Staff Nurses' Perceptions of Support in an Acute Care Workplace

Abstract

People entering nursing have been described as "angels of mercy" (Pines & Kanner, 1982) and as "youthful, enthusiastic crusaders" (Cherniss, 1980). During their training, nurses are told they are unique among the health care professionals because they provide continuity of care and emotional support as integral components of their work skills: they are always there, and always care (Mabbett, 1987). The reality of nurses' work sometimes comes as a shock to new graduates (Kramer & Schmalenberg, 1988). The actual work of nursing is often associated with the witnessing of unpleasant sights and odours, of human pain, suffering and death, in an atmosphere that is often noisy, brightly lit and highly technical. Nurses work around the clock and against the clock, carrying heavy responsibilities and heavy caseloads. Such experiences generally give rise to feelings of anger and worry, fear, depression, shame, embarrassment and resentment. These emotions are often considered incongruent with the "Florence Nightingale-inspired fantasy of ministering angel" (Gaskin, 1986); as a result, occupational stress and burnout are common phenomena (Attridge & Callahan, 1987; Dolan, 1987). Individual counselling and work-related support groups have been cited in the literature as two of the better coping strategies to help alleviate some of the problems associated with stress and burnout (Adey, 1987; Campbell, 1985; Hingley & Harris, 1987; Tschudin, 1987; Weiner & Caldwell, 1983). However, Weiner, Caldwell and Tyson (1983) suggested that support groups are often introduced into the workplace without first assessing the needs of the individual nurse and the group as a whole; as a consequence, they often fail. A clearer understanding of what nurses need in the way of support is required, therefore. The study reported here examined and described nurses' perceptions of support and lack of support in the workplace, and documented the impact of these experiences on them professionally. Research questions were: what were acute care staff nurses' perceptions of support and lack of support in the workplace, and how did nurses perceive support or lack of support to facilitate or hinder their work performance?