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1 A STUDY ON WORK STRESS AMONG NURSING STAFF IN HEALTH CARE SECTOR (With respect to Super Speciality Hospital) Mrs B. Rajeswari, Research Scholar, Dept. of Commerce & Business Administration, Acharya Nagarjuna University, Andhra Pradesh, India Prof. G.V. Chalam, M.Com., LL.M., M.B.A., Ph.D., Dept. of Commerce & Business Administration, Acharya Nagarjuna University, Andhra Pradesh, India ABSTRACT Stress is unavoidable. Though some amount of stress has been attributed to positively impact work success, but excess can create dissatisfaction and even lead to decrease in moral and high attrition. Nursing is a noble service. Nurses and other healthcare professionals are exposed on daily basis to various levels of stress and burnout arising from the demand of their jobs the objective of present work is evaluate the stress level among nurses, sources of job stress and its symptoms among nurses of a super specialty hospital and to suggest measures to increase satisfying aspects in work and decrease their stressful aspects of work. This descriptive study employing 100 staff nurses of a super specialty hospital used a structured personal interview questionnaire consisting of 10 sources of stress and 10 symptoms of stress. The nurses were asked to rate each item according to the extent by which it contributed to their stress experienced in their jobs in the past few months. Key Words: Work stress, Symptoms of stress, Coping strategies, Work load, Counselling Introduction Stress is an internal state which can be caused by physical demand on the body or by environmental and social situation which is evaluated as potentially harmful, uncontrollable or exceeding our resource for coping. These physical environmental and social causes are referred to as stressors (Pantulu, 1996). It is almost impossible to live without some stress and most of as wouldn t want to, because it gives life some spice and excitement (Wieler). Stress can be self-imposed e.g. setting too high standard or having unrealistic expectations regarding one s abilities; situational e.g. time constraints, lack of resources, threats to emotional or physical wellbeing, challenges beyond one s ability to respond, conflicts, between one s personal values and the values of others (Shield, 2001). So, stress relates to life changes, personal and/or work-related; and too many changes at one time, either positive or negative, can overload an individual's capacity to adapt successfully and result in illness of one sort or another. What may be distressful to one person may be excitingly challenging (positively stressful) to another and the same event can be distressful at one time and stimulating or non-stressful at another (Benjamin, 1987). But when stress gets out of control, it may harm health, one s relationship with others and enjoyment of life (Wieler). Whether an event causes distress depends upon the individual's perception of the situation. How a person responds to stress depends upon the environment, the magnitude of the stressors, what has gone before, the persons self-perceived ability to handle the stress or the persons physical condition and just plain habits (Benjamin, 1987). The person s attempts to manage a stressful situation is called coping. Different strategies may be used to cope with stress. If the coping strategy adopted by the person was healthy, the stress is resolved, if not the anxiety associated with the stress persists 122

2 and he could later develop some mental illness (Lyon, 2000). Work stress has been identified as a key factor in service delivery in every organisation and in most field of work. How this work stress affects nurses in healthcare institutions, how they cope with it and the resultant effect of the coping strategies on their output forms the crux of this work. It is a universally accepted fact that human nature is prone to wears and tears associated with daily activities. These manifest in the form of stress and strains as witnessed in everyday life. Nurses and other healthcare professionals are exposed on daily basis to different levels of stress and burnout arising from the demand of their jobs. According to Sexton et al. (2009), nurses are exposed to intense stressors arising from the demand of their jobs. These stress factors could be poor staffing, high workload, communication breakdown, death and sometimes pressures arising from medication errors. They argue that nursing is part of the medical profession with the high demand for high stake decisions and high-level responsibilities. There is also the factor of emotions and supportive care for dying patients and the pain of death. The profession also exposes nurses to un-planned but unavoidable long working hours, lots of paper work and other social vices like physical abuse from either the patients or their families. Healthcare workers especially nurses are prone to these stresses inducing factors seen in Medical care and as such are candidates for deep scrutiny because of the implication of their actions and inactions on the general wellbeing of patients. Review of Literature Schmidt, Denise Rodrigues Costa; and et al, in their work on Occupational stress among nursing staff in surgical settings. They aimed at evaluating the presence of occupational stress among nursing professionals working in surgical settings and investigating the relations between occupational stress and work characteristics. Deshmukh N.H. (2009), Stress and life satisfaction among working and non-working women from similar levels of socio economic status of the society, resulted that there was no significant difference in physical and family stress among working and non-working women. Role stress was significantly higher among working than non-working women. Life satisfaction was better in working women than non-working women. J.E. Agolla in his research titled - Police Officers: The Case of Botswana Police Service, (2009). He has conducted a study in Botswana, among the police to find out work stress symptoms and coping strategies among the police service. This study reveals that the police work stressors are; getting injured while on duty and the use of force when the job demands to do so, etc. The coping strategies were identified as exercising, socializing, healthy eating or diets, career planning and employee training. Connolly, John F and Willock, Joyce and Hopewell, Michele and Chisholm, Vivienne in their research titled Occupational Stress & Psychological Well Being following University Relocation (2009) they describe and analyze that management standards for work related stress (demand, support, control, role, relationships and change) can be analyzed by examining (i) overall levels of psychological strain (ii) job satisfaction, and (iii) the psychosocial working conditions. Khalid A. in his research titled Role of Supportive Leadership as a Moderator between Job Stress and Job Performance (2012), have found that, there is a direct relationship between stress and job performance in any organization. To improve the performance of an individual in an organization an employee should receive good support from their leaders. Therefore, a supportive leader can improve the performance of an employee even at unfavorable situations. Archer (2003) said that stress reactions to various situations affect the overall level of a person s health. One that they felt is always overwhelmed while they eat poorly, sleepless and overwhelmed with stressful events. Objectives of the Study: To know the stress level among nursing staff in health care sector. To find out the major symptoms of stress that are experienced by nurses. To find out the stressors (sources of stress) among selected sample respondents. To suggest coping strategies to reduce the stress levels. Theoretical Framework: To measure the symptoms of stress, a model developed by Smith & Venter in 1996 has been used. The primary areas covered are mental symptoms, physical symptoms. There are 12 mental symptoms items developed by Smith and Venter in 1996, i.e., anxious, worry a lot, irritability, easily frustrated, aggressive outburst, poor concentration, forgetfulness, depression, poor motivation, want to be alone always, poor self-esteem and feel out of control. In this study there are five symptoms used in the present analysis. There are 13 physical symptoms items which was developed by Smith & Venter in 1996, i.e., headache, spastic colon, indigestion, ulcers, high blood pressure, hyper ventilation, asthma, stiff sore muscles, trouble sleeping, decreased immunity, change in married life, change in appetite and palpitation. 123

3 To measure the sources of stress, the model developed by the same author (Smith & Venter, 1996) has been used in this particular study There are 10 items of work sphere developed by Smith & Venter in 1996, i.e., feel overloaded with work, struggle to meet deadlines, carry a lot of responsibilities, struggle to get along with superior-subordinates and peers, have to tolerate a lot of frustration, working long hours, no control over my work schedule, dissatisfied with my salary, my work is boring and not challenging, perfectionist in execution of my task. But 7 sources of stress were used for this study. Variables Caused for Stress: 1. Symptoms of Stress Emotional symptoms of stress: 1. Worry a lot 2. Poor concentration 3. Forgetfulness 4. Easily Frustrated 5. Avoiding Others Physical symptoms of stress: 1. Headache 2. Asthma 3. Trouble sleeping 4. Decreased immunity 5. Change in appetite. 2. Sources of Stress variables Work Sphere: 1. Feel overloaded with work 2. Poorly paid for the job. 3. Overall volume of work. 4. Struggle to get along with superior, subordinates and peers 5. Being involved in emotional distress of patience. 6. Work long hours 7. No control over my work schedule Methodology of the Study: The study used here is descriptive study and sample taken here is 100 staff nurses of a super specialty hospital, used a structured personal interview through questionnaire consisting of: Demographic profile of respondents. 10 sources of stress, 7 symptoms of stress, and the nurses were asked to rate each item according to the extent by which it contributed to their stress in their jobs in the past few months. The stress label measured on a Likert scale of 1 to 5. Table - 1: Demographic Profile of the Respondents N % Age Below above 3 Qualification Intermediate 5 Graduate 93 Post graduate 2 Religion Hindu 46 Muslim 3 Christian 50 Other 1 124

4 Marital Status Married 48 Unmarried 42 Divorced 3 Others 7 Number of Dependents Nil 4 0ne 5 Two 45 Three 36 Four 8 Five & above 2 Table-2: Mental Symptoms of Stress Sl. No Attribute Very low Low Moderate High Very High Total 1 Worry a lot Easily frustrated Poor concentration 4 Forgetfulness Avoiding others Table-2 presents the details on mental symptoms of stress in the selected respondents of the study. From the data in table-2, it can be viewed that the respondents (nurses) are having stress level in between moderate and high most of mental symptoms of stress they are facing is they are easily frustrated (very high-27% and high-44%). Table 3: Physical Symptoms of Stress Sl. No Attribute Very low Low Moderate High Very high Total 1 Head ache Asthma Trouble in sleeping Decreased Immunity Change in 5 Apatite Table-3 depicts the data on the physical symptoms of stress among the selected nursing staff of the selected organization. It can be said from the data in table-3 that nurses are facing severe headache (very high-45%), trouble in sleeping (high 33%) under physical symptoms of stress. 125

5 Table 4: Sources of Stress :( Work sphere) S.No Attribute Very low Low Moderate High Very high Total 1 Feeling overloaded with work Poorly paid for the job Overall volume of work Struggle to get along with superior, 4 subordinates and peers Being involved in emotional distress of patient Working long hours No control over my work schedule Table-4 exhibits the data on sources of stress among the selected respondents during the period of study. From the data in table-4 shows that the top stressor for nurses is working long hours, and poorly paid for the job. Other stressors are having moderate impact on stress of nurses. Conclusion: The nursing staff of the selected hospital was in moderate stress due to the prime stressors. Three top reasons of stress were found, i.e., feeling poorly paid for the job (65%), working long hours and struggling to get along with superior, subordinates and peers. so adequate measures should be taken to alleviate these stressors. This could be achieved through proper coping strategies workload management, job redesign, by offering occupational health education., stress counselling programs, life style modification programs, supportive organization culture, stress management programs, etc. References: 1. Connolly, John F and Willock, Joyce and Hipwell, Michele and Chisholm, Vivienne (2009) Occupational Stress & Psychological Well Being following University Relocation: six months on. Project Report. Queen Margaret University. 2. Urska Treven, Sonja Treven and Simona Sarotar Zizek, Effective approaches to managing stress of Employees, Review of Management Innovation & Creativity, Volume 4, Issue 10 (2011), pp , 3. Afsheen Khalid, Role of Supportive Leadership as a Moderator between Job Stress and Job Performance, Information Management and Business Review Vol. 4, No. 9, Sep 2012, pp J.E. Agolla, Occupational Stress Among Police Officers: The Case of Botswana Police Service, Occupational Stress Among Police Officers: The Case of Botswana Police Service, Vol. 3, Issue 1, pp , Schmidt, Denise Rodrigues Costa; Dantas, Rosana Aparecida Spadoti; Marziale, Maria Helena Palucci and 6. Laus, Ana Maria, Occupational stress among nursing staff in surgical settings, Texto contexto - enferm. [Online]. 2009, vol.18, n.2, pp Archer, James.Ph.D. Christina Carroll, Ph.D., Jaquelyn Liss Resnick, Ph.D. (2003). University of Florida Counseling Center 301 Peabody Hall, Gainesville FL (352) Avinash Kumar Srivastav, (2007), Achievement climate in public sector A cross functional study on relationship with stress and coping, IIMB Management Review, December Reshma S Gavali, (Nov 2009), Applied ergonomics and ways to reduce work stress, Icfai Univ. press, HRM Review, 10. Sunday Hindustan times, (May 4th, 2008), Stress is emerging as a major problem for many successful people. 126