Nursing Profession and Job Stress

Whats is Job Stress,Stress in Staff Nurses,Factors Contribute to Nursing Profession Stress,How to Reduce Stress,Expected Factors in Coming Years.

Whats is Job Stress

    Results
of a 1995 survey conducted by the American Nurses Association indicated that
nurses considered stress to be their number-one occupational hazard. 

    The
nursing literature is replete with opinion articles on factors in the work
setting that make situations conductive to stress for nurses; however, few
articles report research results. 

    It was during the 1970s that nurse
researchers as well as sociologists and psychologists became interested in
studying job stress for nurses. 

    Early research on job stress for nurses focused
on the disruptive effects of changing shifts on circadian rhythms and
subjective sense of well-being. In large measure as a result of research on the
effects of frequent shift changes, the practice of changing shifts more
frequently than every 2 weeks ceased during the 1980s. 

    Research to identify
other factors that contributed to job stress focused on intensive care nurses,
neonatal intensive care nurses, and hospice nurses.

Stress in Staff Nurses

    One
of the first studies concerning the experience of stress by staff nurses was
conducted by Gray-Toft and Anderson (1981). They developed a measure of stress
for nurses called the Nursing Stress Scale (NSS). 

    The commonly used NSS
contains 34 potentially stressful events divided into seven categories: death
and dying, workload, uncertainty concerning treatment, conflict with
physicians, conflict with other nurses, lack of staff support, and inadequate
preparation to deal with emotional needs of patients. 

    In 1983, Jacob’s son and
McGraw published Nurses Under Stress, which included a summary of their
research on stress experienced by neonatal intensive care nurses as well as the
work of other nurse researchers on stress experienced by nurses. 

    During the
1980s through early 2004, much of the research on nurses and stress has been as
conducted by nurse researchers in European and Asian countries.

Factors Contribute to Nursing Profession Stress

    Among
the studies focused on nurses and stress there have been consistent findings
that the following factors make situations conductive to stress for nurses:
work overload, staff shortages, lack of autonomy, equipment failures, conflict
with physicians, conflict with administration or perceived lack of support. 

    From administration, lack of communication, ethical issues concerning patients
on life support, high personal expectations for performance, and caring for
high acuity patients. 

    Several factors have been examined as possible buffers to
job stress experienced by nurses, including hardiness (Wright, Blache, Ralph,
& Luterman, 1993) and social support (Cronin-Stubbs & Rooks, 1985).
There is a fairly consistent finding in research reports that social support
acts as a buffer to stress experienced by nurses in all settings.

How to Reduce Stress

    Consistent
with previous findings, a critical review and meta-analysis of the research
that focused on strategies to help nurses with work related stress (McVicar,
2003) found that work overload, leadership/management style, professional
conflict and the emotional cost of caring have been the main sources of
distress for many years…” (p. 633). 

    Importantly, McVicar also found that
although there were common themes across studies, it is apparent that stress
perceptions are subjective and individualized, making it difficult to
generalize from one clinical area to another.Therefore, it is critical to
examine the personal factors that influence the perception of stress.

    According
to Mimura and Griffiths (2003), based on an extensive search of databases
including CINAHL, Medline, and the Cochrane Library, there were only seven
randomized controlled trials and three prospective cohort studies assessing the
effectiveness of stress management interventions to assist nurses to either
prevent or manage stress effectively at work. 

    Although the use of cognitive
techniques and social support has demonstrated more effectiveness than
exercise, music, and relaxation training, the results of the ten studies
reviewed cannot be interpreted with confidence due to small sample sizes and
methodological problems.

Expected Factors in Coming Years

    Given
the growing shortage of nurses in the United States over the last decade, it is
very surprising that the issue of work-related stress for nurses in the US has
not become a significant focus of nurse researchers. 

    Future directions for
nursing job stress research should include: 

(a) studies to evaluate the person
environment fit model (French, Rodgers, & Cobb, 1974) or the job demand
model (Karasek & Theorell, 1990) to explain factors that contribute to job
stress for nurses

(b) identification of personal factors that put a nurse at
risk for job stress

(c) intervention studies to evaluate the effectiveness of
stress management strategies, including cognitive restructuring to bolster
resistance resources such as hardiness and use of social support

(d)
longitudinal studies to evaluate the effectiveness of stress prevention and
stress management strategies taught to students in nursing by following them to
job sites