Workload and Occupational Stress in Nursing

Abstract

Stress has long been recognized as a pervasive feature of work for nurses and there is evidence that it may be increasing in severity (Calhoun, 1980; Clever & Omenn, 1988; Gray-Toft & Anderson, 1981; Haché-Faulkner & Mackay, 1985; Kahn & Westley, 1984; Klitzman & Stellman, 1986; Leatt & Schneck, 1985; Martin, 1984; Parasuraman & Hansen, 1987). This paper presents qualitative data from a study of nurses' experiences with regard to occupational stress. The major source to which they attributed their stress was workload; that is the focus here. In addition to the amount of work (perhaps the most immediate connotation of workload) other aspects of the problem will be considered. It will be argued that the significance of heavy workloads can only be fully understood in the context of other features of nurses' work, as well as "cutbacks" in public funding of health services. Yet as we note in conclusion, it is difficult to situate nursing in this broader context, given the absence of good documentation of the work nurses do and the ways in which it has been changing. Method Between November 1984 and March 1985, a total of 123 interviews were conducted with nurses employed in two hospitals in southern Ontario. The nurses were part of a larger sample of 492, which included 311 industrial workers as well as 58 other hospital employees. Industrial workers were drawn from six workplaces - carpet manufacture, two steel companies, aluminum can, rubber and brake manufacturing. The hospital workers were in housekeeping and laboratories. Nurses were analysed separately because they formed the largest most homogeneous group in the hospitals, who were also distinctive in their professional status. Clinical areas in nursing were chosen in consultation with nurses' health and safety representatives. The sample in each hospital included Registered Nurses and Registered Nursing Assistants working in a general medical ward, in the operating room and as I.V. nurses. One hospital (415 and 722 beds in two locations) was unionized