SUMMARY

The journal entitled “Stress among Charge Nurses: Tool Development and Stress
Measurement, by Hanna Admi and Yael Moshe-Eilon (2010), focused on describing the
stressors that commonly affects charge nurses by developing a specific tool that measures
the relationship between stressors and demographic characteristics, such as age, seniority
and education. According to the researchers, previous studies regarding stress were too
broad and have yet to measure specifically the stress levels of a particular nursing role,
such as that of charge nurses and managers, who serve as the “front line of the
profession.” The researchers believe that studying the level of stress in nurse managers
and charge nurses is crucial because these positions are the nurses’ first opportunity to
exercise leadership skills, the foundation for their future careers in nursing.
The study used a quantitative descriptive study method, using an anonymous self-
completed charge nurse stress questionnaire (CNSQ), collected from a total of 215 charge
nurses and nurse managers at a tertiary hospital in the northern region of Israel, with 900
beds and 45 patient care units. The final questionnaire is composed of two parts: an
assessment of aspects of stress on a 5-point Likert scale of 50 statements, which were
developed from information gathered from focus group and semi-structured interviews;
and the second, gathering demographic characteristics. The study focused on six factors
that the researchers believed are major contributors of stress among their participants: (1)
authority-responsibility conflict;(2) patient-nurse interaction; (3) deficient resources such
as time, people, and equipment; (4) managerial decision making; (5) role conflict; and (6)
overload (physical and emotional).
The result of the study showed the stress level among charge nurses is overall
moderate to low. Among nurse managers the highest level of stress is due to the
deficiency of resources, such as unskilled staff, missing equipment, and understaffing.
According to the researchers, in a leadership role, charge nurses feels responsible for the
deficiencies. The second and third major sources of stress were found to be in the
categories of managerial decision-making and authority-responsibility conflict, in which
nurses, aside from doing their required tasks with patients, must deal with the
competence of other staff while meeting the expectations delegated within their positions.
 Additionally the study showed that there is no significant correlation between the
stress factors and the demographic variables investigated but post-graduate education and
managerial role had the highest significant impact on the stress level of charge nurses.
According to the researchers as nurses receive further education regarding their roles as
managers, so does their awareness of what is expected increases, making their weakness
and deficiencies more apparent, and as a result increases their level of stress.
As for the recommendation, the researchers believe that staff must be promoted as
charge nurses not only for their excellent performance but most importantly their
leadership potentials. To achieve this goal, the researchers proposed to have a two step
program that involves a training program that not only reinforces areas of knowledge in
decision making, teamwork, conflict management and feedback, but also an ongoing
mentoring program from senior managerial nurses through workshops. By investing in
nurturing future leaders, the researchers believe that the stress levels would not only
decrease but a sizeable increase in patient, staff team, organization and profession
benefits may also be achieved.

SIGNIFICANCE

The group has chosen this journal study because it provides a real worldview of
potential problems when the difference between management and leadership is not well
defined, by describing the level of stress from each of the management functions once in
a leadership role, and the need for preparation for future nursing role endeavors. Nursing
management is defined as a process of working through nursing staff members to provide
care, cure and comfort through patients, by planning, organizing, directing and
controlling available financial, material and human resources; problems exists when new
nurse managers are not able, or are ill prepared to cope with the stress in performing one
of these managerial functions, which results in poor patient care, under utilization of
resources, and organizational problems. Planning alone requires knowledge and
experience to better assess the situation, which new managers may have little or not at all.
A recent nurse manager may have been promoted due to their excellent clinical
performance but may not have a grasp of the demands of the hospital that encompasses
their new role, leading to authority-responsibility conflicts. High expectations from
supervisors but poor relationship with staff and doctors may deteriorate the quality of
care, not to mention the level of stress to the nurse manager. Poor decision-making may
lead to under utilization of an already poorly staffed hospital, faced with a large
workload. Not having experienced prior leadership roles may also cause problems in
directing a team in accomplishing tasks and no control over what needs to be done.

REACTION

As student nurses, we are already offered an opportunity to be in these situations.

Managing group projects and leading a team during clinical management are ways in
gaining experience, as preparation for our future careers. Leadership roles may be
overwhelming at first but

SOURCE

Admi, H. & Moshe-Eilon, Y. (2010). Stress among charge nurses: Tool development
and stress management. Nurse Economics, 28(3): 151-158. Retrieved on November 7,
2010, from http://www.medscape.com/viewarticle/726677.