Occupational Stress in RNs: A Mixed Methods Study

The pervasiveness of occupational stress in healthcare settings and its impact on registered nurses (RNs) has been a professional concern for decades. Occupational stress impacts the well-being of nurses and contributes to attrition from RN direct-care roles. One option for RNs experiencing high stress is to enter graduate school for an advanced degree. This descriptive, mixed-methods study explored the occupational stress of RNs enrolled in a master’s nursing program and workplace factors that motivated their decision to leave direct-care nursing. The participants (n=190) completed the Nurses Stress Scale which divides sources of occupational stress into three environments - psychological, social, and physical. The results demonstrated that physical environment factors including staffing, scheduling, and lack of time to provide quality patient care were the predominant source of occupational stress. Psychological environment factors regarding the emotional work of nursing, including patient suffering and deaths, were perceived as less stressful. Interactions with peer RNs, physicians, and supervisors in the social environment created the lowest perceptions of occupational stress. More than half of the participants also responded to the two open-ended prompts. This narrative data provided context about participant experiences and supported the quantitative results, highlighting the difficulties related to the physical environment and structure of the workplace. The study adds to the literature on occupational stress in nursing and provides insight about stressors leading to attrition from direct-care nursing.