Stress—A Danger to Nurses and Patients

The fact that nursing is a stressful industry is nothing new. With long hours and lengthy task lists, nurses experience high levels of stress in their daily activities. While it’s obvious that nurses face an abundance of daily pressures, the effect that stress has on them and how it affects patient care can be less apparent.

The Effects of Stress on Nurses and Patients

According to a study in the American Journal of Respiratory and Critical Care Medicine, 24% of ICU nurses tested positive for symptoms of post-traumatic stress disorder. Further studies have shown this problem to be worldwide. For example, a study in Hong Kong concluded that nurses are at a higher risk for stress, depression, and anxiety than the general public. And, The Guardian recently reported that stress is the reason for an increased number of nurses taking time off.

With the high-pressure atmosphere of a hospital, nurse turnover is becoming a frequent and pressing problem. In fact, according to one study, almost 20 percent of newly registered nurses leave a hospital within the first year for the same job elsewhere, or a different job in a different organization.

The increased pressure and long shifts can affect patient care as well. As stated in our previous blog post titled “Nursing our Nurses: Maintaining Well-Being for Better Patient Care,” these stresses can lead to lack of sleep, which has the same effect as a blood alcohol level of .05. The post also states that operating on six or fewer hours of sleep increases the chance of errors by 3.4%.

Administrator Perspective

With such high numbers and startling statistics, it begs the question: Why isn’t this a more pressing issue for hospital administrators? Cynthia Rushton, professor of nursing and bioethics at Johns Hopkins Institute of Bioethics and School of Nursing, suggests that the root of this problem comes from the fact that “there is a mindset among some administrators that nurses are easily replaceable commodities—a nurse is a nurse.” When nurses leave, the response is often to hire additional nurses to fill the staffing gaps. However, frequent turnover can also affect the nurses that remain, as well as their patients.

What Can Be Done?

There are positive changes being made at some facilities to help alleviate the stresses, and increase retention rates. The oncology unit at the Cancer Treatment Center of America and Midwestern Regional Medical Center has created renewal rooms as a coping strategy for stressful situations. Other facilities have begun to add new technologies to help decrease the workload of nurses.

Now, nurses are encouraging government intervention to require minimum staffing level standards for hospitals and nursing homes. They are advocating for specific staffing ratios for different units, saying that a “one-size-fits-all” approach doesn’t make sense when hospitals vary so much in size and scope of practice. In addition, there has been a shift toward treating more serious and complex cases in the hospital and sending healthier patients home to recover.   As such, it is increasingly important to ensure adequate staff-to-patient ratios are maintained during all shifts.

A Brighter Future

As changes are made to improve organization and scheduling in hospitals, the stress levels of nurses will become more manageable, and the retention of those nurses is likely to improve, ultimately leading to better patient care. Although it will take time and monetary resources, Rushton states, “If we don’t have sufficient nurses to meet the needs of people in need of health care, the entire heath care system could crumble. I think that it’s time that nurses are recognized as a scarce resource that needs to be invested in, supported, and respected.”

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