Skip to 0 minutes and 8 seconds...on the ward and in clinical practice it's hard. It's a hard job. It's always been a hard job. You've got to be incredibly resilient and you've got to learn how to manage some of the stresses. Some of the things that you see as a nurse, no one else ever sees and that can be incredibly difficult, especially when you go out of nursing and in to your social life. It can be hard to get the right support and I think that encourages people to leave.
Stress within nursing
Watch the video where a nurse describes her personal perceptions of how she has experienced stress in nursing and how, at times, this has crossed over into her personal life.
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 discussion 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 factors include temperature, noise and lighting (Moustaka and Constantinidis 2010). The increased physical workload resulting from inadequate nurse‒patient ratios is perhaps more easily interpreted than the high emotional exhaustion and job dissatisfaction that are also associated with inadequate staffing levels (Aiken et al. 2002).
Workload therefore acts as both a physical and a psychological stressor. 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). Acting also as both a physical and a psychological stressor are violence and aggression towards nurses, with younger staff being at higher risk than their older colleagues (Schablon et al. 2012).
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).
- Thinking about both the video and the text that you have read, can you share your reflection of a time where stress has impacted on your professional and/or personal life?
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 May/June [online]. 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] October 23/30, 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. DOI: 10.1097/MCC.0b013e3282efd28a. 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. DOI: 10.1177/1527154406293968. Abstract 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].
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