Stress and stressors in the clinical environment: a comparative study of fourth‐year student nurses and newly qualified general nurses in Ireland

Abstract

Aims and objectives. To measure and compare the perceived levels of job‐related stress and stressors of newly qualified nurses and fourth‐year student nurses in the clinical environment and to explore the participants’ views on stress and stressors. Background. Stress in the nursing workplace has significant consequences for the person, the patient and the organisation, such as psychological and physical health deterioration and impaired professional practice. To address this problem, stress and stressors need to be measured and identified. Design. This study used a cross‐sectional survey design and self‐reporting questionnaires to measure and compare levels of stress in both groups. Convenience sampling involved all newly qualified nurses (n = 120) and fourth‐year student nurses (n = 128) in Dublin North‐East region in Ireland. Methods. The instrument used was ‘The Nursing Stress Scale’ (Gray‐Toft & Anderson 1981, Journal of Behavioral Assessment3, 11–23). Descriptive, qualitative analysis was conducted on an open‐ended question. Data were obtained from newly qualified nurses (n = 31) and fourth‐year student nurses (n = 40) in six acute hospital sites. Results. Levels of perceived stress and stressors were high in both groups. Themes identified from the responses to the open question by both groups included excessive workload, difficult working relationships and unmet clinical learning needs. Student nurses also reported the combination of academic demands with clinical placement as a major stressor. There was no significant difference between each group. Conclusion. Stress continues to be a problem for nurses in the clinical setting. Excessive workload requires urgent attention by hospital managers in view of widespread retention difficulties. Themes identified could provide a framework for possible interventions for improving the clinical environment for nurses. Relevance to clinical practice. These results can help stakeholders in nurse education and practice to develop interventions to reduce stress for both groups and to ease the transition from student to graduate nurse.

Challenges of fresh nursing graduates during their transition period

“…However, it is difficult for fresh nursing graduates to communicate with doctors, senior nurses, patients, and relatives. This finding is consistent with Casey et al, [12] Parker et al [3] and Suresh et al [8] They are hesitant to speak up because they have less prior experience of communication with others except nurses when they were student nurses. In addition, the superior-inferior relationship with doctors and senior nurses and the blame and complaint culture in hospitals also obstruct effective communication.…”

“…Their stress as qualified nurses comes from excessive workload in the ward. [7,8] They also express challenges in managing and prioritizing routine work and heavy workloads in the first few months. [3,6] Another study showed that the nurses working in general medical or surgical wards have high stress levels due to heavy workloads.…”

“…[5] Fresh nursing graduates express difficulty in developing relationships with colleagues, which makes them feel excluded from the team; they believe that supportive colleagues can facilitate their adaptation to a new role. [8,9] They expect to adapt and learn new roles immediately; they feel frustrated when they fail to meet their own or others' expectations. [3,5,10,11] They also fear duty handover and hesitate to speak up when there is a need to communicate with physicians, senior nurses, patients and relatives.…”

“…[3,5,10,11] They also fear duty handover and hesitate to speak up when there is a need to communicate with physicians, senior nurses, patients and relatives. [3,8,11,12] In addition, they are discouraged when they find variance between theory and practice in clinical contexts which causes them a lack of confidence and poor clinical performance, [12][13][14][15][16][17][18] given their lack of sufficient knowledge, skills, and experience to bridge the gap. Fresh nursing graduates encounter numerous challenges, but some studies have found that orientation, preceptorship, and mentorship programmes could help increase job satisfaction, confidence in caring for patients, and coping with stress.…”

Exploring Factors that Affect the Well-Being of Healthcare Workers

“…Sleep disorders comprise the factor that is specifically highlighted with respect to healthcare workers (Poissonnet & Véron, 2000;Rose & Glass, 2009), especially considering the effects of night shift-work and difficult work schedules. Some authors underlined the role of leisure activities and other off-job experiences in buffering the negative effects of the reported factors (Tuisku et al, 2016), since an improved general quality of life may positively affect employee well-being (Preposi Cruz, 2016 d 'Ettorre & Greco, 2016;Einarsen & Matthiesen, 1998;Estrynbehar et al, 1990;Galletta et al, 2016;Jakobsen et al, 2015;Markwell & Wainer, 2009;McVicar, 2003;Niedl, 1996;Nixon et al, 2015;Park et al, 2004;Salmond & Ropis, 2005;Sun et al, 2016;Suresh et al, 2013;A. Yildirim & D. Yildirim, 2007) highlighted the relevance of mobbing, conflicts, lack of rewards and recognition by superiors, work demands, work duration, difficulty in balancing work and family commitments, and work context factors.…”