Chapter One
Introduction
1.1 Background to the study
Stress can be defined as a physical or psychological stimulus that can produce mental tension or physiological reactions. It is regarded as the awareness of a difference between environmental demands (stressors) and individual capacities to fill these demands. Globally, the costs of work-related stress are estimated to be $5.4 billion each year which is one of the most frequently reported occupational health challenges (Moustaka & Constantinidis, 2010). The World Health Organization (WHO) has considered stress as a global epidemic, which is recently observed to be associated with 90% of visits to physicians (Akinboye, Akinboye & Adeyemo, 2002). It is also considered one of the most important workplace health risks worldwide which results in substantial costs to workers and organizations, related to employees absenteeism and turnover, physical illness, and poor performance (Baye, et al. 2020).
Among nurses, job stress is a global problem; and 9.2% to 68% of nurses may be faced with job stress (Dagget, Molla, & Belachew, 2016). Nurses play a vital role in health institutions and form the largest workforce in health care sectors. The increasing health care demands in the sector has created very tasking responsibilities for nurses especially in clinical settings, and consequently increased the vulnerability of nurses to varying degrees of job stress. Nursing also requires expenditure of energy on many levels. Physically, the job can be demanding with high levels of muscular-skeletal stress, culminating in many aches and pains. Mentally, nurses are required to be alert, making calculations for medication and responding to important questions from patients and relatives. Emotionally, the impact is felt when they empathize and help people, and from the toll of working in an environment where there is pain and sadness. The nurses’ work environment is often characterized by resource constraints, poor staff support and organizational change, which add to the energy expended (Halpin, Terry, & Curzio, 2017; Casu & Giaquinto, 2018).
The nursing role is rapidly changing and, as nurses are assigned to wider range of health care responsibilities, caring for the patients has definitely become more complicated. Nurses are exposed to a range of psychosocial stressors such as a lack of control, long work hours, shift work, interpersonal conflicts, insufficient resources, and poor reward system (Mohammad & Jaradat, 2017). Others include role ambiguity, role conflicts, and poor relationships with colleagues, subordinate officers or boss, just to mention a few. These stressors pose different levels of negative emotional, physical, and psychological effects on nurses and also impact their work performance (Olayinka, Osamudiamen, & Ojo, 2013). Research evidence demonstrated that excessive occupational stress reduces the quality of nursing care. If a nurse is stressed, it is difficult to give holistic nursing care to patients that may increase patient mortality rate (Smeltzer, Bare, Hinkle, & Cheever, 2008). Research evidence has also demonstrated a link between some stressors and work performances of nurses in different hospitals. For example, Donkor (2013) established that workload and conflict among colleagues and supervisors are among the major stressors which impact quality of work and work output of nurses in a hospital in Ghana.
However, the prevalence rates of stress among nurses vary according to healthcare institutions; and significantly determined by the available working equipment, personnel, working environments and work content. Therefore, this study chooses the Lagos State university teaching hospital (LASUTH), Lagos state as a case in point for establishing the different types of stressors prevalent among nurses and how these stressors impact their job performance.
1.2 Statement of the research problem
Although job stress is common to all professions, however, nurses seem to experience more job stress compared to other healthcare providers (Dagget, Molla, & Belachew, 2016). In Nigeria, hospitals are short-staffed and tight in budget. The difficulties in our society plus problems related to viral diseases and emerging health conditions, for example, the Covid-19 pandemic means that our healthcare system should deal with a growing number of complex illnesses.
Another problem is that Nigeria as one of the developing countries of the world is faced with gross shortage of nurses, consequent to poor enrolment into the profession and stresses that has compelled active practicing nurses to quit practice before their constitutional retirement ages. For instance, report shows that in most hospitals in Nigeria, the nurses-patients ratio per shift is 1:13, compared to 1:6 and 1:4 recommended by World health organization (WHO) and Nursing and Midwifery Council of Nigeria (NMCN) respectively (World Health Organization, 2011) . This ratio has no doubt contributed to stresses nurses face and the decline in the quality and efficiency of nursing care. This study therefore, evaluated the impact of job-related stress on work performance among nurses practicing in Lagos State university teaching hospital (LASUTH), Lagos state in order to suggest strategies that would keep nurses in practice and improve quality and efficiency of nursing care.
1.3 Objectives of the study
The aim of this study is to determine the impact of job-related stress on work performance of nurses in Lagos State university teaching hospital (LASUTH), Lagos state. To achieve this aim, the following objectives will be examined throughout the study:
- Determine the predisposing factors of work-related stress (sources of stress at work) among nurses in Lagos State university teaching hospital (LASUTH), Lagos state;
- Assess the stress levels among nurses in Lagos State university teaching hospital (LASUTH), Lagos state;
- Determine the extent to which the predisposing factors of stress affect the work performance of nurses in Lagos State university teaching hospital (LASUTH), Lagos state;
1.4 Research questions
- What are the predisposing factors of work-related stress (sources of stress at work) among nurses in Lagos State university teaching hospital (LASUTH), Lagos state?
- What is the current level of work-related stress among nurses in Lagos State university teaching hospital (LASUTH), Lagos state?
- To what extent do the predisposing factors of stress affect the work performance of nurses in Lagos State university teaching hospital (LASUTH), Lagos state?
1.5 Scope of the study
The scope of this study includes practicing nurses at the Lagos State university teaching hospital (LASUTH), Lagos state. The population of nurses for the study includes from the Nursing Services department of the hospital.
1.6 Significance of the study
Nurses are the cornerstone of the nation’s health care industry, they do not only offer care and comfort, but also serve as role models for good health care. There is, therefore, adequate justification to study the effect of work-induced stress on the work performance of nurses at Lagos State university teaching hospital (LASUTH), Lagos state. Such study will help the nurses and the management of the hospital to identify the causes of their stress and how to manage it and be able to deliver well to increase their performance. The outcome of this study will also be beneficial to researchers in that the findings of the study can inform further investigations across a larger population of nurses.
