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1. International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 5, Issue 5, May (2014), pp. 40-46 © IAEME 40 THE FACTORS INFLUENCING STRESS AMONG NURSING COMMUNITY: EVIDENCE FROM APOLLO HOSPITAL, CHENNAI Mrs. S. CHITRA1 , Dr. R. ARASU2 1 (Research Scholar), Research and Development Centre, Bharathiar University, Coimbatore 1 Asst. Professor, Department of Management Studies, Agni College of Technology, Chennai 2 Principal, University of Madras Arts and Science College (University Constituted College), Chennai ABSTRACT Health Care, like any other services, has become one of the highly growing sectors in India. The hospitals today have been facing greater challenges in terms of growing population, technology revolution and service diversification. The nursing community working in the hospitals is directly affected by the stress as the systems, procedures; patient handling system is getting complicated with the use of advanced technology and shortage of manpower. They suffer to match their job objectives with the fast changes taking place in the work atmosphere. An effort has been made through this research study to identify the factors influencing stress among nurses working in Apollo hospital, Chennai and to find the effectiveness of ways used by them to cope up with the stress generated at workplace. It is found that maximum number of nurses in hospitals remains in stress. Majority of the nurses try to find solution to relieve them from stress. The measures are also suggested in the paper to overcome stress that affects their physical and mental health. Keywords: Employee Stress, Job Overload, Counseling, Training. 1. INTRODUCTION Employee stress is a prevalent and costly problem in today fast paced world. It is unavoidable among the working community irrespective of their job and industry. Organization pushes and pulls employees’ to yield their commitment and services. There is both positive and negative stress, depending on individual’s unique perception of the tension between the two forces. Stress bears deliberating effects on both the employees and the employer. (Khanka, p.319). Symptoms and Causes of Stress - Absenteeism, neglecting work responsibilities, not being punctual, poor work performance, employee dullness, arguing, irritation, accidents and injuries, addiction to bad habits e.t.c may be considered as major symptoms of stress. Improper wages and salaries, lack of rewards INTERNATIONAL JOURNAL OF MANAGEMENT (IJM) ISSN 0976-6502 (Print) ISSN 0976-6510 (Online) Volume 5, Issue 5, May (2014), pp. 40-46 © IAEME: www.iaeme.com/ijm.asp Journal Impact Factor (2014): 7.2230 (Calculated by GISI) www.jifactor.com IJM © I A E M E
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 5, Issue 5, May (2014), pp. 40-46 © IAEME 41 and recognition, Peer employee pressure, ineffective communication, Lack of employee participation, Monotonous nature of job, unhealthy working conditions, Heavy workload, biasing, family member’s expectation, job role, financial problems, career changes, social responsibilities, may lead to stress. 2. OBJECTIVES AND IMPORTANCE OF THE STUDY The main objective of the study is to identify the factors influencing stress among nurses working at Apollo hospital, Chennai. To achieve the main objective, the following sub objectives were set; 1. To identify the work environment factors influencing stress. 2. To identify the job related factors influencing stress. 3. To examine the effectiveness of training programs conducted to overcome stress. Job satisfied and stress-less employees are more focused towards performance and commitment who might be the valuable assets for an organization. By studying the status of stress, Apollo hospitals management may rectify and redefine the policy and procedures causing stress. This in turn may reduce absenteeism, employee turnover and dullness and increases employee performance, improved patient service, employee commitment and employee morale. The study helps Apollo to prepare their employees as best service providers for patients. 3. LITERATURE REVIEW “Jacob Donkor” (2012) in his article specified as Nurses need to feel that they are involved in decision making especially related to patient care issues. Therefore a more decentralized democratic management approach would be beneficial and this is imperative to increase nurses‟ visibility in the workplace by establishing programs that recognizes their contributions. Dayo Akintayo(2012) found that working environment is significantly related to workers‘ morale and also working environment is significantly correlated with perceived workers‘ productivity. Dr. K. Chandrasekar (2011) found that environmental factors are conducive to work and he also found that factors that affect attitude of employees to work are interpersonal relationships control over environment, shift, emotional factors, job assignment, overtime duty, extended work. 4. RESEARCH DESIGN Descriptive Research method is used in this study because it includes surveys, facts, and findings, enquire of different kind. The main purpose of the study is to find description of the state of affairs as it exists at present. The researchers can only report that has happened, and what is happening. Simple random sampling method is used to collect samples from the population. Structured Questionnaire Method is the research tool used to collect the primary data. A total of 143 questionnaires were distributed to the nurses working in Apollo Hospitals situated in Greams Road, Chennai. One twenty fully completed questionnaires were returned for response. The sample size is 120. 5. DATA ANALYSIS Demographic information of 120 nurses who completely responded to the questionnaire in tabulated in Table 1.
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 5, Issue 5, May (2014), pp. 40-46 © IAEME 42 Table 1: Frequency and Percentage distribution on the demographic Features of The samples (n=120) Variables f % Gender Male 20 17 Female 100 83 Age 19-24 68 57 25-30 34 28 31-35 6 5 36-40 5 4 More than 40 7 6 Marital Status Married 24 20 Single 96 80 Native Place Tamil Nadu 70 58 Andhra Pradesh 3 2.5 Rajasthan 1 0.8 Manipur 1 0.8 Kerala 45 38 The length of time of employment Less than 1 year 29 24 1-2 Years 35 29 2-3 Years 21 18 Above 3 Years 35 29 Income 10,000 – 12,000 88 73 13,000 – 15,000 12 10 16,000 – 18,000 10 9 Above 18,000 10 8 Designation Registered Nurse 98 82 Charge Nurse 16 13 Nursing Officer 06 5 Qualification B.S.C Nursing 81 68 DGNM 7 6 GNM 10 8 DNA 1 0.8 MBA (H.M) 6 5 Diploma in Nursing 5 4 Post Basic Nursing 2 2 RN RM 5 4 Diploma in General Nursing 2 2 BSN 1 0.8 Shift Morning 40 33 Evening 50 42 Night 30 25
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 5, Issue 5, May (2014), pp. 40-46 © IAEME 43 6. REGRESSION ANALYSIS TABLE 6.1 Aim - To test whether quality of workplace influence job stress H01: Responsibilities do not influence quality of workplace. H02: Physical working conditions do not influence quality of workplace. H03: Immediate supervising does not influence quality of workplace. H04: Work difficulties do not influence quality of workplace. H05: Too much of manual work does not influence quality of workplace. H06: Equipment and resources does not influence quality of workplace. H11: Responsibilities influence quality of workplace. H12: Physical working conditions influences quality of workplace. H13: Immediate supervising influences quality of workplace. H14: Work Difficulties influences quality of workplace. H15: Too much of manual work influences quality of workplace. H16: Equipment and resources influences quality of workplace. Coefficientsa Model Unstandardized Coefficients Standardized Coefficients t Sig.B Std. Error Beta 1 (Constant) .000 .000 . 0.000 Responsibilities .000 .000 .000 . 0.000 Physical Working Conditions .000 .000 .000 . .0.000 Immediate Supervising .000 .000 .000 . 0.000 Work Difficulties .000 .000 .000 . 0.000 Manual Work 1.000 .000 1.000 . 0.000 Equipment/ Resources .000 .000 .000 . 0.000 a. Dependent Variable: Q1 – Quality of Work Place (Accept H11, H12, H13, H14, H15, H16) Responsibilities, Physical working conditions, Immediate supervising, work difficulties, manual work and equipment influences quality of workplace. TABLE 6.2 Aim - To test whether job attributes instigates stress consistently H01: Additional hour’s does not influence the job attributes. H02: Heavy workload does not influence job attributes. H03: Job repetitiveness does not influence job attributes. H04: Over demanding does not influence job attributes.
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 5, Issue 5, May (2014), pp. 40-46 © IAEME 44 H11: Additional hour’s influences the job attributes. H12: Heavy workload influences job attributes. H13: Job repetitiveness influences job attributes. H14: Over demanding influences job attributes Coefficients Model Unstandardized Coefficients Standardized Coefficients t Sig.B Std. Error Beta 1 (Constant) .000 .000 . 0.000 Additional Working Hours .000 .000 .000 . 0.000 Heavy Work load 1.000 .000 1.000 . 0.000 Repetitive Jobs .000 .000 .000 . 0.000 Over demanding jobs .000 .000 .000 . 0.000 a. Dependent Variable: Job attributes (Accept H11, H12, H13, H14) Additional hour’s, Heavy workload, job repetitiveness and over demanding jobs influences the job attributes TABLE 6.3 Aim – To test whether Workplace stress interferes in my personal life H01: Hobbies and interest does not influence workplace stress. H02: Job role does not influence workplace stress. H03: Personal problems do not influence workplace stress. H11: Hobbies and interest influences workplace stress. H12: Job role influences workplace stress. H13: Personal problems influence workplace stress. Coefficients Model Unstandardized Coefficients Standardized Coefficients t Sig.B Std. Error Beta 1 (Constant) .000 .000 . 0.000 Hobbies & Interest 1.000 .000 1.000 . 0.000 Job Role .000 .000 .000 . 0.000 Personal problems .000 .000 .000 . 0.000 a. Dependent Variable: Work Place Stress (Accept H11,H12,H13) Hobbies and interest, job role and personal problems influences workplace stress.
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 5, Issue 5, May (2014), pp. 40-46 © IAEME 45 TABLE 6.4 Aim – To test whether training program conducted by the organization are effective H01: Employee counseling does not influence training programs. H02: Recognition does not influence training programs. H03: Rewards and appreciation does not influence training programs. H04: Engagement programs do not influence training programs. H05: Employee participation does not influence training programs. H06: Stress level does not influence training programs. H11: Employee counseling influences training programs. H12: Recognition influence training programs. H13: Rewards and appreciation influences training programs. H14: Engagement programs influences training programs. H15: Employee participation influences training programs. H16: Stress level influences training programs. Coeffients Model Unstandardized Coefficients Standardized Coefficients t Sig.B Std. Error Beta 1 (Constant) 1.878 .335 5.613 .000 Employee Counseling .274 .081 .327 3.382 .001 Recognition .109 .087 .124 1.244 .216 Rewards and appreciations -.084 .075 -.093 -1.115 .267 Engagement Programs .319 .081 .362 3.943 .000 Employee participation -.120 .074 -.133 -1.620 .108 Stress level .087 .070 .094 1.233 .220 a. Dependent Variable: Training Programs (Accept H11, H14) Employee counseling and engagement programs influence training programs. (Accept H02, H03, H05, H06) Recognitions, rewards and appreciations, employee participation, stress level does not influence training programs. 7. FINDINGS 83% of the respondents are female candidates falling mostly in the age category of 19 – 24. 58% of respondents belong to the state of Tamil Nadu with the qualification of B.S.C Nursing. Nurses feel they are overloaded with too much of manual work. The jobs assigned to them are over demanding. One third of the respondents mentioned that workplace stress has impact on their family life. Employee counseling programs are conducted on public holidays and Sundays; this is reducing the effectiveness of it. Rewards and recognition are hardly received by the nurses. 70% of the respondents agreed that the stress level prevailing in the organization is high.
International Journal of Management (IJM), ISSN 0976 – 6502(Print), ISSN 0976 - 6510(Online), Volume 5, Issue 5, May (2014), pp. 40-46 © IAEME 46 8. SUGGESTIONS Work assignments can be delegated among the employees which make them feel ease in the work place. Software module can be installed to record and document nursing department data so that organization can reduce too much of manual work. Language skills development classes may be organized to outstation nurses. To overcome workplace stresses interference in personal life; employees can be provided with relaxation time, flexible work schedule, shift adjustments, effective rewards and recreational activities and fringe benefits (paid vacation, health benefits, child care and educational facilities). Organization can boost and motivate employees to resolve their problems by introducing Employee Counseling (EAP), Self Management Trainings (SMT) and Career Counseling Programs (CCP). Nurses must be given Relationship Management Training which educate them to network, influence and manage conflicts with patients. 9. CONCLUSION As most of the respondents feel that they feel stress at work, organization should take positive steps to make their employees feel free from stress so that they can work with optimum efficiency and effectiveness. Guidance and Counseling must be provided to the employees. Organization should introduce flexible work schedule so that the employees can give more time to themselves and their family and discharge other social responsibilities. Stress may have an impact on service productivity and hence it must be managed and controlled by the organization which transforms employees as “A best service provider”. 10. REFERENCE 1. Harish Shukla and Ms.Rachita Garg (2013), “A Study on Stress Management among the employees of nationalized banks” Voice of Research, Vol 2, Issue 3. 2. Syed Mubasher Hussain Naqvi and Mohammad Asif Khan (2013), “Job Stress and Employees Productivity: Case of Azad Kashmir Public Health Sector, IJCRB, Vol 5, No.3. 3. Eric.S.Parilla (2012), “Level of stress experienced by NWU employees: Towards developing a stress management”, Asian Journal of Management Research, Voulme 2, Issue 2. 4. Dr. K. Chandrasekar (2011), "Workplace environment and its impact on organisational performance in public sector organisations", International Journal of Enterprise Computing and Business Systems, Vol. 1, Issue 1, January 2011. 5. Geetha Kumari and K.M.Pandey (2011), “Studies on Stress Management: A Case Study of Avatar Steel Industries, Chennai”, IJIMT, Vol 2, No.5. 6. Kathirvel N,(2009), The IUP Journal of Management Research, Vol. VIII, No. 11, 28-44. 7. Murphy, L. R., and S. Sorenson., (1988), Employee behaviours before and after stress management. Journal of Organizational Behavior, 9, pp 173-182. 8. Robbins Stephen P, Organizational Behavior: New Jersey: Prentice Hall Inc. 9. K. S. Sathyanarayana and Dr. K. Maran, “Job Stress of Employees”, International Journal of Management (IJM), Volume 2, Issue 2, 2011, pp. 93 - 102, ISSN Print: 0976-6502, ISSN Online: 0976-6510. 10. Dr. C.Vijaya Banu, N.Santhosh and Venkatakrishnan Y B, “A Study on Stress Management with Special Reference to a Private Sector Unit”, International Journal of Management (IJM), Volume 1, Issue 1, 2010, pp. 1 - 16, ISSN Print: 0976-6502, ISSN Online: 0976-6510. 11. Dr. Satpal Singh and Dr. Pratibha, “Study of Stress Among Nurses”, International Journal of Management (IJM), Volume 5, Issue 1, 2014, pp. 23 - 32, ISSN Print: 0976-6502, ISSN Online: 0976-6510.