The top 12 ways to frazzle a nurse.

Australian nurses have one of the highest rates of workers compensation claims for work related mental stress.

A small study in the Journal of Nursing Management looked to identify the top occupational stressors from the perspective of nurses working in a regional hospital.

Such causes of occupational (and personal) stress are associated with negative physical and psychological health, as well as increased incidence of depression, increased staff turnover, and high sick leave.

This study interviewed 38 nurses from a variety of clinical settings and roles in a regional acute care hospital.
They asked about sources of stress for them in their own work environment. Here are the top 12 responses:

The top 12 ways to frazzle a nurse.

  1. High Workloads: including inadequate skill mix, staff shortages, high patient acuity and high nurse to patient ratios.
  2. Unavailability of Doctors: Nurses felt increased stress when they were unable to get doctors to review their patients.
  3. Unsupportive Management: limited support from those in senior management positions.
  4. Human Resource Issues: Included underpayment of staff and problems with the casual employment workforce.
  5. Interpersonal Issues: Bullying, poor communication (and documentation) and interpersonal conflict.
  6. Relatives of Patients: Demands placed on nurses by patient relatives. Included unreasonable requests and refusing to let relatives be discharged from hospital.
  7. Shift Work: Interfering with family lives. Sleep deprivation. Leaving nurses feeling exhausted.
  8. Car Parking: Having to park a great distance from the hospital and the associated personal security issues after hours.
  9. Handover Procedures: Communication during handover and confidentiality when providing bedside handover in front of other patients and relatives.
  10. No break room: Lack of dedicated common area for nurses to relax during their breaks.
  11. Not Progressing at Work: Poor career pathways and lack of recognition by management for their efforts.
  12. Mental Health Issues: Nurses stated that they felt under trained to care for patients with mental health issues.


Workplace management interventions may been grouped into primary, secondary and tertiary strategies.

“Primary prevention strategies aim to modify or eliminate stressors (e.g. work design, cognitive restructuring), second- ary strategies target responses to the inevitable stressors (e.g. relaxation techniques, social support) and tertiary strategies promote healing from the negative effects of stressors (e.g. employee assistance programmes).
Generally, primary and secondary strategies (focused on limiting the experience of stress) are preferred over tertiary strategies.”

The solutions proposed by the interviewed nurses included:

  • Looking at ways to modify the workloads.
  • Changing shift hours.
  • Developing processes for nurses to drive practice change.
  • Ensuring nurses get allocated breaks.
  • Growing effective nurse leaders.
  • Providing stress management training.

What do you think? Does this sound like your own work environment? Perhaps you work in a larger metropolitan hospital and have a different group of stressors. Perhaps your own unit has addressed many of these issues.

Let us know your own frazzle triggers.
And share with us any techniques you ay have developed to get from frazzle to flow.


  1. Nurses and stress: recognizing causes and seeking solutions Happell 2013 Journal of Nursing Management Wiley Online Library [Internet]. [cited 2013 Nov 7]. Available from:

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s