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Lily Hall

ENG 1201 Online

Professor Stalbird

18 March 2019

Mental Health of Nurses

People are hard to deal with in general; however, sick people can be even worse. So

many people do not want to do anything, do not want to be bothered, and just want to sleep when

ill and not be told they have to take medications or go through treatments. We have all been sick

at one time and we all know the feeling. That is why we have nurses to help care for patients

when they are sick or in need and have them make sure everyone can become better as soon as

possible by making sure people take their medicine and do what has to be done. However,

patients can be cruel, mean, or just plain rude. They have to be taken care of and the words and

attitudes expressed to nurses can have an affect on their mental state despite not all of the

language being negative. Coworkers of nurses also tend to deal with a lot of stress and can take it

out on other workers on the other hand they can support each other when patients die or days get

rough. A lot of nurses also tend to be very happy in their line of work and feels that it completes

and satisfies a part of them in life to help people through tough times. All of these factors

together lead to a question that has to be answered: Do patients and coworkers leave a lasting

impact on the mental healths of nurses?

A lot of people generally think that with all the negative people and deaths that can

happen on a day to day basis with their patients, people believe that nurses are generally more

depressed than happy in their field of work. However, this is not always the case. A lot of nurses

are actually very satisfied in their line of work believing that what they do is a hard, challenging,
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but worth it with all the lives they can save and with how they can make their patients’ lives

better in the long run by giving them a second chance and a new appreciation of life. As cited in

Job Satisfaction and Psychological Well-being among Mental Health Nurses, they discuss how it

can affect their work in all different ways, “Another research revealed that job satisfaction is an

important facet of nurses’ lives that can affect patients’ safety, productivity, performance, quality

of care and commitment to organization and profession”(Olatunde). Not only was the results

from job care discussed, but also they talked about how “interactions with hospital have a strong

positive impact on the level of job satisfaction among nurses”(Olatunde), regarding healthy

relationships between coworkers and a collaborative and respectful relationship between nurses

and their patients. Which can help nurses cope with the loss or the daily stress.

Despite that nurses do have job satisfaction, in most research studies, the satisfaction rate

is quite low. In a study of 110 people at Neuropsychiatric Hospital, results found that female

nurses had an average of 23.4% of them being satisfied with their job while male nurses were

quite a bit higher but still less than half at about 47.2% being satisfied with their line of work.

The majority of hospitals tend to have a low satisfaction rate with the job of nursing for example,

“This study has identified a need to reform policies for the nursing profession in Pakistan,
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because nurses working in the private and public sectors are not satisfied with their jobs”,

meaning that the problem is world wide issue that must be more well researched as well as

solved.

There are a lot of healthcare professionals and nurses who have worked harder and

learned from patients to make them better at their jobs. Patricia Noonan was an ED nurse who

had many patients suffering from mental health issues. One young boy who was 16 came into the

hospital who attempted suicide by cutting his antecubitals too deeply and was sewed up and was

not able to be admitted for certain reasons and was sent home with a distraught mother. The next

day she went to her nursing director and asked if she could treat the boy for mental health and

was told she could not. So then she went back to school to get a BSN to become a psychiatric

nurse so she would be able to help kids and others just like that boy and not just have to send him

away and made her feel grateful for sending her down a fulfilling and rewarding path. Another

nurse named Kate Blasingame developed stage three ovarian cancer at age 24 and was taking her

last chemo treatment at the hospital she worked at and all of her coworkers each made a square

for a quilt and were sewn together and given as a gift to her during the treatment and were her

greatest support system through it all. Diane Wieland was a RN and was told that her, his

therapist, and two of his Vietnam Veteran buddies were what prevented him from committing

suicide and gave him hope in life, it warmed her heart to hear what an influence and help she was

to him as well as him opening up about his PTSD and what happened in war which he had never

told anyone. This last one was small but had a huge impact to show just how small gestures can

brighten someone’s day or change someone’s life, Linda Indyke watched a seven year old boy

being pushed away every time he tried to hug his mother so everytime she would see him she

would give him a hug as many times he liked for as long as she possibly could stay. So while
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nursing is not for everyone, it is definitely for people like these and that while most people do

not feel satisfied in this specific field of work, a lot of people do and the work that they do is

worth the effort in the end.

Stress among nurses regarding patients has become a major issue in nurses’ mental states.

The continuous stress of the job is said to cause “physical, psychological and cognitive

symptoms, demanding prolonged adaptive responses to tolerate, overcome or adapt to

stressors”(Tajvar). However, most nurses tend to focus on their patients over themselves which

can lead to risks in their mental health as well as overall occupational risks that come with it.

With these high amounts of stress and little care to one’s mental state, nursing has more

commonly becoming associated with things such as a lower quality of life, high chance of

burnout in their work, not only that but also can lead to symptoms of anxiety, depression,

psychological suffering, sleep disorders, fatigue, and other mental declines. The main stress

factors found in the study are “Factors associated with stress include the patients’ impatience,

irritated accompaniers, intolerant physicians, child and emergency care in two sectors at the

same time”(Tajvar), also some other factors stated was that “the excessive hourly workload

hinders having a social life and enjoying recreational activities, thereby contributing to the

physical and mental burden of nursing staff members and exerting a negative impact on both life

quality and work performance”(Tajvar). The amount of stress from work with the combined

stress of work puts a damper on how a person can feel or act. It is important to make sure that the

pressures put on nurses is watched carefully by hospitals as well as make sure the nurses can tell
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if there is any decline in themselves.

While stress, hard work, the things they see, smell, and hear are all part of the job of

nursing, however assault was never in the job description. Assault on nurses by patients, visitors,

and others tends to be a common issue unfortunately despite security in hospitals doing their

best. By doing public campaigns, professional forums, and internal memos, hospitals are trying

to spread awareness to society and patients that there is no reason to harm the person who is

trying to better their health and that violence is not the answer, no matter the issue. The most

common nurses to get assaulted are emergency room nurses with about 1 in 10 nurses being

assaulted in just a seven day period as from a survey in 2011. This is most likely due to the lack

of evaluation of a patient as most emergency room patients tend to be in critical condition or in

quite a lot of pain, meaning time to evaluate is not really given. A lot of states have now began to

teach ER nurses to notice cues that may suggest any mental or violent tendencies with patients to

try to prevent this or to notify security to stay close while working with the patient in question.

States have also introduced a zero tolerance policy with violence and have tried to make

attacking nurses a Class A misdemeanor, this would make attacking nurses on the same level as
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attacking a police officer or a firefighter meaning it is quite a heavy felony. However, this creates

less of a fear when going to work and nurses to feel more safe and secure in their line of work.

The fact of the matter is that change must occur for the better in hospitals. Treatment and

health of nurses directly impacts our healthcare system and that means the better we can help out

our nurses, the better we can help ourselves as stated “The working conditions and health of the

nursing staff underscore the need for changes in the organization and work process, as well as

the responsibility of occupational nurses to develop strategies aimed at factors associated with

the work process of this team that affects their mental health”(Vasconcelos). However, in the

study they discuss that change requires quite a lot of hoops to start help and treatment to nurses

in need. They discuss this topic as well in the paper when saying, “The planning of interventions

directed at health problems stemming from the work process of the nursing staff requires a

diagnostic assessment”(Vasconcelos). Even with the hoops, they still strongly support that an

action aimed at mental health prevention and the promotion of occupational health should be part

of any healthcare program directed at the nursing staff. Another method discussed was to have

healthcare workers go through an emotional intelligence training course which results showed

that those who take the training program tend to have significant improvement of their overall

health and could face numerous occupational stressors with flexibility and skill. No matter the

issue, so much information shows that mental health is a problem and hospitals must at least

consider the ideas and options for nurses, “The nurse’s work need to understand the problems’

complexities of mental health and substance use among nursing workers to recognize, identify

and take care of workers at risk, providing adequate mental health care”(Vasconcelos). If not

then, it will only become more of a problem and discourage those going into the field as well of

patients coming to hospitals as it could be considered unsafe and the nurses untrustworthy.
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Exercise has been the main thing hospitals have been promoting towards nurses and other

healthcare professionals due to the positive impact on mental health such as “reducing tiredness,

relieving stress, improving mood, and boosting energy levels”(American Nurse Association).

Other factors outside of physical activity cause an increased risk in developing a mental disorder

as stated “studies suggest that not enough physical activity is detrimental to mental health and

can lead to cognitive decline and an increased risk of developing depression”(American Nurse

Association). While the talk of exercise is helpful, a lot of people feel as though it is a way for

hospitals to not have to put money into a program to actually have nurses work through their

mental health needs but rather put a front up to make it look as though they are concerned.

With all the stress and pressure on nurses to provide exceptional patient care at all time, a

large percentage of nurses tend to indulge in some rewards sometimes. A common reward being

alcohol. Also, substances such as prescription medication or illicit drugs are used by a small

percentage of nurses when things can become overwhelming. These factors starting in hospitals

is an extremely scary idea, especially when considering the consumption of psychoactive

substances causes ill-adaptation to the stressor with dysfunction in social, as well as, work

activities. If nurses are depending on drugs and alcohol to get through the day, it would be

extremely hard to convince patients to not also indulge in these bad habits as it would be very

hypocritical. Also the effects of drugs are incredibly dangerous, if we cannot drive under the

influence than it should not be a possibility to have someone in charge of lives under the

influence. Quite a lot of nurses and other healthcare professionals are actually experiencing

substance abuse problems that affect their ability to practice; however, the statistics found are

different as most will not elaborate their problems due to fears of losing licenses but from what

was found “Green proposed that 2% to 3% of all nurses are addicted to drugs, while Bissell and
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Haberman estimated that there are 40000 nurses with alcoholism in the United States. The

American Nurses Association estimated that 6% to 8% of nurses may have a drug or alcohol

problem”(Trinkoff). More research does have to be done regarding substance use among

healthcare professionals “Because there have been no extensive studies of substance use among

nurses, there is currently no basis on which to identify groups of nurses at risk for substance use

problems”(Trinkoff). Which creates a major issue at hand.

A big problem regarding nurses is that they are expected to always be perfect. Never

tired, irritated, or at a low at any point in the day as they have to be presentable to patients and

not make any mistakes as it could lead to big problems among patients’ wellness these high

pressures tend to lead to hopelessness and depression. Striving for perfection is not always bad

but maladaptive perfectionism leads to a downward spiral as they tend to be more neurotic like

and striving for unrealistic expectations which tend to lead them towards giving up when these

expectations are not achieved. Perfectionism can lead to depression as most base their self worth

on their achievements as well as their self esteem lowering. It is also said that “Perfectionism has

been found to correlate highly with internalized shame” (Melrose). In nursing, deaths do happen

and can cause guilt which if not told how to handle, can be held and change who they are and
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how their minds work. Nurses must also always encourage and find hope in hopeless scenarios to

try to convince their patients to fight to make it through the tough times but if the nurses are

going through maladaptive perfection “They live with a constant expectation of negative

consequences”(Melrose). Which would make it hard to convince their patients when they cannot

convince themselves. Recognizing perfectionistic tendencies is important for nurses’ health

“Perfectionist tendencies such as over assuming responsibility to ensure tasks are completed

flawlessly leave nurses exhausted and unfulfilled”(Melrose). Also it can lead nurses to not take

risks preventing them from learning new tasks and making them feel powerless. Maladaptive

perfection also can lead nurses to not sharing information when mistake are made making them

ill prepared for their future career in nursing going forward. The strive for perfection is

undoubtedly impossible in the scheme of things as people are flawed and mistakes can happen so

we can learn and improve from them, it is important for nurses to understand perfection cannot

be accomplished but rather trying their best so they can be more understanding of other nurses,

doctors, and especially understanding different patients and their needs.

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Nursing is an extremely difficult job. The stress, the deaths, the mistakes, and the risks

are all things that can negatively impact anyone’s mental health in a major way. The people they

meet, the relationships they can create, and the impact others have on them can affect one’s

mental health in either a negative or positive way. The lives saved and the positive changes in

patients’ lives are big reasons people choose to go down the path of nursing and continue to

pursue and work in the field. No matter what viewpoint over the job of nursing is looked at, you

can tell the long hours and the worries get to them. While nursing may not be for everyone, it is

an important job that helps people in more ways than we even know and that is why our nurses

put up with all of us.

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Citation Page

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