The working environment is a significant recourse of occupational stress .Management of occupational stress is important because it is directly related to loss of productivity and the loss of working hours. Research has established that stress is important and it is healthy. An article published by the journal of organizational journal, the authors associate burnout with the; loss of enthusiasm to work, persistent feeling of cyanism and low sense of personal accomplishment. Research established that 68% of the ICU will not choose their specialty if there careers were to start a new.(Karlson,2019) While the rate of burnout is not high in nurses when compared to physicians, it is still significant .However excessive amounts of stress is not acceptable as it loses its beneficial effect and becomes harmful.
As a profession, nursing requires delivering of proficient, moral and humane care in the working environments despite the responsibilities and the limited resources that are available. Research established that nurses experience fatigue and burnout impacts negatively to the impacts of the nurses negatively and their ability to offer quality and efficacy care to patients. The ICU is characterized by a variety of challenges including dealing with patients who are in chronic conditions and they are almost dying (Chepkwony, 2019). The ICU is also characterized by a lot responsibilities and instruction taking from the physcians.These challenges can affect overwhelmingly the wellbeing of the nurses and in one way or the other the nurses may be involved in behaviors such as alcohol and drug abuse and they are more likely to eat poorly.
There are different motivations that drives individuals to pursue nursing. The primary intentions are usually associated with the desire to help people. However in the course of the work, when the reality strikes, people realize that this was not what they wanted, considering the responsibilities involved and the fact that you are dealing with people who are dying(McDonell et al,2019).Healthcare institutions comprises of different functions and the nurses present are assigned different tasks. The intensive care unit is a unit that handles patients that are extremely in chronic conditions. The ICU is characterized by a lot of challenges including the risk of contracting high infectious. The use of sharp tools like the needles increases the chances of contracting this diseses.Dangerous treatment procedures such as chemotherapy can expose the nurses to this conditions.
The high levels of stress has been associated with truancy and low levels of productivity. The American institute of stress, stress contributes to 80% of all the work related injuries and 40% of the work place turnovers. As a profession, nursing is characterized by high job demands, too much responsibility and less authority Working environments in the ICU are stressful at times and this is mostly because the patients present in the ICU are usually in chronic conditions. Stress is usually a state and not an illness. It usually comes about after continued exposure to a wide unending occupational demands. Stress can contribute to a number of outcomes at the work place. Stress can affect the health of the nurses, their happiness and their productivity at the work place.
The main aim of the study
To define occupational stress amongst ICU nurses and to explore resilience strategies used by ICU nurses to ameliorate stress whilst positively affecting their sense of wellbeing.
Paradigm and Methodology
The paradigm of the research will incorporate the principals of ontology and epistemology .Ontology is a philosophical field that revolves around the study of nature and reality (All that exists) and the different categories that exist within the reality (Wilson et al, 2019). Epistemology on the other hand involves the study of knowledge and how to achieve .A number of theories exist in the field of ontology. There is lack of consensus of stress related terms and in some cases the terms have given out different meanings. Ontology is an enriched model of knowledge. It can be designed to provide a framework for knowledge about human stress.
The data for this study will be collected from both the secondary and the primary .The primary sources of information include the nurses. The selection criteria for the participants who took part in the research is as follows.
i. All nurses working in ICU with nursing registration including the casual nurse
ii. Enrolled nurses without registered number will be excluded.
The data collection will occur in two phases. The quantitative data will be collected before the qualitative data. The phenomelogical paradigm will be used in collection of data. The respondents will be required to describe appropriately basing on what they have experienced and not from a pre conceived perspective or what they have learned before. I choose PA as it is a qualitative approach which aims to provide detailed examination of personal lived experience. (Karp, 2019).PA is especially valuable when examining topics which are complex, ambiguous and emotionally laden. Stress is a prime example for this. This method is good to access and illuminate a difficult or sensitive subject.
The collection of qualitative data will take place in the month of April and it will involve through the use of online surveys from participants located from far geographical backgrounds. The total number of participants sloughed for the research are 200.The questions will majorly seek to establish the stress levels of the participants.
The sample size in phenomenological studies are usually small, which enables a detailed and very time consuming case by-case analysis. This study will use semi-structured interviews. Yüksel, 2019) describe semi-structured interviews as the best data collection method for phenomenology as they allow participants to speak about their personal experience. The semi-structured interviews will begin with general questions to build rapport, provide flexibility, and encourage detailed, rich narratives of personal experiences, and provide novel in-depth data (Van Manen, 2019). Key questions asked for this study will include aspects on stress levels that emanate from the work environment and specifically the stress associated with the intensive care units. The Interview times will to be tailored to fit with staff’s availability. Interviews will last approximately 45 minutes and be completed in a place familiar to the participant. A digital recording device will be used to capture the interviews to provide an accurate account of participants’ conversation and sequence, pauses, in-breaths, and musings. Non-verbal observations will be noted for analysis. The interviews will be transcribed verbatim. An outside researcher will be conducting the interview.
The study will employ a qualitative descriptive mixed methods design .This method involves the researcher or the team of researchers combine a number qualitative and quantitative approaches. This involves the combination of qualitative and quantitative view points in the research approach. The mixed methods design usually has a several primary characteristics that are put into consideration .This involves the purpose of mixing, the theoretical drive, and timing. The time of integration and the degree of complexity.
Semi structured interviews will be used because they make it easier during the interviewing procedures to move from the general topics to more specific topics. Semi structures interviews are the most preferred in qualitative descriptive mixed methods. The online surveys for collection of quantitative will be the most preferred because they are easier to administer, they are cost effective and can relatively cover a larger population.
Qualitative research questions
- How do ICU nurses experience occupational stress and what resilience strategies do they employ to ameliorate stress and maintain a sense of wellbeing?
1) What are the factors that causes occupational stress among ICU Nurses?
2) What does workplace wellbeing look like for ICU nurses?
3) How does the occupational stress affect ICU nurse wellbeing?
4) What particular strategies are used to overcome occupational stress?
Demographic data in this case will be analyzed using descriptive statistics. Mean values will be used to analyze the descriptive statistics. The mean values will be used to describe the quantitative, to portray the absolute and the relative frequencies (Pathak, 2019). Descriptive are very important because it is usually hard to visualize raw data and more especially when a lot of data is involved. (George &Madley, 2016)Descriptive data makes it possible to represent data in a more meaningful way. (Green et al, 2016) The collected data will be analyzing using SPSS 24 software. Statistical tests going to be used in this study included Chi square, T test and multivariate ANOVA. The association of two factors that is the stress levels and its relation to wellbeing of the nurses by Pearson correlation coefficients which were portrayed as absolute and relative frequencies. (Zhou, 2016)
Evidence of credibility for this study will be established through the participant interviews by an outside researcher. More over two members of the research team will verify the interview transcripts independently along with triangulation and verbatim quotes. Use of the triangulation helps in removing the biases and helps to determine the accuracy of the research. Any disagreements will be discussed and agreed upon. The evidence of study findings are transferable to similar demographics in other hospitals. The interactive data collection and the constant comparison analysis chosen for this study will help reach theoretical saturation. (Duan et al, 2016) The use of questionnaires, focus groups, interviews will form the basis of audit trail and will be supported by peer debriefing and previous literature already published .Judith &Nicki (2018) stated mixed methods can make significant contribution to enhancing the generalizability and transferability of research.
In summary, the study will employ qualitative descriptive mixed methods design to explore occupational stress amongst ICU nurses and to explore resilience strategies used by ICU nurses to ameliorate stress whilst positively affecting their sense of wellbeing. The research will incorporate the principals of ontology and epistemology to provide more knowledge related to stress. Semi structured interviews will be used because they make it easier during the interviewing procedures to move from the general topics to more specific topics Semi-structured interviews with active female business owners is the primary data source. Triangulation will be used to remove bias from the answers from the respondents.
Chepkwony, I. C. (2017). Effect of occupational stress on employee psychological well-being. A case of medical professionals in hospitals in Baringo County, Kenya (Doctoral dissertation, Egerton University).
Duan, S., Tian, G., Ji, Y., Shao, J., Dong, Z., & Luo, Y. (2015). Theoretical modeling of plasmon-enhanced Raman images of a single molecule with subnanometer resolution. Journal of the American Chemical Society, 137(30), 9515-9518.
George, D., & Mallery, P. (2016). Descriptive statistics. In IBM SPSS Statistics 23 Step by Step (pp. 126-134). Routledge.
Karlsson, A. C., Gunningberg, L., Bäckström, J., & Pöder, U. (2019). Registered nurses’ perspectives of work satisfaction, patient safety, and intention to stay–a double‐edged sword. Journal of nursing management.
Karp, N. C., Hauer, K. E., & Sheu, L. (2019). Trusted to learn: A qualitative study of clerkship students’ perspectives on trust in the clinical learning environment. Journal of general internal medicine, 34(5), 662-668.
McDonnell, L., Lavoie, J. G., Healey, G., Wong, S., Goulet, S., & Clark, W. (2019). Non-clinical determinants of Medevacs in Nunavut: perspectives from northern health service providers and decision-makers. International journal of circumpolar health, 78(1), 1571384.
Van Manen, M. (2016). Phenomenology of practice: Meaning-giving methods in phenomenological research and writing. Routledge.
Pathak, A., & Intratat, C. (2016). Use of semi-structured interviews to investigate teacher perceptions of student collaboration. Malaysian Journal of ELT Research, 8(1), 10.
Wilson-Anstey, E., Lambert, W. M., & Krog, H. (2019). Wellness for All: Diversity, Challenges, and Opportunities to Improve Wellness for Medical Students. In Medical Student Well-Being (pp. 125-153). Springer, Cham.
Yüksel, P., & Yıldırım, S. (2015). Theoretical frameworks, methods, and procedures for conducting phenomenological studies in educational settings. Turkish online journal of qualitative inquiry, 6(1), 1-20.
Zhou, H., Deng, Z., Xia, Y., & Fu, M. (2016). A new sampling method in particle filter based on Pearson correlation coefficient. Neurocomputing, 216, 208-215.