Hassles (minor demands) are cumulative and can present a significant drain on resource, limiting coping capacity.

Many important physiological systems can be influenced via hormonal and autonomic pathways.

High levels of demand can disintegrate normal activity and are psychopathogenic and may also generate pathophysiological changes.

When demands are perceived, and threat is presented under circumstances where meeting the demands taxes the perceived resources available, high levels of stress are perceived and increased coping effort occurs. Prolonged effort can lead to burnout, common in health care occupations, reflected in loss of motivation, behavioural and emotional withdrawal, demoralization and high staff turnover. In other circumstances there is an increase risk of making errors.

However, just like other people, doctors and nurses are vulnerable to stress and can become hazards to others as a result.

Secondary appraisal evaluates the effectiveness of coping efforts. If these are easily effective, there is no stress. If these a re of borderline effectiveness, there is stress, especially if the consequences of non-control (crashing a plane or killing a patient) are severe. If effectiveness is very low, the person may give up, become withdrawn and/or experience very high levels of stress.

Hassles, daily demands, can add up to use significant coping resources. So stress can be experienced in the absence of life-threatening, or even moderately harmful situations. That is why you feel pressure in this course and are always looking for ways to reduce the load of information you have to learn or improve its efficiency.