Stress among Charge Nurses: Tool Development andStress Measurement
Hanna Admi, PhD, RN; Yael Moshe-Eilon, PhD, RNPosted: 09/17/2010; Nurs Econ. 2010;28(3):151-158. © 2010 Jannetti Publications, Inc.
Abstract and Introduction
Changes in health care systems, including the international shortage of nursing staff, have implications on rolestress felt by nurses, especially by nursing managers. In a review of 68 articles on nurses' role stress, the mostfrequently identified stressors were workload, role conflict, ambiguity, and lack of support (Chang, Hancock,Johnson, Daly, & Jackson, 2005). Stress leads to job dissatisfaction, burnout, and absenteeism; also, negativelyimpacts patients (Aiken et al., 2001; Lee & Henderson, 1996).Most research has focused on traditional and general role stressors, measured by standardized tools. Studies of the specific stressors unique to nursing roles are few. One such role is the managerial role of charge nurses inhospitals. Charge nurses serve on the front line of the profession. They are expected to be responsiblesimultaneously for three separate groups of clients: patients, nursing staff, and multi-disciplinary staff. Thecharge nurse has a central role in patient outcomes and safety, the well-being of the nursing staff, liability prevention, and managing a multi-disciplinary team (Doherty, 2003; Sherman, 2005).Though a complex and challenging position, the role of the charge nurse has received little attention in nursingliterature compared with other nursing leadership positions (Connelly, Yoder, & Miner-Williams, 2000; Miner-Williams, Connelly, & Yoder, 2000; Sherman, 2005).The objectives of this study were:1.
Develop a specific tool for measuring the stress of charge nurses in hospitals.2.
Assess the level of stress of charge nurses.3.
Explore the relationship between stressors and demographic characteristics (age, seniority, andeducation).
In their review of 100 studies, Lambert and Lambert (2001) found the following to be associated with nurses'role stress: high job demands; low supportive relationships; dealing with death and dying; work overload;uncooperative family members and clients; inability to reach physicians; unfamiliarity with situations; concernfor the quality of nursing staff, medical staff, and patient care; inability to deliver quality nurse care; timedemands; state laws restricting the ability to carry out the advanced practice role; poor relationships withsupervisors, co-workers, and physicians; and low organizational commitment.According to Lazarus and Folkman (1984), stress is a complex multi-dimensional phenomenon focusing on a particular dynamic relationship between a person and his/her environment. They proposed that stress isdetermined by a person's subjective perceptions and interpretations of a given transaction as taxing or exceedinghis/her resources and endangering his/her well-being. In applying this theory to the charge nurse, we focus on