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Stress test

D. Murali

HERE is an exercise to help you recognise extreme job-related stress or burnout, extracted from Not another guide to stress in general practice, edited by David Haslam. A simple agree/disagree answer is adequate and the duration of th e symptoms should be at least four weeks.

* When I wake up in the morning I dread the idea of going to work.

* I feel tired all the time.

* I seem to be `behind time' and unable to catch up with the work I have to do.

* I tend to be irritable, and get angry easily with patients, partners and staff.

* I have an increasing tendency to blame others.

* I don't care about what my patients, partners or staff think of me.

* I spend less time listening to my patients during consultations.

* I tend to prescribe more.

* Increasingly, I resent the idea of visiting patients at home or advising them over the phone.

* I feel that most of my patients are very demanding and make unfair requests.

* I feel very isolated in my job and notice a sense of withdrawal from my patients, partners and staff.

* I feel I have no time for friends and family.

* Lately, I have not had the time for off-work activities such as sports or other interests.

* I have to forego my coffee breaks and lunch breaks due to the pressure of work.

* I feel very negative about general practice and its future. `I see no light at the end of the tunnel.'

* I find it difficult to concentrate at work or at home.

* Increasingly, I feel trapped and that I have lost my autonomy and control.

* I have sleep disturbance.

* I have started taking sleeping tablets, so that I could get some sleep before another long day.

* I have a tendency to drink more coffee at work, while seeing patients.

* I have a tendency to drink more alcohol.

* I tend to have frequent colds, flu or headaches.

* Most of my consultations are either trivial or inappropriate.

* I would rather not discuss my work with my partners or colleagues.

* Tears well up in my eyes often, for no obvious reason.

* Increasingly I feel that we ought to go by our `terms of service' when dealing with our patients.

* I have lost the enthusiasm and joy I once had for my job.

* I only do my job to earn a living.

* I hate attending practice meetings.

* I feel I am working much harder and longer, but achieving less and less.

If you have agreed to over 10 statements, it is very likely that you are experiencing burnout, says Haslam. ``If you have agreed to more than 20 statements, it is very likely that you are experiencing severe burnout and you need help.''

Since stress cuts across professions, CAs and lawyers too may find the exercise relevant.

Secret word

WHEN choosing a password you should always make sure that it will be easy for

you to remember, and difficult for others to guess. Here are a few suggestions from The essential guide to the Internet for health professionals, by Sydney S. Chellan.

* Select the first letter of each word of your favourite proverb, catchphrase or song; for example, IHSS1WF (I Have Started So I Will Finish); YSFT (Your Starter For Ten).

* Select two colours and join them together; for example, redblue.

* Select a significant year and spell some of the digits -- 10SIXTY6 or TEN66.

* Select an English word you use a lot and add a two-digit number before or after it -- 18LOVE or LOVE18 (the number could be the first or last two numbers of your telephone or year of birth).

* Select two words which are the opposite of each other -- YESNO, for instance.

* If you have been allocated a password that you can't change, you can make it easier to remember by creating a mnemonic. For example, if your password is wkjll you could remember it as Willie King John the eleventh.

Hotel franchising

MODERN, business format hotel franchising has its origins in America, where, in 1954, Holiday Inn launched its franchising system, recounts Conrad Lashley in Franchising hospitality services. The earliest example of any form of franchising in the hotel i ndustry probably occurred in 1907, according to Lashley, when Cesar Ritz granted permission for his name to be attached to hotels in New York, Boston, Montreal, Lisbon and Barcelona.

Hotel organisations with established brand names and market reputations use franchising as a relatively low-risk method to expand their chain system. It is particularly attractive as a means of supporting international expansion where equity-based strate gies are frequently perceived as a high risk foreign market entry mode.

New barbarians

``FINANCE ministers have not learnt that they are no longer in control of national economies,'' writes Ian Angell in The new barbarian manifesto, a book on how to survive the information age. ``Economically wrong decisions, made on the basis of political expediency, or large spending programmes on prestige symbols of national pride, will be punished severely by the money markets,'' he warns.

According to Angell, the real generators of wealth are the knowledge workers. They always have been so but only now they realise it. Their knowledge is the basis of innovation, he says. And, innovation underpins the creation of alternatives -- not on ly alternative products but also alternative procedures.

``Alternatives deliver new competitive advantages, and destroy the old. It is the never-ending story, that all advantage is temporary and transitory. Without the ability to innovate, a company or a country is doomed.''

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Tailpiece

I began to see that all of life was divided in two or into an infinite number of fragments, that nothing was whole, not even the strongest or purest feeling. As for the way before me, it multiplied before my eyes, the simplest question leading to a

hundred possible answers. This led me to blunder around in a state of still greater indecision. (Anita Desai in Diamond dust and other stories.)

A description of what many CA students could be facing in the exam halls?

(Books courtesy: The British Council Library, Chennai. e-mail: contact@in.britishcouncil.org)