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Experience of Job Stress among Nurses Working in Long-term Care Hospital: A Phenomenological Approach

Hui Jin Kim, BSN, RN1, Hye Young Kim, Ph.D., RN2
Korean Journal of Adult Nursing 2016;28(5):572-584.
Published online: October 31, 2016

1Nurse, Jeong Daun Long Term Hospital, Changwon

2Assistant Professor, College of Nursing, Keimyung University, Daegu, Korea

Corresponding author: Kim, Hye Young College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea. Tel: +82-53-580-3934, Fax: +82-53-580-3916, E-mail: hye11533@kmu.ac.kr
• Received: July 31, 2016   • Accepted: October 24, 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study was to explore the subjective experience of job stress among nurses working in long-term care hospitals.
  • Methods
    A phenomenological approach was used for the study. Data were collected from May to June, 2016 using open-ended questions during in-depth interviews. Participants were nurses working in long-term care hospitals and had reported experiences of stress. Six nurses participated in this study.
  • Results
    Six themes emerged from the analysis using Colaizzi's method: (a) Heavy workload and responsibility due to nurse shortage, (b) Getting exhausted by caring for cognitively impaired patients, (c) Feeling pressure due to conflict with patients’ family, (d) compassion for patients who are getting worse, (e) Low value in being a long-term hospital nurse, and (f) Efforts to overcome stress.
  • Conclusion
    Sufficient labor supply, environmental improvements, program for improving interpersonal skills, education and counseling on end-of-life care, and recognition improvement about long term hospital are suggested to reduce the job stress of long-term hospital nurses.
Table 1.
General Characteristics of Participants
Participants Gender Age Marital status Period of long-term care hospital work (year) Period of hospital work (year)
A Female 48 Married 5 18
B Female 34 Single 6 11
C Female 37 Married 4 10
D Female 37 Married 5 10
E Female 36 Single 8 14
F Female 34 Married 2 5
Table 2.
Themes, Theme Clusters and Categories of the Study
Themes Theme clusters Categories
․ Nurse shortage leads to various problems that work time per duty gets grow, and lack of break time makes nurses exhausted. Burden caused by Insufficient nurses Heavy workload and responsibility due to nurse shortage
․ There are no solutions for nurse shortage issue in long term care hospital.
․ Nurses have no choice in nurse shortage situation, and it makes them more exhausted.
․ Care-giver and nurse's aides feel bad to have working directions from younger nurses. Conflicts from unclear work borders between nurse and other care givers
․ Sometimes care-giver and nurse's aides don't proceed the orders they had.
․ Mental and physical burden becomes so large that staff must carry out many duties, from those related to their expertise, to the trivial. Trivial workloads for nurses who care old patients Getting tired and exhausted by caring for cognitive disorder patients
․ Miscommunication occurs between patients and their family members when the staff perform trivial duties.
․ It is difficult to control dementia patients when they have cognitive disorder. Difficulties in controlling symptoms of patients
․ It is difficult to control patients even with the use restraints and tranquilizers, that family members often will not agree to proceed with treatment.
․ Patients' family does not follow protocols and rules of the hospital. Stuffy upset made by patients’ family Feel pressure due to conflict with patients’ family
․ When patients’ family has a different opinion and does not agree with hospital's rules, they follow their rules.
․ When unexpected accidents occurs, family members may become suspicious of the nurse.
․ They feel guilty about the patients and family who complain about the care they receive from the nurses. Difficulty in building trust with patients’ family
․ Nurses receive blame from patients, even it is due to their own appointed condition change.
․ They are stressed from seeing the death of patients. Feeling of helplessness in death Sadness from patient's worse condition than recovery
․ They feel sadness from seeing patient's painful last moments.
․ There are no additional care for patients as a nurse to be taken other than attending to the patient. Dilemma between death and life
․ They have a complexed mind when they do not have active care or treatment duties.
․ Negative judgement and cognition for sanatorium exist. Prejudice towards the long-term hospitals Low awareness about the long-term hospital and their nurses
․ It makes nurses very discouraged that nurses in long-term care hospital have less expertise.
․ Nurses even avoid to work in long-term care hospital. Do not getting respect as professional nurses
․ Nurses get lower self-esteem because the duties that are necessary in long-term care hospitals involve less expertise.
․ Nurses help each other while performing difficult duties. Willingness to help each other The efforts and power of overcoming stress
․ Nurses overcome crisis by understanding and helping each others.
․ Nurses feel appreciated when patients’ family thanks to them with nice words. Getting energy from patients and patient's family
․ Nurses feel energetic when patients are satisfied with their treatment and care.
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References

    Citations

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    Experience of Job Stress among Nurses Working in Long-term Care Hospital: A Phenomenological Approach
    Korean J Adult Nurs. 2016;28(5):572-584.   Published online October 31, 2016
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    Experience of Job Stress among Nurses Working in Long-term Care Hospital: A Phenomenological Approach
    Experience of Job Stress among Nurses Working in Long-term Care Hospital: A Phenomenological Approach

    General Characteristics of Participants

    Participants Gender Age Marital status Period of long-term care hospital work (year) Period of hospital work (year)
    A Female 48 Married 5 18
    B Female 34 Single 6 11
    C Female 37 Married 4 10
    D Female 37 Married 5 10
    E Female 36 Single 8 14
    F Female 34 Married 2 5

    Themes, Theme Clusters and Categories of the Study

    Themes Theme clusters Categories
    ․ Nurse shortage leads to various problems that work time per duty gets grow, and lack of break time makes nurses exhausted. Burden caused by Insufficient nurses Heavy workload and responsibility due to nurse shortage
    ․ There are no solutions for nurse shortage issue in long term care hospital.
    ․ Nurses have no choice in nurse shortage situation, and it makes them more exhausted.
    ․ Care-giver and nurse's aides feel bad to have working directions from younger nurses. Conflicts from unclear work borders between nurse and other care givers
    ․ Sometimes care-giver and nurse's aides don't proceed the orders they had.
    ․ Mental and physical burden becomes so large that staff must carry out many duties, from those related to their expertise, to the trivial. Trivial workloads for nurses who care old patients Getting tired and exhausted by caring for cognitive disorder patients
    ․ Miscommunication occurs between patients and their family members when the staff perform trivial duties.
    ․ It is difficult to control dementia patients when they have cognitive disorder. Difficulties in controlling symptoms of patients
    ․ It is difficult to control patients even with the use restraints and tranquilizers, that family members often will not agree to proceed with treatment.
    ․ Patients' family does not follow protocols and rules of the hospital. Stuffy upset made by patients’ family Feel pressure due to conflict with patients’ family
    ․ When patients’ family has a different opinion and does not agree with hospital's rules, they follow their rules.
    ․ When unexpected accidents occurs, family members may become suspicious of the nurse.
    ․ They feel guilty about the patients and family who complain about the care they receive from the nurses. Difficulty in building trust with patients’ family
    ․ Nurses receive blame from patients, even it is due to their own appointed condition change.
    ․ They are stressed from seeing the death of patients. Feeling of helplessness in death Sadness from patient's worse condition than recovery
    ․ They feel sadness from seeing patient's painful last moments.
    ․ There are no additional care for patients as a nurse to be taken other than attending to the patient. Dilemma between death and life
    ․ They have a complexed mind when they do not have active care or treatment duties.
    ․ Negative judgement and cognition for sanatorium exist. Prejudice towards the long-term hospitals Low awareness about the long-term hospital and their nurses
    ․ It makes nurses very discouraged that nurses in long-term care hospital have less expertise.
    ․ Nurses even avoid to work in long-term care hospital. Do not getting respect as professional nurses
    ․ Nurses get lower self-esteem because the duties that are necessary in long-term care hospitals involve less expertise.
    ․ Nurses help each other while performing difficult duties. Willingness to help each other The efforts and power of overcoming stress
    ․ Nurses overcome crisis by understanding and helping each others.
    ․ Nurses feel appreciated when patients’ family thanks to them with nice words. Getting energy from patients and patient's family
    ․ Nurses feel energetic when patients are satisfied with their treatment and care.
    Table 1. General Characteristics of Participants

    Table 2. Themes, Theme Clusters and Categories of the Study

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