Occupational Health: Exploring Job Stress and Work Ability in Nurse Managers


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Nurse managers provide key leadership toward reaching patient care and organizational goals in the new models of healthcare endorsed by the Institute of Medicine (2011). While much work had been reported in the literature related to stress and nursing, no studies were found that assessed job stress and work ability among nurse managers in the United States. This quantitative, exploratory study used two instruments—the Nurse Stress Index (1989) and the Work Ability Index™ (2013)—and investigator-generated work-related questions to assess levels of job stress and work ability among nurse managers working in acute care hospitals in the United States. The Neuman Systems Model (2002), a holistic, open systems model provided a theoretical framework in which the nurse manager is situated among the variables in the study. The role of the nurse manager has evolved from one of expert clinician (i.e., head nurse) to one with significant spans of control and responsibility for patient care outcomes and organizational goals (Shirey, 2006). The current definitions of healthy workplaces in nursing found in the literature are narrow in scope and relate to the nursing practice environment (American Association of Critical Care Nurses, 2005). By measuring work ability, this study adopts a broader view and looks at healthy workplaces from an occupational health standpoint within the context of the World Health Organization model of healthy workplaces, which includes physical work environment, psychosocial work environment, personal health resources, and enterprise community involvement (Burton, 2010).
The findings of this study (n=92) suggest that nurse managers in the United States are experiencing relatively low to moderate levels of work-related job stress and have average or good/excellent work ability. Limitations include a nonrandom homogenous sample of limited size, which could account for results that contradict findings from other studies that found high levels of job demands and stress (Johansson, Sandahl, & Hasson, 2013; Shirey, 2009).



Occupational Health, Job Stress, Work Ability, Nurse Manager, Stress, Nurse Stress Index