Introduction
The tremendous growth within the Indian healthcare industry has unfolded healthcare service scope and employment opportunities but has still not been able to meet the demand for better patient care. This poses a challenge for nurses to satisfy patient care expectations.2 Many tasks of Nurses are routine, quite difficult, disgusting, unpleasant, and not rewarding, nurses are likely to burn out.3, 4, 5 Job stress could be a serious phenomenon that's associated with any feature within the workplace that poses a threat to employees. It’s believed that moderate levels of stress can stimulate creativity and encourage effort, while excessive levels of stress have destructive consequences for the individual and there fore the organization.6, 7 Moos (1992)8 and Westman (2006)9 conceptually defined job stress as a condition that happens when job demands exceed skills and resources.
Indian researchers have identified that 87.6% to 92% of nurses are experiencing stress10, 11 and demand a necessity for further exploration of job stress and related factors. Extended exposure to job stress factors induces a range of mental and physical health problems other than stress generated low productivity, low job involvement and commitment, dissatisfaction, absenteeism and employee attrition in hospitals.12, 13, 14, 15, 16, 17, 18, 19
Literature Review
P J Dewe (1987)20 interviewed 2,500 nurses and identified the causes of stress at work: overwork, difficulties with the remainder of the staff, difficulties in caring for the seriously ill, and concerns about patient treatment and care of sick or distressed patients. The result suggests that each one nurses often experience a range of stressful situations. Cox (1993 and 2005),21, 22 reported that factors related to job stress include, rigid and irregular work schedules, excessive workload and speed of labor, poor interpersonal relationships, job insecurity, lack of involvement, undefined roles, poor communication and career development, and conflicting demands between work and residential. Additionally, some risks could also be unique to particular organizations and new risks may emerge as workplaces evolve and alter.
Bhatia N (2010)23 conducted his cross-sectional study on 87 randomly selected staff nurses from two tertiary care hospitals of Delhi. Data were collected employing a pre-tested and self-administered questionnaire. The prevalence of occupational stress amongst nurses was 87.4%. ‘Time Pressure’ and ‘High level of skill’ were found to be the foremost source of stress. Other life and work-related sources of stress were: handling various life issues, caring for own children/parents, learning new things and having to attend to too many patients at the identical time. A high prevalence of job stress amongst nurses’ warrants stress reduction programmes that address specific key stressors. Bincy, R. (2012)24 conducted an experimental study among 30 Critical Care Unit nurses, and reported that job stress affects nurses' health, increases absenteeism and attrition, errors in treating patients, infection rates, and increased cost of employment for hospitals. Caring for patients and workload were the key stress for the nurses.
According to Optum's Online Health Risk Assessment Study (2016) conducted on 200,000 Indian employees in the year 2016, shows that 46% of staff suffers some sort of stress. The study also found that employees have an increased risk of diabetes (30%), hypertension (30%) and stress (46%), more importantly; these figures are 30% over the 2014 result.25, 26 Chaudhari A P (2018)10 evaluates the job stress among nurses at BARC Hospital. Ninety-seven staff was evaluated for occupational stress using the Expanded Nursing Stress Scale, during a cross-sectional study. More than half (51.5%) of nurses experienced mild, and 34% had moderate stress and is more in nurses with 6–10 years of service. Conflicts with colleagues, patients and their families and workload were the causes of occupational stress. The strain levels of nurses with lesser experience correlated with somatic complaints.
Bai J H (2019),27 reported multiple factors of job stress for nurses: care demands, professional and work issues, hospital policies, family-related issues and nursing procedures. Job stress can unconsciously affect patient care as well as the health of nurses. Appropriate coping strategies are needed to mitigate job stress and better patient care. Support is significant to enable nurses to address job stress.
Materials and Methods
The purpose of the present study was to find out the Job stress of female staff nurses working in private hospitals in the Kottayam district. A quantitative descriptive survey was chosen as the research design for the study. A total of 300 female nurses working in selected private hospitals in the Kottayam district were selected by simple random sampling technique in December 2021. Socio-demographic tool and Nurses’ Occupational Stressor Scale (NOSS)28 were used for data collection. The data collected from 300 subjects were analyzed using descriptive and inferential statistics with the help of the Statistical Package for Social Sciences 16th version.
Results
The majority (61%) of the subjects belonged to the age group of 31 to 40 years. The data showed that the majority of the subjects (89%) were married, 56% were from nuclear families and most had 1-2 children. Among the subjects, 55% of spouses had private jobs while 2% were unemployed and 9% worked abroad.
Most of the subjects (78%) were GNM. The scope of work was divided equally among the staff, ie, medical 30%, surgical 17%, and critical care medicine/emergency medicine/OT 43%. Of 300 subjects, 47.6% had more than 5 years of experience. 82% of subjects underwent CNE and 73% participated in stress management programs at some stage of their professional life. Of the 300 subjects, 80.3% reported as they are receiving support from their immediate supervisors and Hospital management, while 53% reported that their job interfered with family life, and 44% were moderately satisfied in meeting their family needs. 81% of the subjects showed medium job stress. The mean was 51 (the mean percentage was 60.8%) with a standard deviation of 5.9.
Discussion
In the present study 81% of subjects had moderate job stress. Similar findings are reported by Sharma P et al. (2014)1 where 51% of nurse had moderate to severe level of job related stress. Sreelekha et al. (2016)29 showed that 60% had severe stress which is contrast with present study findings. Funmilola Adenike Faremi (2019)30 Mean stress was 51in the present study which was in contrast with another study done in Nigera where mean job stress was 99.
In India, one study10 identified 87.6% of the nurses to be experiencing stress, in which 2.1% had severe stress. Another study found 92% of nurses with stress, of which 52% had severe stress.12 These findings indicate a high prevalence of work-related stress among nurses in India and demand a need for further exploration of job stress and related factors.
Conclusion
For nurses, job stress seems to vary according to individual and job characteristics and work-family conflicts. Common job stressors for nurses include workload, role ambiguity, interpersonal relationships, and concerns about death and dying. Stress at work can also lead to emotional stress, burnout, and mental morbidity. Interventions should be planned to prevent and manage stress, which in turn contributes to job performance and productivity.
