Page 213 - Essentials of Nursing Leadership and Management, 5th Edition

CikguOnline
2208_Ch13_197-216.qxd 11/6/09 6:01 PM Page 200
200 unit 3 | Professional Issues CikguOnline
5. Bad stress leaves feelings of exhaustion and Initial Concerns
avoidance. The first few weeks on a new job are the “honey-
6. Good stress helps growth; bad stress is limiting. moon” phase. The new employee is excited and
Good stress improves interpersonal relation- enthusiastic about the new position. Coworkers
ships; bad stress makes these relationships usually go out of their way to make the new person
worse. feel welcome and overlook any problems that arise.
7. Processing all stress requires human action. But honeymoons do not last forever. The new
graduate is soon expected to behave like everyone
The Real World else and discovers that expectations for a profes-
sional employed in an organization are quite differ-
Today’s health-care system has adopted the cor- ent from expectations for a student in school.
porate mindset. Both the new graduate and the Those behaviors that brought rewards in school are
seasoned professional continue to experience not necessarily valued by the organization. In fact,
redesigning, changing staffing models, complex some of them are criticized.The new graduate who
documentation requirements, continued nursing is not prepared for this change feels confused,
shortages, and the expectation that work does not shocked, angry, and disillusioned. The tension of
end when the employee goes home (Trossman, the situation can become almost unbearable if it is
1999). Most agencies expect new graduates to not resolved. Table 13-2 provides a list of ongoing
come to the work setting able to organize their and newer workplace stresses
work, set priorities, and provide leadership to Graduate nurses in the first 3 months of employ-
ancillary personnel. New graduates often say, “I ment identified concerns related to skills, personal
had no idea that nursing would be this demand- and professional roles,patient care management,the
ing.” Even though nursing programs of study are
designed to help students prepare for the
demands of the work setting, new nurses still need
table 13-2
to continue to learn on the job. In fact, experi-
enced nurses say that what they learned in school Stress in the Workplace
is only the beginning; school provided them with Ongoing Sources Newer Sources
the fundamental knowledge and skills needed to Conflict with physicians Terrorism
continue to grow and develop as they practice Work overload/ Changes in technology
nursing in various capacities and work settings. work devalued
Graduation signals not the end of learning but the Role conflict Downsizing
beginning of a journey toward becoming an expert Ineffective, hostile, Constant changes in nursing
nurse (Benner, 1984). incompetent supervisors care delivery
and/or peers Work/home conflicts
Right now you are probably thinking,
Lack of personal job fit; Elder and child care issues
“Nothing can be more stressful than going to
inadequate preparation, Workplace violence
school. I can’t wait to go to work and not have to recognition, or clear job
study for tests, go to the clinical agency for my description
assignment, do patient care plans,” and so forth. Poor work control, fear Lawsuits related to job stress
In most associate degree programs, students are and uncertainty related
assigned to care for one to three patients a day, to career progress
working up to six or seven patients under a Age, gender, racial, Demands of accreditation/
religious discrimination compliance issues
preceptor’s supervision by the end of their pro-
Dealing with death Pressure for immediate results
gram. Compare this with your “next clinical rota-
and dying patients/
tion,” your first real job as a nurse. You may work families
7–10 days in a row on 8- to 12-hour shifts, car- Salary Colleagues’inexperience
ing for 10 or more patients. You may also have to Adapted from DeFrank, R., & Ivancevich, J. (1998). Stress on the job: An
supervise several technicians or licensed practical executive update. Academy of Management Executives, 12(3), 55;
nurses. These drastic changes from school to McVicar, A. (2003). Workplace stress in nursing: A literature review.
Journal of Advanced Nursing, 44(6), 633–642; and Hall, D. (2004).
employment cause many to experience reality Work-related stress of registered nurses in a hospital setting. Journal
shock (Kraeger & Walker, 1993; Kramer, 1981). for Nurses in Staff Development, 20(1), 6–14.