Stress is a well-known and identified problem within the nursing profession. According to Atkinson stress occurs when one is faced with events or encounters that they perceive as an endangerment to their physical or psychological well-being (as cited in McGowan, 2001). Additionally stress levels will increase when controllability and predictability in a situation decrease. There is an inverse relationship between stress and job satisfaction, as stress goes up, job satisfaction falls. As a result this increased stress could commonly results in decreased job satisfaction and decreased quality of life. This could potentially contribute to nurses leaving the profession and as an end consequence, account for the current nursing shortage.
The cause of stress for nurses has found to be related to the nature of the profession. Included in these stressors are an intense work environment with extended work hours, weekends, night and holidays. According to Ruggiero
Factors of the intense emotional support that is needed for the patient and family is yet another burden of stress placed on
The lack of organizational support and involvement, which are outside of the control of nurses can greatly affect job satisfaction (McGowan, 2001). There is also a lack of control and power in an environment predominantly controlled by physicians. These stressors can contribute to psychological exhaustion and increased stress.
In my initial search for stress
There were comparative studies between different nursing backgrounds and
There were also illustrations comparing different styles of management and how nursing stress is affected. Magnet organizations were compared with traditional organization (Upenieks, 2003). The results of this particular study did prove that positive and supportive administration could make a difference in the levels of stress but again no specific stress intervention measures were used
There is a clear recognition and acknowledgement of the problem of stress in nursing but there is a significant lack of information that actually addressed the problem with potential positive interventions. The few studies discovered were all found to show positive results to some degree. These findings support the positive outcome that the initiation of actual stress interventions or programs within the workplace can offer.
The first study used the physical intervention of massage therapy over a 5 week period for nurses in a hospital facility (Bost & Wallis, 2006). This intervention was identified to reduce stress as well as support nurses individually and organizationally. The effects measured were physical and psychological. The study found no change in the physical findings of blood pressure and urinary cortisol levels,
The other interventions researched involved a more interactive process. These studies called upon the motivation of the participants or nurses to take part in the intervention. The involvement of these nurse participants supports a need to decrease stress by their desire to assist in making changes internally that will affect them externally.
The use of
Mindfulness-Based Stress Reduction (MBSR) Program was a series of quantitative and qualitative studies offered and taught within the hospital work environment. This program specifically addressed the issue of stress for nurses. MBSR is based on the concept of becoming mindful and fully present in the moment without judgment (Cohen-Katz et al., 2005). The study measured levels of burnout, emotional exhaustion, emotional overextension and psychological distress.
This particular intervention program not only decreased the stress level post treatment but the control group also experienced a benefit prior to treatment while waiting for the program. This could be related to the desire to reduce stress in anticipation of participating in the program. This further support the need nurses have to make changes for the better by decreasing stress levels.
This MBSR study again found a reduction in emotional exhaustion and an increased feeling of personal accomplishment in the treatment group
A third positive interactive intervention study was a program, which offered a conflict-management training class in order to decrease potential stress for employees in health care organizations. This particular study also supported the need to offer a way to prevent or decrease stress by creating a positive environment through personal empowerment. There was a significant reduction pretest and posttest in role overload, interpersonal strain, role boundaries and psychological strain. The participants reported that they were better able to find balance in their position and were able to manage the demands of their job (Haraway & Haraway, 2005). These findings confirm the need to make available even brief interventions such as this in an effort to reduce conflict. This could in turn reduce stress and increase perceived control and empowerment, which increases job satisfaction. Furthermore this would improve work environment by making it more supportive
All of these programs discussed, offered intervention for at least one aspect of possible stress factors. Reducing physical or emotional stress and offering more control and empowerment while creating a more positive working environment are all successful interventions to increase job satisfaction. Consequently increased job satisfaction leads to decreased stress. The results of this study suggest a strong link was identified between the two issues (Ruggiero, 2003).
There is a common thread within all these interventions. They are available and effective interventions that can be implemented to become a part of nursing practice and other health care workers in many different health care settings. These
Future studies in programs for stress intervention should include additional similar studies offered to a larger sample with long term and ongoing evaluations of their effectiveness. Consideration of other alternative adjunct intervention therapies that assist in stress reduction could be examined such as yoga and mediation. The use of these physically and emotionally stress-reducing techniques may also be effective in stress lessening and coping measures increasing.
It is my hope that in the future interventions to prevent stress in nurses and health care workers will be offered as a standard part of a
Bormann, J. E., Becker, S., Gershwin, M., Kelly, A., Pada, L., & Smith, T. L. et al. (2006). Relationship of frequent
Bost, N., & Wallis, M. (2006). The effectiveness of a
Cohen-Katz, J., Capuano, T., Baker, D. M., & Shapiro, S. (2005). The effects of mindfulness-based stress reduction on nurse stress and burnout, part II. Holistic Nursing
Haraway, D. L., & Haraway, W. M. (2005). Analysis of the effect of conflict-management and resolution training on employee stress at a healthcare organization. Hospital Topics: Research and Perspectives on
McGowan, B. (2001). Self-reported stress and
Ruggiero, J. S. (2003). Health, work variables, and job satisfaction among nurses. JONA, 35(5), 254-263. Retrieved October 3, 2006, from Ovid data base
Salmond, S. & Ropis, P. E. (2005). Job stress and general well-being: a comparative study of medical-surgical and home care nurses. Retrieved September 28, 2006, from Ovid data base
Upenieks, V. V. (2003). The interrelationship of organizational characteristics of magnet hospitals, nursing leadership, and nursing job satisfaction. Health Care Manager, 22(2), 83-98. Retrieved September 27, 2006, from Ovid data base
Christine Ross ARNP-BC
Christine is a Nurse Practitioner Board Certified in Family Practice and currently working in a retail clinic, also a Certified Yoga Instructor and Certified Holistic Life Coach.
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