Literature Review:

A search was conducted using electronic databases in the fields of nursing, medicine, education, psychology, and sociology. Using ProQuest Direct and EBSCO search engines, the following databases were accessed: CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE in PubMed, Ovid, and PsycINFO. The search terms were grouped in the following key concepts: (a) occupational stress in nursing, (b) stress perception in nursing, (c) occupational stressors in nursing, (d) nursing generational diversity, and (e) coping in nursing. In a commentary on patient safety in nursing practice from the Agency for Healthcare Research and Quality, Hughes and Clancy7 reported that complexity and bullying represent 2 clear examples of nurse stressors. Li and Lambert8 concluded that nurses who are more satisfied with their job are more likely to remain in the workforce and to be committed to delivering high-quality patient care. Hall9 found that healthcare professions have some unique characteristics leading to occupational stress including physical responsibility for people, potential catastrophic effects on the patient and the employee, frequent exposure to pain and suffering, and exposure to infectious diseases and potential hazardous substances. Hamaideh et al10 identified that death and dying were the strongest stressors perceived by Jordanian nurses. In this study, workload and guidance were found to be the most supportive behaviors provided to nurses facing stress followed by emotional support.10

Carver and Candela11 concluded that considering the global nursing shortage, managers should increase their knowledge of the generational diversity. It is suggested that understanding how to relate to multiple generations can lead to improved nursing work environments.11 Repar and Patton12 found that the combined effects of compassion fatigue, chronic grief, and emotional and physical exhaustion led to significant burnout and prolonged job dissatisfaction in the nursing profession. In this study, using guided sessions, a massage therapist gave 10-minute chair massages, and a visual, language, or musical artist engaged participants in imaginative and creative activities such as poetry reading, free writing, guided imagery, and listening to live music.12 The results suggest that the activities reduce some of the unpleasant, stressful, and tension-producing emotions that nurses typically experience at work, leaving them more peaceful and energized.12 Based on the findings of this review of the literature, it is recognized that stress is a major component of nursing and can be detrimental to nurse retention. In addition, most studies identified some differences that exist between the present generational nursing cohorts in terms of values and beliefs. No studies were identified reporting how work-related stress affects different generations of nurses, how the generations perceive stress, and what coping styles are used.

Study Design:

A descriptive correlational design was used to examine the relationship of occupational stress, age, years of experience, and education level and stress perception among a sample of MS RNs. Measures of perceived stress and coping were compared between the 3 age cohorts to determine if there is a difference between these groups. The researcher used 4 instruments that were administered in the following order: a demographic tool, the Nursing Stress Scale (NSS),13 the Perceived Stress Scale (PSS),14 and the Ways of Coping Scale (WAYS).15

A 4-item demographic questionnaire developed by the researcher was used to describe the participants and to measure select study variables such as age, gender, years of experience, and the highest level of education.

The NSS scale was designed to measure the frequency in which hospitalnurseshad work-related sources of stress.

The NSS consists of 34 items that describe situations that have been identified as causing stress for nurses in the performance of their duties. The subscales measure workload, uncertainty about treatment, conflict with other nurses, conflict with physicians, inadequate preparation, lack of support, and death and dying. Responses are assessed on a 4-point Likert scale ranging from (1) never stressful, (2) occasionally stressful, (3) frequently stressful, and (4) extremely stressful.