A study into the causes and effects of occupational stress in a regional women's health service

Abstract

Hospital-based health systems have the potential to be high stress environments, as staff work towards meeting the many and varied demands of the patients and their families / whanau in a situation of limited resources and unpredictable workloads. Dealing with physical and emotional trauma, and the 'normal' exigencies of daily life in what may be a far from normal workplace may compound the stresses facing health workers. Nurses, who are often at the interface between patients and other health professionals, may be caught in a cross-fire of transferred stress while also coping with stressors associated with their own jobs. As well as being likely to have a negative effect on their well-being and job satisfaction, any such compounding impact of stress and stressors could have adverse impacts on patients and their supporters. The primary focus of this study has been to identify stress levels among nurses in a womens health service, and to establish the causes of elevated stress. In order to explore and identify relative stress levels and stressors, all staff were surveyed (with a 68% response rate). Midwives made up the largest portion, followed by nurses, doctors, therapies, support and clerical groups. Two tools, the Job Stress Survey (JSS) and the General Health Questionnaire-12 (GHQ-12) were used to help detect emergent stressors, and stress effects that staff were experiencing at the time in a New Zealand Women's Health Service. Aggregate data only is used, focussing on the six occupational groupings and the nine areas within the Service. Findings from the JSS confirm that the staff has experienced a number of stressors, while indications of deleterious mental health effects in some staff emerged from the GHQ-12 scores. Occupational stress is a subset of general stress, making it difficult to separate one from the other as spheres of our lives overlap and interact. The stressors that were identified should contribute to discussions and policies that might abet the reduction of stress. On the other hand, it is not possible to attribute the effects described by the GHQ-12 as being derived primarily from occupational stress. A stressed staff member, no matter what the source of their stress might be, still needs support in order to cope. The negative outcomes of occupational stress manifest themselves in a variety of ways such as; mistakes, absenteeism, horizontal violence, burnout and turnover. These all affect the quality of the patient care delivered, leading to decreased patient satisfaction and an increase in morbidity and mortality. The problem of occupational stress in the health system needs to be addressed for these reasons.