Wednesday, November 14, 2007

Nurses and Stress: A Rant

Thanks to a comment on yesterday's post, I was recommended to read this article on stress and healthcare workers. Brief and to the point, the article elucidates that Canadian "nurses, doctors and lab technicians have the highest levels of stress related to their jobs" of all interviewees, with 45 percent reporting that there work was "quite" or "extremely" stressful.

The International Labor Organization has identified nursing as an industry with relatively high levels of stress and burnout. In identifying the sources of stress in nursing, they elucidate thus:

"The role of nursing is associated with multiple and conflicting demands imposed by nurse supervisors and managers, and by medical and administrative staff. Such a situation appears to lead to work overload and possibly to role conflict. One form of such conflict often mentioned in surveys of nurses relates to the conflict inherent in the instrumental and goal-oriented demands of "getting the patient better" and those related to providing emotional support and relieving patient stress. Role conflict of this kind may be most obvious when dealing with patients who are critically ill and dying. Indeed, one of the areas of nursing that has attracted particular attention has been critical or intensive care nursing. Health care is also a sector which suffers a high rate of violent behaviour (see our pages on
violence at work).

"Many studies on stress in nursing have attempted to measure, or have speculated on, the effects of such stress on nurses’ health and well-being. There appears to be general agreement that the experience of work-related stress generally detracts from the quality of nurses’ working lives, increases minor psychiatric morbidity, and may contribute to some forms of physical illness, with particular reference to musculoskeletal problems, stress and depression."

Hmmmm, says the nurse on medical leave of absence.

In South Africa, stress has been identified as the major cause of a nursing shortage in the setting of HIV/AIDS care. The BBC reported earlier this year that stress was harming nurses' sex lives, causing nurses to smoke more, and that stress-related absences from work costs the British National Health Service more than 300 million pounds per year.

Many nurses complain about frozen wages, lack of clinical supervision, increasing nurse-patient ratios, and rapidly shrinking benefit packages. While loss of benefits and frozen wages are ubiquitous across the general workforce (unless you're a CEO, member of Congress, movie star, or professional athlete, of course), nurses face other stressors which are singular to their profession. Workers in other professions also naturally face challenges typical to their careers and workplaces, and each of us can truly only speak from our own work experience.

We simply have to face the facts. Americans (and workers in other countries, as well) work too hard, earn too little, have paltry time for vacation and leisure, and are expected to marry their jobs to a degree never before expected in the history of labor. Unions have slowly been dismantled and vilified over the last century (especially here in the US), and healthcare benefits have crumbled, leaving many of us paying higher premiums and copayments for office visits, procedures, and medications. With housing costs and fuel costs through the roof, our paychecks have less buying power than they used to, and those of us in the middle class and working class are left to pick up the crumbs left behind by the 1 percent controlling the wealth.

Are nurses stressed? Of course we are. We earn moderate incomes within a high-stress industry where workloads have exponentially increased and benefits faltered. Retirement seems less than certain, the economy continues its volatile course, and the healthcare industry asks more and more of us without offering any further compensation. Still, I never regret my career choice, and have even encouraged others to walk this path. Nurses are always needed, work is generally easy to find, and when the economy hits bottom, we will still be irreplaceable, since illness never takes a holiday.

So, what's an earnest nurse to do, you ask? Dedicated to my chosen career, I take a few weeks to reassess my options, care for my body and mind, soul and spirit, and plan to reenter the fray with---perhaps---a hopeful and newly-minted outlook and approach. I have been ravaged by the effects of stress and vicarious traumatization, and I now attempt to reconstitute myself during this brief hiatus. I consider myself both lucky and blessed, and pray for my nursing brethren who are unable to afford the luxury of such self-care. May we all be free from suffering.

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