1. Job Related Stress Among The
Nurses Working in Critical Care
Areas at BPKIHS
R S Mehta
Medical-Surgical Nursing Department
B.P. Koirala Institute of Health Sciences
Dharan, Sunsari, Nepal

2. BP Koirala Institute of Health
Sciences (BPKIHS)
BPKIHS is one of the pioneers Health
Sciences university of Nepal. It was
established in 1993 with the help of GOI.
Over the years it has been grown in every
sphere and render the hospital services in
various specialties and super specialty. At
present the bed strength of hospital is more
than 700 and about 400 nurses are
working.

3. Introduction:
• Nurses positioned to influence the health
care and Nursing
• Demand for lifelong learning with:
foresight, environmental scanning & sound
health policies.
• In UK: 342 nurses committed suicide
( 1992-1998=6 years)
• Stress is: inevitable & is a part of our life,
Majority of people suffer from it.

4. Introduction ( continue):
• It is impossible to avoid stress
• We live in an imperfect and unpredictable
world.
• Stress causes: Positive as well as
Negative influence in our life.
• Positive Influences: Motivating force
towards progress
• Negative influence: Creates feelings of
distress, rejection and depression.

5. Negative influences:
• Causes physical and psychological
Problems.
• Stress may causes: High BP, Heart attack,
APD, Headache, Asthma, Cancer,
Depression
• Stress causes Reduced attention, forgetting
& poor work performance.
• Stress and depression are like a virus: you
catch it at work and take it.
All of are potentially dangerous for critical care
unit nurses.

6. Objective of the study:
The main objective of this study was
to find out the job-related stress
among the nurses working in critical
care areas at BPKIHS.

7. Research Design and
Methodology:
• Design: Hospital based descriptive
exploratory study.
• Areas: All critical care units ( 63 bedded)
• Population: All the 81 nurses working in
critical care units were included.
• Sampling: Total enumerative sampling
technique was used.
• Sample
size:
57
subjects
were
participated (sample mortality =24)

8. • Tools: semi-structured questionnaire
• Ethical clearance: written permission
from concerned authority & Informed
verbal consent from participants
• Methods of data collection:
- Tool given in self-addressed envelop
- Anonymity & personal identity was not
included in the tool
• Analysis of Data:
SPSS-10.5 software package was used

9. Results
&
Discussions:

10. Unit wise distribution of bed
strength, population & sample: N=57
Fig. -I Unit wise distribution of Subjects
35
30
28
30
Bed strenght
20
20
15
10
20
15
1314
8
6
4
5
IC
U
IC
U
/M
P
N
IC
U
/N
ur
se
ry
E
m
er
ge
nc
y
C
C
U
0
units/ Wards
Total Staff Nurse
(Population)
12
8
7 6
6
IC
U
Number
25
Study Subject
(Sample)

11. Age group of the study subject:
Fig. II Age group of the study subjects
9%
26%
65%
<25 years
26 - 30 years
>30 years
N=57

12. Level of job satisfaction: N=57
S.N.
Factors
Responses: (%)
Not at all
(<25% )
Slightly
(25 – 50%)
Moderately
(50 – 80%)
Fully satisfied
(> 80%)
a.
Job security
25.5
21.3
34.0
19.1
b.
Pay scale
31.9
29.8
31.9
6.4
c.
Nursing administration
40.4
25.5
27.7
6.4
d.
Evaluation system
44.7
23.4
21.3
10.6
e.
Nursing care provided to the
Patient
6.4
6.4
38.3
48.9
f.
Security service
27.6
21.3
34.0
17.0
g.
Cooperation from helpers
12.8
40.4
31.9
14.9
h.
Guidance & supervision service
12.8
42.6
25.1
19.5
i.
Physical facilities available in the unit
i.e. light toilet, furniture, etc.
6.4
27.7
36.2
29.8
j.
Overall
career.
10.7
31.9
36.2
21.2
satisfaction
with
nursing

13. Factors of stress related to workload:
N=57
S
N Stress factors
a.
Responsibility on patient care
b.
Shortage of staff
d.
Inadequate time to complete
task
e.
Workload too high
f.
Trying to achieve minimum
standard
Responses: (%)
Not at all
(< 25% )
Slightly
(25 – 50%)
Moderately
(50 – 80%)
Very much
(> 80%)
29.8
14.9
14.9
40.4
4.2
14.9
23.4
57.7
23.3
34.0
29.8
12.8
6.3
12.8
21.3
59.6
21.3
23.4
40.4
14.9

14. Factors of stress related to lack of
support and involvement
N=57
Responses: (%)
S.N Stress factors
.
Not at all
( 25% )
Slightly
(25 – 50%)
Moderately
(50 – 80%)
Very much
(> 80%)
a.
Lack of friendly working
condition
25.5
36.1
21.3
17.0
b.
Lack of
colleagues
51.1
27.6
12.8
8.5
c.
Poor Motivation
42.6
25.5
10.6
21.3
d.
Lack of recognition for ones
effort
21.2
25.5
23.3
29.8
e.
High sickness among staff
19.2
34.0
27.7
19.1
support
from

15. Stress factors related to
patients/relatives: N=57
Responses: (%)
S.N Stress factors
Not at all
( <25% )
Slightly
(25 – 50%)
Moderately
(50 – 80%)
Very much
(> 80%)
a.
Demanding patients
36.1
27.7
23.5
12.6
b.
Aggressive relatives
8.5
31.9
27.6
31.9
d.
Pressure from other
staff
36.2
31.9
21.1
10.8

16. Stress related to administrative
problems: N=57
Responses: (%)
Not at all
( <25% )
Slightly
(25 – 50%)
Moderately
(50 – 80%)
Very much
(> 80%)
from
34.0
21.3
19.1
25.5
b.
Poor promotion opportunity
10.6
14.9
25.5
48.9
c.
Poor
structure
19.1
34.0
23.4
23.4
d.
Limited annual leave
19.1
27.7
31.9
19.1
e.
Organizational
managerial problems
21.2
25.5
27.7
25.5
S.N.
Stress factors
a.
Lack of
supervisor
support
organizational
and

17. Major findings:
Too high workload (59.6%) & shortage of Staff
(57.5%) are main reasons for job
dissatisfaction.
• Half of the subjects (48.9%) were satisfied
with Nursing care, they provided.
• 44.7% subjects not satisfied with evaluation
system.
• Similar findings were reported in the study
conducted by Hall, Shaver, Makhija, &
Bhattacharya.

18. Recommendations
• A similar study on a large sample including
various units can be conducted.
• Continuous & scientific evaluation system
can decreases stress among the nurses.
• In-service education programme can be
arranged for the nurses working in the critical
care
unit
in
various
aspect
like,
communication,
interpersonal
relations,
technical component to raise the satisfaction
level.

19. References:•
•
•
•
•
•
•
Bhattacharya A. Stress among Cardiac nurses related to
patient’s satisfaction during hospitalization. Asian Journal
Of Cardiovascular Nursing 1998;6 (1).
Makhija N, Gupta R. Personality Development and Stress
Reduction in Nursing Personnel. NJI. 2000; 89 (12): 275276.
Hall DS. Work related stress of registered nursed in a
hospital setting. Journal of nurses staff development.
2004;20(1):6-14.
Shaver KH , Lacey LM. Job and carrer satisfaction among
staff nurses: effect of Job setting and environment.
Journal of nursing administration.2003, 33(3):166-72.
Sura O. strategies for stress. Nursing Times . 1989. Sept:
13-19.
Riding R. Occupational stress and cognitive style in
nurses. BJN: 1992, 4 (2).
Julia C . Opting out of burn out. Nursing Times. 1991,
May ;15-21.

20. Thank you