The Causes Of Stress Among Nurses
Hans Selye defines stress as ‘the nonspecific response of the body to any demand for change’ (AIS, 1979). Job stressors are the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities or resources of the worker. Stress is defined as ‘an external cue that threatens the equilibrium of an individual’ (Gray-Toft and Anderson 1981: 639). ‘Stress is a psycho-physiologic arousal response occurring in the body as a result of a stimulus which becomes a "stressor" by virtue of the cognitive interpretation of the individual’. (Everly G.S.; Rosenfeld, R. pp. 4-5.) The perception of job stress is often mixed up with challenge. A challenge usually boosts us psychologically and physically and it also inspires us to learn new skills. The concept of stress has two components, one component deals with a person’s perception of demands that are being made on them and other component deals with a person’s perception of their ability to meet those demands (Mc Vicar 2003: 633). Severe and long lasting distress leads to more consistently observed symptoms of emotional ‘burnout’ and severe psychological disturbance (Mc Vicar 2003: 634, Stordeur et al 2001: 534, Coffey 1999: 435). Emotional exhaustion leads to failure of being concerned about others and workers develop feelings of inadequacy (Stordeur et al 2001: 535). Various manifestations of burnout are insomnia, exhaustion, employment of different coping strategies, thinking of alternate career options.
Literature shows that there are countless stressors which lead to stress in nurses (International Labor Organization 1998). Nursing literature is replete with descriptions of fatigue/ sleep deprivation, compassion fatigue, consequences of being bullied and other stress related maladies. (Graner, 2010) Work in which the demands imposed are threatening and not well matched to the knowledge, skills and ability to cope of the nurses involved, Work which does not meet the needs of the nurses involved, Situations in which nurses have little control over work, and Situations in which nurses receive little support at or outside or work. For many years, the main sources of distress for nurses are related to workload, leadership, professional conflicts and emotional cost of caring but there is disagreement as to the magnitude of their impact (McVicar 2003: 633). Stordeur et al. (2001) categorized stress in order of rigorousness of the impact, the most important are categorized as (a) elevated workload, (b) clash/conflict among colleagues (c) ambiguity about the assigned tasks (c) having an head nurse who always keeps an eye on activities of the nurses and is ready to detect errors. These categories are related to work overload and multi-tasking, lack of skills and ineffectiveness, lack of incentives (motivation and actuation), lack of support from colleagues, trust deficit and rivalry, role conflict and uncertainty, institutional limitations and finally house hold responsibilities/domestic demands (family demands and expectations). Work load is considered to be the most stressful among the eight areas of work stress (Boey et al 1997: 258). Janssen et al. (1999: 1366) confirmed that working under time pressure and highly demanding work are the major stressors faced by nurses. Demerouti et al. (2000) in their study of 185 nurses presented the model of burnout and life satisfaction which differentiates between two different categories of working conditions related to the development of stress among nurses (p. 456). These two categories are job demands and job recourses. Jameton (1984) defined moral distress as taking place when “one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action”. This definition was further developed by Wilkinson (1987), who defined such distress as “the psychological...
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