The Influence Of Stress On Work Behaviour Of Nurses In Auchi Central Hospital, Auchi, Edo State

Project and Seminar Material for Nursing (Science)

The Influence Of Stress On Work Behaviour Of Nurses In Auchi Central Hospital, Auchi, Edo State


The nursing profession is the largest health care workforce in the healthcare system having more direct contact with patients and being more susceptible to stress form their workload and responsibilities, it becomes imperative to assess the influence of stress on work behavior among nurses in Auchi Central Hospital, Auchi, Edo state. The data was descriptively summarized with the use of frequency, percentages and tables and inferential statistics of t-test for the hypothesis. Results revealed that majority of the respondents strongly agreed that lack of encouragement from superior (53%), work overload (63%), pressure to work longer hours (63%), lack of growth opportunities or rapid changes for which workers are unprepared (60%), unpleasant physical working condition (54%) and late payment of salaries and lack of resources to perform job (72%) are the major causes of stress among nurses. The strategies for reducing occupational stress were adopting management by objectives (60%), redesigning job to increase challenges or reduce work load helps in reducing stress (73%), time management programs if properly initiated goes a long way to reduce work stress (52%), and improved organizational communication (50%). This study concludes that in order to make individuals perform to their capacity, efforts should be done to ensure that the authorities cater for welfare of the nurses by providing all necessities needed to perform their duties.

Chapter One

1.0 Introduction

1.1 Background to the Study

Work is an essential need for everyone. It is estimated that over 75% of adults non- sleeping time is devoted to job activities and people find satisfaction and personal identity by means of their employment. Among life events the workplace stands out as a potentially important source of stress purely because of the amount of time spent in this setting (Scott, 2012). Employees are exposed to tension, frustration and anxiety as they go about the task assigned to them. The negative effect of work on an individual is referred to as occupational stress. Nakasis and Ouzoni (2018) defined occupational Stress as the harmful physical and emotional responses that occur when the requirements of the job do not match the resources, capabilities and needs of the worker. Occupational stress is also referred to as a pattern of emotional, cognitive, behavioral and physiological reactions to adverse and noxious aspects of work content, work organization and work environment (European Commission, 2018). Occupational stress is a condition arising from the interaction of people and their job and is characterized by changes within the people that force them to deviate from normal functioning. Occupational stress arises when the individual normal coping responses cannot be found (that is, the individual is unable to cope anymore) and as such not able to get along with his job resulting in propensity to leave the organization, absenteeism to mention a few. OS is also seen on a process in which a professional’s attitude and behavior change in negative ways in response to job stressors.
Occupational stress is a growing global concern as all countries, profession and all categories of workers, families and societies are affected by occupational stress. Over the past two decades there has been a growing belief that the experience of stress at work has undesirable effects, both on the health of the employee and the effectiveness of the organization. Stress is second in frequency health problem with regards to occupational environment (Moustaka, Antoniadon, Malliarrou, Zanthos, Kiriaki and Constatinidis, 2010). In the UK, occupational stress is estimated to be the largest occupational health problem (Edward & Barnard, 2018). World Health Organization (WHO) has viewed it as a worldwide epidemic as it has recently been observed to be associated with 90% of visits to physicians.

Occupational stress has been associated with chronic health problems like cardiovascular diseases, musculoskeletal disorders, physical injuries and cancers (Alves, 2016). Significantly, it reduces brain functions such as memory, concentration and learning and also impairs the immune system, all of which are central to effective performance at work. Occupational stress adversely affects performance in the workplace due to factors such as absenteeism, lower productivity, employees’ turnover and industrial accidents. Figure given by the Health and Safety Executive (2011) in the UK suggests that stress related medical problems are responsible for the loss of 6.5 million working days each year which in turn cost organizations in UK around three hundred and seventy (370) million dollars (about five hundred and eighteen million US dollars) (Sutherland & Cooper, 2012). US business and industry lose about five hundred and fifty (550) million working days annually because of absenteeism and 54% of these cases are stress – related (Lin, 2017).

The problem of occupational stress is not limited to these regions. Although, there is paucity of data as regards the impact of occupational stress in the sub-region of Africa and Nigeria to be precise, it has been defined as a “global epidemic” by the United Nations International Labor Organization. Occupations in the field of human services are considered to be high stress occupations dealing with diverse social as well as individual problems. Occupational stress is a major occupational health problem for health care professionals especially nurses. Nurses provide care for three (3) types of clients: individuals, families and communities. This involves, promoting health and wellness, preventing illness, restoring health and caring for the dying. Nizamd et al (2016) stated that caring for individuals, families, groups, population or entire communities with multiple, complex and distressing problems can be overwhelming for even the most experienced practitioner. Nurses encounter complex and stressful conditions due to special demands of their profession which enhances their vulnerability to occupational stress (OS). Stress among nurses is an endemic problem and nursing is known to be stressful throughout the world (Onasoga, Ogbebor and Ojo, 2013). Nad (2019), stated that nursing is emotionally, physically and psychologically demanding. Many nursing tasks are by normal standards distasteful and disgusting, others are often degrading while some are simply frightening.

Most studies on occupational stress management have viewed it as a response to a stressor. Occupational stress management strategies refer to measures initiated by an individual or organization that aim at reducing the presence of work related stressor or assisting individuals to minimize negative outcomes of exposure to these stressors. It could be referred to as physical and psychological resources used to counter the effects of occupational stress or to cope with the stress. In the present study, coping is synonymous to occupational stress management. Coping has been considered as a very crucial element in the stress literature as individuals under stress can use various coping strategies to buffer, minimize or tolerate the effects of the stressor (Lin, 2017). It could also be seen as effort, whether cognition or action that people use to cope with environmental stressors. Such efforts could be problem focused or emotion focused strategies. The strategies include; confrontive coping, distancing, self-controlling, and seeking social support, accepting responsibility, escape- avoidance, planful–problem solving and positive reappraisal (Lambert and Lambert, 2018). Problem focused strategies are highly action focused and involve altering or managing the problem that is causing the stress while emotion focused strategies refer to those strategies that help the individual reduce the negative emotional response associated with stress such as embarrassment, fear, anxiety to mention a few. Studies have shown evidence that use of coping strategies can have beneficial effect on both the employer and the employees, enhancing work satisfaction, reducing rate of absenteeism and turn over and also workplace related tension (Lin, 2017; Lambert & Lambert,2018).

In the previous studies, it was reported that nurses used mostly problem-focused coping rather than emotion-focused coping strategies and that nurses used a variety of coping strategies in order to deal with numerous workplace stressors (Chang et al., 2016; Tyson & Pongruengphant, 2014; Xianyu& Lambert, 2016; Welbourne et al., 2017). Studies have shown that some demographic variables have significant association with coping strategies adopted by nurses (Jose & Bhat, 2013; Payne, 2011). Some of these variables are age, marital status, married status, years of working experience, experience in current area, area of work and daily working hours. Each coping strategy function independently in stressful situations, the type of strategy adopted largely depends on the specific profile of the individual’s stress perception and demographic characteristics (Kariv& Heiman, 2013). It has been established that the nursing profession is stressful (Nad, 2019; Papageorgiou, Karabetsou, Nikolakou & Paylakou, 2017) but work on how nurses cope or manage occupational stress and the demographic determinants are rather few and inconclusive. In order to fill this gap in knowledge, this study, ill be carried out.

1.2 Statement of Problem

Papageorgiou, Karabetsou, Nikolakou & Paylakou, (2017), noted that nurses are one of the most vulnerable professional groups to occupational stress as they often encounter stressful situation in their human service profession. Nursing could be described as a job that requires expenditure of energy on many levels. Physical demands of the job could result in many aches, strains and pains. Mentally, the nurse is required to make calculations for medications and to respond professionally to questions of patients and relatives. Emotionally, she is expected to be clothed with empathy to provide the needed care to her clients. All these notwithstanding, the nurse is still confronted with issues like resource constraints, poor staff support and organizational change to mention few. These also add to the energy expended by the nurse.

The physiological, mental and emotional harm caused by stress can adversely affect their performance (example in medication errors). A nurse under stress will be indifferent to patient’s demand. More so, she may be withdrawn, behaves negatively, most often absents herself from work and has a desire to quit the profession. It is in lieu of this that the researcher seeks to study the influence of stress on work behavior among nurses in Auchi Central Hospital.

1.3 Objectives of the Study

The main purpose of this study is to study the influence of stress on work behavior among nurses in Auchi Central Hospital, Auchi, Edo state.

Specifically, the following objectives will guide the study;

  1. To determine the causes of stress that nurses encounter in Auchi Central Hospital.
  2. To evaluate the extent to which occupational stress affect nurses performance in Auchi Central Hospital.
  3. To analyze the various strategies adopted by the nurses to reduce occupational stress in Auchi Central Hospital.
  4. To evaluate the impacts of stress on nurses’ job performance in Auchi Central Hospital.

1.4 Research Questions

The following questions were formulated to guide the study based on the research objectives;

  1. What are the causes of stress that nurses encounter in Auchi Central Hospital?
  2. To what extent does occupational stress affect nurses’ performance in Auchi Central Hospital?
  3. What are the various strategies adopted by the nurses to reduce occupational stress in Auchi Central Hospital?
  4. What is the impact of stress on nurses’ job performance in Auchi Central Hospital?

1.5 Hypothesis

The following hypothesis was formulated of the purpose of the study

There is no significant relationship between stress and work behavior of nurses in Auchi Central Hospital

1.6 Significance of the Study

This study will be of great significance to the nurses, the healthcare profession and the academia. From the findings of this study, nurse leaders and management of Auchi Central Hospital would be provided adequate information to enable deal successfully with challenges of occupational stress and work behavior. This research will also inform policy makers in the Ministry of Health and the Health Service stakeholders, Nurses and Midwives Council and Management of the Auchi Central Hospital on the directives on motivation practices that could effectively result in better work performance among healthcare workforce in Nigeria. Lastly, the study will serve as an empirical literature for researchers to develop further research in future studies.

Chapter Five

Conclusion and Recommendation

5.1 Conclusion

The results of this study show that nurses are at the risk of occupational stress. The results of the study are consistent with most of the findings from other studies done on influence of stress on job performance and satisfaction among nurses. The study revealed that the main causes of occupational stress among nurses are; lack of encouragement from superior, work overload, pressure to work longer hours, lack of growth opportunities or rapid changes for which workers are unprepared, unpleasant physical working condition and late payment of salaries and lack of resources to perform job. The causes of stress among nurses call for urgent need to design interventions which can easier make the work environment conducive for nurses. The environment which individuals work determine the level of satisfaction with work performed and can also contribute to a sense of achievement among the individuals. Understanding the relationship between stress and the workplace is still a challenge, and thus it is important to acknowledge that work can cause stress and therefore stress should be prevented. This study concludes that in order to make individuals perform to their capacity, efforts should be done to ensure that the authorities cater for welfare of the nurses by providing all necessities needed to perform their duties. There need also to identify the problems encountered in the day-to-day duties and work as a team to come up with interventions to reduce the problems. It is important to have a healthy mind and body in the workplace. Stress affects the employer and employees in many ways and must not be underestimated. There is a need to prevent stress in the workplace to improve the quality of lives and contribute positively towards improved productivity of the organizations.

5.2 Recommendations

The following recommendations were made based on the findings of the study;

Firstly, there is need for the introduction of interventions in the workplace to address stress among the nurses. An urgent need to come up with interventions that are specifically designed to address stress issues that are experiences by nurses is essential to nursing care delivery and their work behavior. The interventions should be monitored and evaluated regularly to ensure that address the needs of nurses.

Secondly, the health authorities and hospital management need to create a conducive environment that will reduce stress. This could include the creation of active wellness programs to address stressors, addressing work conditions such as improved working relationship, addressing staff welfare, increasing essential services, reducing long working hours, and improving ventilation.

Lastly, there is a need to motivate the nurses in order to increase level of job satisfaction and performance. Staff welfare such as recognition, promotion, and personal growth needs to be taken as a priority by the hospital management.

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