Sources of occupational stress for nurse executives in rural Manitoba's community hospitals

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Edmundson, Sharon Mary
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Today's hospitals are becoming increasingly complex and stressful organizations. Few studies have examined the stressors experienced by nurse executives working in this highly stressful environment. None have considered the stressors experienced by nurse executives working in a rural hospital setting. An exploratory descriptive design was used to explore and describe the major stressors that have caused nurse executives in rural Manitoba's community hospitals to experience job-related stress. As well, the relative intensity of the identified stressors was determined. Cooper and Marshall's (1978) Sources of Managerial Stress Model served as the conceptual framework for the study. The Delphi technique, consisting of three successive rounds of mailed questionnaires which incorporated feedback from the previous round, was used for data collection. Data were analysed after each round of questionnaire using both qualitative and quantitative procedures. Fifty-four nurse executives completed all three questionnaires. Forty-four stressor items were identified. Findings of the study generally supported Cooper and Marshall's (1978) intra-organizational stressors. Two additional categories of extra-organizational stressors, namely the governing board and physical-related issues, arose. As well, contextual stressors related to the provincial government's health reform initiatives were also evident... Strategies to prepare rural nurse executives to individually and collectively address the identified stressors are recommended. Ways that employers, the professional nursing association, and educational institutions can help to lessen nurse executives' perceived stress are also suggested. Design and methodological considerations for future research are addressed.