Home  News Room  Nursing Matters ICN on Occupational Stress and the
  Threat to Worker Health

Nursing Matters fact sheets provide quick reference information and international perspectives from the nursing profession on current health and social issues.

 

ICN on Occupational Stress and the Threat to Worker Health

"If you wanted to create the optimum environment for the manufacture of stress, many of the factors you would include would be clearly recognized by nursing staff as events which they encounter in their daily routine. These include an enclosed atmosphere, time pressures, excessive noise or undue quiet, sudden swings from intense to mundane tasks, no second chance, unpleasant sights and sounds, and standing for long hours¹ ."

What is job stress?
Job stress is the harmful emotional and physical reactions resulting from the interactions between the worker and her/his work environment where the demands of the job exceed the worker's capabilities and resources².

When we are under stress our bodies prepare for a "fight or flight response":  adrenaline, cholesterol, and sugar are released into the bloodstream.  Some commonly felt experiences are anxiety or panic attacks, migraine headaches, stomach problems, back problems, racing heart beat, dizziness, sweaty hands, and dry mouth.  A certain amount of stress is required to live and enjoy life, however, when we are under unremitting stress or if we do not deal with it properly, we cause wear and tear on our bodies leading to physical and psychological problems such as depression and hypertension.

Figure 1: Risk: Pathways from hazard to harm3

What causes job stress?⁴

• Working conditions:  shift and week-end work, inadequate remuneration, hours of work, conflict, discrimination, and danger in the work environment.
• Relationships at work:  quality of relationships with peers, subordinates, or supervisors.
• Role conflict and ambiguity:  ill-defined role, functions, expectations, and duties.
• Organisation structure and climate:  communication policy and practice, major changes in the workplace, culture of the organisation, and lack of participation in decision-making.
• Work-home interface:  competing demands on time and expectations.
• Career Development:  under utilization of skills or failing to reach full potential, change to a position ill-suited to the skills and interests of the individual, uncertain job expectations, job insecurity and lack of opportunities to learn and advance.
• Nature of the job:  amount of physical and emotional stamina required, workload and work pace.

Major Sources of Stress for Nurses⁵

1.	Dealing with death and dying.
2.	Conflict with colleagues, including supervisors and other health care professionals.
3.	Inadequate preparation to deal with the emotional needs of patients and their families.
4.	Lack of staff support.
5.	Workload.
6.	Uncertainty concerning treatment plans.

Facts and Figures on Job Stress

• Work-related stress accounts for $200-300 billion a year in the American workplace.
• Worker stress is implicated in 60-90% of medical problems.⁶
• The California Workers' Compensation Institute reports that the number of workers compensation claims for mental stress increased by almost 700 percent between 1979 and 1988.⁷
• Workers who report high stress are 30 percent more likely to have accidents than those with low stress.⁷
• In the European Union in 1996, 28% of workers reported stress-related health problems (this amounts to about 41 million EU workers).³
• Violence at work is a growing problem: in the EU, 3 million workers reported being subjected to sexual harassment, 6 million to physical violence, and 12 million to intimidation and psychological violence ⁸.  In the U.S., almost 1000 workers each year are murdered on the job with homicide being the leading cause of death for women in the workplace.⁹

Effects of Stress

Stress Management
 
What nurses can do:

1.	Healthy living:  get enough sleep, eat a balanced diet, and exercise regularly.
2.	Self-awareness:  recognize the signs of stress within yourself.  Identify what thoughts, feelings, and behaviours you exhibit when under stress.
3.	Coping strategies: learn effective relaxation techniques, think positively, prioritise and set limits, and develop a sense of humour.
4.	Support:  share your concerns with empathetic family members, co-workers, and friends.  If necessary, seek professional counselling.
5.	Job satisfaction:  know what type of work and environment you enjoy and seek to find it.
6.	Limit smoking and drugs:  decrease consumption of alcohol and smoking.

What health care organizations can do:

1.	Apply the control cycle of risk assessment and management through the identification, analysis and management of risks, and protection of workers.4
2.	Ensure workloads correspond to workers' capabilities and resources. Clearly define workers' responsibilities.
3.	Design work duties so that workers can make decisions, take responsibility, and feel empowered.
4.	Seek out value improvement ideas from workers.
5.	Improve communication channels.
6.	Provide for mentoring and on the job training.
7.	Support initiative and praise work that is well done.
8.	Support zero tolerance for sexual discrimination, harassment, and violence.
9.	Provide for long-term job security, salary increases, and promotions.

 

For further information please contact ICN at

______________________________________

1	Dewe, P. (1987). New Zealand Ministers of Religion: Sources of Stress at Work. Work and Stress, 1, 351-363.
2	European Agency for Safety and Health at Work. Stress at Work.http://agency.osha.eu.int/publications/factsheets/facts8. November 2000.
3	European Agency for Safety and Health at Work. Research on Work Related Stress. http://agency.osha.eu.int/publications/reports/stress/. November 2000.
4	Wynne, R., Clarkin, N. & McNieve, A. (1993). The Experience of Stress Amongst Irish Nurses: A Survey of Irish Nurses Organisation Members, and Cox, T. & Griffiths, A. (1996). Work-related Stress in Nursing: Controlling the Risk to Health. Working paper, CONDI/T/WP.4/1996. International Labour Office, Geneva.
5	Gray-Toft, P. & Anderson, T.G. (1981). The Nursing Stress Scale: Development of an Instrument. Journal of Behavioural Assessment, 3, 11-23.
6	The 20th Century Disease. http://www.jobstresshelp.com/20thC.htm. November 2000.
7	Employee Stress. http://www.jobstresshelp.com/DV_jobstress.htm. November 2000.
8	European Agency for Safety and Health at Work. Work Hazards and Stress. http://agency.osha.eu.int/publications/reports/stress. November 2000.
9	International Labour Organization. When Working Becomes Hazardous. http://www.ilo.org/public/english/bureau/inf/magazine/26/violence.htm. November 2000.

version française versión española

 

Site Map | About ICN | Programme Areas | ICN Members | ICN Policies | Nursing Networks |
Book Shop | News Room | Fact Sheets | Guidelines | Contact Us | Search | FAQs | Home

© 1899 International Council of Nurses (ICN) Copying, downloading
and distribution of material from the ICN web page is permitted as long
as credit in print is given and that the material will not be used for
commercial or for-profit purposes without permission.