Nurse tired from work while wearing PPE suit, concept of wellbeing and emotional resilience
HealthSeptember 10, 2021

Study examines link between work stress and resiliency

By: Sarah Handzel, BSN, RN
Even before the pandemic, nurses were at higher risk of compassion fatigue, burnout, and other issues related to high stress levels. It’s no secret nursing is one of the highest stress occupations — even when everything is “normal”, the healthcare industry constantly changes to meet the demands of our society.

Nurse managers are often faced with the unique challenge of managing performance expectations while also mitigating and coping with stress. A small pilot study was recently conducted in a Magnet®-designated 476-bed acute care community hospital that examined the effect of a stress reduction education program on nurse manager’s resiliency in the face of continued stress. This study, which included only 25 voluntary nurse manager participants, used surveys before and after the educational program to evaluate the impact of such a program.

Understanding the Challenge-Hindrance Stress Model

Introduced about 20 years ago, the Challenge-Hindrance Stress Model (CHM) groups workplace stressors into two categories:

  • Hinderance stressors, which interfere with job performance or goals
  • Challenge stressors, which contribute to performance opportunities

High workload, time pressure, and elevated levels of responsibility are all challenge stressors that nurse leaders face on a daily basis. They stem from demands or circumstances that have potential gains for the individual.

On the other hand, organization politics, red tape, and role ambiguity are all examples of hinderance stressors. They arise from demands or circumstances that might interfere with or constrain an individual’s work achievement.

Not all stressors have negative effects; but to have a positive effect, a nurse manager should try to remove hinderance stressors. This helps increase employee engagement and provides challenge stressors to help maximize performance.

Education program helps boost resiliency in high stress environments

Researchers used a questionnaire about work stressors and resiliency before and after presentation of an education program designed to promote resilience. At the start of the study, participants completed a 20-item survey rating stressors in terms of magnitude while also categorizing the stressor as a challenge or hinderance. Each stressor listed in the survey included 10 questions. Challenge stressors ask about:

  • Accountability
  • Responsibility
  • Task complexity
  • Time pressure
  • Workload
  • Work pace

On the other hand, hinderance stressors inquire about:

  • Administrative hassles
  • Interpersonal conflict
  • Organizational politics
  • Resource inadequacies
  • Role ambiguity
  • Role conflict

After completing the initial questionnaire, nurse leader participants were invited to attend and participate in an educational program designed to promote resiliency. The program enabled nurse leaders to master professional resilience competencies — topics covered included defining resilience, building support for resilience, growing stress hardiness, and more.

Implications for nurse leaders on workplace stressors and resilience

After participating in the educational program, nurse leaders completed another survey to measure the effect of the program on developing and enhancing resilience. Post-survey results showed the mean total score for resilience was higher, as was the mean challenge stressor score and the mean hinderance stressor score. The researchers identified a positive and significant correlation between resiliency and challenge stressors. Additionally, a positive, significant relationship was identified between challenge and hinderance stressors.

These results show how resilience training helped nurse leaders cope with various types of stressors in the workplace. Therefore, the principles of resilience should be taught and practiced among nurse leaders, not only to help with workplace functions, but to also improve job satisfaction and, ultimately, nurse retention.

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Sarah Handzel, BSN, RN
Freelance Health and Medical Content Writer, Wolters Kluwer Health
Sarah has over nine years’ experience in various clinical areas, including surgery, endocrinology, family practice, and pharmaceuticals. She began writing professionally in 2016 as a way to use her medical knowledge beyond the bedside to help educate and inform healthcare consumers and providers.
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