Friday, February 29, 2008

Nursing Stress

There are many issues related to stress within the nursing profession, many of which seem to be overlooked quite often. The shortage within the nursing profession presents everyday challenges for nurses who are forced to work long hours and to the quality of their work. This is concerning because health policy experts say that the nursing shortage could very likely worsen in the next three decades (Yeager & Cheever, 2007).

Every patient is entitled to the best attention possible. The quality of a nurse may be questioned or jeopardized if they have a large number of patients to care for all at once. In this situation a nurse cannot fully concentrate on giving one particular patient all the care and attention that they need. A survey done with a group of medical staff regarding the nursing shortage reported that “substantial proportions of respondents perceived negative impacts on care processes, hospital capacity, [and] nursing practice” (Buerhaus, Donelan, Ulrich, Norman, DesRoches, Dittus, 2007).

A second issue due to the shortage is that nurses have to work extra hours. During a 28-day study of nurses, about thirty-three percent of those nurses studied worked overtime (Phillips, 2004). This, too, could potentially decrease the quality of their work because by the end of their long, strenuous shift they may become worn down (both physically and mentally) and may not perform as they would optimally. Nurses need to take care of themselves before they can take care of their patients. After all, the safety of the nurse is just as important as the safety of the patient.

With the current world-wide lack of nurses, is it possible that people may want to get into the profession for the wrong reasons? Because there is such a big need for nurses, many positions will be available and people may be getting into the profession simply because there is a shortage, not because that is what they actually want to do. If it is assumed that going into nursing is a sure way to get a job, will the quality of their work be as good as that of those who truly desire to be nurses.

An increased danger of professional burnout plagues nurses as a result of the pressure and stress imposed upon them due to the nursing shortage (Stress and Nursing, n.d.). Nurses may place their patients’ care before their own well-being and consequently, the level of their happiness is hindered. In acute healthcare settings, there are stressors, both internal and external, which cause stress (Flanagan, 1990). External factors include: too many patients, inadequate staffing, overtime, and paperwork. Internal factors include: relationships with coworkers and familial problems that may trouble many healthcare workers (Flanagan, 1990). Stress essentially results from dramatic changes in the workplace or home, perceived threats, challenges to one’s capabilities, and unmet needs (Sutterley & Donnelly, 1982). The existence of stress within a nurse’s life is known to cause altered amounts of different bodily chemicals, higher levels of anxiety, insomnia, lack of appetite, sweating, and even depression (Flanagan, 1990; Sutterley & Donnelly, 1982). In the workplace, stress takes its toll on nurses in that it makes them feel emotionally drained, used up, or frustrated. Consequently, these feelings may lead to absenteeism, decreased motivation, lack of trust, or low morale (Flanagan, 1990). The issue of being aware of the causes of stress and how it affects nurses in the workplace is vital to the knowledge of healthcare professionals because they can be aware of, or even attempt to avoid, certain stressors.

Eighty percent of illnesses are caused by stress; therefore, nurses should know how to deal with these problems (Stress, n.d.). Coping with stress may be a difficult task. However, various techniques for helping nurses with their stress-related problems exist. For example, identifying stress symptoms and stressors in one’s environment and subsequently developing a plan to eliminate stress is one option (Self-Care, 2005). This plan involves a constant process in which all aspects of one’s self are addressed (Flanagan, 1990). Nurses must realize that the self is most important and that in order to lead a satisfying life, one must take care of one’s needs as well (Self-Care, Dependent Care, 2003). Many techniques relating to self-care are readily available to nurses willing to eliminate stress. Intellectual self-care encompasses the idea of challenging one’s mind by striving to complete more education while social self-care embraces the concept of networking, mentoring, and collective action (Flanagan, 1990). The most prominent self-care technique related to emotions is for nurses to express their inner feelings, values and attitudes (Flanagan, 1990).

The existence of stress within the workplace could potentially be caused by moral distress, “the reaction to a situation in which there are moral problems that seem to have clear solutions, yet we are unable to follow our moral beliefs because of external restraints” (Burkhardt & Nathaniel, 2008 pg. 91). Moral distress causes anger, dissatisfaction, and poor performance in the workplace and these behaviors coincide with those triggered by stress (Burkhardt &Nathaniel, 2008). By working to eliminate moral distress in the workplace, nursing stress can be alleviated and subsequently result in a more conducive work environment.


Buehraus, P.I., Donelan, K., Ulrich, B.T. Norman, L., DesRoches,
C. & Dittus, R.(2007). Impact of nurse shortage on hospital patient
care: Comparative perspectives. Home Affairs: Project Hope,

Burkhardt, M. A., & Nathaniel, A. K. (2008). Ethics and Issues in
Contemporary Nursing
. Clifton Park, New York: Thomson
Delmar Learning.

Flanagan, L. (1990). Survival Skills in the Workplace: What Every
Nurse Should Know
. Kansas City, Missouri: American Nurses
Self-Care, Dependent Care and Nursing.  (2003).  SCDNT.  Retrieved
February 12, 2008, from
Self-Care Framework.  (2005).  Nursing Theory.  Retrieved February
12, 2008, from
Stress Is Costing Business Big-Time. (n.d.). CNN. Retrieved January
23, 2008, from

Sutterley, D. C., & Donnelly, G. F. (1982). Coping with Stress: A
Nursing Perspective
Rockville, Maryland: Aspen Systems

Yeager, S.T. & Cheever, K. H. (2007). A residential nursing camp
program: Effects on adolescent attitudes toward nursing careers.
The Journal of Nursing Education
, 452-459.