Contemporary Issues In Professional Practice | Stress in workplace

In this assignment, I will elaborate on the contemporary issues of the stress at workplace. Stress is the reaction of the body to a change in the environment and event that happen that resulting in the need of a physical, mental as well as an emotional adjustment or response. Stress can come from any condition, event or thought that makes you feel discouraged, angry, irked, nervous, or anxious. (http://dying .about.com/od /glossary/g/ stress.htm) (accessed 1st Febuary 2013).

The person who is under a stress are likely to experience a certain sign. Stress can be categorized into 2 stress signs; mental sign and physical sign. Mental sign includes tendency to make bad judgment, difficulties to focus, anxious feeling, and develop irrational fears. Whereas, physical sign includes faster heartbeat, continuous sweat, dry mouth and feel constantly tired. Many people often take this sign lightly and seek for normal medical attention and not realize that they are having a stress. There are also some people who are under a stress but oblivious on the methods to cure them.

Stress can be caused by various of reasons. Some of the common causes are the survival stress, internal stress, environmental stress and fatigue and overwork. For nurses, the sources of stress are most probably are the environmental stress as well as fatigue and overwork. Stress is caused by a stress factor called an existing stress-causing factor or mostly known as the stressor. The stressor is not only for a negative matter but also positive (known as eustress). A good example of it is receiving a promotion or the birth of a baby. Despite being positive, if the matter requires strains and anxious feeling, it will most likely to result on the stress. Although stress is necessary in life, if it gets out of control it may harm our life and people around us.

As issued earlier, an environmental stress is one of the most common sources of stress. In our context, it is the work stress cause by the working environment in the ward. Work stress is contributed by things such as relationship with fellow workers, massive workloads, work requisite, patients demand and low amount of paycheck.

In a particular ward, the doctors are regarded as the person who is at the top hierarchy in the status of the occupational health worker, thus they will naturally be appointed as the leader. As a leader, they ought to possess a leadership quality and the ability to gain a respect from the follower. As being mentioned by Ang and Long (2003) "Someone once said, 'Leaders are people who develop leaders and not followers'". But sometimes, not all the doctors have the ability to lead. The inability of the doctor to fully lead the workers will put many stresses on the nurse as they will be the one who will take over the doctors job to distribute the work and manage the patients. Some of the nurses are not being trained thus they are not qualified to make decisions on certain matters. They will likely be under pressure to handle the work as they fear to commit a mistake. Any mistake will put their career in jeopardy. Pesut and Herman (1998) once said that the nursing process was developed to organize thinking so that the problems experienced by the patients could be anticipated and solved quickly.

As the nurses are handling the doctor's work in distributing the work and taking care of the patients. They sometimes receive a backlash from the patient who are not convinced of the capability of the nurses. Most of the patients sometimes demanding to be treated by the doctors. This has put the nurses in stressful situation as they have to meet high requirements of the patients. According to Australian Medical Council (2009), the patients have unconditional believe in the doctors. They believe that the doctors are competent and will not take advantage of them as well as display qualities such as integrity, honesty, determination, empathy and compassion.

Apart from that, the workloads of the nurses have increased tremendously over the years. As the world becomes more advanced, more and more people are becoming oblivious about their health. This lead to the rise in the amount of the patients in the hospital with all sorts of disease and they demand a quick and effective treatment. This has put the nurses under a lot of stress to cope with all the work and the demand from the patients. As mentioned by Sveinsdottir, Biering, Ramel (2006), it is also of great considerable to gain more knowledge about the working conditions of the nurses, occupational stress and job satisfaction regarding the knowledge that might be used to decrease nurses' occupational stress and increase their job satisfaction.

As cited from Kirpal (2004), since the 1980s, the nursing profession has experienced significant change. The cost pressure, rationalization and new quality standards induced a reorientation from hierarchical structures and strictly regulated professional roles in a new work organization that also involves the outsourcing of services. Nowadays, the profession of the nurses is evolving parallel to the development of the educational system. The demand for higher education has risen even in the nursing practice. Recently, most of the newly graduated nurses are either a degree holder or a master holder. This has put a pressure to a more senior nurse as they do not posses higher qualification. It will hurt their pride to be working with all new nurses and they tend to feel anxious about their position. Chapman (1999) highlighted that in a more recent attempt to arrive at a compromise over this tension of interests between nurse employment and nurse education, the competence- based approach to nurse preparation for practice was adopted in order that nursing regulatory authorities could convey to universities the requirements for nursing students in the form of stated competencies. This will stress the nurses as they will try hard to fulfil the demand of the evolving nursing profession by being forced to further their studies. Lancaster, McQueeney, and Van Amburgh (2011) said that as we attempt to educate ever-evolving generations of students, we must learn to adapt and tailor our teaching approaches to meet the students' needs.

Some of the nurses will just try to cope with the ever growing nurses profession. They tend to further their study in degree or masters program to be on par with everyone else. This does not necessarily good for them as they have to juggle their time to work and study at the same time. This can give a lot of stress to the nurses as they does not have the time to spend with their friends and family. Burns and Paterson (2005) on the nurse education mentioned that the aim of nurse education is to provide skilled and knowledgeable practitioners; central to this is the learning that takes place in the practice placement area, which is designed to make the link between theory and practice.

One of the biggest stress contributor for the nurses is the patients themselves. With the advancement of the technologies nowadays, the patients could easily get the information about their disease and treatment process via the media and internet. Some of the patient come to seek the medical attention well prepared and they expect the nurse to give the treatment that they are aware of. This may cause stressful situations to the nurses as the patients sometimes appear to be more knowledgeable than the nurses. The nurses may also be under stress in order to cope with advanced information so that they will not be underestimated by the patients. Codier, Kooker and Shoultz (2008) mentioned that, for nurses caring for and caring about people with a life limiting illness, the stress can be considerable due to the emotional challenges. Managing the emotional challenges involves emotional work, subsequently intensifying the emotional labor required to perform nursing care. As a consequence, nurses need to protect themselves against stress at work by utilizing emotional intelligent strategies.

In Malaysia, the responsibility of the nurse is not limited only to care for the patients but they also have to do many other things such as do paperwork and settle the patient administration. This can put a lot of stress to the nurses as they have to focus on many things on the same times. The shortage of the nurses force in Malaysia has put tremendous stress to the nurses as they have to commit an extra work every day. The nurses will grow tired of the workloads and becoming less spirited. Despite all these, the nurses still have to show support to the patients and maintain good quality services. Cited from NHS (2007), the patients who are admitted to the hospital believed that they are entering a safe place which they confident to receive the best possible are there. Even when their disease worsens, they confident that they are in the best place for immediate and effective treatment.

As a nurse, one has to face many risks in their daily lives as sometimes their work can be regarded as dangerous. The nurses frequently have to deal with a patient with a contagious disease and the though of being infected by the disease will put them under a lot of stress. However, the nurses still have to show their willingness to take care of the patients. It was not right for the nurses to discriminate the patients based on their disease only. Nurse preparation involved acquiring theoretical knowledge pertaining to the care of patients and involved an assessment of the personal qualities of the nurses, including their moral character and how well they related to patients and colleagues alike (Bradshaw, 2000).

The amount of a paycheck can also be a source of stress. Many nurses had complained that despite their massive amount of workloads, they still receive a small amount of paycheck every month. Even tough it was not necessarily right to complain over a money, the nurses still have the right to receive as much as they work for. A bonus or incentive in once in a while will definitely boost the working spirit of the nurses thus increase the quality and productivity.

The excessive workload will not only affect the work life but also the personal lives. The nurses who own a family will be stressed to deal with the family after a day of a busy work schedule. They will also feel pressure of not having to spend enough time with their family. The relationship between the family will grow apart as the nurses put more focus on the work. As cited from Mackay (2007), the more you can involve an employee in decisions that affect his or her job, the more motivated that employee will become in working towards establishing goals, the highest level of participation is letting the employee actually make the decision.

Stress could have great impact on your body. It is often to be linked with disease such as heart disease, abnormal heartbeat, peptic ulcers, and obesity, depression and anxiety. It is important for the nurses to stay positive in handling their stress to avoid any of the side effects.

The stress felt by the nurses will not only affect the nurses but the patient as well. Having to be treated by a stressed nurse will give a bad impression on the patient. The patient will most probably report such behavior to the administration. The nurses who work on a stress demeanor will most likely to conduct a mistake in their work. This should avoid as it will bring danger to the patient and jeopardize the nurses career. The nurses represent the majority of the hospital workforce and they are the most consistent caregivers at the patient bedside (Coffman, 1998).

Stress at work place can also be connected with the communication problem between nurses, doctors, and patient. The nurses who are busy will not have time to communicate with their patients thus make the patients fell distant towards the nurses. This could give a stress to the nurses as the patient will grow uncomfortable with the nurses as the treatment proceed. Some patient may even rejecting a treatment as they do not have faith in the nurses. Slev and Pop (2012) claimed that the effectiveness in new roles and environments can be achieved by interacting with other people, therefore social learning skills are of great importance, and learning occurs when engaged in work projects.

As team work is very important in this line of career, it is stressful for the nurses when they are having a difficulty to communicate well with their fellow worker especially the doctors. The communication problem usually occurs when there is some misunderstanding in the division of workload between the nurses and doctors. Some of the doctor tends to put all the workloads on the nurses shoulder thus have incite an unsatisfactory feeling among the nurses. As cited from Hanifi, Parvizy and Joolaee (2012), communications within the clinical environment create an atmosphere conducive to either motivation or demotivation among nursing students.

As stress has become a huge factor in disrupting the work, it is recommended for the nurses as well as the hospital management to apply some methods in reducing the stress. It is crucial for the hospital management to develop a policy to grant a support to the fellow nurses in order to reduce their stress and workload. The management has to be alert on the source of stress for the nurses. For instance, when the nurses complained of having an intense workload, the management should take an initiative to decide on a work schedule. Everyone should be assigned on doing the same amount of work and there should be a specific time on the schedule for the nurses to visit the patients, do the report and paperwork and deal with patient's administration. Nurses who gain information about managed care based on patients' negative experiences are likely to develop pessimistic perceptions of managed care changes implemented in their workplace. As mentioned by Apker (2004),"these views may differ from those of nurse executives, who may perceive managed care positively after learning how managed care initiatives can increase organizational efficiency and effectiveness in ways that reduce costs and maximize profits".

The management should also give an ample attention to the condition of the ward in order to make the working environment more conducive for the nurses. The setting of the ward such as temperature control, ventilation, lighting as well as the noise sound should be given a proper attention so that the nurses can work comfortably. The workstation for the nurses have to be suitable for long working hours. The chair use has to be ergonomic to avoid neck and back pain. The work study method has to be applied in order for the working process to run smoothly and increase the productivity. Lawless and Moss (2007) once claimed that there is a direct and critical relationship between nursing work, nursing work environments and the patient experience, particularly the patient outcomes.

The nurses also should be given a sufficient amount of breaks and holidays. As a normal person, the nurses must be wished to spend some quality time with their friends and family. When the relationship between the family is close it will automatically affect the work. The nurses will become more enthusiastic and enjoy as they working.

While some workplace stress is normal, excessive stress can interfere with your daily activity and disrupt the productivity at work. It is can also impact your physical and emotional health. However, it is crucial for us to deal with stress rather than avoiding it. With strong determination and continuous motivation, we are sure being able to put the stress under a control. Girot (1993) has noted that the definitions of nursing competence were divided between behavior, this equating with the ability to actually perform the tasks and a psychological construct, this equating with cognitive, affective and psychomotor skills, although these two senses were not mutually exclusive, as for example, psychomotor skills determine the ability to perform tasks.

In conclusions, stress is important in our lives. A positive stress will induce your motivation to work hard towards the goals whereas the negative one, if it was dealt properly, will serve as an extra encouragement while working. Since stress is inevitable, therefore, the nurses ought to find ways of responding to the stress and deal with them diligently. We, as registered nurses, are responsible in maintaining our standards to a high level. Rose and Glass mentioned that not only it is critical to listen to and acknowledge the nurses' experiences of their professional practice, but also it is necessary to conduct further research into what can be regarded as the emotional 'package' of workplace demands, stresses and its effects on well being.

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