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Stress can be defined as the body’s response or reaction to a particular environmental stimulus. It is also a person’s reaction to events that make the person feel threatened upsetting their balance in some way; this response could be either physical or emotional and is the body’s way of protecting itself. “Stress is not always a negative thing but beyond a particular point it is harmful to one’s health” (Cohen & Wills, 1985, pp 310).

Stress produces a number of symptoms both emotional and physical depending on the situations and the severity. Physical symptoms include low energy, headaches, and nervousness just to mention a few. Emotional symptoms include depression, frustration, and poor judgment among many others. A number people cope with stress in very unhealthy ways such as smoking, drinking, over eating and under eating, withdrawal from the society and even taking it out on others through violence.

However, through stress management, stress can be managed and reduce the effects it strings along. “Stress management can be defined as a variety of techniques and psychotherapies that are aimed at controlling stress and assist in improving the day to day functioning of an individual suffering from stress” (Cohen & Wills, 1985, p. 310). A number of stress management techniques are readily available in order to control a person’s life and well-being.

Impact of stress on nurses   

Just like in any profession, stress affects professionalism among nurses and stress management is a very important part of nursing. This is because the nursing profession involves caring for others on a daily basis through development, implementation and evaluation of care plans for patients and is in fact a very demanding profession. A number of factors can cause stress to nurses as most of the time they are shorthanded, overworked and understaffed while still risking exposure to dangerous diseases. “Issues that nurses face that contribute to stress include the demands of the job, inability to cope with the job due to lack of knowledge or experience, ineffective leadership and management, lack of motivation and other stressors from their personal life” (Burke, 2000, p. 15).

Employee stress usually leads to job dissatisfaction and burn out and has severe consequences especially in the nursing profession. Physical related stress can bring health problems such as migraines, heart diseases, body pain, and mental problems such as insomnia, depression and anxiety. These symptoms can directly lead to absenteeism of nurses, decreased morale and decreased work performance, which in term affects the patients.

Stress related problems among nurses often reduce the safety measures and the level of care that patients are required to be given, often making numerous clinical errors. An example of a clinical error made by nurses is the wrong administration of drugs to a patient, which could be very harmful to their recovery and sometimes be fatal. “Absenteeism due to stress related problems can prove to be quite costly for the administration as they would be forced to make unplanned expenses such as recruiting and replacing nurses” (Aiken, Clarke & Sloan 2002, p. 1992).

Stress related problems directly affects the productivity of the nurses as well as the institution as a whole and needs to be dealt with. “Organizations and health institutions should ensure that stress management programs are available to help the nurses cope with their work to ensure efficient care for patients and maintenance of a professional work ethic”(Burke, 2000, p. 33). Various ways assist nurses in management of stress such as regular exercise and maintaining a healthy diet to keep their bodies fit and healthy enabling one to cope with both physical and emotional stress better. Other techniques include visualizations and affirmations.

Management of stress produces positive and healthy mental physical and emotional changes within an n individual. To avoid burn out, coping mechanisms such as self-affirmations and self-talks have been used although they appear to be insufficient. Social support systems among individuals greatly assist in coping with stress and specifically help in avoiding the negative ways to cope with stress such as smoking and drinking. Institutions should ensure that there are effective burnout prevention programs for nurses suffering from stress in order to ensure effectiveness and efficiency of the nurses (Aiken, Clarke & Sloan 2002).

Stress and stress management on the four paradigms of nursing


The individual refers to a single person or a unit such as a group or a family that are in need of nursing care. It explains that individuals are responsible for their own health in collaboration with the nurses. Individuals recognize the basic need to be respected as well as maintain the right to manage decisions regarding their health. This paradigm states that a person consists of the psychological, physiological, socio cultural, spiritual and developmental aspects in order to make the total composition of a human being (Cohen & Wills, 1985).

The physiological aspect of the body refers to the physicochemical structure as well as the functioning of the body. When faced with stress this aspect of the body reacts in a negative way and hence alters the regular functioning of a person’s physiology and eventually affects day-to-day activities. The psychological aspect refers to the mental and emotional processing of a human being. As mentioned before, mental and emotional symptoms of stress such as depression and anxiety affect the productivity and the work ethic of a nurse often leading to devastating clinical errors.

The socio-cultural aspects of an individual include their relationships, expectations and activities in the society. Symptoms of stress on this aspect such as withdrawal from the society and angry outbursts greatly affect the individual’s interaction with other people and their work ethic as a nurse. The spiritual aspect refers to spiritual beliefs while the developmental aspect refers to the known processes related to life development

Stress among nurses should be managed at an individual level. Health institutions should ensure that stress management programs are easily available to those who need it and that proper working conditions are established in order to avoid work related stress.


The environment in which an individual is situated is very influential to their well-being and overall health. It can be defined as both the internal and external forces that an individual interacts with and is an integral part of the nursing profession. Nursing requires that these influences on them as well as their patients are improved in and maintained positively in order to maintain professionalism. “Environmental stressors can be quite harmful to the individual and alters their day to day functioning hence affecting their work.” (Cohen & Wills, 1985, p.330).These stressors include being underpaid, and understaffed, overworked and poor working conditions that will take a toll on the nurses as well as the patients


Health is defined as a state of harmony between the psychological, physiological, spiritual and social aspects within an individual and the environment i.e. a state of wellness within a person. “Maintaining the health of an individual is the main objective of nursing”. (Aiken, Clarke & Sloan 2002, p. 7).Stress affects the health of an individual negatively as one can get both mental and physical problems as discussed before.


The nursing profession is unique as it entails all the variables that influence a person.  Nursing has been defined, as the action, which assists people, be it in the individual or group level to maintain the maximum level of wellness and stability. “The nursing profession entails direct care giving to patients and promotion of health through proper management, teaching and research on the subject matter.” (Aiken, Clarke & Sloan, 2002, p. 1989). The perception and the wellness of a nurse will greatly influence the care given to a patient proving that a nurse must be healthy both mentally and physically avoiding any type of stressors. A concerned relationship between the nurse and the patient must be developed in order to promote good health and recovery through medical knowledge and practice of good judgment.


Stress is very harmful to employees as it affects their health as well as their productivity in work. Nursing is a very demanding profession that demands care and skill to their patients making stress management a key part in this profession.

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