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

Hui Jin Kim; Hye Young Kim

doi:10.7469/kjan.2016.28.5.572

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

Original Article

Korean J Adult Nurs 2016;28(5):572-584.

Published online: NaN October 2016

DOI: https://doi.org/10.7469/kjan.2016.28.5.572

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

Hui Jin Kim, BSN, RN^1,, Hye Young Kim, Ph.D., RN²

^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 31 July 201629 September 2016 Accepted 24 October 2016

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.

Abstract

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.

Keywords: Long-term care, Stress, Nurses

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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.	Trivial workloads for nurses who care old patients
․ 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.	Difficulties in controlling symptoms of patients
․ 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.	Difficulty in building trust with patients’ family
․ 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.	Feeling of helplessness in death
․ 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.	Dilemma between death and life
․ 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.	Prejudice towards the long-term hospitals
․ 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.	Do not getting respect as professional nurses
․ 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.	Willingness to help each other
․ 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.	Getting energy from patients and patient's family

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