Running head: Stress in the hospital 1

Stress and Coping in the Hospital Environment

David M. Host
Ferris State University

Stress in the hospital 2

Abstract
Stress and anxiety caused by the workplace is a key factor in burnout and the high turnover rate
of RNs in the hospital environment. Exploring the causes of these stressor and finding more
effective ways to mitigate the effects of stress is key to the operation of the modern medical
system. With better education and time management, hospitals will be better equipped to retain
skilled medical professionals and improve workplace safety and the quality of care provided to
patients.

Stress in the hospital 3

Stress and Coping in the Hospital Environment
Stress is an ever present factor in the hospital environment. Stress affects job satisfaction
and burnout rate. This research paper will attempt to collate data on how stressors affect the lives
of nurses in the hospital workplace, as well as find effective coping strategies.
Stress and Burnout
Stress is one of the the main factors that lead to burnout and quitting among nurses.
Burnout rate for newly graduated Registered Nurses (RNs) is at an all-time high due to the
nursing shortage in the United States and worldwide (Wu, Fox, Stokes, & Adam, 2012). The
combination of these factors makes the prospect of pursuing a career in nursing unattractive to
prospective students. This in turn may just fuel the RN shortage, increasing stress via increased
workload all around. It is estimated that the nursing shortage in the United States will increase to
one million persons by the year 2020 (Wu, Fox, Stokes, & Adam, 2012).
A large portion of this stress seems to come from conflict with physicians, and how a
nurse chooses to deal with those conflicts (Tabak & Koprak, 2007). Conflicts with physicians
can be especially stressful for new RNs and ones that more passively try to avoid any form of
conflict, simply for the fact that while the conflict may have been averted, the needs of the nurse
are not being addressed which can lead to feelings of guilt. This exposure to stress makes nursing
a very high health risk profession. Compromised health and performance can also lead to
substantial safety risks on the job (Drach-Zahavy & Marzuq, 2013). For medical personnel
exposed to a warzone or combat, developing Post Traumatic Stress Disorder (PTSD) is a real risk
as well. It also appears that nurses are more than five times more likely to develop PTSD than
physicians as well (Ben-Ezra, Palgi, & Essar, 2007).

Stress in the hospital 4

Mitigating the effects of stress
With stress taking such a catastrophic toll on the lives of nurses, there must be ways of
mitigating and coping with the encountered stressors. The current burnout rate of Registered
Nurses is unacceptable. There are too few studies currently being undertaken to find ways to
relieve stress in a healthy, positive manner; there is some hope, however.
Many studies conclude that one of the keys to eliminating stress in the hospital
environment is to increase the education levels and training of RNs (Wu, Chi, Chen, Wang, &
Jin, 2010). With higher levels of training, nurses are more equipped to deal with the multitude of
problems encountered on a daily basis, reducing anxiety and increasing quality of life. Having a
stronger foundation of education can reduce stress and anxiety when dealing with the authority
of physicians. To many RNs, senior physicians command power and respect. That can make it
quite difficult to speak up when they may make a mistake or possibly request an action be done
that could possibly harm the patient. With increased education, these junior RNs are given the
confidence to know that what they are doing is right (Tabak & Koprak, 2007).
Unsurprisingly, having time off from work does wonders for stress recovery. It was,
however, determined that when RNs had a weekend break as opposed to a weekday break, that
weekday breaks did less to reduce stress and increase vigor than weekend breaks did. That could
be a problem for nurses that are expected to work weekends (Drach-Zahavy & Marzuq, 2013).
Obviously, it would not be feasible nor recommended that hospitals cease operations during the
weekend, but maybe a rotating schedule could provide some much needed relief.
Discussion
Clearly, hospitals must begin to recognize the symptoms and treatments for stress among
its workforce. Its simply not enough to focus on the health and welfare of the patients, but also

Stress in the hospital 5

of the nurses and physicians in the hospitals employ. Education seems to be a key factor in the
stress levels of nurses working in high stress positions. In fact, the Institute of Medicine (IOM) is
recommending that nurses pursue even higher levels of education (Health Resources and
Services Administration, 2013). If hospital administrators could make higher education more
available to the nursing workforce, stress levels and work safety could be greatly enhanced.
The other ways to achieve better coping mechanisms may be through better work hours
or additional leave time. Working in an emergency room especially can take its toll on the
healthcare providers. They are often on call and work long hours that can lead to an additional
accumulation of stress.
Mitigation of these stressors is imperative for the future of the nursing profession.
Retention of skilled personnel and reducing the stress and anxiety of said personnel will increase
the efficiency and the quality of care provided to hospital patients.

Stress in the hospital 6

References
Ben-Ezra, M., Palgi, Y., & Essar, N. (2007). Impact of war stress on posttraumatic stress
symptoms. General Hospital Psychiatry, 264-266.
Drach-Zahavy, A., & Marzuq, N. (2013). The weekend matters: exploring when and how nurses
best recoverfrom work stress. Journal of Advanced Nursing, 69(3), 578-589.
Health Resources and Services Administration. (2013, April). The U.S. Nursing Workforce:
Trends in Supply and Education. Retrieved from HRSA Website:
http://bhpr.hrsa.gov/healthworkforce/reports/nursingworkforce/nursingworkforcefullrepor
t.pdf
Tabak, N., & Koprak, O. (2007, April). Relationship between how nurses resolve their conflicts
withdoctors, their stress and job satisfaction. Journal of Nursing Management, 15(3),
321-331.
Wu, H., Chi, T.-S., Chen, L., Wang, L., & Jin, Y.-P. (2010, March). Occupational stress among
hospital nurses: cross-sectional survey. Journal of Advanced Nursing, 66(3), 627-634.
Wu, T.-Y., Fox, D. P., Stokes, C., & Adam, C. (2012). Work-related stress and intention to quit in
newly graduated nurses. Nurse Education Today, 669-674.