Perceived occupational stress in nurses working in Ireland

Background: This study examines perceived stress and its potential causal factors in nurses. Stress has been seen as a routine and accepted part of the healthcare worker’s role. The lack of research on stress in nurses in Ireland motivated this study. Aims: The aims of this study are to examine the level of stress experienced by nurses working in an Irish teaching hospital, and investigate differences in perceived stress levels by ward area and associations with work characteristics. Method: A cross-sectional study design was employed, with a two-stage cluster sampling process. A self-administered questionnaire was used to collect the data and nurses were investigated across ten different wards using the Nursing Stress Scale and the Demand Control Support Scales. Results: The response rate was 62%. Using outpatients as a reference ward, perceived stress levels were found to be significantly higher in the medical ward, accident and emergency, intensive care unit and paediatric wards (p<0.05). There was no significant difference between the wards with regard to job strain, however, differences did occur with levels of support; the day unit and paediatric ward reporting the lowest level of supervisor support (p<0.01). A significant association was seen between the wards and perceived stress even after adjustment (p<0.05). Conclusion: The findings suggest that perceived stress does vary within different work areas in the same hospital. Work factors, such as demand and support are important with regard to perceived stress. Job control was not found to play an important role.

Nurses’ perceptions of nursing presence and the relationship between nursing presence and moral sensitivity in nurses working with people with dementia in residential care

Aim: The aim of this study was to measure nursing presence among nurses caring for people with dementia in residential care settings, and to investigate the relationship between nursing presence and moral sensitivity. Background: Nursing presence is a core relational skill in nursing and holds many benefits for nurses and their patients. Moral sensitivity is defined as how one recognises the moral elements of a situation, and how one’s moral or ethical decision making may impact on an individual. Methods: A descriptive, cross sectional quantitative methodology was used with a sample of 150 registered nurses. The Presence of Nursing Scale for Registered Nurses was used to investigate nursing presence, and the Moral Sensitivity Questionnaire for moral sensitivity. Results: Findings from the study demonstrated that participants agreed with the majority of elements of nursing presence, (mean 76.97, SD= 7.51). A mean score of 36.22 was evidence of a well developed level of moral sensitivity in participants. Nurses who perceived themselves to be highly present to their patients also scored highest on certain elements of moral sensitivity such as moral strength. Nursing presence was also found to be more developed in those participants that rated themselves as having higher levels of expertise based on Benner’s (1984) definitions. Older nurses also scored higher on nursing presence. There was a high level of agreement that factors such as lack of time (n=133), and heavy workload influenced nursing presence. Nurses, who were older and had longer clinical experience, were shown to have greater moral strength. There were differences in elements of moral sensitivity between groups of nurses who ranked themselves according to Benner’s (1984) competence framework with higher scores evident in the more expert groups. Conclusion: Overall, this study showed that participants had a well developed level of nursing presence, and certain elements of moral sensitivity are positively related to nursing presence. Nursing presence appears to be linked to the level of expertise of the nurse but factors such as time and workload do influence nursing presence.