Problem/Issue IdentificationOccupational stress refers to “harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the workers” (NIOSH, 2008). meaning that the nurses do not have the work ability or capacity to perform their job due to some contributing factors. The key factors identified as occupational stressors among nurses are, inadequate preparation and resources, lack of support from the management, poor job structure, and lack of control in decision-making. The issue of inadequate preparation and resources arise when nurses do not have enough training experience on how to deal with difficult patients, the tools required during an important surgery, or even how to properly handle dangerous and hazardous chemicals used during emergencies. Having these lack of resources or preparation, might create intensive occupational stress, for example, when nurses do not know where to look for these equipment, or are wasting their time to find the appropriate tools in the correct intensive care. Likewise, not having the proper training, and being exposed to dangers, such as cancer patients where strong chemicals are being injected to them or doing the chemotherapy, also working with a higher rate of HIV patients, might stressed the nurses because of their fear of being exposed, also in the process of handling needles and bloods components improperly, where they might hurt themselves, then be injected instead. For all these nurses, working in theses infectious environment, really increase their stress, because of this constant fear of being infected in which will result to other factors such family conflicts, fear of dying and losing their family, or even have to quit their jobs. (Behdin, N et al, 2015; Mark, G. and Smith, A. P, 2012)Lack of support from the management can also create workplace stress among nurses, especially, conflicts between the management and the nurses on the improvements of nurses’ working conditions such as less intensive workload, more comprehensive and flexible work shifts, better compensation, and a supportive environment. The framework of job demand-job control model argues that higher stress occurs in the workplace, when the demands, i.e. the nurses’ duties are higher and their control for making decisions and the social support from the management and supervisors are low. (Karasek & Theorell, 1990; Muncer, Taylor, Green, & McManus, 2001). Equally, having poor relationships, little support, and encouragement from the management can lead to a loss of trust for example, when a physician and a nurse assistant are working together on a serious case, the nurses may end up having a low interest in problem solving, or do not know where to look for support or feedback, when they have to report serious working conditions, or difficult patients. Having to deal with all these difficult situations without a management support system, create an emotional stress for the nurses, and will be uncomfortable or fearful for them to ask for help or support from their supervisors or management due to their previous unresponsive claims. Due to this stress, nurses reported a higher rate of absenteeism, (Schalk et al., 2010), which lead to their “intent to quit” because of the lack of effective communication and support from management. (Mark, G. and Smith, A. P, 2012)The workplace is a complex environment, and stress at a work is a complex process. (Mark, G. and Smith, A. P, 2012) The lack of better workplace systems such as undefined job tasks, as well as job structure, and an excessive work overload can contribute to this complex and stressful processes. These issues of working long shifts, no flexibility, and heavy work schedules might arise from a shortage crisis of nurses who previously suffered from workplace stress. Hence, the actual employees have to bear with the hectic work schedules, due to no new staffs. According to World Health Organisation, the health care global shortage is a 7.2 million, and is expected to rise to 12.9 million by 2035, and Canadian studies showed that nurses are more likely to quit their position within the next 12 months due to high reported occupational stress. (World Health Organization, 2014). This issue can be seen as a continuous cycle, because the remaining nurses will work intensively with excessive and physical duties to fill up the gap, such as lifting heavy patients for their habitual check or bath, pushing patients on beds or trollies to different stations, have to work at irregular hours such as morning and night shifts, during their days off, and even have to change units to cover the shortage. Additionally, it takes time for nurses to readapt to a new work environment and build new relationships. Therefore, this situation will create more occupational stress, leading to more quits among nurses. (Clegg, 2001; Nelson, Lloyd, Menzel, & Gross, 2003) Lastly, nurses’ lack of involvement in decision making can contribute to higher occupational stress. (Behdin, N et al, 2015). This of lack of involvement in decisions, can also be explained using the framework of job demands-job control models, because stress arise due to higher nurses’ responsibilities and duties, and lower control in making decisions about the work shifts, the equipment and tools required for patients, and for nurses to execute their duties properly and timely. Therefore, the non-involvement of nurses in these decisions, create stress, frustration, and conflicts because they will have to deal with the patients, the families, and the management for not performing their work appropriately, which leads to being overwhelmed at work, and stressed about meeting the ends. To conclude, all these identified problems are interrelated, i.e. one issue is contributing to another one. However, the main drives of these issues, can be as well identified as a management problem regarding the hiring of nurses and the funding cutbacks happened in the 1990’s till today in the health-care sector. (Schalk et al., 2010).
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