Introduction
In the past decade, there has been significant research on the theme of stress and its association with the scientific environment. Stress is associated with a range of negative effects on an individual’s life and also has significant implications on the quality of life. Stress has been observed among various healthcare staff, especially nursing professionals. The co-relation of stress with work and the profession has been a major focus in recent times. In the public health care domain, stress has been used many times, though inappropriate and inconsistent. Studies in health care have focused on the clinical stress and intention to leave early the jobs, among graduate nurses. At the same time, only a few studies paid attention to the interaction between competence, stress, and intention to leave nursing jobs, in a long-term period. Nurses’ turnover rate is high, compared across the rates for other professionals. Voluntary turnover of nurses has unfavorable effects on healthcare system and patients. Many researchers have also conceptualized stress and aggregated various concepts which, however, have led to its irregular use in public and inadequate understanding. There have been studies published, which has proved that stress affects the normality of an individual’s life, regardless of the social level, sex, age, and professional activity.
Stress is known to affect everyone in different ways and at all places, both work and private life. Some of the key characteristics of stress include concern, anxiety, and alertness, which have become part of people’s life. In the healthcare sector, stress affects both the nurse’s professional and personal life, including the nurse’s performance during practice (Cheng, C.-Y., et al. 2014). Stress has its impact on the nurse’s reaction towards different things in different ways. Reaction to stress is associated with the response from the interaction with the environment.
Nurses in the healthcare sector are evaluated based on their social, economic, and cultural characteristics for stress. The concept of stress is rather complex and is based on a wide array of factors, such as situations and activities. Also, organizational changes across different healthcare sectors, sometimes, bring undesired innovations and developments with them that can eventually expose healthcare workers to stress in the workplace. There is a need to understand the impact of stress among healthcare professionals such as doctors, healthcare workers, and nurses in order to provide a critical review and synopsis. This paper would provide an overview on the concept of stress in the healthcare sector, especially its implications among nurses (Adib-Hajbaghery, et al. 2012).
Stress among Doctors
Stress is a common environmental and organizational issue observed among doctors. Stress is more common among doctors due to the demanding nature of their work. The profile of most doctors is often conscientious, obsessive, and committed. In most case scenarios, insufficient rewards and the lack of subjective control with respect to the demanding workplace has led to significant increase in stress among doctors. If there is no change in the current scenario, stress would have a delirious impact on the physical and mental health of doctors. Most researchers claim that doctors suffer from a ‘burnout’ which impacts the workplace. In order to avoid consistent ‘burnouts’, doctors need to control their work environment. Employees and other healthcare workers need to recognize the need of doctors and should make decisions in order to facilitate a better and healthier workplace (Kemper, K., et al. 2011).
The study asserts the need for minimizing occupational exposure to stress across the healthcare sector, through implementation of stress management programs. Exhaustion and stress can cause a number of occupational risks in healthcare professionals’ work, which may lead to the likelihood of mistakes and errors in their daily practice.
Stress among Healthcare Workers
Healthcare workers are considered to be one of the most stressed compared to any other profession based on the review and analysis of a Chicago-based company, ComPsych. Stress among healthcare workers can be avoided if colleagues are helpful. With increasing job demands, employees are likely to report about sickness absence; however, with enough of support at work, employees will have fewer sickness absences.
Pay, benefits, and flexible working hours including medical benefits are said to reduce the amount of stress levels. However, in order to get most benefits from the organization, healthcare workers would have to work on more patients which are not ideal under any circumstances. Managing and coping with stress is the most beneficial for healthcare workers (Mosadeghrad, A. M. 2013). This paper proposes organizational-level interventions to be considered at the workplace to promote a more friendly work environment in the long-term.
Stress among Nurses
Apart from doctors and healthcare workers, nurses are said to suffer from regular burnouts due to the high volume of patients, long working hours, poor wages, and less benefits. Stress among nurses has increased in the past decade and understanding the various factors and concepts is of prime importance (Khamisa, N., et al. 2013). Turnover among nurses results in substantial decrease in nurse staffing, which often leads to work overload and dissatisfaction among colleagues. Long day and night shifts at hospital settings bring lower nurses’ job satisfaction. The adverse turnover affects the nurses’ ability to effectively meet patients’ needs and may even sacrifice in providing of acceptable care for patients. Work-life quality is believed to go with job satisfaction, and if those demands are not met, this may result in job stress and burnout, which then leads to work-family conflict. These factors are considered as the main variables that could provoke nurses to turn over their jobs.
Role of Stress in Healthcare: Concept Analysis
The term stress has been in scientific literature since the early 1930’s. In the healthcare sector and nursing professional, stress has been reported since the last 1950’s. However, the term stress in the nursing profession was not familiar until the late 1970’s and 1980’s. Furthermore, today the term stress is used in a wide variety of situations in order to express disruptive or disturbing situations in an individual’s experience. Stress among nurses was not taken into consideration since it was considered as a normal factor in the profession. In addition to nursing, many disciplines such as psychology, medicine, and social psychology have identified stress. Stress in nursing and other disciplines have been identified to be associated with chronic diseases such as cardiovascular disease, stroke, and cancer. There are different concepts of stress based on the profession. Here are a few concepts of stress based on the current literature review:
Stress as a Response
Stress is considered to be a response to the surrounding environment. The concept of stress as a response was first coined by Hans Selve wherein, nurses responded to stress (burnout) due to factors such as workload and long working hours (Phiri, L. P., et al. 2014). Stress has a long-term negative effect on nurses and may lead to a number of work-related diseases, due to poor eating habits and lack of regular physical exercises. Stress as a response in hospital work environment is the aftermath result of the long-term exposure to infectious disease, which adds strain on nurses.
Stress as a Stimulus
Stress as a stimulus can be considered to be a psychological experience. The concept of stress as a stimulus is based on the individual’s experience. In the nursing profession, nurses would react to a series of personal experience at the workplace and personal life which may add to stress and eventually cause a burnout. Stressors such as low pay, less benefits, workload, and log working hours. The response to such stimulus is likely to cause stress and the best way to deal with stress among nurses is to eliminate the stressors. Thus, the concept of stress to stimulus is different than the response-based concept. Here stress is considered to be an independent variable (Khamisa, N., et al. 2013 and Mosadeghrad, A. M. 2013).
Stress as a Transaction
Stress as a transaction is the third concept based on the current literature review. Stress is not an event but rather a transaction between the environment and the nurse. This concept of stress co-relates to the event ongoing factors in the environment and that any disturbing events would translate into stress. Nurses in the healthcare sector are stressed due to several factors and that stress is not a measurable factor. It is also said to affect the nurse’s cognitive function along with emotional and physical needs (Adib-Hajbaghery, et al. 2012).
Conditions for Stress
Stress is one of the most observed psychological health issues in the healthcare sector. Nurses often complain of stress due to several internal and external conditions. These conditions include: (a) Work hours: Nurses who work for long hours or extended period of time often complain of stress. Continuous work causes cognitive decline. (b) Low pay: Although most nurses are highly paid, there are many nurses who are not paid as per industry standards which impacts both, professional and personal life (c) No medical or other complimentary benefits: Nurses would feel better if there were any benefits associated with their work life. A health benefit such as a health insurance for self and family can ease down the burden in the case of an untoward health or accident. There could be many conditions to stress but the aforementioned conditions can be prevented or controlled (Cheng, C.-Y., et al. 2014).
Outcomes of Stress
Stress among nurses causes physical, emotional, and psychological distress. Some of the common outcomes include burnout, cognitive decline, cardiovascular disease, cancer, emotional imbalance, and low self-esteem (Adib-Hajbaghery, et al. 2012). According to research, nurses encounter ongoing stress, which leads to undesirable eating habits, smoking and use of alcohol that negatively affects their health, well-being and patient care efficiency. This negative impact on nurses is also related to their ability to perform tasks, which may cause in individual cases slower reaction times, apathy, and anxiety. These factors, in turn, affect nurses’ job performance and patient safety.
Clinical attributes
Based on a critical analysis, stress can be defined as a stimulus or reaction. The concept and definition of stress is correlated with the changes that take place in the human biological system. With respect to the definition of stress to stimulus, it is associated with the environmental events that can lead to stress in various forms. Some of the events can cause stress which could be chronic, acute, continuous, or remitting chronic form.
Some of the consequences of stress include emotional, biological, social, and spiritual imbalances. The consequences of stress are often mixed since it affects the person as a whole. In the case of biological stress, homeostasis could also be affected. Negative emotions are a direct consequence of stress. The problem solving skills of nurses could be affected due t stress. The individual’s relationship with other co-members and people is significantly affected due to stress. The moral values and beliefs of an individual is bound to be affected by spiritual distress. Furthermore, a reaction to a stressful even does not necessarily cause damage. On the other hand, there are situations that affect the individual’s efficiency which can cause the feelings of pleasure, joy, and satisfaction. Furthermore, when these emotional stimulations reach high levels, they affect the individual’s efficiency significantly. However, if the same stimulations are held high for an extended time, the consequences could be negative. Low levels of emotional intensity are often linked with negative effects on health and performance. In a recent review, people were found to be more efficient when levels of emotions are high such as challenges or opportunities (Adib-Hajbaghery, et al. 2012).
The successful management of stressful situation and related problem is termed as coping with stress. Researchers state that the coping strategy to such situations of often acquired or innate with respect to the problem/situation or changing environment. The process of coping is based on the behavioral effort of the individual (Cheng, C.-Y., et al. 2014).
Stress: Case Scenario
Ms. Michelle has been working in case management for over 2 years. She complains of continuous burnouts (three to four times a week) and considers her job as a nurse very stressful. The role is not physically demanding but is the main cause of mental stress and anguish. She complains that at times there is so much of work, that catching up the requirements of the unit seems to be likely impossible. The overall experience in the past 2 years has made her depressed and she seeks a new job/profile. The amount of work and the consistent role of multi-tasking has had a significant impact on her mental health. In such cases of extreme mental stress, an alternative therapy or break time is required. Counselling with such nurses is highly recommended (Phiri, L. P., et al. 2014).
Ms. Rebeca is a junior nurse in the intensive care unit. She has lost her interest in the job profile and is looking forward to quit. Two major reasons of her leaving the job include stress and the lack of appreciation. She also suffers from depression and is most likely to suffer from cognitive decline or psychological imbalance. In all three cases, it was observed that workload, extended work time, low wages, and poor appreciation were leading causes of stress among nurses. Empirical referents such as workload, low pay, and extended work time were identified as critical factors in stress as a concept (Kemper, K., et al. 2011).
References
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Cheng, C.-Y., Tsai, H.-M., Chang, C.-H., & Liou, S.-R. (2014). New Graduate Nurses’ Clinical Competence, Clinical Stress, and Intention to Leave: A Longitudinal Study in Taiwan. The Scientific World Journal, 2014, 748389. doi:10.1155/2014/748389
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