Only time will tell: the temporality of occupational stress in foundation doctors

Although scholars have recently started to acknowledge the embeddedness of time in the experience of occupational stress, the dominant orientation is grounded in the actual passage of measurable time (objective time). A key question that remains is how subjective aspects of time, broadly defined as psychological time-travel, also influence the stress experience. To investigate these matters, 58 foundation doctors were interviewed at the start of their rotations and subsequently completed regular audio-diaries over a two month period. At the end of their rotations, a final interview was undertaken with the participants to get their retrospective perceptions of stressful events. This data collection effort yielded 745 diary entries and 118 interviews, totalling just under 6,400 minutes of data and 1.2 million words of transcription. This data was analysed with interpretative phenomenological analysis and a combination of sequential techniques. Three trajectories of the stress experience were identified based on repeated exposure to particular stressors: (1) adaptation through experience, (2) functional sensemaking and (3) dysfunctional sensemaking. Sensemaking was also found to influence how critical incidents were remembered in the longer-term, with those having developed a positive schema less likely to recall the triggering event. Several temporal features of the occupational stress experience also emerged. This included future-facing cognitions such as anticipation, which appeared to influence reported stress in the present moment; and, other characteristics like reference points whereby participants used events in the past to benchmark how they were feeling in the current. Finally, real-time, persistent and pervasive stressors for the occupational group of foundation doctors surfaced. Overall, the findings add to the work-stress literature by unearthing the ways in which subjective time mechanisms are fundamental to the experience of occupational stress, and how these are situated within objective time. Specific theoretical and practical implications of this are considered herein.