Alleviating Job Stress in Nurses

Rashaun Roberts, PhD; Paula L. Grubb, PhD; James W. Grosch, MBA, PhD


June 25, 2012

Editorial Collaboration

Medscape &

In This Article

Job Stress and the Nursing Profession

Nurses are exposed to many stressful demands and pressures and are therefore at heightened risk for an array of health, safety, and other problems. This article provides an overview of stress among nurses, including job features and workplace characteristics that contribute to the high stress levels. It also describes the effect that nursing stress has on the individual's health, safety, and well-being as well as on healthcare organizations. Finally, it discusses approaches that healthcare organizations can take to prevent or reduce nursing stress and its negative consequences.

Stress as a Workplace Problem

Stress is pervasive in the American workforce. One fourth of workers in the United States view their jobs as the top stressor in their lives,[1] and 26%-52% of workers report moderate-to-high levels of stress at work.[2,3,4] Furthermore, 75% of employees believe that they incur more on-the-job stress than workers did a generation ago. Work-related stress is more strongly associated with health complaints than are financial or family problems.[5]

How is this ubiquitous concept defined? As it has garnered increasing attention from public health and other researchers,several definitions of job stress have surfaced over the past few decades. The National Institute for Occupational Safety and Health (NIOSH) defines job stress as "the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources or needs of the worker."[1] Other definitions of job stress emphasize that it is an adverse reaction to excessive job pressures and demands.[6] Still other definitions assert that job stress occurs when workers do not have the decision-making authority and skill levels to meet the demands of the job and when the efforts they make on the job are not matched by the job's rewards (eg, support, respect, security, or opportunities for advancement and income).[7,8] Although these concepts differ slightly, each conveys the general idea that job stress arises when a person lacks adequate resources (eg, skills, equipment, support, training) to manage the demands of his or her job effectively.

Stress engendered by an inability to meet work demands can lead to illness, injury, and psychological distress.[9,10] An impressive body of empirical research supports the link between job stress and problems in health and safety. Mood and sleep disturbances, upset stomach, headaches, and disrupted familial relationships are common early manifestations of job stress.[1,11,12,13] In addition, rapidly accumulating evidence suggests that stress at work plays an important role in high blood pressure and elevated cholesterol levels,[14] cardiovascular disease,[15,16] infectious and autoimmune diseases,[17] anxiety and depression,[18] and accidents and injuries.[19]

Job stress has far-reaching consequences, not only for the health and safety of workers but also for employers. Stress contributes to outcomes that threaten organizational success, including physical injuries at work, absenteeism, turnover, reduced productivity, diminished job satisfaction,[20] low morale, and burnout.[21] Job stress is believed to account for approximately 50% of all workplace absences and for as much as 40% of employee turnover.[22,23] These and other stress-related outcomes result in considerable losses to industry, costing employers up to $60 billion per year.[24]

Significant financial costs associated with job stress also are absorbed by the US economy. Econometric analyses show that healthcare expenditures have increased nearly 50% for workers who perceive their jobs as stressful and nearly 200% for those who report high levels of job stress and depression.[20] According to national estimates, the total cost of job stress incurred by the US economy ranges from $250-$300 billion annually.[25]


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