Many practice managers (PMs) report that their job is stressful, but some seem to be “not waving but drowning”. It’s a worrying situation for those seriously affected by stress and also for those around them, including work colleagues, family and friends. Feeling stressed most or all of the time can have a significant negative impact on your mental and physical well-being. We all need to feel challenged in our job and a certain amount of pressure is helpful, but each person is unique and what stresses us the most is different for each person. There are real physiological differences between pressure and stress. Stress occurs when pressure exceeds our perceived ability to cope. The signs of stress include declining/inconsistent work performance, withdrawal, regression (arguments, irritable behaviour), aggressive behaviour (temper outbursts, bullying, shouting), physical outward signs (shaking, sweating, forgetfulness) and behaviour that’s out of character.
We know that stress is caused by three main factors:
- Demand – not being able to cope with the demands of the job
- Control – not having adequate say over how work is done
- Support – not having enough practical and emotional support
PMs work in unique circumstances which are worth considering. As discussed in my previous blogs about workload management and delegation, many managers don’t have the support they really need to manage the practice, which means that tasks from strategic management to operational management fall on their shoulders. Operational management takes priority because it’s often crisis management, but this is at the expense of strategic management and planning. Sadly, this means that many managers are firefighting rather than taking a step back and overseeing the whole and planning for the future. PMs are often acutely aware that they’re not spending enough time on higher level management tasks and they start to feel guilty and inadequate. Added to this, the expectations of their GP partners may be unrealistic. Many GP partners don’t fully appreciate what their PM does and they can oscillate from being kind and supportive to being irritable and demanding. I’m sure much of this is because of their own stressful working life, but some of this behaviour only makes matters worse.
I can only encourage you to have some frank discussions about what you can and can’t do in the time you have at work (that means your contracted hours by the way!). Make it clear if you need support to manage the practice, even if that means an increase in the wages budget. It’s a business after all.
Another major stress for PMs stems from external relationships with CCGs, CQCs, Federations and PCNs, to name just a few – including providing obscure information with little notice and attending time-consuming meetings with no real benefit to the practice, thus reducing the amount of time available to do your job.
Another pressurised area is keeping up to date with legislation and employment practices as well as dealing with difficult situations as they arise without an inhouse HR or health and safety department to advise you. Then there are difficulties recruiting clinicians and administrators; this can be extremely time-consuming and frustrating if the right candidate can’t be found. And, of course, keeping the team motivated and performing well with their own workload pressures is a priority.
Phew, I feel exhausted already! But despite everything, I know that being a PM can be a great and rewarding job. If you’re feeling really stressed, I do have some tips that might help:
- Use self-talk to be more positive
- Learn to be more assertive
- Improve your time-management techniques
- Get things into perspective; write down your worries and let them go
- Take regular breaks during the day
- Go for a walk and get some fresh air
- Take regular exercise – walking, running, swimming and exercise classes all improve your mental health and your physical stamina
- Ensure regular breaks away from work, preferably holidays where you can switch off completely
- Smile, laugh, lighten up – children laugh 500 times a day on average, adults only five
- Use relaxation techniques, meditation or mindfulness
- Be around people who are “good” for you and who have a positive outlook – negativity is highly contagious and will only make you feel more stressed
- Ensure good nutrition and regular meals and control your weight
- Avoid smoking, too much caffeine or alcohol
Recognise the need for good social support. This might include your partner, children, parents, relatives, friends, colleagues within and outside the practice. Talking about your feelings without seeing yourself as a failure is incredibly important and the right person will help you find the right solutions.
Additionally, you might want to consider one of the following:
- Counselling will help you understand and come to terms with your past, providing support and helping you move out of a crisis situation. It’s particularly helpful for those who are feeling low most of the time and worried about their mental health.
Another consideration that could be helpful to support your own development and manage your own work/life balance could be to think about coaching. Coaching will help you move forward in your life, from where you are to where you want to be. It’s goal orientated and will help you take practical steps to make changes in your life. It can be challenging but also exciting and will help you feel more in control of your life.
Finding the right balance can help you feel better, give you greater job satisfaction and the ability to enjoy your time off – and it couldn’t come at a better time!