Knowledge of Models of Stress for Nurses - Research Paper Example

Running Head: Knowledge of Models of Stress for Nurses Knowledge of Models of Stress for Nurses of Stressful work conditions have a direct impact on worker safety and health. There are more than three million registered nurses nationwide, out of which a remarkable percentage is showing a trend of leaving the job, creating a shortage of these healthcare professionals in the practical field. In order to improve job retention among nurses it is vital to find out factors of leaving including the stress. This paper is intended to focus the stress among nurses, its root causes and impacts on the patient’s health. Moving towards coping mechanisms, several stress management models are presented so that nurses may select a suitable one according to their specific needs. Knowledge of Models of Stress for Nurses Stress: Introduction In psychology, stress is a threat or demand or any other event or circumstances that compel someone to cope to the changed positions. It is quite common to say that stresses are unavoidable and significant part of one life. They are of various intensities; for instance the lower intensity ones can be such as family argument, a traffic jam or a withering comment by one’s employer and or the higher ones could be fear of death during wartimes or the demise of a close relative. (Hancock and Desmond, 2000) Reactions of different people to stress differ widely depending on their different family and cultural backgrounds, their temper at the time, their individual experiences, and on other strains present at the same time. It is usual to observe that the daily life and lighter stress are easily dealt with by people, however when problematic issues arise earlier than they could be solved, it may overload ones adaptive capacity, thus leading to depression, chronic ailments and anxiety. (Hancock and Desmond, 2000) Impacts of Stress on Common Health As elucidates by Cunningham (2000) the present theoretical models in this regard put forward various passageways, though inconsistent in negligible aspects, in which disease or illness may be influenced by stress. The related literature determines stress as a process when a person realizes that his adaptive capacities are insufficient or too demanding to absorb the unexpected environmental changes. As stated by Marshall et al. (2000) stress is considered as an intrinsically psychosomatic progression, within such models. It is for this reason that more emphasis is placed on the psychology of stress. However, it has been realized that physical stress, independent of psychological mechanisms, may influence health, for instance longer exposure to excessive temperatures. Figure 1: Adopted from Figure 2.1 Marshall et al. (2000) Stress in Nursing Numerous aspects contribute to the stressful nature of the nursing profession (Chang, Hancock & Johnson, 2005). According to Boey (1999) Inadequate staffing, work overload, awareness of tremendous responsibility, feelings of incompetence, lack of support from superiors, and interpersonal conflicts have been identified as work stressors for nurses. Other research indicates organizational factors, such as bureaucratic political constraints (Dolan, 1992) and role ambiguity, as key stressors for nurses (Sullivan, 1993). The research seems to identify a broad range of factors that cause stress in a nurse’s work life. As stated by Cooper et al. (2001) the research on work stress with nurses can be organized using the six general domains of occupational stress. Job-specific tasks in nursing can be highly stressful. Clegg’s (2001) research notes that nurses are on the interface of service delivery and deal with many crises. Power & Sharp (1988) discussed some nurses’ feelings of inadequate preparation to meet emotional demands of patients and their families in these situations. Stress may also arise because nurses accept a high degree of responsibility with little control over the environment or workload. Common stressors identified in the literature are issues of death and dying and work overload. Munley’s (1985) research also found that job stress was primarily related to patient care, concern about patients and families, and their own feelings of grief and responsibility. Further, qualitative research conducted by Buchanan and Considine (2002) found that increased role responsibility might contribute to nursing turnover. Performing duties outside of their specialty due to lack of staff, and having to train other stuff to use newly introduced technology, were identified as particularly demanding The next general source of nursing stress comes from relationships at work. In the field of nursing, most research has focused on nurses’ relationships with supervisors, other nurses, and physicians. (Buchanan & Considine, 2002) Career development issues have also been identified as a significant source of nursing work stress, although there have been relatively few studies in this domain. Wickett et al. (2003) found nurses’ perception of lack of career development in the field to be a potential stressor. Organizational issues may also increase strain among nurses. Kouzes and Posner’s (1997) work identified organizational change as a source of stress in nursing. They found that many health care organizations are forced to employ staff on short-term contracts due to nursing shortages, further straining the work environment and leading to nursing stress. Coping Mechanism Stress: Positives and Negatives According to Klinkman et al. (1998) stress can be useful or helpful as well. For instance it can aid someone to respond rapidly to a potentially precarious position or can act as a motivator to help get something done. When the body reacts to stress, it emits hormones called the epinephrine and the cortisol. This leads to the stimulation of the sensitive response which generally referred to as the fight or flight reaction. It can be however useful in some cases, but if occurs too often or for a longer than usual durations, it can negatively impact one’s body. Eustress is the term given to the stress that stimulates metal or physical functions for instance joyful feeling due to an upcoming event or holidays, a competition or a tough assignment that must be completed within time. This kind of stress is often rewarding and helpful. Whereas the term distress is term given to the type of stress those results due to an unpleasant or unexpected event for instance stresses due to any harm or feeling of getting harmed. These stressing event i.e. stressors can be physical or psychological. (Klinkman et al., 1998) There are a number of factors that contribute to stress. Theses stressors or the contributing factors can range over a wide array of notions such as disturbances due to a world incident such as natural disaster or a war. Times at work places, educational institutes, different lifestyles and family troubles, all can be significant in leading to stress, considerable events in one’s life can be one of the key sources of stress as they turn out to overweigh ones personal adaptive capabilities. Pregnancy, marriage, divorce, changing job and moving to a newer place can be examples of such stressors. Moreover ones feelings, thoughts and perceptions can also lead to stress. The reason for which stress in extremely personal and individual in nature is this, someone may consider a particular event as stressing while other may feel it normal, this is because everyone’s point of view is not similar and what they perceive about the things are or they are supposed to be may be different in all aspects. (Klinkman et al., 1998) The body, mind and behavior, in both positive and negative ways, are affected by stress. In how they are observed or realized, indications of stress differ from individual to individual. Although, as we just discussed that stress can be positive and negative as well, no matter who ever you are it can be physically and emotionally harmful. Models of Stress Over the years of study and research different stress models have been presented by various psychologists. Though adding more knowledge but ignoring some too. It is clear that none of these models maybe sufficiently comprehensive and they can help determine new insights about one’s own circumstances. In some case it may be incompatible to the truth but maybe consistent to someone else’s position. A Conventional Model Under this model it is intended to express the simple notion that stressful elements (stressors) could lead to the phenomenon in which ones mental resources may not be able to cope to different events and thus lead to fatigue and heaviness, that can further lead to long term and short term consequences. Particularly in this model, no consideration is given to the varying perceptions of different people regarding their response to significant events; therefore this variable is eliminated by considering that all people respond in analogous manner. Figure 2: Adopted from Models of Stress (2009) The ‘Bucket’ Model This model was presented by the ergonomist Etienne Grandjean, who first referred to the basic notion of fatigue by who considered the human body as a bucket that could be filled with the day to day undesirable occurrences, and which can be emptied by recuperation from say entertainment and sleeping for the next fresh day. Analogous to the ‘traditional model’ this model also considers everyone’s reactions to be same. However, it realizes the possibility of the unattractive results, but at same time offers lesser allowance for the positive or desirable ones at work. Figure 3: Adopted from Models of Stress (2009) A scholastic model The straightforwardness of the ‘bucket model’ was considered as ‘simplistic’ by lesser people, provided that it predisposed (only) to direct public as unavoidably reacting in a particular manner. If was possible to show and present the notion that people turn out evaluate their situation, rather than accepting it submissively, actual nations would have been easier to understand. Again, there is no declaration of the affirmative practices likely in offices – or demarcation of ‘intimidation’ and ‘contest’. Figure 4: Adopted from Models of Stress (2009) Another Perspective for Models of Stress Hazel et al. (1995) present another perspective in models of stress. According to them such models are meant to recognize the stressors for individuals and to envisage their particular reaction. These models highlight distinctive features of stress and offer a guideline to nurses while dealing with a patient with out of condition rejoinders. Response - Based Model It is apprehensive to identify the specific reaction or prototype of reactions which suggest a stressor. In this context, Sely’s model of stress was presented in 1976 which elucidates stress as an imprecise body reaction towards any demand. Here stress is presented as an exclusive psychosomatic response called ‘General Adoption Syndrome’ or (GAS). In this model individual differences are not allowed in patterns of response and there is a lack of flexibility which may cause some problems for nurses as individual variations need to be recognized during the appraisal stage. (Hazel, et al., 1995) Based on Adaptation This model proposes four factors to determine a situation as stressful: i. The power of managing stress which is based on the encounters of an individual having comparable stressors, sustain techniques and general discernment of the stressor. ii. It tackles the exercises and standards of the colleagues cluster of the concerned individual. If the peer group. If it is considered by them as normal to discuss a specific stressor, the individual may probably show a response in terms of worry or complaint. Such responses assist the patients in stress adaptation or he or she reacts so merely to agree with the behavior of the peer group. iii. This aspect includes the influence in communal surroundings to assist a person in stress adaptation. Such as, a low-ranking learner having a disease which can be passed on sexually possibly will disclose it to a superior in order to get his support in seeking medical consultation. Therefore, the acuteness of the stressor could be reduced by the resources of the superior. Thus, the adaptation model has its roots in the comprehension of the patients victimized by nervousness and chronic stress, in the situations where they are not ready to manage the worrying circumstances. Nurses may use this model for stress management. (Hazel, et al., 1995) Based on Stimulus This model spotlights distress caused by troublesome distinctiveness inside the surroundings. Some traditional studies claimed that stress becomes a stimulus and results in the progress of community re modification magnitude and determines the outcomes of main life occurrences on disease. It has three suppositions: i. It is normal to have dynamics in life patterns and such changes need identical nature and period of regulation. ii. Individuals seem to be unreceptive for stress, and their insights for proceedings may be inappropriate. iii. Individuals encompass a general edge of incentive, and disease may affect any time after this edge. (Hazel, et al., 1995) Based on Transaction This model takes into consideration the patient and his surroundings in a way which seems to be forceful, shared, interactive affiliation. It takes stressor as an exclusive sensitivity reaction embedded in emotional and cognitive courses. Anxiety instigates on or after the connection connecting the patient with his surroundings. It emphasizes stress- allied procedures for example cognitive assessment and management. (Hazel, et al., 1995) Thus considering all above models a nurse may select one to develop her stress adaptation process and to cope with it gradually. However, it must be noted here that stress and depression are sort of psychological dilemmas. Since, millions of people differ each not only physically, intellectually and psychologically, there can never be a single key to unlock so many dead bolts. Thus a nurse will also find out a way with a combination of all the factors discussed above best suited for her particular case. References Nursing Boey, K. M. (1999) ‘Distressed and Stress Resistant Nursing’, Issues in Mental Health Nursing, 19, 33-54. Buchanan, J, & Considine, G. (2002) ‘Stop Telling Us to Cope!’, Australian Center for Industrial Relations Research and Training (ACIRRT), University of Sydney Chang, E, Hancock, K. & Johnson, A. (2005) ‘Role stress in nurses: review of related factors and strategies for moving forward’, Nursing and Health Sciences, 7(1), 57-65 Clegg, A. (2001) ‘Occupational stress in nursing: a review of the literature’, Journal of Nursing Management, Volume 9, 101-106 Cooper, C., Dewe, P., & O’Driscoll, M. (2001) Organizational Stress: A Review and Critique of Theory, Research, and Applications, Sage, Thousand Oaks, CA Cunningham, J. B. (2000) Stress Management Source Book. Publisher: McGraw-Hill Professional, p 3-11 Dolan, S. L. (1992) ‘Lack Of Professional Latitude and Role Problems as Correlates to Quit Amongst Nursing Staff, Journal of Advanced Nursing, 17, 1455-1459 Hancock, P. A. & Desmond, P. A. (2000) Stress, Workload, and Fatigue, Publication: Mahwah, N.J. Lawrence Erlbaum Associates, Inc., P 5-10 Hazel, B. M. Heath, P. A. P. & Perry, A. G. (1995) Potter and Perrys Foundations in Nursing Theory and Practice, Elsevier Health Sciences Klinkman, M. S., Coyne, J. C., Gallo, S. & Schwenk, T. L. (1998) ‘False Positives, False Negatives and the Validity of the Diagnosis of Major Depression in Primary Care’, Archive of Family Medicine, 7: 451-461 Kouzes, J, & Posner, B. (1997) The Leadership Challenge. London: Jossey Bass Publishers Marshall,G. N., Davis, L. M., Sherbourne, C. D., Foy, D. W., Jaycox, L. H., & Morland, L. (2000) A Review of the Scientific Literature as It Pertains to Gulf War Illnesses: Stress Vol. 4, Rand Publishers Models of Stress, Department of Labour - Health and Safety, (Date accessed April 10. 2009) Sitehttp://www.osh.govt.nz/publications/booklets/stress-tools2008/models-stress.asp Munley, S. A. (1985) ‘Sources of hospice staff stress and how to cope with it’, Nursing Clinics of North America, 20(2), 343-355. Power, K.G., & Sharp, G. (1988) ‘A Comparison of Sources of Nursing Stress and Job Satisfaction among Mental Handicap and Hospice Nursing Staff’, Journal of Advanced Nursing, 13, 726-732 Sullivan, P. J. (1993) ‘Occupational stress in psychiatric nursing’, Journal of Advanced Nursing, 18, 591-601. Wickett, D, McCutheon, H, & Long, L. (2003) ‘Commentary: An Australian perspective’, Journal of Advanced Nursing, 43, 343-345 . Read More