Stress in nursing and intentions of leaving the profession

Differential Relationships Between Work-Life Interface Constructs and Intention to Stay in or Leave the Profession: Evidence From Midwives in Canada

This paper investigates how positive and negative work-personal life interface constructs are differentially associated with intentions to stay in or leave the profession. The findings help map work-personal life interface constructs on the typology of determinants of intention to stay and intention to leave (disengagers, retainers, criticals, and neutrals). The ordered logistic regression (ologit) modelling of cross-sectional data from a representative sample (n = 601) of midwives in Canada shows that work interference with personal life is a disengager, which has a stronger association with intention to leave than with intention to stay in the profession. Among the work-personal life interface constructs, work enhancement of personal life seems to be the most critical determinant, showing the most substantive association with both intention to stay and intention to leave. This finding suggests that interventions to increase midwives' intention to stay and decrease their intention to leave should focus on amplifying the enhancing effects of working on midwives' personal lives. Interventions that aim to reduce work interference with personal life might be more effective in decreasing intention to leave the profession than increasing intention to stay.

Reliability and Validity of a Stress Scale in Public Employees from Murcia (Spain)

Stress is common in all work environments. Technostress and the difficulty of separating the family arena from the work environment are some of the new and emerging risks faced by companies, employees and society in general. Most of the available instruments for measuring stress in workers have been focused on education professionals and healthcare workers. Therefore, it is necessary to validate simple and friendly-use tools to detect stress levels in public workers. The aim of this study was to determine the internal consistency of an adapted version of the Student Stress Inventory-Stress Manifestations (SSI-SM) for public employees and to determine if high-stress levels are related to personal and work-related factors. A cross-sectional and descriptive study was conducted from October 2016 to February 2019 including 468 Spanish public workers based in Murcia. An adapted version of the SSI-SM was administered and data on personal and work-related factors were collected. Results showed that all of the factors had Cronbach’s α over 0.700, and no items need to be deleted due to correlations with the factor exceeding 0.300. Factor 1, “Self-concept”, has a Cronbach’s α of 0.868, with values of 15.62 ± 4.99; factor 2, “Sociability”, Cronbach’s α: 0.853, with mean values of 13.33 ± 4.17; factor 3, “Somatization”, Cronbach’s α: 0.704, mean value of 5.35 ± 1.90 and: factor 4, “Uncertainty”, Cronbach’s α: 0.746, with a mean value of 8.19 ± 2.51. In conclusion, the internal consistency of the adapted SSI-SM for public employees with different work positions and shifts has been validated and determined. This study provides a useful tool for the early detection of stress in public employees and may be potentially useful for preventing the harmful consequences of stress.

Not All Leaving Is Created Equal

Abstract. Drawing on social cognitive career theory (SCCT) and the focus–congruence approach, this study examines how organizational and occupational turnover is differently influenced by work-related factors. Using a sample of 2,353 teachers in rural China, results first showed that negative relationships between organization-focused predictors (i.e., leader support, colleague support, and physical resources for work) and organizational turnover intentions were significant. Similarly, the negative relationship between occupation-focused predictors (i.e., occupational satisfaction, salary satisfaction, and occupational choice motivations) and occupational turnover intentions was also significant. Moreover, occupation-focused predictors have a stronger relationship with occupational turnover intentions than organizational turnover intentions, and vice versa. Implications for research and practice are discussed.

Job demands-resources, burnout and intention to leave the nursing profession: a questionnaire survey

OBJECTIVES

The aims of the paper are to examine the role of burnout in the relationship between stress factors related to nurses' work and social environment and intention to leave the profession and to investigate the nature of the relationship between burnout and intention to leave the nursing profession.

BACKGROUND

A postulate of the job demands-resources model is that two distinct yet related processes contribute to the development of burnout. The energetic process originates from demands and is mainly centered on emotional exhaustion; the motivational process originates from resources and is mainly centered on depersonalization. Moreover, we postulated that the two components of burnout are linked indirectly to intention to leave the profession via psychosomatic complaints, associated with the energetic process, and via professional commitment, associated with the motivational process.

METHOD

The research model was tested on cross-sectional data collected in 2005 from 1636 registered nurses working in hospitals who responded to a self-administrated questionnaire.

RESULTS

Demands are the most important determinants of emotional exhaustion and indirectly induce depersonalization via emotional exhaustion, whereas resources mainly predict depersonalization. Moreover, emotional exhaustion and depersonalization are linked to psychosomatic complaints and professional commitment, which are in turn associated with intention to leave the profession.

CONCLUSION

The results suggest that a dual strategy is needed in order to retain nurses within the profession: a decrease in job demands, coupled with an increase in available job resources. In particular, nurses' tasks and role should be restructured to reduce work overload and increase the meaning of their work.

On physician well being-you'll get by with a little help from your friends

This study identifies positive and negative factors associated with physician well being. We collected two sets of data from physicians at a university-based Department of Medicine in Western Canada. First, we conducted exploratory, in-depth interviews with 54 physicians to identify factors associated with their well being. Participants explained that certain aspects of their work are demanding and negatively related to their well being, whereas other 5 factors are more enabling and contribute positively. Second, we mailed a structured questionnaire including measures of the key factors identified in the physician interviews to all physicians in the same Department of Medicine. Multivariate analysis was used to assess the extent to which the factors identified in the interviews are significantly related to physicians' well being. The findings show the importance of co-worker support, both in terms of being directly related to physician well being as well as buffering the negative effects of work demands. We discuss several important implications for physicians and the organizations that employ them in understanding the factors related to physician well being. In addition, patient interactions appear to be both a key source of stress and a major source of satisfaction in physicians' daily work lives.

Retaining nurses in their employing hospitals and in the profession: effects of job preference, unpaid overtime, importance of earnings and stress

The purpose of this paper is to examine the effects of job preference, unpaid overtime, importance of earnings, and stress in retaining nurses in their employing hospitals and in the profession. Data come from our survey of 1396 nurses employed in three teaching hospitals in Southern Ontario, Canada. Data are analyzed first for all nurses, then separately for full-time, part-time, and casual nurses. Results show that the key to understanding the effects of these variables may be to pay attention to the work status of nurses. With regards to retaining nurses in their hospitals, working in their preferred type of job is important, particularly for part-time nurses. Working unpaid and longer than agreed hours is also a factor for increasing the likelihood of part-time nurses to leave the profession. All nurses are less inclined to leave as the importance of their earnings for the family increases, but it is particularly important for part-time nurses. Stress is an ongoing concern for retaining nurses in their hospitals and within the profession. We suggest managers and policy makers pay attention to employing nurses in jobs they prefer, decrease unpaid overtime, and consider the importance of earnings for them and their families in developing policies and programs to retain nurses. More importantly, stress levels should be lowered to retain nurses.

Sources of occupational stress and coping strategies among nurses working in AIDS care

Nurses working in AIDS care experience high rates of occupational stress and therefore are vulnerable to emotional exhaustion and occupational burnout. This study surveyed 499 members of the Association of Nurses in AIDS Care regarding their work-related stress experiences and coping strategies for managing stress. Qualitative analyses identified a hierarchical structure of occupational stress, with two supraclusters representing workplace and patient care-related stress and eight specific subclusters of stressors: institutions, personnel, biohazards, death, informing patients, challenging patients, families, and treatment dilemmas. Analyses showed that nurses experiencing stress from their workplace were significantly more likely to use wishful thinking, planful problem solving, and avoidance as coping strategies, whereas stress originating from patient care was more likely to be dealt with using positive appraisal and acceptance. Interventions designed to assist nurses in managing occupational stress and to prevent occupational burnout must include the sources of work-related stress among nurses in AIDS care.

Verbal abuse of staff nurses by physicians

The prevalence and consequences of verbal abuse of staff nurses by physicians were examined in the context of Lazarus' stress-coping model. Of the 130 staff nurses completing a mailed Verbal Abuse Questionnaire, 90 per cent reported experiencing at least one episode of verbal abuse during the past year. The average number of reported incidents during the year was between 6 and 12. The most frequent and most stressful types of verbal abuse came in the forms of abusive anger, ignoring, and condescension. Nurses tended to interpret the abuse in an adaptive fashion, e.g., they viewed the abusing physician as someone with a problem and perceived themselves as not deserving the abuse. They used a variety of adaptive palliative as well as problem-focused coping skills. The most severe long-term effects of verbal abuse were a negative relationship with the offending physician and negative effects on job satisfaction. These findings show clearly that verbal abuse of nurses by physicians continues to exist and is associated with negative consequences on their personal as well as professional well-being. Nurse and physician educators as well as nurse administrators must address this problem through educational activities as well as protective hospital policies.

Stress among student nurses: is it practical or academic?

Previous research into stress among student nurses has only concentrated on the practical aspects of nursing and has ignored stress caused by the academic side of training. In comparing Registered General Nurse (RGN) and Diploma of Higher Education in Nursing (Dip. HE Nursing) students using a modified nurses stress scale, the intensity of stress was investigated. It was hypothesized that there would be a difference in the total stress scores between the two pre-registration education courses as well as within the practical and academic elements. Dip. HE Nursing students were significantly more stressed than RGN students, but equally for practical and academic elements. RGN students were significantly more stressed on the practical elements. Factors analysis clearly identified two factors: (i) the practical elements, and (ii) the academic elements of nursing. A third factor was also identified and this was related to stress induced by issues concerning death and suffering in the patient. These results have implications for the development of the nurse education course (Dip. HE Nursing) which is still in its infancy.

Sources of stress for nurse practitioners

The purpose of this study was to identify perceived stressors and manifestations of stress in nurse practitioners practicing in Missouri and California. The greatest sources of stress reported by the entire sample (N = 80) were in the categories of time demands and role restrictions. Missouri nurse practitioners found role restriction problems significantly more stressful than California nurse practitioners did. Manifestations of stress fell within the norms of non-psychiatric adults on the Symptom Check List 90-R.

Curriculum Issues Related to Nurse Turnover

The problem of turnover rates among registered nurses has implications for nursing curriculum and for continuing education programs. After a brief presentation of turnover issues, curriculum implications will be discussed under three broad areas: (a) content about turnover included in nursing management textbooks; (b) nursing curriculum issues that influence the survivability of graduates of schools of nursing and thereby affect turnover rates; and (c) continuing education needs of registered nurses. This paper is not a summary of solutions for turnover. The problem of turnover is complex and poorly understood. The curricular issues provide challenges to traditional nursing education that would increase the likelihood of the development of "hardy" nurse graduates who have survival skills for the practice environment.