STRESS AND ADAPTATION STRATEGIES AMONG NURSE PRACTITIONERS

1.1 Introduction

Stress defined in terms of external, usually physical, forces acting on an individual. Stress is caused by stressors, which are events that create a state of disequilibrium within an individual. Many employees may suffer from anxiety disorders or stress-related illnesses (Ritchie et al. 2009). Similarly, stress is also regarded as a particular relationship between the person and the environment that is assessed by the person as taxing or exceeding his or her resources and endangering his or her well-being (Irving, J.A. et al., 2009). Stress on its own does not have any damaging effect on an individual; however individuals' assessment of an event, their perceptions and interpretations give meaning and their coping ability determines whether events are viewed as threatening or positive. Personality traits also influence individual reaction to stress because what may be strenuous to one person may be stimulating to another (Robinson, M. D. et al., 2011).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.

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1.2 Background of Study

Every work environment especially within a hospital setup needs to be conducive, friendly and stress free to promote quality care and wellbeing of health care workers whose job demands are increasing day by day. This is as a result of advancement in technology and patient's demand for quality in response to increasing health care cost. Stress is considered a normal part of life which is necessary occasionally as a push to increasing functional capacity, but when it is experienced over a prolonged period it becomes detrimental to health leading to a decline in productivity (Salleh, M.R., 2008).

Job related stress is a widespread problem across industry, but it is endemic in the human services where nurses form the largest group (Schaufeli and Greenglass, 2001). Nursing by its nature is subjected to a high degree of stress. Each day the nurse deals with grief, stark suffering, and death as few other people do. A lot of tasks are boring and unrewarding. Some are distasteful, normal standards, even disgusting, degrading and frightening (Sarafino, 2002).

As far back as the mid-1950s, stress was regarded as an occupational hazard and occupational stress cited as a significant health problem (Jennings, B.M., 2009) while in the 1960s, patient's care, decision making, taking responsibility, and change were identified as sources of anxiety among nurses which predisposed them to work stress (Menzies, 1960). Nurse's role has long been regarded as stress-filled based upon the physical labor, human suffering, work hours, staffing, and interpersonal relationships that are central to what the work nurses do (Lukpata, F. E. et al., 2013).

This stressful nature of nursing can ultimately lead to job dissatisfaction and burnout (Arafa, M.A., 2003). This statement is in line with some studies which conclude that the provision of health care services is demanding both physically and psychologically ( Ilhan, M.N., 2005). Nursing occupies a conspicuous position among the professions that have been identified as the most stressful worldwide as nurses relate with humans mostly in times of pain, suffering and death (Lukpata, F .E. et al., 2013).

Nurses work tirelessly rendering care to critically and chronically ill patients who are between life and death in an environment where there is lack of tolerance for error (Rowe, J., 2003), all these can exert intense psychological and physical pressures on the health care giver leading to stress or burn out syndrome.

Among health care professionals, nurses have been found to be most prone to burnout (Abushaikha, L. and Saca-Hazboun, H., 2009). This is more so because nurses are expected to deliver humane, empathetic, culturally sensitive, proficient and moral care, in working environments with limited resources, reduced supply of nurses and increasing responsibilities. Such imbalance between providing high quality care within an environment of limited resources leads to stress (Khamisa, N., 2015).

Therefore, in Federal Medical Centre Abeokuta where the research was carried out, the activities that was conducted is to know the The Stress and Adaptation Strategies among Nurse Practitioners.

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1.3 Statement of the Problems

Investigation revealed that job satisfaction and burnout among health care providers are important issues since they affect turnover rates, staff retention and ultimately the quality of patient care (Atencio, 2003). Burnout has been defined as “a syndrome of physical and emotional exhaustion, involving the development of stress which can lead to the development of negative self-concept, negative job attitudes and loss of concern for clients”. Burnout has also been associated with high employment turnover, excessive absenteeism, negative job attitudes, low morale and a reduction in willingness to help others (Abushaikha, L. and Saca-Hazboun, H., 2009).

The way that an individual views and processes stress determines how much stress is felt and how close the person is to burnout. Perceptions of job stress and burnout are not just a product of work conditions because not all workers, exposed to the same conditions, develop burnout or perceive stress (Robinson, M. D. et al., 2011).

An individual can be exposed to few stressors but be unable to process the stress well and thus experience burnout. Another person, however, can be exposed to a significant amount of stressors, but process each well, and avoid burnout. How close a person is to a state of burnout is greatly dependent on individual differences (Truby, B., 2009)

According to psychological theories, stress is determined by the balance between the perceived demands from the environment and the individual's resources to meet those demands (Ursin, H. and Eriksen, H.R., 2004)

The International Council of Nurses (ICN) (2008) declares that nurses, doctors, and laboratory technicians experience the highest job related stress with 45 percent reporting that their jobs are quite or extremely stressful. Likewise, the International Labour Organization has identified nursing as an industry with relatively. These problems make it necessary to examine the Stress and Adaptation Strategies among Nurse Practitioners in Federal Medical Centre Abeokuta.

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1.4 Aim and Objectives of the Study

The main aim of this study is to investigate the Stress and Adaptation Strategies among Nurse Practitioners on the safety of patients in Federal Medical Centre Abeokuta. In achieving this aim, the following specific objectives were laid out as follows:

1. To ascertain the causes of work stress among nurses in Federal Medical Centre Abeokuta;
2. To examine the effect of stress among nurses on the safety of patients Federal Medical Centre Abeokuta;
3. To investigate the impact long working hours on the job performances of Nurses in Federal Medical Centre Abeokuta;
4. To know if work stress influences negative job attitude among Nurses in Federal Medical Centre Abeokuta; and
5. To determine the relationship between stress and job dissatisfaction among Nurses in Federal Medical Centre Abeokuta.

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1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• What are the causes of work stress among nurses in Federal Medical Centre Abeokuta?
• What is the relationship between stress and job dissatisfaction among Nurses in Federal Medical Centre Abeokuta?
• What is the effect of stress among nurses on the safety of patients Federal Medical Centre Abeokuta?
• What is the impact long working hours on the job performances of Nurses in Federal Medical Centre Abeokuta?
• Does work stress influences negative job attitude among Nurses in Federal Medical Centre Abeokuta?

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1.6 Significance of the Study

This study is very important to medical directors because it elucidates some of the factors that are responsible for the poor performances of Nurses in hospital. The relationship between stress and the work behavior among nurses is well examined. Long working hours is one of the causes of work stress among nurses and its impacts on the productivity of nurses are well investigated.

This study also examines the ways of reducing work stress among nurses in hospital. If these measures are implemented, it will have impact on improving the safety of patients. Nurses who are stressed tend to be aggressive on patients and this affects the recuperation of patients.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

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1.7 Scope of the Study

The scope of this study restricted to examining the Stress and Adaptation Strategies among Nurse Practitioners in federal medical centre Abeokuta.

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1.8 Limitation of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Establishment Policies: Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this project work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
3. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
4. Lack of Initial Cooperation from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.

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1.9 Definition of Terms

Stress:

It is a state of mental or emotional strain or tension resulting from adverse or demanding circumstances.