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The Caring Support Blog

Stress in Nurses: What You Need To Know

November 27, 2023

The field of healthcare requires professionals who are quick, efficient, and always ready to attend to the needs of the patients, and one of the most in-demand healthcare workers is nurses, who are expected to provide quality care and support to all patients.

However, the demanding nature of their work, coupled with long hours, understaffing, and high-pressure environments, often leads to significant levels of workplace stress. The impact of this chronic stress on the mental health of nurses cannot be understated.

In this article, we will shed light on the adverse effects of workplace stress on the mental well-being of nurses in Canada and emphasize the urgent need for comprehensive support systems for nurses. We will also tackle the various mental health issues among healthcare professionals in general, as well as other concerns regarding the nursing community and how to address them.

Understanding Job Stress

Job stress or workplace stress refers to the physical, emotional, and mental strain experienced by those in their professional environment. For nurses, this stress can arise from various sources, and some of the most common stressors include work overload, frequent exposure to trauma and suffering, long shifts, and insufficient staffing levels.

Additionally, administrative burdens, conflicts, lack of control over decision-making, and lack of social support can lead to higher stress levels among healthcare providers, specifically those in the nursing profession.

Different from other types of environmental stress, workplace stress among nurses is felt more intensely and frequently because nurses are subjected to it every day to a significant degree. What also sets nurse stress apart from other forms of stress is that there is often limited control and autonomy in managing these sources of strain as they derive from external factors within the professional environment. Emotional labour, emotional stress, and emotional exhaustion also come into play when we're dealing with workplace stress in healthcare environments.

The Toll on Mental Health Among Nurses

It's been established that workplace stress is distinct from other types of stress due to its unique nature and contributing factors. Unlike personal or relationship stressors, the toll that workplace stress has on mental health is predominantly influenced by organizational dynamics, job demands, and professional expectations. Mostly stemming from the pressure nurses experience to perform well, meet deadlines, and balance work-life demands, stress branches out and manifests in different ways, as shown below:

Nurse Burnout

Nurse burnout isn't just about the decline of the physical health of nurses; it's also about the psychological distress that's prevalent among them. Chronic workplace stress can lead to burnout, a state of physical, emotional, and mental exhaustion.

Nurses experiencing burnout often feel detached and emotionally drained, which may develop into an overall negative attitude toward their work. Also characterized by feelings of cynicism, depersonalization, and reduced personal accomplishment, staff burnout among nurses often manifests in decreased empathy towards patients, impaired critical thinking and decision-making skills, and increased medical errors.

Nurse burnout can therefore lead to high turnover rates in healthcare facilities and exacerbate staff shortages already plaguing the industry. This inevitably compromises the state of patient care all throughout the system.

Depression Among Nurses

High stress levels can contribute to the development of depression among nurses. The constant pressure, demanding responsibilities, and limited time for self-care can take a toll on their mental health, leading to these debilitating conditions. This leads to nurses experiencing negative emotions like sadness, frustration, as well as low mood.

Some symptoms of depression among nurses include overwhelming feelings of sadness, hopelessness, or emptiness, Fatigue, irritability, difficulty concentrating, sleep disturbances, changes in appetite, and loss of interest in the things they used to love doing, which could largely be their job in the healthcare industry.

Anxiety Among Nurses

Keeping in mind that nurses are also human, they shouldn't be seen as the ultimate embodiment of resilience and strength, as they're not immune to experiencing symptoms of anxiety either. The demanding nature of their profession, including long working hours, high-stakes decision-making, constant exposure to patients' suffering, and emotional burnout, can significantly impact their psychological well-being.

Meanwhile, some symptoms of anxiety among nurses may manifest in several ways. Physically, they may experience restlessness, headaches, nausea, or even physiological phenomena such as gastrointestinal discomfort. Psychologically, nurses with anxiety may exhibit excessive worry or fearfulness, irritability, difficulty concentrating, or even panic attacks. Behaviourally, they might withdraw from social interactions or display heightened vigilance and hypervigilance towards their work environment.

Post-Traumatic Stress Disorder (PTSD)

Nurses frequently witness traumatic events, making them susceptible to developing PTSD. Whether it's a critical incident, patient death, or continuous exposure to distressing situations, the cumulative impact can lead to psychological trauma and can impair the quality of their work, especially patient care, compassion, and the necessary hard skills for nurses.

Some symptoms of PTSD among nurses include intrusive thoughts or flashbacks related to traumatic events, persistent avoidance of triggers associated with those events, heightened anxiety or irritability, as well as problems with concentration and sleep disturbances. Moreover, nurses with PTSD may experience feelings of detachment from colleagues and patients due to emotional numbing.

Substance Abuse

Some nurses, when unable to cope with the stress, may turn to substances as a way to self-medicate and temporarily escape their difficulties. This coping mechanism can result in addiction, further exacerbating mental health issues. Substance abuse among nurses is a concerning issue that can have serious implications for patient safety and the overall functioning of healthcare systems.

Some common symptoms of substance abuse among nurses include frequent absences from work, arriving late to shifts or leaving work early, increased incidents of medication errors, poor judgement and decision-making abilities, erratic behaviour, mood swings, and physical signs such as bloodshot eyes or dilated pupils. These symptoms can negatively impact not only the quality of care provided to patients but also the trust and confidence that patients place in nurses.

Suicidal Ideation

Extreme stress and mental health disorders can increase the risk of suicidal ideation among nurses. The emotional burden, coupled with a lack of support, may push them to a breaking point, highlighting the urgency of providing comprehensive assistance. To spot signs of suicidal ideation, take note of sudden changes in behaviour such as increased withdrawal from social interactions or loss of interest in activities they once enjoyed.

Additionally, nurses experiencing this ideation may exhibit signs of extreme sadness or hopelessness, persistent feelings of guilt or shame, decreased energy levels, disruptions in sleep patterns, and changes in appetite. They may also demonstrate a decline in job performance, concentration difficulties, and increased irritability or agitation. Moreover, there could be physical manifestations such as unexplained weight loss, neglected personal hygiene, or frequent illnesses due to compromised immune systems.

Self-harm or Suicide Attempts

Nurses who may have attempted suicide may have cuts or slashes commonly on their wrists, neck, arms, or legs. Those who self-injure might also have burns, scratches, or bruises from hitting themselves. They can even be caught banging their head, pinching or piercing their skin with sharp objects, pulling their own hair, or brutally inserting objects under their skin. These acts of self-harm are very dangerous and even fatal, and symptoms like these shouldn't be ignored, and the people displaying them must be sent to the psychological ward right away.

Meanwhile, there are also subtle signs like actually expressing their suicide attempts on paper, in text, or on social media. If they share about how sad, empty, and meaningless their job or life is or about how they want everything to end, those are huge warnings already.

A nurse with a sad aura sitting on a corner during their shift.

Concerns Regarding the Nursing Community

Some issues surrounding the nursing community include the shortage of qualified nurses, exposure to aversive situations without adequate support, and lack of technologically advanced equipment. These concerns can be addressed only if they reach the right people, such as those who are in high positions in the healthcare industry.

Shortage of Qualified Nurses

This issue has been prevalent for several years and is expected to worsen in the coming decades. The aging population, increased prevalence of chronic diseases, and retirements within the nursing workforce are contributing factors to this shortage. Additionally, many nurses experience burnout due to high patient loads, long working hours, and inadequate resources within healthcare facilities.

The shortage of qualified nurses could also partly be due to the aging population has led to an increase in demand for healthcare services, placing a heavier burden on the already strained nursing workforce. There's also the intricate and demanding nature of nursing which requires the professionals in the field to possess comprehensive knowledge and expertise, making it a highly specialized field. However, the limited number of nursing students pursuing nursing education further exacerbates the problem.

Exposure to Aversive Situations Without Support

As nurses face another pressing and longstanding issue of constantly being exposed to high-stress situations, long working hours, and emotional strain, this combination inevitably leads to nurse stress, burnout, and other mental health challenges, as mentioned above, which can all negatively impact their well-being.

There could also be little to no physical, psychological, and financial support or compensation for a heavily taxing healthcare job like nursing, especially in certain locations. Nursing could be more tolerable had it been providing appropriate support for the workers, but it currently continues to struggle.

Lack of Technologically Advance Equipment

While advancements have been made in medical technology, nurses often find themselves working with outdated or inadequate equipment in their day-to-day tasks. This not only hinders their ability to provide efficient and accurate care but also affects patient safety and outcomes. The absence of sophisticated monitoring devices, for instance, limits the ability of nurses to closely monitor the vital signs of the patients and detect early warning signs of deterioration.

Similarly, the reliance on manual documentation methods instead of electronic health records increases the risk of errors and delays in accessing critical information. Without cutting-edge tools for medication administration or wound care, nurses may struggle to deliver interventions that are at par with current evidence-based practices.

Addressing the Issue of Stress Among Nurses

In recognizing and mitigating workplace stress, address the potential negative impact it can have on both their personal well-being and patient care. This can include providing access to therapy or counselling services, implementing regular breaks during shifts, and fostering a positive work environment.

Apart from these, you can also offer educational programs on stress management techniques, such as mindfulness and resilience training for nurses. By recognizing the significant role that stress plays in nursing burnout and addressing it proactively, we can ensure that nurses are able to provide optimal care while maintaining their own well-being.

Improved Work Environments

Healthcare organizations should prioritize creating supportive work environments that promote employee well-being. Adequate staffing levels, regular breaks, and manageable workloads are essential in reducing stress and preventing burnout, maintaining work-life balance, especially for nurses, and ensuring safer patient care. Adequate resources such as modern equipment and updated technology are also essential for efficient patient care delivery from nurses.

Furthermore, offering competitive compensation packages, including competitive salaries and comprehensive benefits, is essential in recognizing and valuing nurses' contributions, enhancing job satisfaction levels while attracting new talent to address the ongoing nursing shortage problems all across the healthcare industry.

Resilience Training and Education

Comprehensive mental health support programs, including counselling services, should be readily available to nurses. Offering confidential spaces for debriefing, therapy, and resilience-building programs can help them manage stress effectively.

Additionally, incorporating stress management and self-care techniques into nursing curricula can equip future nurses with the tools to navigate high-stress environments. Ongoing professional development programs can also provide nurses with strategies to cope with stressors.

Resilience among nurses is a quintessential trait, as this enables them to bounce back from adversity, such as witnessing traumatic events or experiencing patient loss, without compromising their overall well-being and ability to continue providing quality care.

In a field where burnout rates are high and emotional strain is pervasive, resilience allows nurses to maintain their mental strength, emotional balance, and professional integrity.

Mindfulness Strategies

Incorporating mindfulness techniques into the daily routine of nurses allows them to cultivate a heightened awareness of the present moment, leading to improved focus, attention, and compassion towards both patients and themselves. By practicing mindfulness, nurses can effectively manage their emotions and respond more empathetically to patients' needs. It also helps them develop better self-care practices and cope with the challenges they face in a healthy manner.

Mindfulness strategies also further promote effective communication and teamwork among healthcare professionals by fostering an environment of non-judgmental understanding and mutual respect. Ultimately, incorporating mindfulness into nursing practice not only benefits nurses personally but also has positive outcomes for patient satisfaction and quality of care delivery.

Strong Leadership and Support for Advocacies

Effective leadership is crucial in recognizing and addressing workplace stress. Nurse leaders should foster open communication channels to create a positive work culture. This is done to manage and support nursing staff effectively, encouraging open communication and providing opportunities for professional development.

Advocacy also helps since this guides the trajectory of nursing careers. Advocacy serves to empower nurses to voice their concerns, such as participating in initiatives like community outreach programs to remote areas where people need medical help.

By supporting the advocacies of nurses, they get inspired and reminded every day of their passion and purpose, giving them a renewed outlook not just on work, but also on life in general. This, in turn, benefits healthcare professionals that nurses work with, employers, and patients alike.

Community Support

Encouraging peer support networks and fostering a sense of community among nurses can help alleviate the effects of workplace stress. Engaging in regular team-building activities and support groups can promote camaraderie and provide a platform for shared experiences which happen both in and out of the workplace.

When we create a culture of respect and collaboration within the workplace, we contribute to a positive work environment for nurses, promoting teamwork and mutual support between colleagues instead of dragging each other down and engaging in unhealthy competition, office gossip, and workplace politics, which could be detrimental to healthcare workers like nurses.

Read More: Healthy Eating Habits Recommended For Nurses

A list summarizing the strategies to address the issue of workplace stress among nurses.

Advantages of Being a Nurse

Despite the challenges, being a nurse also has some benefits that are fulfilling, rewarding, and satisfying. Some of these advantages include the following:

Saving Lives

One of the key advantages of being a nurse is the opportunity to make a meaningful impact on people's lives. As healthcare professionals on the front lines, nurses are definitely necessary and instrumental in providing care and support to patients during times of vulnerability and distress.

They have the privilege of not only tending to physical ailments but also assisting patients of all types in their emotional well-being, often serving as confidants and advocates for both patients and their families. In fact, nurses are seen as modern-day heroes, being one of the many healthcare professionals who were the frontliners not only during the recent COVID-19 pandemic but also in various settings all around the world.

Career Opportunities

Nurses are part of a respected profession that demands high levels of expertise and critical thinking skills, contributing to their personal growth and intellectual development. With the growing demand for healthcare services, nurses are required to work across various settings, including hospitals, long-term care facilities, community clinics, and home health agencies.

Moreover, nursing offers a wide range of specialties, such as pediatrics, oncology, critical care, and mental health, ensuring that healthcare professionals can pursue their passion within this field. Nurses have endless opportunities in their field, so they can explore as much as they can.

Job Security

Alongside these professional benefits, nursing grants job security and flexibility to those who graduate from it, as healthcare will always be an essential need. Being a nurse provides the advantage of having a fulfilling career that positively impacts both individual lives and society as a whole.

There's a projected 7% employment growth for registered nurses from 2019 to 2029, faster than the average for all other occupations. With nursing shortages seen across various specialties, including critical care, pediatrics, and gerontology, highly skilled nurses can often secure employment more easily and enjoy enhanced job stability.

Furthermore, as mentioned above, the COVID-19 pandemic has highlighted the indispensable role of nurses in tackling global health crises. As frontline healthcare workers, nurses' expertise and compassionate care are consistently valued and needed by communities worldwide. Overall, nursing offers a profession that not only brings personal fulfillment but also affords job security amidst ever-changing healthcare landscapes.

Conclusion

Nurses are the backbone of the healthcare system, devoting their lives to caring for others. However, the toll of workplace stress on their mental health cannot be overlooked. It's imperative for healthcare organizations, policymakers, and society as a whole to recognize the importance of addressing this issue. By implementing supportive work environments and mental health programs for them, we strengthen the workforce that keeps society well and healthy, and ultimately, we strengthen the whole of society as well.

But as much as there are some flaws in the system, there are still many benefits to being a nurse, no matter your background or years of experience. Depending on your healthcare employer, your career can be very rewarding and fulfilling, so it's definitely key to pick the right clinic or hospital to accommodate your needs as a healthcare professional.

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About The Author
Kate Piamonte
Content Writer

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