(ASSIRJ) Applied and Social Sciences International Research Journal

Volume.1, No.1,June,2018

OCCUPATIONAL STRESS FACED BY NURSES AT HYDERABAD SINDH

(A COMPARATIVE STUDY OF GOVERNMENT AND PRIVATE SECTOR)

Faiza Hisbani1 Qurat-ul-ain Abro2

PhD Scholar Mehran University of
Engineering and Technology Jamshoro,
Sindh , Pakistan
Dr. Parveen Munshi3
VC University of Sufism and Modern
Sciences, Bhitshah, Sindh, Pakistan
PhD scholar, and Lecturer at University
of Sufism and Modern Sciences,
Bhitshah, Sindh, Pakistan
Azra Soomro4
PhD Scholar Mehran University of
Engineering and Technology Jamshoro,
Sindh, Pakistan

Zubair–ud-Din Buriro5
PhD Scholar Mehran University of
Engineering and Technology Jamshoro

Abstract: The paper is in relation to discover the stress level produce in the Nurses
working in the hospitals, especially in the case of Sindh (Pakistan). Nurses have to face
stress in the Hospitals. The profession of Nurse has the main stress is of less occupational
incentives, others stresses are included: lack of training, sexual harassment. The focus of
this paper is about the stress level of nursing profession by comparing study between
public and private hospitals. Research based on quantitative study and the data were
collected from public and private hospitals of Hyderabad Sindh, Such as from the staff
nurses Head nurses staff and from students. About 240 questionnaires are distributed
50% approximately response achieved, from hospitals of Hyderabad. For data analysis
SPSS software was used.

Keywords: Occupational stress; Occupational incentives; Public and private hospitals;

SPSS software

1. Introduction
The fundamental and essential assets of hospitals are Nurses. Any health department depends on
Nurses; Nurses take care of all the patients in hospital before doctor reached the patients. Nurses play
an important role in daily critical situations. Nurses are very careful, they take care of patient as well as
their family members. Nurses tried to physically support the patient but also guides in the critical
position of the patient. With this sincere behaviour of Nurses they also faced many problems which
create the stress in Nurses. Such as their working time, incentive trainings and bullying or harassment
issue are problems faced by nurses. With these critical factors Nurses become frustrated and cannot
perform their duties effectively. Pakistan is developing country, as a country already facing lot of
issues in which the problems of Nursing is not focused well. In our country most parents choose the
career for their girls.
Due to lack of interest, respect parents avoid to taking nursing as a career for their children, in
spites of fact if girls choose their profession as nurse then they face a lot of problems. Now a day’s

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male also performs most perfectly the duties of nurses. The male nurse’s staff ratio is comparatively
less than female takes a less interest in this profession. Females nurses face lots of the problems and
these all circumstances makes the nurses the nurse’s ratio very low. The nurses to patient ratio that
exist in Pakistan are 1: 3175; the same ratio in U.S is 1:102 (Hasnain 2010) and this genuine issue
make the nurses very stressful. “Nursing is not the first choice for many girls. It is not considered a
well-reputed profession and something that is generally meant for women” (salma Rattani 2014).

2. Literature Review
The Nursing is very sensitive and tough job, the patients’ needs care, attention, nurses performs
duties in day and nights shifts to take care of the patients. The literature about work stress are present,
and all research paper evidence that Nurses manipulated very much work stress on the job. According
to Kyriacou (1987), defines “Nurses Stress are the experience of unpleasant emotions such as tension,
frustration, anger and depression resulting from aspects of his work”.
Nurses felt lots of untouched stress and publicise to worrying situations they challenged many
problems one author Huber (2006) said that Nurses faces extremely difficult and testing work and
challenged remarkably selective and dependably confusing circumstance to adapt in the emergency
time. Due to stress nurses remarkably increase their weight because of stress and hormonal imbalance
that causes increases in weight and lots of health hazards this stress sometimes leads to death. When
there is high Stress level it decreases the satisfaction level and increases in unusual behaviour of
nurses. (Aden-Saeedi, 2002; Sullivan & decker, 2009) defines that stress frequently make a very
harmful effects on nurses life, yet it also effects on the connotation less profit, nonappearance and
disappointment in balance work life.
In public and the private sector working environment is different and also face different situations.
The public sector has better financial security they have a less stressful environment, as compared to
the private sector, the private sector are more conscious about the performance concerned they focus
on performance and work. There are many other factors that affect that are salary, leaves, pay are
important to consideration This study basic aim is to find the factor of stress that leads to work and
occupational stress in female nurses working for private and public hospitals. Internationally, there is
lot of work has done on the job stress, job satisfaction and occupational stress among female nurses.
Nurse’s work and job stress has an impact on economic, social and personal lives. The stress leads to
stress-related employee absenteeism, burnout and a negative impact on pupil outcomes (Kyriacou,
1987). According to Sodoma and Else (2009) an increased in job surroundings, circumstances make
the job more stressful for working women. Asad and Khan (2003) define that job stress occurs due to
increase of tension on employees by the job pressures that meet the deadlines to fulfil job assignment,
and tasks. Salik and Kamal (2007) say that most of the people spend a most of life there as working in
offices. D’souza, et al., (2005) explained that certain stress experienced by people often it depends on
the nature of the work and demands of the setting in which people live.
It is definite that Nurses have challenged typical context and perform extremely upsetting earned in
the human services framework since they are specifically included with Human behaviour and stress
level some time surpass at abnormal amount and leads to very critical situations. This study
investigates the variable which causes stress around nurses.
Research Objectives:
• To identify the factors which influence the Occupational stress.
• To compare the Extent of Occupational stress between Government and Private nurses
Hospital.
• To analyze critical factors of Occupational stress in nurses of government and private
hospitals.

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3. Research Methodology
The data were collected from public and private hospitals of Hyderabad. Such as from the staff
nurses Head nurses staff and from students. About 240 questionnaires are distributed 50%
approximately response achieved, from hospitals of Hyderabad.

Table: 1 Sample Distribution

Hospitals Distribution of Response achieved
questioner
Public 120 60
Private 120 80
Total 240 140

4. Analysis and result:

4.1. To identify the factors which influence the Occupational stress: In literature, many factors
are found that creates job stress but most important factors which are observed from literature and
through pilot survey. According to these factors in private and public sectors. The all answers show the
percentage that is taken through quantitative analysis.
4.1.1 Working Condition:
The Working conditions for staff nurses, students nurses of public as well as private sector are
different according to their working time, good and lack of burden, all answer shows positive response,

working condition
80%
70%
60%
50%
40%
30%
20%
10%
0%
Disgree

Disgree

Disgree
Agree

Agree

Agree

Agree
Uncertain

Uncertain

Uncertain

Uncertain
Dis agree

s.disagree
S.disAgree

s.disagree

s.disagree
s.agree
s.agree

s.agree

s.agree

Are you irritated from Are you presurred to Iam unable to take Ifeel disaapoint to
shift work work long hours sufficent breakes repetative work

Public Private

Fig No: 1
According to, Copper (1998) the amount of workload has to be performed is one of the significant
stress for Nurses.

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 The flexible working hour in private as well as public sector, but rotation of works creates problems
4.1.2 Incentives: The major sources of job satisfaction are status pay, promotions and bonuses and
increment that get during time to time, and all increases the job satisfaction and increases the
motivation for work

Fig. No.2
The respondent in private sector and public both get salary on time but in public sector nurses are
satisfied, for increment, promotion were more chances in public hospital as compare to private sector,
salary is very lack in private sector and in job security question the private sector are nurses are less
security about the job they can be terminated at any time

4.1.3 Training/Skills:
Training is very important part of every organization, and basic requirement of job, in the public as
well as private sector, but the satisfaction level is different for sector.

Fig: No: 03
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 The respondent answered that in the private sector staff is more satisfied with their training as
compare to public sector. The training deliver in private hospital is excellent, also in Private sector
nurses get training on latest instruments and learn techniques of handling new instruments and also get
more awareness on the training program, but in public sector they are less aware about knowledge of
instruments, diseases.
4.1.4 Relationship:
Relationships are sustained in any organization by co-operation with head, senior staff, and junior
staff. Nurses have to manage relationship with doctors and management, in hospital management had

Fig No: 04

much impact on Nurses. During these all they have to face many problems.

In the private sector respondent shows the positive relationship with management peer and all staff of
hospital. In the public sector there is different situation they face many difficulties during
communication with upper staff and management.
4.1.5 BULLIED/ HARRASMENT:
Bullied/ Harassment is the most important factor of consideration. In literature and many articles had
many research on Nurses bullying and harassment at the hospital.

As indicated by NIOSH 1996, The National Institute for Occupational Safety and Health (NIOSH)
described workplace violence is act of any physical assault, aggressive behaviour or verbal abusive
language occur in the workplace.
In public sector staff fare much discouraged from patient’s behaviour and working environment people
mostly threat staff and ask many personnel questions and often used abusive language with lower staff.
But in private sector staff not bullied by the patients.

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 Bullied/Harrasment

90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
e e n
i e e e e n
i e e e e n
i e e e e n
i e e e e n
i e e e e n
i e e
e
rg e
r at e
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r e
rg e
r at e
r e
r e
rg e
r at e
r e
r e
rg e
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r e
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rg e
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r e
r e
rg e
r at e
r e
r
a ga r g g a ga r g g a ga r g g a ga r g g a ga r g g a ga r g g
e
c A A
. e
c A A
. e
c A A
. e
c A A
. e
c A A
. e
c A A
.
si si n S si si n S si si n S si si n S si si n S si si n S
D
. D U D
. D U D
. D U D
. D U D
. D U D
. D U
S S S S S S
Iam subject of The people I work mostly the People verbally iam a subject of The patients or
bullied always mis patients or talk are bed Harrasment family members
behaves relatives mis takes personal
behaves intrest in me

public Private

Fig No: 05
4.1.6 BULLIED/HARRASMENT:
The respondent shows the positive response and agreed that if they are bullied by management or
publically they can take action against it but they are not confident that they can stop

Fig No: 06
The respondent of Private sector staff are satisfied with their environment and are not harassed by
management or patients But in Public sector graph shows that public sector Nurses are more
discouraged and in the last 12 years they were Harassed and bullied in hospital
4.1.7. HEALTH:
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 In Hospital the health of nurses very much affected in public hospital, there health is very much
affected. it is some time leads to in ability to concentrate on work. Also depression is seen in staff
Nurses If their health is affected they impact on their productivity and due to stress very low
productivity in job and less satisfaction, but in private sector staff are less stressed in wok

Fig no 07
4. 2. To compare the Extent of occupational stress between Government and Private nurses
hospital:
The second objective is based on the comparison analysis between private and Public sector. The
comparison analysis predicts deeply that either public sector Nurses face stress or private sector. The
comparative analysis depicts more clearly between the public and private Sectors. The t test is used for
comparative analysis; the t test result is showing result of every factor, in a detailed way.
4. 2.1 WORKING CONDITION:
Group Statistics: Take a look at the box. Here graph shows the no of participants for condition 1
(public) is N 60 and condition 2 (private) is 71. The mean for condition 1 (public) is 3.3. The mean for
condition 2 (Private) is 2.69. The standard deviation for condition 1 is.827 and standard deviation for
the condition is.386
Group statistics

Std.
N Mean Deviation Std. Error Mean
60 3.3688 .82705 .10677
71 2.6919 .38662 .04588

4.2.2 Independent sample test: To figure out which column to read from, see at the Leven’s Test
for Equality of Variances. This is a test that figures out whether the two conditions have same or
different measures of variability between scores. Here the two sections named F and Sig. the sig value
shows which column to read if the sig value is greater than 0.05 then read from above row and if it is
less than 0.05 then read from bottom row to interpret the significance between two groups. “Therefore,
a significant difference in the score of working condition of public sector and private sector Nurses
(M=3.368 SD=.80725) and private sector (M=2.6919 SD=.38662) conditions t (129) = 6.149, P=
(.00)”.

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 It is concluded that the contrast between two conditions means are not likely same because of
working time.
4.2.3 Incentives:

Group Statistics: In the Group statistics the mean for group 1 (public) is 3.42. The mean for Group
2 (private) is 2.71. The standard deviation for 1 is .562 and for condition 2 is .391. The number of
participants in condition 1(N) is 60 and in condition 2 N is 71.
Group statistics:
Std. Std. Error
Hospital name N Mean Deviation Mean
Incentives public 60 3.4222 .56287 .07267
Private 71 2.7160 .39177 .04650

Independent Samples Test: “There was a significant difference in the score of incentives of public
sector and private sector Nurses (M=3.368 SD=.80725) and private sector (M=3.4222 SD=.56287)
conditions t (129) = 8.431, P= (.00)”
It was also shows the significant difference between public and private sector. It means the public
sector Nurses got their salary on time and they are happier with their incentives as more compared to
private sectors.
Independent sample test

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 4.2.4 SKILLS/TRANING:
Group Statistics: In the Group statistics the mean for group 1 (public) is 3.38. The mean for Group
2 (private) is 3.48. The standard deviation for 1 is .838 and for condition 2 is .309. The number of
participants in condition 1(N) is 60 and in condition 2 N is 71.
Group Statistics
Std. Std. Error
Hospital name N Mean Deviation Mean
Skills/Training 60 3.380 .83864 .10827
public 0
Private 71 3.484 .30921 .03670
5
Independent Sample Test
There was no significant difference in the score of skills/Trainings of public sector and private
sector nurses (M = 3.3800 SD = .83864) and private sector (M = 3.4845 SD = .30921)
Conditions t (129) = .914, P= (.364). It means they likely take the same training in public as well as
private sectors. There is no impact of training on skill and development the Nurses get same training
and skill in private as well as public sector.

Independent sample test

4.2.5 Relationship:

Group Statistics: In the Group statistics the mean for group 1 (public) is 3.38. The mean for Group
2 (private) is 3.48. The standard deviation for 1 is .838 and for condition 2 is .309. The number of
participants in condition 1(N) is 60 and in condition 2 N is 71.

Group statistics:

Hospital name N Mean Std. Deviation Std. Error Mean

Skills Trainings Public 60 3.3800 .83864 .10827
Private 71 3.4845 .30921 .03670

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 Independent Samples Test: “There was a no significant difference in the score of incentives of
public sector and private sector Nurses (M=3.3800 SD=.83864) and private sector (M=3.4845
SD=.30921) conditions t (129) = .914, P= (.364 )”. There is no significant difference found in score,
it means there is no impact of salary on the work stress.
Independent Samples Test

4.2.6 BULLIED/HARRASMENT:
Group Statistics: In the Group statistics the mean for group 1 (public) is 3.83. The mean for Group
2 (private) is 3.68. The standard deviation for 1 is .543 and for condition 2 is .316. The number of
participants in condition 1(N) is 60 and in condition 2 N is 71.
Group Statistics
Hospital N Mean Std. Std.
name Deviation Error Mean
Harassment 60 3.3800 .83864 .10827
Public
Private 71 3.4845 .30921 .03670

Independent Samples Test: “There was a significant difference in the score of incentives of public
sector and private sector Nurses (M=3.368 SD=.80725) and private sector (M=3.4222 SD=.56287)
conditions t (129) = 8.431, P= (.00 )”. There is significant difference found between here, it means
that bullied and harassment takes place in public sector more as compared to private sector.

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 Independent Samples Test

4.2.7 HEALTH:

Group Statistics: In the Group statistics the mean for group 1 (public) is 2.45. The mean for
Group 2 (private) is 2.75. The standard deviation for 1 is .051 and for condition 2 is .046. The number
of participants in condition 1(N) is 60 and in condition 2 N is 71.
Group Statistics
Hospital N Mean Std. Std.
name Deviation Error Mean
Health 60 2.4500 .39809 .05139
Public
Private 71 2.7535 .38843 .04610
Independent Samples Test

Independent Samples Test: “There was a significant difference in the score of Health of public
sector and private sector Nurses (M=2.4500 SD=.39809) and private sector (M=2.7535 SD=.38843)
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conditions t (129) = 4.406, P= (.000 )”.The health of public sectors are showing much affected their
health from stress.
4.3. To analyse critical factors of occupational stress in nurses of government and private

hospital

4.3.1 PUBLIC HOSPITAL:

In Public hospital the nurses faced the problem of bullied or harassment problem. Many of the
patient and patient relatives misbehaves very much to the Nurses. From the first objective was
analysed from secondary data, literature and from Primary data, the two main factors are found
stressful for the public and private sector. For the findings of critical factors the Pareto test were
applied.

Fig no: 1

The Pareto test result shows the nurses in public sector faced the highest problem of bullied
and misbehaviour of people to Nurses, the result shows that nurses faced the lots of problems in the
public hospital, if the highest problem of behaviour solved. Ultimately lowest problems will be solved.
Mostly young female Nurses harassed by ward boys, public because they are new in this profession at
public sector. Many Nurses don’t know how to cope with difficult situation like harassment, behaviour
of people there is no difference between duties of nurses mid wives LHV they all are at same category
and have same duties.

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4.3.2 PRIVATE HOSPITAL:
In private Hospital nurses as compare to public nurses faced less problems of harassment or
behaviour of people. The Nurses are also aware about the cases of harassment, and have confidence if
they are bullied they can complain and it would be stopped.by the management

Fig.no 2
It shows that in private sectors Nurses faced less problems of harassment and bullied cases. They
are more confidence that they should stopped. The mean values as compare to public sector are very
low and remaining can be solved easily the private sector are more confident that they can stooped by
saying to management.
4.3.3 SECOND FACTOR (Private hospital):
The second important factor after analysis finds in private sector are Incentives, in Private
sector salaries are main issues of hospital, They get very less salary in most private sector they don’t
get promotion and salary on the time.
F

Fig. no 3

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 In findings shows that salary in private sector is more important issue, they are under paid
means they get very less salary, and another that they don’t have job security. In private sector Nurses
have no security regarding job they can be hire and fire any time. In private sector if these highest
problems solved ultimately the lowest problems will be solved if they much focus on salary of Nurses.
In private sector the chances for promotion are very low, they are not satisfied with incentives that
organization are offered.
4.3.4 PUBLIC SECTOR:
In public sector there is also issue of less salary but this factor is not high in public sector as
higher in Private sector Public sector Nurses get salary on the time they have job security and if they
have high degrees means get BS degree then they get promotion and promotions are also handed fairly.

Fig no 4

In public as compare to Private shows less frequency means they are not satisfied with their
Incentives. As incentives are major satisfying factor in any sector Public or private both are working to
get earning and increase earning resources. But private sector female nurses get very less salary and
other incentives.
5. Discussion and conclusion:

In public hospital staff nurses face lots of stress about patients management senior staff junior
staff, doctors, there are so many problems for every nurse in many wards, they have difficulty to
perform the duties, because of no awareness of technique lack of training, reliable instruments for
nurses to perform tasks.In public hospitals patients and their relative misbehaves many times and
scream and threats, in public hospitals nurses face lots of problem and critical situation, also harassed
and bullied many times from patients and relatives. In the private sector the main issue is to draw the
salary they receive very less incentives, and not on the time. They don’t get any promotion or chances
to develop their own abilities they are mostly bullied by management; The Private hospitals maintain

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discipline and there is well trained staff of hospital. The job security is also a major issue in the private
sector. The Pakistan Nursing Council (PNC) has to take action and mares some laws about the security
and safety of nurses in public sector.

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