The Effects of Stress on Nurses, Research Paper Example

Literature Review

It is clear through many years of research that stress is a key factor that affects a nurse’s performance on the job and off. Stress for nurses is due to the long shifts, lack of pertinent breaks throughout a shift, supervisory and co-worker complications, and the lack of sleep. Many studies have shown us that stress and the lack of sleep for nurses can cause more complications than many nursing homes want to admit. With little to no sleep and a large amount of stress, nurses have a tendency to make more errors while administering medications to patients, checking vitals, and performing routine check-ins on the patients. These things can not only hurt the nursing home, but can also hurt the well-being and the psychological state of the nurse. Many studies have shown the correlation between the amount of stress on a nurse and the complications this stress can cause. However, much more needs to be done by nursing home personnel and more studies need to take place in order to provide nurses with the right intervention practices in order to help them deal with the stress. The research within this paper discusses the problem of stress on the clinical nurse, the background of the problem, the individuals who are at stake due to the stress, and the interventions and recommendations for policy change and perfection.

Problem Identification

There is a huge problem with stress in the workplace for nurses. Nurses are consistently stressed about numerous things in reference to their jobs, their patients, their co-workers, and their supervisors. For example, I am currently dealing with a lot more workload due to the fact that the nurse manager is creating more work for the night nurses. This has put more stress on me and on my co-workers as we already have a lot of duties for the evening shifts. The nursing profession is very taxing on the nurse’s psyche, his or her emotional state, and even his or her physical state. According to an article by J. Albar Marin and M. Garcia-Ramirez (2005), nursing staff “has been identified as one of the groups at risk of suffering emotional exhaustion, a preliminary stage of burnout syndrome, due to the nature, intensity and diversity of the stressors related to their job tasks” (p.96). This is common in nursing homes just as any other medical facility. The job demands of nurses can greatly increase the stress on the job and overwhelm personal coping mechanisms and resources. This, unfortunately, then creates physical and emotional reactions. The nature of the demands of the nursing field could be physical (work-load), emotional (continuous contact with sick and dying patients), and social (problems with co-workers or supervisors). As a consequence of these things, both the nurse’s health and their job performance are affected (Marin et al., 2005, p.97). It is very emotional for me to continuously be in contact with sick or dying patients, but this is the profession I have chosen because I know that I will be able to make a difference. Marin et al states:

Among the psychological reactions which take place as a consequence of the continuous exposure to this job stress is burnout syndrome, characterized by the development of the experience of finding oneself mentally fatigued, negative attitudes towards the people whom their work is directed, and the idea of having failed professionally (Shaufeli et al 1996). It is a process, initiated after continuously suffering the perception of inability to face job demands with the available resources, which leads to the development of emotional exhaustion (97).

It is important to state this as all of these are causes of stress in the nursing field. There are other stressors for nurses as well. These include an intense work environment with extended work hours, sometimes over 12 hour shifts, weekends, nights, and holidays; shift work; and “the lack of organizational support and involvement, which are outside of the control of nurses can greatly affect job satisfaction (Ross, 2012, p. 1). According to Bonnie M. Jennings (n.d.), “numeric ratings from a survey of 1,780 RNs indicated that supervisor support and quality of supervision were lowest for nurse managers” (p.4). Some other problems in this area include “inadequate unit leadership and the frequent turnover of nurse managers; insufficient physical presence of the supervisor on the unit; failure to address problems; and modest awareness of numerous staffing issues” (Jennings, n.d., p.4). Most of the time, I do not feel as if managers and supervisors at the nursing home are actually fit for the leadership roles they are playing. These individuals need to understand how to work with us as we are the ones giving the care to the patients. This does not happen in my workplace as much as I would like. Finally, according to Meeta in a blog entitled “Stress Levels among Nurses,” “the National Holistic Nurses Association reports that 70.5% of nurses cited the acute and chronic effects of stress and overwork among their top three health and safety concerns. Further, 75.8% of surveyed nurses report that unsafe working conditions do, in fact, interfere with their ability to deliver quality care” (Meeta, 2011, p.1). The effects of this stress on nurses causes them to make more errors while performing their work, have lower job satisfaction, and increases risks to their emotional and physical health. If this continues, future effects will include the same problems, but may also include the well-being of the nursing home, loss of staff, greater emotional depression, and further problems with patients. Soon, nurses will no longer want to be at their workplace and will not provide the proper care to the patients.

Background of the Problem

Legal and ethical problems may occur if nurses are working under pressure and in heightened stressful environments. As stated previously, if nurses do not comprehend what they are doing and are still tending to patients, there is more room for error. At this point, nurses are not keeping to their ethical standards of providing care to their patients. If an error is so great, there is the possibility of legal issues in reference to the patients. The patient themselves or their families may decide to sue the nurse or the nursing home. In the event that this happens, the nursing home is now facing economic issues. The nursing home would be spending its money on a lawsuit instead of spending its money on a program that could have prevented the lawsuit in the first place. In addition, word gets around. If a nursing home has a reputation for providing less than excellent service, many individuals are not going to choose to go to that place when care is needed. The social and political factors then come into play. This is where we see nursing homes fighting to stay open and alive. The political world, where nursing facilities are fighting for patients and rapport, can be a harsh one. If nurses are stressed and over-worked, not providing the care that is essential for patients, it is only acceptable for the public to choose another facility for their needs. It would be much easier for nursing homes to implement programs that help nurses deal with their stress in order to combat all of the social, economic, ethical, legal, and political factors that could arise from making their nurses work long hours and develop more stress.

Stakeholders

There are many individuals that are affected by the stress that is put upon nurses in the field. The first and foremost important person that is affected is the nurse. That individual nurse deals with emotional, mental, and physical strain each and every day of his or her life. They lose sleep, work long hours, and provide care that may not be up to par to patients. I cannot begin to explain how sleep deprived I am based on my job. I work very long hours sometimes with a workload that could be for more than three people. Nursing is one of those jobs that you just have to work through. The benefits to me are important as I am helping others. Secondly, this problem affects the patients. If the individuals who are caring for them are not aware of their surroundings, are sleep deprived, are stressed and overworked, these individuals are bound to make more errors while caring for the patients. The patients deserve the best care possible and they would not be getting this if their nurses are stressed in any way. Other nurses and staff are also affected in this situation. It is difficult to work with anyone who is stressed, overworked, emotional, and not persistent in their job duties. This creates complications for co-workers and supervisory staff as it makes them do more work, causing work overload for them. It then becomes a cycle. This happens almost nightly for me as the supervisory staff does not always give the work to individuals that need it; they give it to the individuals that are more qualified to do it. Finally, the nursing facility is affected as a whole. If nurses are not providing the type of care that the facility advertises, the facility could lose a lot of rapport and money. This could lead to further problems such as the closing of the facility where needed the most.

In many cases, it does not seem as if anyone is actually supporting or opposing change. It just seems as if nursing home personnel and supervisors feel as if they do not have the time, resources, or money to implement programs that would help the nurses reduce the stress that is put on each of them every day. If they felt that the programs would be beneficial and if they had a chance to see them work, it may provide a clear understanding of the importance to have such programs in effect. It may just take them one time to see that the nurses are getting the help they need in order to put something into effect and make it mandatory for all nurses. Change is only good if it is seen and provided. It must be given and accepted in order for the nurses and the supervisory staff to take advantage of it.

Policy Change and Recommendations to Solve the Problem

Change can only be implemented if the nursing home agrees to spend the money on the programs that are actually working to help nurses and other nursing home staff members. However, change has to occur in order for nurses to alleviate the stress of their work life and provide exceptional care to their patients. Christine Ross (2012) discusses some great prevention methods and programs for nurses who are dealing with a great amount of stress. She speaks of a study that used the physical intervention of massage therapy which was done over a 5 week period. From this, there were no physical changes in nurse’s blood pressure or urinary cortisol levels. “Although there were no benefits measured, it did reduce the psychological effects of stress” (Ross, 2012, p.2). Another recommendation is the use of mantra to relieve stress. According to Ross (2012), “this is a good example of a valid and tangible intervention that can be offered to increase coping mechanisms while decreasing stress” (p.2). The findings of the study of using a mantra “supported positive results of this study by showing a significant reduction in perceived stress (Perceived Stress Scale), trait anxiety (State-Trait Anxiety Inventory), and trait anger (State-Trait Anger Inventory) post intervention” (Ross, 2012, p.2). Finally, Ross (2012) speaks of a positive interactive intervention study that offered conflict-management training classes in order to decrease the potential stress that health care employees normally experience. After completing this training class, “participants reported that they were able to find balance in their position and were able to manage the demands of their job” (Ross, 2012, p.2). It is very important for nursing homes to work with nurses in order to provide these intervention strategies as the reduction of stress is able to increase job satisfaction and increase nursing retention. These also provide “stress management techniques, increase social support, open communication, role strengthening and empowerment and individual growth to fully utilize positive interventions” (Ross, 2012, p.3). All of these seem to be great interventions and practices that should be put into place in every nursing home as it helps us as nurses become better professionals and gives us all a chance to enjoy our jobs. I would prefer that intervention and programs were put into place in my workplace so that we can do our jobs at the level of potential that we all have. I feel these programs to be important as they help us learn to cope with our stress, be less sleep deprived, and give us the opportunity to do our jobs without making as many errors. However, I feel it can only be done if the nursing home I work for actually spends the money and puts their time and effort into the programs.

References

Jennings, B. M. (N.d.). Chapter 26. Work stress and burnout among nurses: Role of the work environment and working conditions. Patient Safety and Quality: An Evidence-Based Handbook for Nurses, Retrieved from http://www.ahrq.gov/qual/nurseshdbk/docs/JenningsB_WEWCN.pdf

Marin, J. A., & Ramirez, M. G. (2005). Social support and emotional exhaustion among hospital nursing staff. European Journal of Psychiatry, 19(2), 96-106. Retrieved from http://scielo.isciii.es/pdf/ejpen/v19n2/original4.pdf

Meeta. (2011, July 14). [Web log message]. Retrieved from http://www.onlinerntobsndegrees.com/blog/advice-for-student-nurses/stress-levels-among-nurses/

Ross, C. (2012). Literature review for nursing stress interventions. Ezine Articles, Retrieved from http://ezinearticles.com/?Literature-Review-For-Nursing-Stress-Interventions&id=1534683