
 A beliefs injury

A
grief
injury
 A fatigue injury
 Due to loss by  Due to conflict
 Due to the
between
death or
accumulation
moral/ethical
of stress over
separation of
beliefs and
time
people who are
current
cared about
experiences
Stress Injury Sources:
Common Examples in
Healthcare Setting
Impact
ER Trauma
Care
Psychiatric
Emergencies
Response
ICU, NICU, etc
Wear &
Tear
LOSS
INNER
CONFLICT
 Loss by death of  Facing decision
 Long shifts
about balancing
critical care pts.
 Frequent
Pt. care with
Deployments
suicide, etc.
Self-Care
 Staffing
 Loss of job/role,
 Feeling
shortages, and
relationships,
changes; PCS
disillusioned
etc.
HEALTHY
READY
“Fit & Focused”
 Well-trained and qualified
 Positive command climate
 High morale
 Strong cohesion
 Good order and discipline
 Clear sense of mission
 Exhibits ethical and moral
behavior
 Balanced & healthy
relationships

READY
REACTING
INJURED
GREEN ZONE
ILL
RECOGNIZING STRESS REACTION
REACTING
Anxious, irritable, sad
 Poor concentration
 Trouble sleeping,
fatigued
 Changes in appetite
 Apathy, loss of interest
 Negative, pessimistic
 Increased interpersonal
conflict
Poor decision-making

READY
REACTING
INJURED
ILL
RECOGNIZING STRESS INJURY
INJURED
 Poor
emotional control
 Major sleep difficulties
 Guilt, shame, fear
 Loss of interest
 Disruption of moral
values
 Substance Abuse
 Decreased confidence
 Poor morale
 Family disruption
READY
REACTING
INJURED
ILL
RECOGNIZING STRESS ILLNESS
READY
REACTING
ILL
• Chronic and severe distress
• Substance dependence
• Major disruptions of sleep, appetite, mood
• Significant problems at work
• Panic, rage, guilt, and shame
• Symptoms that persist or get worse over
time
• Injuries that don’t heal without help
• Family/relationship violence or abuse
INJURED
ILL
What Doesn’t Help
• Using alcohol or drugs
• Violence or conflict
• Overeating/restricting diet
• Working too much
• Blaming others
• Withdrawing from pleasant activities
Building, Maintaining and Restoring
Your Resiliency
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Create small goals
Stay in the here and now
Don’t run from the problem/Keep things in perspective
Maintain an outlook of hope
More fun
Rely on good relationships
Exercise
Breathing/Relaxation
Conclusion
• Managing stress takes practice
• Be preventative
• Stay in the Green/Yellow
• Look out for each other
• Know when to get professional help.