Stress in nursing

Stress in nursing has been widely studied. In this article, Kim Craig provides an overview of the research.

Nursing is a demanding occupation, emotionally and physically. Workplace stress in nursing has been the focus of much research which demonstrates that levels of job dissatisfaction are high and translates into an intent to leave the profession (Aiken et al. 2001).

The concept of burnout is often found in discussions concerning stress and is used to describe the effects of long-term stress, including feelings of depersonalisation and exhaustion (Embriaco et al. 2007). Stress is also associated with decreased efficiency and performance.

The causes of stress in nurses may be viewed in three categories: physical, psychological and social environments.

Physical

Physical factors include temperature, noise and lighting (Moustaka and Constantinidis 2010), and the increased physical workload resulting from inadequate nurse‒patient ratios. Violence and aggression towards nurses also acts as a physical and a psychological stressor with younger staff being at higher risk than their older colleagues (Schablon et al. 2012).

Psychological

High workload, associated with inadequate staffing levels, also acts as a psychological stressor, leading to high emotional exhaustion and job dissatisfaction (Aiken et al. 2002). Nurses working in conditions of understaffing highlight their associated frustration at being unable to deliver the care they wish to (Moustaka and Constantinidis 2010).

Further psychological stress occurs in situations in which opportunities to be autonomous and make decisions are restricted; that is, when an individual nurse senses a lack of control (Oulton 2006). Violence and aggression also have a psychological impact (Schablon et al. 2012).

Social

The nature of nursing itself may act as a stressor in some contexts. Nurses care for the sick and dying, and comfort family and friends at their most vulnerable. For some nurses, the social perception of nursing and care create tension.

In countries and cultures where gender-based discrimination against women continues, a lack of value is attached to the role of the nurse, with this being seen negatively as ‘women’s work’ (Buchan and Aiken 2008). Social factors originating in the organisation may also promote stress, including role conflict or ambiguity among professions and a lack of development opportunities (Moustaka and Constantinidis 2010).

Your task

How does the research reflect your personal experiences of nursing?

References

_{Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, R. B., Clarke, H., Givannetti, P., Hunt, J., Rafferty, A. M., and Shamian, J. (2001) ‘Nurses’ Reports on Hospital Care In Five Countries’. Health Affairs [online] 20 (3). available from https://doi.org/10.1377/hlthaff.20.3.43 [11 November 2017]}

_{Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., and Silber, J. H. (2002) ‘Hospital Nurse Staffing and Patient Mortality, Nurse Burnout and Job Satisfaction’. American Medical Association [online] 288 (16). available from https://doi.org/10.1001/jama.288.16.1987 [10 November 2017]}

_{Buchan, J., and Aiken, L. (2008) ‘Solving Nursing Shortages: A Common Priority’. Journal of Clinical Nursing [online] 17 (24), 3262-3268. available from https://dx.doi.org/10.1111%2Fj.1365-2702.2008.02636.x [11 November 2017]}

_{Embriaco, N., Papazian, L., Kentish-Barnes, N., Pochard, F., and Azoulay, E. (2007) ‘Burnout Syndrome Among Critical Care Healthcare Workers’. Current Opinion Critical Care [online] 13, 482-488. abstract available from https://www.ncbi.nlm.nih.gov/pubmed/17762223 [11 November 2017]}

_{Moustaka, E., and Constantinidis, T. C. (2010) ‘Sources and Effects of Work-related Stress in Nursing’. Health Science Journal [online] 4 (4). available from http://www.hsj.gr/abstract/sources-and-effects-of-workrelated-stress-in-nursing-3575.html [11 November 2017]}

_{Oulton, J. A. (2006) ‘The Global Nursing Shortage: An Overview of Issues and Actions’. Policy, Politics & Nursing Practice Supplement [online] 7 (3), 345-395. available from https://www.ncbi.nlm.nih.gov/pubmed/17071693 [11 November 2017]}

_{Schablon, A., Zeh, A., Wendeler, D., Peters, C., Wohlert, C., Harling, M., and Nienhaus, A. (2012) ‘Frequency and Consequences of Violence and Aggression towards Employees in the German Healthcare and Welfare System: a Cross-sectional Study’. BMJ Open [online]. available from http://dx.doi.org/10.1136/bmjopen-2012-001420 [11 November 2017]}