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  • Mental health

Exposure to Stress: Occupational Hazards in Hospitals (Part 1)

Occupational stress has been a long-standing concern of the health care industry. Studies indicate that health care workers have higher rates of substance abuse and suicide than other professions, and they experience elevated rates of depression and anxiety linked to job stress. In addition to psychological distress, other outcomes of job stress include burnout, absenteeism, employee intent to leave, reduced patient satisfaction, and diagnosis and treatment errors.

What causes occupational stress?

The National Institute for Occupational Safety and Health (NIOSH) defines occupational stress as "the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the worker."

The following workplace factors (job stressors) can result in stress:

  • Job or task demands (work overload, lack of task control, role ambiguity)
  • Organizational factors (poor interpersonal relations, unfair management practices)
  • Financial and economic factors
  • Conflict between work and family roles and responsibilities
  • Training and career development issues (lack of opportunity for growth or promotion)
  • Poor organizational climate (lack of management commitment to core values, conflicting communication styles, etc.)

Stressors common in health care settings include the following:

  • Inadequate staffing levels
  • Long work hours
  • Shift work
  • Role ambiguity
  • Exposure to infectious and hazardous substances

Stressors vary among health care occupations and even within occupations, depending on the task being performed:

  • In general, studies of nurses have found the following factors to be linked with stress:
    • Work overload
    • Time pressure
    • Lack of social support at work (especially from supervisors, head nurses, and higher management)
    • Exposure to infectious diseases
    • Needlestick injuries
    • Exposure to work-related violence or threats
    • Sleep deprivation
    • Role ambiguity and conflict
    • Understaffing
    • Career development issues
    • Dealing with difficult or seriously ill patients
  • Among physicians, the following factors are associated with stress:
    • Long hours
    • Excessive workload
    • Dealing with death and dying
    • Interpersonal conflicts with other staff
    • Patient expectations
    • Threat of malpractice litigation

The quality of patient care provided by a hospital may also affect health care worker stress. Beliefs about whether the institution provides high-quality care may influence the perceived stress of job pressures and workload because higher quality care may be reflected in greater support and the availability of resources.

What are the potential adverse health effects of occupational stress?

Stress may be associated with the following types of reactions:

  • Psychological (irritability, job dissatisfaction, depression)
  • Behavioral (sleep problems, absenteeism)
  • Physical (headache, upset stomach, changes in blood pressure)

An acute traumatic event could cause post-traumatic stress disorder (PTSD). Not every traumatized person develops full-blown or even minor PTSD.

Although individual factors (such as coping strategies) and social resources can modify the reaction to occupational stressors to some degree, working conditions can play a major role in placing workers at risk for developing health problems.

U.S. Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH). (Reviewed 2014, June 6). Exposure to stress: Occupational hazards in hospitals (NIOSH Pub. No. 2008-136). Retrieved December 17, 2020, from https://www.cdc.gov

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