Occupational stress and burnout in acute care medical surgical nurses in a rural area

Abstract

The purpose of this study was to investigate stress and burnout in acute care, medical and surgical nurses in a rural hospital setting. The relationships between age, level of education, years of nursing experience, marital status, shift worked, length of the shift, and full or part time status with stress and burnout were investigated. The relationship between stress and burnout was also studied. Hans Selye's General Adaptation Syndrome was the theoretical basis for the study. The design for this study was a descriptive, correlational one, using a convenience sample of 84 registered nurses who worked on medical and/or surgical areas in a rural regional medical center in a mid-Atlantic state. Participation in the study was voluntary, and anonymity was guaranteed. The tools used in this investigation included a demographic questionnaire, the Nursing Stress Scale (NSS) , and the Maslach Burnout Inventory (MBI). Spearman Rho correlation coefficients were computed to examine the relationships between age, years of experience, stress and burnout. The relationship between the total stress score (NSS) and age was not significant. However, it was found that older nurses felt that they could not share experiences and negative feelings toward patients with their co-workers (r=.1950, p=.038). Older nurses also felt less emotional exhaustion than younger nurses (r=-.2533, p=.010). Statistically significant relationships were found between stress and burnout, including moderately positive relationships for emotional exhaustion and depersonalization with total stress (r=.3682, p=.000 and r=.3255, p=.001 respectively). A weak significant negative correlation existed between stress and personal accomplishment (r=.2382, p=.016). Mann Whitney U Tests, and Kruskal-Wallis one-way analyses of variance were used to test the differences between full and part time status, education, shift worked, length of the shift, and marital status with stress and burnout. Statistical significance was not reached at the .05 level on any of these compared differences. Multiple regression was used to explain the effect of the demographic variables on stress and burnout. Inadequate preparation to deal with the emotional needs of patients and their families (Factor 3 of the NSS) was found to explain 18% of the variance in depersonalization scores (p<.Ol). This same factor explained 27.6% of variance in personal accomplishment scores at the p=.000 level. Inadequate preparation, workload, and age accounted for 28.5% of the variance in emotional exhaustion (p=.0000). Implications for nursing, including the need for staff support groups and education in conflict resolution was suggested. Suggestions for further research, including the effect of personality hardiness on stress and burnout, were given.