Knowledge of Models of Stress for Nurses Essay

Critique and Analysis of Family Stress Theory Nursing theory explains the relationship between concepts to enhance understanding and knowledge about a phenomenon (Walker & Advant, 2005). Theoretical frameworks for nursing of families provide a foundation for guiding the development of family centered care and research (Friedman, Bowden, & Jones, 2003).The application of theory helps to guide nursing practice, education, and research and supports the development of evidence-based nursing strategies and interventions for both the individual and the family as the client.Knowledge of Models of Stress for Nurses Essay

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This paper will critique and provide an analysis of the family stress theory. A brief introduction of the history and author of this theory will be provided and the…show more content…
In 1996, McCubbin and McCubbin outlined the theory’s assumption of a family in crisis (Smith & Liehr, 2008, p. 227) : Families over the course of life face hardships and changes as a natural and predictable aspect of family life. Families develop basic competencies, patterns of functioning, and capabilities to foster the growth and development of family members and the family unit, and to protect the family from major disruptions in the face of transitions and changes. Families develop basic and unique competencies, patterns of functioning, and capabilities designed to protect the family from unexpected or non-normative stressors, and strains and to foster the family’s recovery following a family crisis or major transition or change. Families draw from and contribute to the network of relationships and resources in the community, including its ethnicity and cultural heritage, particularly during periods of family stress and crises. Families faced with crisis situations demanding changes in the family’s functioning work to restore order, harmony, and balance even in the midst of change. In the Family Stress theory’s metaparadigm, nursing is responsible in assisting families in the process of adaptation by promoting the family member’s health, help to recover from illness, assist the family member to function within the specific health limitation,Knowledge of Models of Stress for Nurses Essay

Draper states that nursing theory is a tool This simile, although quite crude, captures the notion of goal orientation that a nursing theory is said to require. Drapper focuses on two goals that a nursing theory has or should have in view. First, a nursing theory serves as a framework to provisionally understand some part of the nursing world by identifying relevant phenomena that need examining, and second, it identifies a special task of nursing, i.e. to postulate an ideal world of nursing. It is the combination of ideas, explanations, relations, and assumptions derived from nursing models or from other disciplines and project. Actually theory is an idea or mixture of ideas that is suggested to explain phenomena. For understanding of theory, it is important to learn about the concept, conceptual frame work, and other elements of the theory. Nursing theories have greater impact on today’s nursing, it helps in education, nursing care, and research. In this paper I am discussing the Orem theory and Roy adaption model, and will compare and contrast to conclude the better applicability of it.

Orem’s theory

Every human has the capability to perform self-care and maintain his/her health and life met paradigm of the theory is human, health, environment, and nursing. Orem’s theory is made up of three related theories Knowledge of Models of Stress for Nurses Essay

Theory of self-care

Theory of self-care deficit

Theory of nursing process

First is theory of self-care, Orem explains that if individual can attain all the needs are capable for self-care. Self-care comprises those activities performed independently by an individual to promote and maintain personal well-being throughout life. She suggested that human beings are capable and responsible for taking action to adjust their health, and life. The term she provided to this capability to take action on one’s own behalf is self-care agency. The second is self-care deficit theory, which tells us that human beings have some need for survival, and are capable to attain it for health, and life. Human beings take some action to attain their needs and sustain life, which is called therapeutic self-care demand. When these actions are insufficient to fulfill all or part of the therapeutic self-care demand (needs), a self-care deficit develops. In this way the person is unable to perform and manage everything she/he needs to maintain health, and life. Third is theory of nursing process, to develop and organize an action plan that connects the identified gap between self-care agency and therapeutic self-care demand.” (Whitener, 1998, PG). It build up the capabilities to meet their self-care, for example a person is unable to maintain his health. In this way the nurses will help the person to perform the needed action, or find someone to assist in the performance of the actions.Knowledge of Models of Stress for Nurses Essay

Nursing goal focuses to overcome human limitation for needs and self-care. Nursing process is further divided in to nursing practice and fundamental nursing science. Nursing practice is based on observation, judgment and decision in nursing practice.it is evidence based practice awareness and critical thinking in nursing practice. Critical thinking further divide into diagnostic, prescriptive, regulatory and control evaluation. Orem explains five ways, on the basis of that nurses can help their patients in enhancing self-care: acting and doing for others, guiding, supporting, promoting personal development and teaching.Knowledge of Models of Stress for Nurses Essay

Roy Nursing Model

Roy developed adaptation model of nursing, and define the delivery of nursing care. Roy explain the Human beings as a set of interrelated system(psychological, biological, and social).human beings are in struggle to bring equilibrium between their system and environment. Human beings are facing factor (stimuli) from the environment, which alter the balance between the individual and environment. Stimuli may be external or internal which help or hinder in the process of adaptation. To bring balance human beings develop coping mechanism (behavior) to the stressor. It is a framework between environment and human beings, and stimuli, human beings changes his capabilities for adaptation.it also comprises the four domain concepts of person, health, environment, and nursing. In Roy’s model goal for nursing is to help in adaptation to improve person health, quality of life, and dying with dignity. These are four modes which she used in her model are physiological, self-concept, role function and interdependence. She used six step nursing process assessment of behavior, assessment of stimuli, nursing diagnosis, goal sitting, intervention, and evaluation. It is a complete process, on the basis of which we can do assessment and plan for intervention to get the desire goal.Knowledge of Models of Stress for Nurses Essay

Roy’s model has three basic concepts: the human being, adaptation, and nursing. The human being is continually interacting with the environment (stimuli), and nursing is the helping to bring balance and adaptation. The person has two major internal processing subsystems, the regulator and the cognator.” These subsystems are the mechanisms used by human beings to cope with stimuli from the internal and external environment. The regulator mechanism works through the autonomic nervous system and includes chemical, neural, and perception pathways. This mechanism prepares the individual for coping with environmental stimuli. The cognator mechanism includes emotions, perception, processing, learning, and judgment.Knowledge of Models of Stress for Nurses Essay

There are three types of stimuli focal, contextual, and residual. Important factors in all human beings adaptation include developmental stage, family and culture. In the same way adaptation level of the life process is explained on three different levels: integrated, compensatory, and compromised. Adaptation is a mechanism in which a person is coping mentally, physically, socially, spiritually and emotionally. Nursing role in adaptation process is to help out in adaptation and improve capabilities. Roy adaptation model has a great implication in nursing care, education, and research.Knowledge of Models of Stress for Nurses Essay

Compare and contrast between the Orem and Roy nursing theory

Dorothy Orem’s Self-Care Deficit Theory and Sister Callista Roy’s Adaptation Model are grand nursing theories, but their applicability are the same as the middle range theory. The grand nursing theories consist of conceptual model, which find out the main point of nursing investigation and monitor the development of mid-range theories that will be suitable to nurses and as well as to other health professionals. According to Walker and Avant (2011), these theories contributed in “conceptually sorting the nursing from the practice of medicine by demonstrating the presence of distinct nursing perspectives.”Knowledge of Models of Stress for Nurses Essay

Orem’s Health Care Deficit Theory and Sister Callista Roy’s Adaptation Model are compared and analyzed for their importance in nursing. The main aim and purpose of the nursing theories is to provide nursing care to the human beings. Orem and Roy nursing theories based on the interrelating framework, which emphasis on the nursing practice. Therefore these theories promote better patient care, improve the status of nursing profession, and help in communication between the nurses, and provide supervision to the researches and education.in both theories the nursing process are the same, first we do assessment, identify the problems, plan goal, intervention , and evaluation. They used the different word for nursing but the process and approach are the same.

Orem and Roy used the same paradigms system which is related to nursing-person, health, environment, and nursing-are basic and important to nursing practice, but the main focus is health and improvement of life. Today the main focus of health professionals is prevent illness, give medication, and implementation. These paradigm have greater relation with each other, help in every intervention of nursing as well as the other professionals.Knowledge of Models of Stress for Nurses Essay

In both of the models age, past experiences, developmental, and sociocultural environment influences the individuals. These factors are directly and indirectly affect the person for self-care and adaptation with the internal and external environment. Nurses, patients, other family members, and environment are involved to improve capabilities, possibilities to attain necessary needs to sustain life and growth Furthermore, Zarkowska and Clements (1994) share Orem’s (1991) concept of the dynamic interplay between social, physical, environmental and psychological issues in relation to the adjustment of personal behaviors. They suggest that it is through the manipulation of the environmental settings, triggers, human actions and responses that an individual can be motivated to adjust personal behavior. In both models the nurses assess patients’ potential and capabilities to attain their needs, nurse select the most appropriate and effective process and take actions survival and health.Knowledge of Models of Stress for Nurses Essay

Orem and Roy model are preventive and rehabilitative nursing models. In the Orem nursing theory, she focus on the needs which are required for sustaining life, growth and development. It is used for rehabilitation and as a primary care, in which the individual is encouraged to be independent. The main purpose of this theory is to assess the individual at different level and provide care accordingly to the needs .Roy model of adaptation is also a rehabilitative and preventive model, according to her nursing is a service to the society. Human beings have the capabilities to change the stimuli or adapt the stimuli to promote health and life. Adaptation is a positive response to the surrounding environment and changes; it is the response from the individual and choice to bring equilibrium between self and environment. Before the stimuli to harm the individual, individual responded to the stimuli to build adaptation. The goal of adaptation is build coping mechanism to achieve survival, development and mastering to the stimuli.Knowledge of Models of Stress for Nurses Essay

Orem’s and Roy’s nursing theories, addressed each theory with respect to the four meta-paradigms of nursing, and finally compared the one meta-paradigm of health across both theories. This analysis has shown that Orem’s theory is more occupied with activities that promote health, while Roy’s theory is more concerned with where the patient stands on the health-illness continuum and how he can be brought to greater wholeness. It is argued that Orem nursing theory is always applicable; it is only a theoretical model.

Orem model only focus the individual, that each individual has the capabilities to perform self-care. Every person will perform activities for his/ her needs to survive, maintain growth, health, and life. (Polit & Henderson p. 103). The fundamental principle of the model is that individual will take responsibility for his/ her health and the health of other; it is the main drawback in her theory.in Roy model the there are four adaptive modes for survival, physiological, role function, self-concept, and interdependence mode.it means that Roy adaptive model focus on different perspective of the patient. “In Roy’s Adaptation Model, humans are bios psychosocial adaptive systems who cope with environmental change through the process of adaptation.” (Polit & Henderson, p. 104).Knowledge of Models of Stress for Nurses Essay

Orem theory has one limitation i.e. it doesn’t not comprise all aspects of care and needs of a specific client. Therefore some dilemma and miss conception has been found with Orem theory, having unclear definition of family, community, nurse society relationship, and public education area. Although the family, community and environment are considered in self-care action, the focus is primarily on the individual (Balabagno, et.al, 2006). Roy model explain the definition of family, community, environment and nurse society relationship it is the nurse role to enhance capabilities in situation of health and illness and to improve the involvement of human systems with the environment, and promote survival (Roy &Andrew, 1999, p.55)

The most noticeable limitation of Orem theory is that in her theory, she did not explain well the individual emotional needs. She focuses on physical care and provides limited stress to psychological care. Roy nursing model explains it very well in detail, but at the same time it needs time and deep knowledge for understanding..Knowledge of Models of Stress for Nurses Essay

Orem’s theory of self-care is more applicable to acute care settings, whereas Roy’s adaptation model is more useful in the chronic care setting as elaborated by Alligood and Tommy (2010). The assessment process in adaptation model takes longer time and often happens to be a repetitive process for various components of assessment. So, in acute care setting like in emergency care and in ICU, a less need to adaptation to stimuli is less pronounced. However, self-care model is more applicable in acute care settings. Moreover, Self-care model incorporate concepts of nursing process as developed by American Nursing Association (ANA) that are espoused by North American Nursing Knowledge of Models of Stress for Nurses Essay

Application in nursing

Every theory has its own implications and importance in nursing, both the theories have greater impact on today’s nursing, it help in education, nursing care, and research. Dorothy Orem’s Self-Care Deficit Theory and Sister Callista Roy’s Adaptation Model are using as a grand nursing theories, but their applicability are the same as the middle range theory. Orem and Roy nursing theories based on the interrelating framework, which emphasis on the nursing practice. These theories follow the same approaches, both the theories help in curriculum development, and nursing care to prioritize the nursing needs. After discussion I conclude that Orem nursing theory is best suited in the clinical practice. Orem nursing theory is more applicable in hospital set up and community, and based on the evidence base critical decision. The self-care theory associates the patient assessments with nursing diagnosis, expected patient outcome, discharge planning, quality assurance, clinical research, and external agency reports. Many researches has been done on the Orem nursing theory application in different area of health .it is applicable acute care units, ambulatory clinics, community, nursing homes, hospice, and rehabilitation center. Orem theory is applicable to a variety of patients, specific diseases, chronic disease, alcoholic, head and neck surgery, arthritis, and cardiac condition (Conway, McMillan, & Solman, 2006). This theory is also applicable to different ages, children, and mother with newborns.Knowledge of Models of Stress for Nurses Essay

Conclusion

All the nursing theories have their significances; nursing theories create new approaches, and method to nursing practice. Theories challenge the existing knowledge and practice, and change the structure of laws and principle. The main purpose of theory is to improve nursing practice, and the goal is guide the nursing practice. We are familiar that nursing practices are totally based on theories. We are using these theories directly and indirectly in our practice, but it that variety of definitions and concepts explain in nursing theories does not predict anything. It cannot be applied to the clinical practice and have a little impact on nursing practice. All the concepts, paradigm, and frame work guide and provide rationale for practice, but due to advancement in practices the incorporation become problematic.Knowledge of Models of Stress for Nurses Essay

Nursing is by nature perceived to be a stressful job; Menzies,
1959 was the first author who confirmed that, caring environment
arouses strong emotions such as pity, anger, resentment &
compassion. The author affirmed that Nurses use defense
mechanisms such as avoidance, denial, substance abuse, and this was
evidenced by increased turnover. It is possible that in today’s world,
nursing may be generating unbearable stress related to emotional
trauma, change in patients’ life styles, change in disease patterns,
and the increasing violence and abuse. Desire to conduct the study
was stimulated by an increasing numerous public complaints that
was consistently covered by the media and discussed in political
field. The purpose the study was to examine the nature of stress
among Nurses working in the primary health care clinics. The study
is significant to health care providers and policy makers who are
encouraged to acknowledge stress in nursing and how it impacts
on nurses. In this way, managers and policy makers could be in a
position to be aware of stress and develop programs for managing
stress at work for the welfare of nurses. The study addressed
questions related to nurses’ understanding of a concept of stress
and factors that contribute to stress in the nursing profession.
Further exploration was on the signs and symptoms that nurses’
experience when stressed, their coping mechanisms and how they
can be assisted to deal with stress at work.
An Occupational Stress Indicator (OSI) Model was used as a
guiding framework for the study; sections of the model used were:
a) Knowledge about stress,Knowledge of Models of Stress for Nurses Essay
b) Perceived stressors,
c) Effects of stress and
d) Coping strategies
However, it is necessary to acknowledge that OSI scale does
not look at other stress contributing stress such as personal
Cite this article: Mmule M M, Mabedi K. Perception of Stress by Nurses in their Profession: A Case of Primary Health Care Clinics. Biomed J
Sci & Tech Res 2(1)- 2018. BJSTR. MS.ID.000643. DOI : 10.26717/BJSTR.2018.02.000643
Abstract
Background: The study examined the nature of stress among nurses working in Gaborone City Council clinics. The aim of the study was
to investigate the nature of stress affecting nurses with a particular attention to nurses understanding of stress, contributing factors, their
experiences, coping mechanisms, as well as suggestions on measures they use to minimize stress.
Methods: An Occupational Stress Indicator (OSI) was used as a framework to guide the study. A combined paradigm approach in which a
semi structured questionnaire and focus group were used to collect data. None probability technique using conveniently selected sample was
employed to identify research participants [1].Knowledge of Models of Stress for Nurses Essay
Findings: The findings revealed that 90% of nurses have an adequate knowledge about stress, that nurses experience tremendous stress
and most have already developed signs and symptoms of stress. Major stressors in the nursing environment were found to be poor conditions
of service, in particular poor management styles, lack of resources and supplies such as equipment and drugs. Forty three percent (43%) cited
blood pressure machines, weighing scales and furniture as old, poorly maintained and inadequate. Nurses used various strategies to deal with
stress; included in the list were smoking, dysfunctional behaviours such as aggression, anger and irritability.
Conclusion: It is apparent that nurses are mostly stressed by poor working conditions related to lack of resources, heavy workload
and poor management styles. Though the study cannot be applied to all nurses in Botswana, it is adequate to represent nurses who offer
primary health care in the clinics and outpatient settings. Researcher recommended a national study that would be highly representative,
more exploration about the extent and the nature of smoking amongst nurses; the need to improve work conditions and to develop counselling
programs for nurses.
Submission Link: http://biomedres.us/submit-manuscript.php
Mmule M Magama. Biomed J Sci & Tech Res Volume 2- Issue 1 : 2018
2138
believe system and personality traits. According to a student
essay “is not intended to assess or question personality or to test
the personal attributes of the individual, but instead, to provide an
indication of how one perceives their working environment and how
a number of variables interact to produce potentially stressful effects
for the individual’’ (2017) https://www.ukessays.com/essays/
employment/occupational-stress-indicator.php [1].Knowledge of Models of Stress for Nurses Essay
Methods
Mixed method (qualitative and quantitative) approaches were
used to conduct the study; quantitative approach being more
dominant. Ethical clearance was accorded by the Ministry of
Health Research Unit and clinic authority to have access to nurses
was granted by the senior nursing supervisors of various clinics.
Confidentiality was assured and participation was voluntary. A
previously used Chartered Society of Physiotherapy questionnaire
was adopted with minor modifications; the tool reflected contents
of the OSI model. A self-developed interview guide was developed
to guide a focus group discussion for collecting qualitative data.
The questionnaire was piloted on 5 nurse practitioner students
who had worked for over a period of a year in local clinics in which
data was collected. The results for a pilot test were not included
in the main result analysis. A convenient sample of 53 nurses was
drawn from 7 out of 15 clinics which were randomly selected;
the sample only included nurses who were found on duty during
data collection period, nurses who were off duty were excluded.
All respondents were nurses of different levels and specialties.
It is important to note that these respondents had experience of
working in both rural and urban areas; hence, their views included
experiences reflected views from both areas. Quantitative data were
coded using epidemiological information which was transferred as
raw data into the Statistical Package for Social Sciences (SPSS) and
qualitative data were analyzed thematically to examine emerging
themes [2].Knowledge of Models of Stress for Nurses Essay
Results
Data were collected from one of the major cities in the Southern
part of Botswana which has a population of 208.441 people (World
pop., Prospects, 2017). According to one of the nursing supervisors,
the city has 382 nurses. There are 15 clinics out of which 3 has a
maternity unit, and 4 provide a 24 hour service. Each busy clinic
was allocated 9 nurses, 3 of which were midwives while the less
busy were allocated 7 to 8 nurses.
The results revealed that, over 80% of the respondents were
able to define stress; respondents defined stress as:
a) Accumulation of unresolved grievances manifested by
physical symptoms, and
b) Internal and external force perceived to be threatening,
c) Emotional state of despair aggravated by strenuous work
which may result in mental and physical disorders.
The prominent concepts from the definitions were: psycho
social factors, psycho somatic syndrome, tension, disappointment,
inability to adapt, inability to cope, strain and stressors. Workload
was said to be unbearable with multiple responsibilities and this
forced respondents to perform duties outside the scope of the nursing Knowledge of Models of Stress for Nurses Essay
practice. According to respondents, high workload resulted in long
queues which made patients disgruntled; harassment, belittlement
and abusive language directed to nurses were a common trend.
Despite the rough conditions that prevailed, respondents revealed
that management is more skewed to protection of patients and not
professionals. Management and leadership were reported to be
poor, dominated by failure to discuss issues and inability to carry
out supervisory visits. One respondent cited that the “senior staff is
autocratic, never listen, jealous and never involve juniors in decision
making” Transfers were reported to be unfair and dominated by
bribery and favors; while some nurses circulated in towns, some
were bound to rural areas. This state of affairs makes it difficult for
respondents to decide on life choices such as choosing marriage
partners, education of children, acquiring property and selfdevelopment. One respondent said: This has resulted in the increase
in the rate of marriage and intimate relationships between nurses
and drivers, watchmen and herdsmen, because there is no one else in
the rural areas except nurses and the animals.Knowledge of Models of Stress for Nurses Essay

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Among the top reported environmental factors that contributed
to stress were that, the facilities were too hot or too cold and noisy;
unsafe, poor, and uncomfortable; there were no resting places and
the lighting was bad. The following Table 1 outlines respondents’
views in regard to what they perceived as stressors in their
profession. Other work place factors that scored high were lack of
environmental risk assessment (96%), failure to control hazards
(66%) and repetitive work (55%). Excess workload (11%) and
increased working hours (38%), boring work (34%), lack of training
(17%), harassment (38%), threat and violence (32%) were cited
as some of the stressors. In an attempt to elaborate on stressors
respondents’ faced in the workplace, one respondent said: I have so
many frustrations; the work is boring and I am expected to do some
duties without any training,” while the other respondent cited that
the “workload is too much; we attend 60-75 patients per day against
the stipulated rate of 30 patients per nurse per day” All respondents
agreed that equipment used in clinics is old, unreliable, inadequate
and never replaced. Forty three percent (43%) reported shortages
of equipment such as blood pressure machines, weighing scales,
furniture, wheel chairs and oxygen apparatus affirming that some
of these are faulty, old, rusty and unsafe. Buildings and others
structures were said to be worn out and while some were almost
falling.Knowledge of Models of Stress for Nurses Essay
Table 1: Factors Contributing to Stress
Contributing Factors Percentage
Workload related problems 26%
Management problems 23%
Lack of Incentives 17%
Abusive acts 10%
Resource related problems 22%
Socialization problems & Burn-out 2%
Total 100%
Submission Link: http://biomedres.us/submit-manuscript.php
Mmule M Magama. Biomed J Sci & Tech Res Volume 2- Issue 1 : 2018
2139
In response to a question exploring if respondents suffer stress
related symptoms; a wide variety of symptoms such as confusion,
fatigue, exhaustion, headaches, anxiety, depression and palpitations
and many other symptoms were mentioned and irritability scored
high (73%). One respondent said “I normally experience tension
headache which I normally take treatment for and gastric ulcers
which I am also taking treatment for.” One respondent disclosed
that: ‘sometimes I feel like going away where nobody would find
or trace me and sometimes I feel like resigning.” Exploring how
respondents cope with stress and stressors; most respondents
use various strategies ranging from rest, prayer, sleep, talking with
someone, exercises, television, novels, crying, taking sleep tablets,
and self-reward (new clothes, doing facials & visiting relatives).
In regard to what respondents do to clients, themselves and or
management when experiencing stress, respondents revealed
symptoms of irritability. One respondent said “I become angry at
clients, and consult them quickly so that they can get out of my sight,” Knowledge of Models of Stress for Nurses Essay
while the other one she “i ignore management or tell them that what
they are doing is wrong.” Another respondent said “I develop selfblame on why I took nursing as my profession” On enquiring use of
substance as a means to reduce stress or overcoming symptoms
experienced, results revealed low substance use or abuse; 10%
sometimes use drugs or alcohol. However, over 80% of respondents
admitted frequent smoking to cope with stress. Refer to the graph
below for details of responses (Figure 1).
Figure 1.
Respondents recommended a series of strategies to assist
them in coping with work related stress; that development of
welfare policies for nurses, emphasizing that policies should cover
transfers and accommodation, appreciation of work that nurses do
and development of safety measures such as making police part of
staffing of health facilities.
Discussion and Conclusions
According to results, respondents understand the meaning
of stress; however, different respondents explained the meaning
differently (Hardy & Carson, 1998). Respondents’ view of stress and
job stressors is different and they respond differently to stressful
stimuli. Respondents seem to associate stress with extrinsic factors
such as workload, management styles and environmental factors etc.Knowledge of Models of Stress for Nurses Essay
These findings are similar to other studies on stress on health care
providers [3-5]. Intrinsic factors such as professional socialization,
personality traits and spiritual health status were not considered
as having a relationship with stress that respondents had. Bangkok
Charter of 2005 for the Health Promotion in a Globalized world
endorsed determinants of health as encompassing not only
physical and mental health, but also the spiritual well-being. This
may be a limitation of knowledge in which respondents could not
relate personality traits, professional socialization and spiritual
health status as determinants of the level of stress that nurses may
develop. It is evident that nurses experience tremendous stress at
work, coupled with personal issues, the situation may be worse.
According to findings by Chartered Society of Physiotherapy (2004)
employment relations and Union services, “stress at work is not an
illness, but if it is excessive and prolonged, it can lead to mental and
physical ill health, including depression, nervous breakdown and
heart disease”.
Major stressors for respondents were associated with
workload, limited resources and supplies, poor management, lack
of incentives and security. There seem to be a relationship between
respondents’ disgruntlement and the stress experienced; hence, it
may be possible that dealing with the root cause of stress would
motivate nurses to improve service delivery and the relationship
with communities at large. Dealing with resources and supplies will
not only satisfy nurses, but, but also improve quality of services;
it will enhance accuracy of results and client diagnosis and reduce
medical errors [5-8].Knowledge of Models of Stress for Nurses Essay
Since respondents consider external forces as responsible
for stress, counseling strategies were not viewed as measures
that could alleviate stress; how-ever, various strategies such as
development of welfare programs and development of welfare
policies that provide support to nurses and the nursing profession
would be beneficial. Though evidence of stress has been identified;
there was no prove that stress experienced by respondents is
directly work related and the pathological and mental impact of
stress among these respondents could not be determined because
other sources of stress were not explored and the respondents
were not medically examined to confirm the impact of stress on
their well-being. Respondents seem to be well educated in regard to
drug use and abuse because majority was not engaged in substance
use and or abuse. However, it would be interesting to explore more
about smoking in order to determine the nature of smoking and
its impact on respondents’ health. Generally, recommendations for
improvement should focus on improving administrative procedures,
management skills for supervisors, and conditions of work and to
regularly provide training opportunities. Due to a small sample size
and the nature of sampling, the study may not be generalized to all
nurses in Botswana; however, it is adequate to generalize the study
to nurses working in the major cities of Botswana; the study can
serve as a clue to what could be happening in the Botswana Health
care system. Future research should explore other factors that may
be responsible for stress in the nursing profession using theoretical
models such as Pressure Management Indicator (PMI) which are
more holistic in nature. According to Williams & Cooper, 1996.
PMI is reliable, comprehensive and quick to complete than the OSI
Model.  Knowledge of Models of Stress for Nurses Essay