NMC PGMEB guidelines for stress reduction among PG medical students

The stress faced by medical students during post-graduation is noted by National Medical Commission and issued guidelines to all colleges to take steps like regulating working hours, weekly offs, sanctioning of leaves, counseling, yoga classes, etc. 

Though ragging is prohibited, colleges may identify by inviting anonymous grievances with grievance boxes placed in multiple locations NOT in open places but in toilets, so that students do not feel under watch and thus fair reporting of issues faced by students can be received and action can be taken accordingly.

These boxes can be opened at regular intervals, say, once in a day by an attendar. Receiving of this type of feedback will help college managements to improve their reputation and more students may prefer such colleges for admission. 

Students can be placed in round the clock 8 hour shifts like in factories with 24 hour minimum rest between shift change over periods. Also, students need to have access to hygienic food and water. 

It has to be seen that the faculty will have a fair assessment methodology without depending upon the feedback of senior residents, else, junior students may be forced to do the work of their seniors.

Though the junior doctors complain of stress, these same junior doctors may handle their juniors in the following years. Else, there should not be any such complaints about senior residents. 

Some of the links to news items are shared  below:

https://medicaldialogues.in/health-news/nmc/give-weekly-off-stress-counselling-yoga-sessions-nmc-dictum-to-medical-colleges-to-manage-resident-doctors-mental-health-97414

https://www.newindianexpress.com/nation/2022/aug/11/nmc-directs-all-medical-colleges-to-take-care-of-pg-studentsmental-health-well-being-2486235.html

Control panel alarms - Do not acknowledge or reset unless action is taken

As the title goes, with huge control panels having several parameters to monitor, it becomes routine for operators to acknowledge the error message alarms. The intention is to take note of it or taken action if required. However, with work stress, it is likely that we may forget to take action. Then next high-level alarm will come, and by this time, we would have lost some precious time. It is suggested to take necessary action where it is to be done manually and then acknowledge instead of the other way. No doubt, audio alarms, make the person mad. But, if action to be taken is forgotten, it will have wider implications. May be in such places, shift hours can be shorter than normal 8 hours or more number of qualified persons are engaged with work definition.

Doctor's health

A news item today in Deccan Chronicle about doctors to take care of themselves in light of stressful conditions faced by them.

https://www.deccanchronicle.com/nation/current-affairs/200120/doctor-first-heal-thyself-ek-doctor-ki-maut-physicians-must.html

From Yahoo - Stress contributors

An article in yahoo states about factors that cause stress in human beings.
http://in.lifestyle.yahoo.com/10-habits-contribute-stress-071639766.html

Amont them are lack of sleep, irregular meals, long hours of work, family/work place problems, no exercise, not giving time to self, etc.

In the name of getting in the eyes of bosses, some spend long hours at work place, sometimes even when there is no work. This reduces the time available to family members, affects the health in sitting idle for long hours without exercise, may be leading to commuting back to house in busy hours, no relaxation (spending time at office is definitely as good as spending the same at home), missing friends/relatives, etc. Similarly not having time for self like for leisure reading, entertainment, spending time in happy surroundings, etc will lead to stress buildup. Piling up of personal jobs due to more office work also increase the stress levels.
Spending time on internet without purpose also causes stress and after spending for few hours, we might have felt that we wasted our time without any gain. Further, sitting for long hours for surfing will also cause health problems due to sitting in same posture.
As recommended by experts, observing no phone / no internet / etc will bring some peace of mind. We should also take our leaves to be away from routine office works so that we can concentrate better rather than working continuously without even consuming our eligible leaves. This will also help the organization for which we are working. May be some shortsighted bosses think that the person on leave is not committed, but we have to take care of our health also.

Emotions - health effects

I read the following in a local magazine.

• Brain contracts with increase in age and leads to forgetfulness. However, physical exercise compared to metal exercise and social activities will help to keep the brain active.
• Happiness and heart are linked. More happiness increases heart beats and one will not get sleep. I experience this, when I got good marks (beyond my expectations) in my XII standard, engineering final year, receipt of appointment letter (25 years ago) in the organization of my choice where I am continuing still and my first promotion. Similar is my experience, I was under pressure. 
• Anger affects liver which leads to generation of bile juices and headache. Blood pressure too raises.
• Tension, stress affects lungs and one feels suffocation.
• Depression/sorrow reduces energy levels which affects lungs and leads to associated respiratory problems.
• Fear affects kidneys and one looses control over urination.
• Threat affects heart and at higher levels it can affect kidneys also.

Education system - stress on children

Every few years, syllabus of lower classes is being increased by adding that from higher classes and this is making the children to spend more time to study with no time for sports, etc thus causing stress in them. People say that increasing competition is leading to stress, but when we compare how we were and what our children are, it is apparent that the present syllabus in classes VI-X is heavy and contains some portions from higher classes of our time. Though, experts say young brains are capable of grasping whatever is fed to them, but there should be a limit to it. One should remember that innovations and technologies of present day are due to efforts of people who studied earlier with the syllabus not so heavily loaded. 

With the shortsightedness of some people who review and decide syllabus, children are getting stuffed with more and more syllabus with passing years. For an adult, syllabus of lower classes appears easy but not for the kids who have to actually go through. This appears to be a reason why syllabus is increased at regular intervals without realizing its effects on the growth of the young children.

More syllabus is leading to shortcuts in studies for getting marks, without understanding. Students are fed with questions and answers, asked to remember the answers and in the process killing their interest, logical thinking abilities, and eventually harming the future generations. Even parents also join the race by forcing their wards to study with no relaxation. If a kid comes to parent for explanation, many of the present day parents are not in a position to clarify the doubts. When left with no other option, they ask their kids to memorize without understanding.

The results are already visible with many students in colleges (after 10+2) having back log of subjects because no body feeds them with questions and answers in higher classes unlike in lower classes. Many corporate HR managers of the view that the present day job aspirants do not have good understanding of the subjects though they got good marks in their college examinations. 

Sometimes, I read in news papers that the syllabus are trimmed by some governments but unless it is done for all states, no gains can be seen forcing the children to memorize the lines.

DGCA removes its top safety officer - Home - livemint.com

DGCA removes its top safety officer - Home - livemint.com
The above article is about removal of safety in-charge working for The Directorate General of Civil Aviation (DGCA) for delay in investigations and not producing reports in time.If the officer is inefficient, the action is warranted. But, in the same article it is mentioned that only 14 officers monitor over 1000 flights on Indian skies. With the increase in number of air craft, no. of incidents/accidents and other activities, the staff will be stressed to perform. And the issues are concerned with safety of invaluable human lives. Under stress, the performance will deteriorate over a period of time and the quality will dive to the bottom. After all, they are also human beings and not machines to generate output automatically after keying in certain parameters. If the problem i.e delay in reports, persists for long time, then the system needs to analyzed for problems. The issue of man-power and other issues like training need to be addressed before holding safety personnel as responsible. Airlines too should be held responsible for engaging persons with fake certificates, for incidents and accidents, instead of blaming one man. It may be a management principle taught to accept additional work, but will not help the organization in the long run when limits of human beings are exceeded.

Stress and accidents

Reason for many of the accidents appears very simple and silly at times.  Many of the accidents did not occur because of some complex reactions or failure of safety systems. But, why do people get involved in such silly accidents. I think, lack of peace of mind is the reason. When we are not at peace, we cannot concentrate on our activity. Lack of peace can be due to

• arguments with relations / servants / milkman / paper boy/ gas station employ
• children education
• well being of blood relations
• arguments with colleagues
• business loss
• greed
• simple problems like vehicle breakdown, plumbing problem at home, ...
• financial needs
• thinking about meeting, examination, bank loan, ...
• etc

We keep thinking about these problems and something happens suddenly causing some injury / emergency. I saw a video, in which it is said, SAFETY IS NO ACCIDENT, NO ACCIDENT DOES NOT MEAN IT IS SAFE.
Accident means an event that unplanned, unexpected, unintentional,...
Though, nobody intends to get in to accident, lack of hazard identification, failure to take preventive measures and not reviewing the safety processes are the reasons for accidents. However simple the hazard appears, we should not be casual. It should be attended immediately. There is no use of repenting after the accident.
Similarly, one should not be relaxed when there are no accidents. May be they are not reported. May be there are many unreported nearmisses. May be the attitude of the manager is not to see minor accidents as accidents.
It is common for top management to boast of good safety record and take credit for it. But, a trulyaccident-free workplace is a reality because of sustained efforts all employees over a period of time. It will not happen overnight or in a week or in a month or in a year.
Some people attach value to human life and workout how much money can be spent on safety programme. My life may be worth $ 1.0 million to you. But, my family does not see like that. For them, it is invaluable. Nobody can remove the tears in the eyes of family members, when somebody dies. Nobody got right to decide the value of human life.
I read in the internet that some organizations care for their employees by attending to their personal problems, employ professionals to teach yoga, meditation and allocate time within working hours so that their employees can have healthy and peaceful life.
What for we earn money, if we do not have stress-free life. Though, some people say, certain stress is required for the growth of the individual, I think this is purely business oriented. The increase in suicide rate everywhere in the world shows that so called acceptable stress is NOT acceptable to the individual. As there is no other means to earn income, persons accept the additional demands and stress themselves. Ultimately, weak hearted will take their lives.  Persons responsible for causing stress should think twice by entering into others shoes and then decide about the work.

Stress on Safety Professionals?

Many safety professionals face the problem of getting attention from their colleagues and management. People are not receptive to suggestions. Suggestions are treated as fancy ideas which are not workable. Or, not economically feasible. Safety professionals are blamed that they do not have project experience. As soon as a safety officer visits a workspot, people think that he has come to stop a work. Complain that they are tensed by seeing him, or make sarcastic comments, or disappear from the place to avoid him, etc. In meetings also instead of listening to safety man, they keep talking with others and when safety presentation is over, all feel relieved that a ritual is completed and is recorded. To show that they are committed to safety, people pay lip service by saying 'safety first, production next'.

Leaving apart production people, what about the stress in safety man. He finds many hazards, unsafe acts, wrong practices, etc. When he tells plant people, he will get no response or he will be entertained with arguments. Being a safety professional and is responsible, he can't keep quiet. He has to engage plant people in convincing them about elimination of hazards identified. Over a period of time, continuation of such practices by plant people can stress safety person and he may become cynic. It can also affect his health and family life as he carries work place thoughts and tensions to home. Everything at home also appears in disarray and he will enter into discussions first, arguments later and finally he may end up a big loser.

Experts say that safety professionals should not get disheartened for poor response from production people, but I don't think this is possible for ever for any person. Even those preaching professionals would have lost temper at various occasions.

Sometime back when I attended a 3-day training programme, one faculty arranged a discussion (actually a drama / skit) among the partcipants dividing them into production and safety groups. I happened to be in production group and few production people happened to be in safety group. During the skit, When I questioned the group playing as safety department, as they used to question me in my plant visits, they were searching for words as were taken aback by my ferociousness as a production man. I think they understood during the skit what I want to convey to them that they actually make such mindless arguments on the shopfloor with the safety man.
I also enjoyed the skit in repeating the questions whatever they said earlier to me. What I want to convey is that by stepping into others shoes, we can understand the problem and intentions. We can ask production man what he will do if he is in safety department and sees such unsafe condtions. Then, he too may think some alternative. This may ease the stress on both production and safety persons. However, this is possible if there are people who are technically sound and are patient to listen. We can't talk to bullying personalities and is futile in conversing with them. Only written communication with copies to their superiors will have some impact in removing hazards at work place.

Whether safety procedures cause stress at workplace

Sometimes I hear shopfloor people grumbling at safety supervisors that by seeing them, B.P. increases in shopfloor workers. Others say that they are afraid that safety manager will come to them to enquire on some issue. Shopfloor supervisors advise safety persons not to approach their workers directly to avoid undue stress. All such talk or apprehensions appear to be unwarranted unless people do not follow safety procedures or the safety man talks in a dominating manner.
Some safety professionals too think that they get truth, if they pose like a  tough guy. But, with my own experience, I can say that this is not true. Whatever the shopfloor person is willing to tell will escape from the scene next time as soon as he sees the tough talking safety guy. The smooth talking safety supervisors also should be careful that they are not taken for granted. They have to develop friendly networks in all departments so that before entering the shopfloor to enquire about unsafe conditions or investigate accidents / incidents, full information is obtained through these friendly networks.
When someone gives information on phone, safety person should not insist to know the name of the person so that he will feel secured and will have peace of mind. If he is willing, then safety person can declare his sources and also recommend for some appreciation and reward.
Stress will be felt by safety guys also when all shopfloor people surround him questioning his failure to identify and communicate hazards. This, I think should be handled by being visible in the shopfloor through frequent inspections,giving pep talks as often as it warrants and making the people to know about their responsibilities under law. Then, safety department persons will be viewed as their friends and get their help to solve safety issues at the shopfloor.
Workers will be stressed for other reasons also as it was mentioned in a news paper article today that spouse causes more stress than the boss. Again, males cause more stress to their spouse than the female. Other reasons for stress can be ill health, unfulfilled ambitions,  family issues, etc