Stressors and workplaces—perception of stressors by hospital nurses

Stressors in healthcare settings seems to be related with some workplaces features in hospitals, namely some healthcare activities and on some work conditions. Aims: (1) to identify the principal stressors mentioned by nurses, working in wards, intensive care units, operating rooms and emergency department; (2) to characterize how intense stressors are perceived by the same professionals. Methods: This study was carried out on 136 healthy nurses, from 1.154 nurses of the selected areas of work in the studied university hospital (83.8% female; mean age 33 (from 22 to 63 years old, median 29 years old). Individual interviews were conducted to identify stressors valorised by nurses working in wards (n = 84; 61.8% of the sample), in intensive units (n = 26; 19.1% of the sample), in operating rooms (11.8% of the sample) and in emergency department (n = 10; 7.4% of the sample) from an university hospital. We also applied a Likert scale to characterize the stressors intensity perceived by nurses (from 1 to 5 points). Intense stressor were classified with 4 or 5. Results: The most referred stressors identified by the total of the sample were: (1) Work overload (58.8%), with 73.8% considering an intense stressor; (2) Conflicts between professionals (53.7%), with 42.5% considering an intense stressor; (3) Patient clinical situation (41.9%), with 63.2% considering an intense stressor; (4) Witnessing the suffering and death of patients (39.7%), with 61.1% considering an intense stressor; (5) Physical work conditions (20.6%), with 46.4% considering an intense stressor. Nevertheless, when we analyse stressors identified by nurses of the different workplaces, the most emphasized stressors were: By nurses working in wards : (1) Work overload (64,3%), with 38/54 considering an intense stressor; (2) Witnessing the suffering and death of patients (53,6%), with 29/45 considering an intense stressor; (3) conflicts between professionals (48,8%), with 16/41 considering an intense stressor. By nurses working in intensive units : (1) Clinical state of patients (69,2%), with 13/18 considering an intense stressor; (2) Work overload (53,8%), with 10/14 considering an intense stressor; (3) Conflicts between professionals (46,2%), with 3/12 considering an intense stressor; By nurses working in operating rooms : (1) Conflicts between professionals (16/16), with 11/16 considering an intense stressor; (2) Clinical state of patients (9/16), with 7/9 considering an intense stressor; (3) Work overload (5/16), with 4/5 considering an intense stressor. By nurses working in emergency department : (1) Work overload (7/10), with all considering an intense stressor; (2) Conflicts with patients or their families (6/10), with 2/6 considering an intense stressor; (3) Clinical state of patients (5/10), with 3/5 considering an intense stressor. Conclusions: Work conditions and work activity seems to influence perception of stressors by nurses. While nurses working in all studied departments, in a general way, referred work overload, other stressors seems to be more specific. Therefore, witnessing the suffering and death of patients is preferentially referred by nurses working in wards, probably because they usually have a more extended and intense contact with patients, what may engage an emotional involvement. Another example related with some specificity of the workplaces is the conflicts with patients and their families, in emergency departments. As a matter of fact, they seem to occur more frequently in that workplace, because of its specific characteristics. Otherwise, organizational conditions and workplace environment can influence conflicts between professionals and the perception of clinical state of patients as a stressor. The perception of the last stressor is not only related to the clinical state per si (like in intensive care), but also may depend on the perception of the doctors’ support that nurses have in their workplaces.