Journal of Advanced Nursmg, 1990,15, 531-543
Occupational stress and coping strategies among female baccalaureate nursing faculty DoUy Goldenberg PhD RN* Assistant Professor, Faculty of Nursing, The University of Westem Ontano, London, Ontano
and Janice Waddell MA RN* Instructor, School of Nursing, Ryerson Polytechnical Institute, Toronto, Ontano, Canada
Accepted for publication 29 June 1989
GOLDENBERG D & WADDELL J (1990) Journal of Advanced Nursing 15, 531-543 Occupational stress and coping strategies among female baccalaureate nursing faculty Considerable stress is involved m nursing education However, the sources and extent have not been fully investigated, nor have ways of coping The mam purpose of the study was to explore the sources and levels of perceived stress, coping strategies and efifectiveness among female baccalaureate nursing faculty The second purpose was to examme the relationship between stress, copmg and academic responsibilities of the faculty member such as teaching, research and community service A sample of 70 subjects from eight Ontano universities completed the demographic questionnaire, the researcher-developed 'StressCoping Anxiety Inventory', and the 'State-Trait Anxiety Inventory' Form Y (STAI) (Spielberger et al 1983) Analysis of data using frequencies, cross tabulations, ANOVA and Pearson product-moment correlation were computed Perceived stressors chosen most frequently as high m stress ( > 4) (range = 1-5), m rank order, were lieavy workload (combmed clmical and classroom teachmg)', 'retaining failmg students', 'failing chnically unsatisfactory students', 'meeting research requirements' and 'providmg individual clmical supervision' Active coping strategies were selected more frequently as bemg efiFective ( > 4) than passive copmg strategies Age of the respondent, number of years of full-time teachmg and tenure status were most often significant factors ( < 0 05) relatmg to the level of stress Implications for nursing education admmistrators and their faculty are discussed
INTRODUCTION
apparently has not sufficiently captured the mterest of investigators (Sobol 1978) Stress and the effeds of stress on health care professionals Empincal evidence exists of role stress m nursing faculty has received considerable attention (Caplan et al 1975, and potential for bumout (Corbett & Marsieo 1981,0'Shea Menaghan & Merves 1984) However, there is a pauaty of research on nursmg educators related to stress as it 1982, Phillips 1984, Smith 1979) Nursing faeulty are aware of the stress assoaated with nursmg edueation Yet there is 'This project teas fundedby the Faculty of Nursing The University of Westem Onbmo limited researeh direeted toward assistmg them to develop and the Iota Ormcron Chapter, Sigma Theta Tau Intematumal Honor Society of Nursing Correspondence Dr Dolly Coldeidmg Assi^imt Professor Faculty of Niirsng. The strategies to cope (Mancmirffl/ 1983) Further exploration Umoeraty of Westem Onbmo London, Ontano, N6A 5Cl Omada of this phenomenon is valuable, not only in view of the effect 531
D Goldenberg and J Waddell
oi stress on nursing faculty and their performance, but m view of the significance of the relationship between a sfressful work envirormient and the attradion and retention of qualified nurse educators Purpose of study The purpose of this study, therefore, was to explore the sourees and levels of pereeived stress, eopmg strategies and effeetiveness among female faeulty m Ontano baeealaureate nursing programmes Also examined was the relationship between stress, eopmg and aeademie responsibilities of the faculty member such as teaching, research and community serviee No attempt was made to assess psyehologieal stress or physieal effeets of stress
Coping strategies Copmg strategies are numerous and vaned and have been descnbed as pnmary and secondary (Lazarus et al 1974), affective and problem-onented Qaloweie & Powers 1981), or as a three-step system (Beyer & Marshall 1981) Selfhelp eopmg strategies mdude relaxation tedmiques, diaphragmatic breathing, exereise programmes, prayer, problem-solvmg, hobbies, drugs, aleohol, TV, and a support network (Maneini et al 1983) Researeh on eopmg strategies has shown attempts at eategonzation However, there is a need for refinement as lists are lengthy, unwieldy and often of different levels of generality A niajor goal of researeh on eopmg is to develop a dassifieation system of copmg strategies to faalitate their desenption and use Qaeobson & MeGrath 1983)
LITERATURE REVIEW Stress and copmg Stress and eopmg is a field of study whieh has spread aaoss the disaplines Gaeobson & MeGrath 1983) In particular, stress as a concept, construct, syndrome, theory and transaction, has been investigated (Lazarus 1966, Lazarus et al 1974, McGrath 1970, Schacter 1964, Selye 1956, Wolffe 1953) The hterature on copmg shows less information than stress, reflective of the recency of saentific mterest Oacobson & McGrath 1983) Important contnbutions to copmg m clarification of terms have been made by White (1974) and Lazarus (1977) The current view of eopmg as a transactional proeess between the mdividual and the environment is based ehiefly on the work of Lazarus and his assoeiates This view has been extended by Mechanic (1970) and Antonovsky (1979) Coping instruments A search of the literature on copmg yielded a number of different studies and several copmg strategy mstruments (Antonovsky 1979, Conway & Glass 1978, Jacobson & McGrath 1983, Jaloweie & Powers 1981, MeConnell 1982, Quayhagen & Quayhagen 1981, White 1974, Zeitlm 1980) A study of neonatal mtensive-eare nurses resulted in the development of the Nurses' Coping Scale (NCS) Oacobson & McGrath 1983) Duff (1979) developed a 42ltem coping scale which measures six coping styles Jaloweic's (1981) copmg scale measures 40 copmg behaviours m three dimensions Hammer & Marting's (1987) Coping Resources Inventory lists currently available resources for managing stress The hterature revealed no instrument for nurse educators 532
STRESS IN NURSING FACULTY Workload The heavy workload of nursing faeulty is a reeurrent theme (Beyer & Marshall 1981, deTomyay 1987, Fisher 1983, Jorgenson 1986, Kams and Sehwab 1982, Lenhart 1982, McCarthy 1981, McKay 1978, Phillips 1984) Causes of work-related stress mdude overload, lnequabty of load, meompetent leadership, faeulty eonfliet, eomnuttee work, researeh and publieation, lack of positive reinforcement and takmg job and self too senously (Langemo 1988) Nurse educators have been descnbed as reludant to refuse additional tasks beyond their heavy teaching load and academic obligations (Hardy 1978) Other studies implicate similar pressures of university existence (Barger 1987, CoUison & Parsons 1980, Fisher 1983, Fry 1975, Nieswiadomy 1984, Phillips 1984), but include cumcular and administrative responsibilities as well (Hinds et al 1985) Negative effects of the job on the health, aeativity and productivity of nursmg faculty have also been documented (Hmds et al 1985, Little & Camevali 1972) Beyer & Marshall (1981), on the other hand, have acknowledged that educators m all disaplmes face a heavy workload, with multifaceted role expectations and the necessity for professional advancement Added stressors expenenced by nursing faculty, however, mduded helpmg students cope with illness, loss and death, and satisfymg nursing service, medical, legal and institutional requirements Clinical T 4 degree of pereeived stress There were no contmunity service sfressors 536
which met the cntena The five occupational stressors with the highest degree of perceived stress ( > 4) m rank order are displayed in Table 3 When asked to suggest other occupational sfressors, the respondents identified several more, such as 'not enough time', 'conflict over content to teach', 'hmited clinical facilities and patients', 'lack of provincial funding' and 'political decision-makers and university admmistrators who tnvialized nursing edueation' 'lnaeased work load' was eited as a high stressor by 50% of those who suggested other stressors Heavy workload has been doeumented as one of the single most stress-produemg faetors m the nurse edueator role (Barger 1987, Biddle & Thomas 1966, Coudret 1981, deTomyay 1987, Hardy 1978, Jeglm-Mendez 1982, Langemo 1988, Paekard & Motowidlo 1987, Smith 1979) It IS generally aecepted that nurse edueators spend well over 40 hours per week fulfilhng their role obligations (Saylor et al 1979) To sueeeed, faeulty members are 'pressured to exeel as teaehers, dinieal praetitioners, researehers, and authors, and are expeeted to provide serviees to the eommunity and profession' (Langemo 1988) Faculty find it impossible however, to do research and maintain or enhance their practice skills v«th such a heavy workload (Coudret 1981) Clinical teachmg aeatmg high work stress concurs with the findmgs of Cooper & Marshall (1979), Kams & Schwab (1982), Little & Camevali (1972), O'Shea (1982), Ray (1984), Sfrauss & Hutton (1983) and Wardle (1984) Ray found that nurse educators with a dmical teaching component were particularly stressed Cooper & Marshall and O'Shea established that role ambiguity, the dual or simultaneous responsibility for people (students and patients), eompounded the stress Kams & Sehwab attnbuted high dirucal stress to faculty practising without help or guidance from admmisfrators Little & Camevali assoaated this sfress with faculty accountability for students who are charged with high nsk situations so early m their careers Sfrauss & Hutton likened sfress m the dmical area to the interactional concept of sfress m which the stress response results from the lack of fit between individuals and their environment Wardle compared the heavy dmical demands and pressures to bemg on a 'treadmill' Clinical teaching compnsed a major portion of the work week for the faculty m this study While 87 2% reported that teachmg was their major activity, approximately 58% of the work week mvolved dmical and classroom teachmg with student advisement Seventeen per cent was spent m research and pubhcation, and 11% m community service Table 4 presents the percentage of work week adivities of the respondents These findmgs resemble those of
Occupational stress
Table 2 Rank order per category of occupational stressors with > 4 degree of perceived stress*
Selected by respondents Occupational stressor
SD
n
%
X
29/44 29/58
660
3 95 101 3 43 I I I
Teaching
Classroom Retain failing students Work with faculty of conflicting values/work habits Clinical Heavy workload (clinical, classroom) Provide individual supervision Fail unsafe students Lack of clinical exp»enence
50 0
45/58 39/63 37/60 26/48
619 616
54 1
4 14 3 63 3 72 2 63
38/69
55 0
3 65 123
79 3
110 102 124 130
Research
Meet research requirements 'Range of ijercei ved stress =1—5
Table 3 Rank order by mean of occupational stressors with highest degree (> 4)' of perceived stress Stressor
study spent an average of 55% of their time in teaehmg, 13% in research, 9% in publication and 26% m institutional and public serviee
SD
Research Questions 2 and 3 Heavy workload (dinical, classroom) Retain failing students Fail clinically unsafe students Meet researeh requirements Provide individual clinical supervision
414 3 95 3 72 3 65 3 63
110 101 1 24 123 102
Coping strategies were as vaned as the number of choices m the instrument To be eonsidered effeetive, the degree of effeetiveness was set at > 4, ranked by over 50% of respondents Coping sfrategies most frequently selected as efiFective for > 4 stressors usmg this standard are presented m 'Range of perceived stress = 1 - 5 Table 5 Of interest were the eopmg sfrategies for 'meeting researeh requirements', pereeived as a high stressor ( > 4) Table 4 Mean percentage of faculty work week activities by 55% of 69 respondents 'Upgrading researeh shUs', 'jommg m eollaborative research' and 'setting short and long-term goals' were pereeived as efifeetive Barger's SD P/o Activity (1987) findmgs showed usmg a eomputenzed database and ideas and perspeetives generated by faculty and students 17 24 2665 Classroom to be effective Nieswiadomy (1984) found that faculty 16 58 24 28 Clinical who did not engage in research and publication, coped by 7 70 1011 Research attnbuting this to lack of time, sblls, mterest, funds, facili5 77 669 Publication ties and adminisfrative support However, this was seen as 8 26 1152 Community a least effedive copmg sfrategy by 35% of the respondents 1722 14 75 Administration m the current study 6 69 738 Advisement Noteworthy was the most effective copmg strategy for 101 38" the highest ranked stressor, 'heavy workload, combined Total dmieal and dassroom teachmg and feelmg of mequity' The sfrategy selected was 'seekmg support from faculty 'Numbers exceed 100% because of rounding and admmistrators' which concurs with the results of Beyer Venn (1984) who surveyed faeulty of nursmg programmes & Marshall (1981), Langemo (1988), Caplan et al (1975), aeaedited by the National League for Nursmg withm Firth rffl/ (1987), Maslach (1979) and PhiUips (1984) Soaal research uruversities m the United States Faculty m Verm's support and collegiahty, that is, expressing, analyzing and 537
D Goldenberg and J Waddell
Table 5 Coping strategies most frequently selected as effective ( > 4)" for ( > 4)'' stressors Selected by respondents Stressor
Copmg strategy
n
%
Consult with peers/dean Adhere to regulations Employ sense of humour Engage m RDE'
37/49 21/41 39/59 22/43
75 5 58 5
Seek faculty/admin support Engage in RDE Use preceptors, peers Have RNs supervise/comment Give students feedback Assess by colleagues Update knowledge & skills Work on ward, increase skills
25/46 22/42 38/49 31/56 56/63 40/51 39/44 31/37
54 3 52 3 77 5 55 3 88 9 78 9 88 8 83 8
Upgrade research skills Collaborate in research
34/55 36/61
618
Classroom Teaching
Retain failing students Work with faculty of conflicting values
611 511
Clinical Teaching
Heavy workload (classroom, clinical) Provide individual supervision Fail unsafe students Lack of clinical expenence Research
Meet research requirements
59 0
Range of perceived effectiveness = 1-5 "Range of perceived stress = 1—5 Recreation diversion exerase
shanng personal feelings with others, have been desaibed as deaeasmg tension and stress, lessening pressures and providing a sense of control over professional behaviour In O'Shea's (1982) study involving clinical teaching, the most frequent causes of role strain were overload of students, conflicts with agency personnel and patient care beyond the ability of students The most effective coping strategies were providing a better onentation, maeasmg practice skills, altenng the teaching approach, attempting to do more work, assuming more responsibility and verbal confrontation with persons involved These copmg strategies were consistent with those selected as effective by the majonty of respondents m this study for the perceived clinical stressors of 'fulfilling liaison role with agencies', 'handling conflicts between student and staff nurse' and 'heavy workload (combined clmical and classroom teaching)' Other dmical stress-reduang mechanisms have been offered by Jackson (1987), Fisher (1983) and Goode (1960) The least effechve copmg strategies for all stressors, perceived by the majonty of respondents, are worthy of mention Passive strategies such as 'assume posihon of affective neutrality', 'mtellectualize', 'employ sense of humour', 'resign to situahon or to lack of power to make a 538
difference', 'take mental health days', 'alter nutntional intake' and 'engage m use of alcohol, medication or smoking', were rated as non-applicable or least effective Corbett & Marsico (1981) and Storlie (1979) have classified these strategies as bumout behaviours It is possible, however, that the faculty in this study were responding to passive coping strategies as they beheved they should and therefore rated them as meffechve Although the respondents offered other coping strategies, many were a rewording of those already m the mstrument Those suggested were rated as bemg very effechve and most were achve copmg strategies One example, 'joint appointments between school and agency', was recommended as a coping strategy for the stressors of 'fulfyimg liaison role with clinical agencies', 'lack of clmical expenence' and 'unclear policy regarding substitute or relief faculty m the clinical area' There was much evidence of student advocacy m the proposed strategies for stressors assoaated with teaching, such as 'obtaining feedback from students after class to assure understanding of matenal', 'consulhng with students to ldenhfy ways of presentmg classroom matenal more effechvely', 'listenmg to student concems', 'designmg
Occupatumal stress Table 6 Mean and standard deviation of stressors related to selected faculty charactenshcs (FC) Category ofFC
Stressor
FC
Classroom Pressure for doctorate
Years in jjosihon Tenure status
I0 Tenure
Non 50 10 10 Tenure
Non Teaching students with low standards Clinical Heavy workload
Type initial nursmg education
Years in position
Dipl Bacc
Tenure status Age
Research Workmg with faculty perceived incompetent
Years of teaching Tenure status Type initial nursmg education
117* 132
133" 0-84 0 79* 136 124
127* 2 34 118 3 52 107** 300
257
2 68 3 50 3 56 2 73
123
115* 131
119* 127
Tenure
Non
Ali
>39
40-49
3 94 129** 4 07 0-85
>50
280
137
10 Tenure
Ii7 i66
131**
Non Meeting requirements
3 65 2 80 2 97 4-00 4 08 3 11 2 91
3 89 120* 4 61 0 6 0 3 4 6 126*
10
Failing unsafe students
SD
Dipl Bacc
103
129
3 54 131** 2-09 130 4 02 099** 3 29 132
"P 4 ) No other stressor was selected by as many respondents or rated as highly The effect of this and other stressors on faculty, on their ability to function or remain in their present position, could be considerable The fact that community service was not statistically significant may have been due to the placement of these stressors at the end of the instrument It is possible that faculty did not respond to these items in the same fashion Several respondents did comment on the length of the instrument Age, number of years of full-time teaching expenence and tenure status were most often significant factors relating to the level of stress In general, younger and more mexpenenced, untenured faculty perceived the occupational stressors to be higher Despite this, active coping strategies were seen as nearly equally effective by both groups One would wonder, however, why the stressors were rated highly stressful if the coping strategies were indeed effective Identification of occupational stressors and effective copmg strategies is important m nursing education The findings may contnbute to effecting positive changes m the academic setting of nursmg schools More research m an episodK tradition is necessary This includes studying actual behaviours as they occur m stressful situations and then mfemng coping processes inherent m the behaviour Prospective rather than retrospective studies are also
necessary if we are to provide more creative and productive instructional efforts (Hinds et al 1985, Jacobson & McGrath 1983) School administrators play tin important role m workload considerations They need to be realistic planners, assist and support faculty, espeaally those untenured and with less expenence, recogruze their unique qualities and needs, and reward their efforts (Corbett & Marsico 1981, Phillips 1984) The most important factor in the attraction and retention of qualified nurse educators is the work itself (Plawecki & Plawecki 1976) Limitations and recommendations Instruments were retumed on a voluntary basis No attempt was made to study charactenshcs of the non-respondents This, as well as the relatively small sample size would limit the generalizability of the results The study was also subject to limitahons inherent m the instrument design The stressors and coping strategies mduded m Part I of the instrument may not be all-indusive, despite inclusions from the literature, expenenced faculty and respondents At best, these responses were perceptions of stress and copmg strategies rather than actual There may also have been a tendency for the respondents to select the 'appropnate' coping strategy Some speafic reconnmendations include 1
Facilitation of effective coping strategies through (a) asserhveness workshops, (b) ongomg support/discussion groups, (c) a formal faculty networking system for research projects, (d) joint agency/faculty onentahon 2 Establishment of (a) construct validity and rehability of sechon I of instrument, (b) a theoretically-based taxonomy for copmg strategies 3 Replication of study with a larger, more geographically representative sample size, relatmg psychosociocultural veinables References Antonovsky A (1979) Health, Stress and Copmg Jossey-Bass, San Franasco Barger S (1987) The potenhal for research and research use m academic nurse-managed centers Nurse Educator 12(6), 19-22 Batey M (1969) The two normative worlds of the university faculty Nursmg Forum 8(1), 5—16 541
D Goldenbetg and} Waddell
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543
Occupational stress and coping strategies among female baccalaureate nursing faculty DoUy Goldenberg PhD RN* Assistant Professor, Faculty of Nursing, The University of Westem Ontano, London, Ontano
and Janice Waddell MA RN* Instructor, School of Nursing, Ryerson Polytechnical Institute, Toronto, Ontano, Canada
Accepted for publication 29 June 1989
GOLDENBERG D & WADDELL J (1990) Journal of Advanced Nursing 15, 531-543 Occupational stress and coping strategies among female baccalaureate nursing faculty Considerable stress is involved m nursing education However, the sources and extent have not been fully investigated, nor have ways of coping The mam purpose of the study was to explore the sources and levels of perceived stress, coping strategies and efifectiveness among female baccalaureate nursing faculty The second purpose was to examme the relationship between stress, copmg and academic responsibilities of the faculty member such as teaching, research and community service A sample of 70 subjects from eight Ontano universities completed the demographic questionnaire, the researcher-developed 'StressCoping Anxiety Inventory', and the 'State-Trait Anxiety Inventory' Form Y (STAI) (Spielberger et al 1983) Analysis of data using frequencies, cross tabulations, ANOVA and Pearson product-moment correlation were computed Perceived stressors chosen most frequently as high m stress ( > 4) (range = 1-5), m rank order, were lieavy workload (combmed clmical and classroom teachmg)', 'retaining failmg students', 'failing chnically unsatisfactory students', 'meeting research requirements' and 'providmg individual clmical supervision' Active coping strategies were selected more frequently as bemg efiFective ( > 4) than passive copmg strategies Age of the respondent, number of years of full-time teachmg and tenure status were most often significant factors ( < 0 05) relatmg to the level of stress Implications for nursing education admmistrators and their faculty are discussed
INTRODUCTION
apparently has not sufficiently captured the mterest of investigators (Sobol 1978) Stress and the effeds of stress on health care professionals Empincal evidence exists of role stress m nursing faculty has received considerable attention (Caplan et al 1975, and potential for bumout (Corbett & Marsieo 1981,0'Shea Menaghan & Merves 1984) However, there is a pauaty of research on nursmg educators related to stress as it 1982, Phillips 1984, Smith 1979) Nursing faeulty are aware of the stress assoaated with nursmg edueation Yet there is 'This project teas fundedby the Faculty of Nursing The University of Westem Onbmo limited researeh direeted toward assistmg them to develop and the Iota Ormcron Chapter, Sigma Theta Tau Intematumal Honor Society of Nursing Correspondence Dr Dolly Coldeidmg Assi^imt Professor Faculty of Niirsng. The strategies to cope (Mancmirffl/ 1983) Further exploration Umoeraty of Westem Onbmo London, Ontano, N6A 5Cl Omada of this phenomenon is valuable, not only in view of the effect 531
D Goldenberg and J Waddell
oi stress on nursing faculty and their performance, but m view of the significance of the relationship between a sfressful work envirormient and the attradion and retention of qualified nurse educators Purpose of study The purpose of this study, therefore, was to explore the sourees and levels of pereeived stress, eopmg strategies and effeetiveness among female faeulty m Ontano baeealaureate nursing programmes Also examined was the relationship between stress, eopmg and aeademie responsibilities of the faculty member such as teaching, research and community serviee No attempt was made to assess psyehologieal stress or physieal effeets of stress
Coping strategies Copmg strategies are numerous and vaned and have been descnbed as pnmary and secondary (Lazarus et al 1974), affective and problem-onented Qaloweie & Powers 1981), or as a three-step system (Beyer & Marshall 1981) Selfhelp eopmg strategies mdude relaxation tedmiques, diaphragmatic breathing, exereise programmes, prayer, problem-solvmg, hobbies, drugs, aleohol, TV, and a support network (Maneini et al 1983) Researeh on eopmg strategies has shown attempts at eategonzation However, there is a need for refinement as lists are lengthy, unwieldy and often of different levels of generality A niajor goal of researeh on eopmg is to develop a dassifieation system of copmg strategies to faalitate their desenption and use Qaeobson & MeGrath 1983)
LITERATURE REVIEW Stress and copmg Stress and eopmg is a field of study whieh has spread aaoss the disaplines Gaeobson & MeGrath 1983) In particular, stress as a concept, construct, syndrome, theory and transaction, has been investigated (Lazarus 1966, Lazarus et al 1974, McGrath 1970, Schacter 1964, Selye 1956, Wolffe 1953) The hterature on copmg shows less information than stress, reflective of the recency of saentific mterest Oacobson & McGrath 1983) Important contnbutions to copmg m clarification of terms have been made by White (1974) and Lazarus (1977) The current view of eopmg as a transactional proeess between the mdividual and the environment is based ehiefly on the work of Lazarus and his assoeiates This view has been extended by Mechanic (1970) and Antonovsky (1979) Coping instruments A search of the literature on copmg yielded a number of different studies and several copmg strategy mstruments (Antonovsky 1979, Conway & Glass 1978, Jacobson & McGrath 1983, Jaloweie & Powers 1981, MeConnell 1982, Quayhagen & Quayhagen 1981, White 1974, Zeitlm 1980) A study of neonatal mtensive-eare nurses resulted in the development of the Nurses' Coping Scale (NCS) Oacobson & McGrath 1983) Duff (1979) developed a 42ltem coping scale which measures six coping styles Jaloweic's (1981) copmg scale measures 40 copmg behaviours m three dimensions Hammer & Marting's (1987) Coping Resources Inventory lists currently available resources for managing stress The hterature revealed no instrument for nurse educators 532
STRESS IN NURSING FACULTY Workload The heavy workload of nursing faeulty is a reeurrent theme (Beyer & Marshall 1981, deTomyay 1987, Fisher 1983, Jorgenson 1986, Kams and Sehwab 1982, Lenhart 1982, McCarthy 1981, McKay 1978, Phillips 1984) Causes of work-related stress mdude overload, lnequabty of load, meompetent leadership, faeulty eonfliet, eomnuttee work, researeh and publieation, lack of positive reinforcement and takmg job and self too senously (Langemo 1988) Nurse educators have been descnbed as reludant to refuse additional tasks beyond their heavy teaching load and academic obligations (Hardy 1978) Other studies implicate similar pressures of university existence (Barger 1987, CoUison & Parsons 1980, Fisher 1983, Fry 1975, Nieswiadomy 1984, Phillips 1984), but include cumcular and administrative responsibilities as well (Hinds et al 1985) Negative effects of the job on the health, aeativity and productivity of nursmg faculty have also been documented (Hmds et al 1985, Little & Camevali 1972) Beyer & Marshall (1981), on the other hand, have acknowledged that educators m all disaplmes face a heavy workload, with multifaceted role expectations and the necessity for professional advancement Added stressors expenenced by nursing faculty, however, mduded helpmg students cope with illness, loss and death, and satisfymg nursing service, medical, legal and institutional requirements Clinical T 4 degree of pereeived stress There were no contmunity service sfressors 536
which met the cntena The five occupational stressors with the highest degree of perceived stress ( > 4) m rank order are displayed in Table 3 When asked to suggest other occupational sfressors, the respondents identified several more, such as 'not enough time', 'conflict over content to teach', 'hmited clinical facilities and patients', 'lack of provincial funding' and 'political decision-makers and university admmistrators who tnvialized nursing edueation' 'lnaeased work load' was eited as a high stressor by 50% of those who suggested other stressors Heavy workload has been doeumented as one of the single most stress-produemg faetors m the nurse edueator role (Barger 1987, Biddle & Thomas 1966, Coudret 1981, deTomyay 1987, Hardy 1978, Jeglm-Mendez 1982, Langemo 1988, Paekard & Motowidlo 1987, Smith 1979) It IS generally aecepted that nurse edueators spend well over 40 hours per week fulfilhng their role obligations (Saylor et al 1979) To sueeeed, faeulty members are 'pressured to exeel as teaehers, dinieal praetitioners, researehers, and authors, and are expeeted to provide serviees to the eommunity and profession' (Langemo 1988) Faculty find it impossible however, to do research and maintain or enhance their practice skills v«th such a heavy workload (Coudret 1981) Clinical teachmg aeatmg high work stress concurs with the findmgs of Cooper & Marshall (1979), Kams & Schwab (1982), Little & Camevali (1972), O'Shea (1982), Ray (1984), Sfrauss & Hutton (1983) and Wardle (1984) Ray found that nurse educators with a dmical teaching component were particularly stressed Cooper & Marshall and O'Shea established that role ambiguity, the dual or simultaneous responsibility for people (students and patients), eompounded the stress Kams & Sehwab attnbuted high dirucal stress to faculty practising without help or guidance from admmisfrators Little & Camevali assoaated this sfress with faculty accountability for students who are charged with high nsk situations so early m their careers Sfrauss & Hutton likened sfress m the dmical area to the interactional concept of sfress m which the stress response results from the lack of fit between individuals and their environment Wardle compared the heavy dmical demands and pressures to bemg on a 'treadmill' Clinical teaching compnsed a major portion of the work week for the faculty m this study While 87 2% reported that teachmg was their major activity, approximately 58% of the work week mvolved dmical and classroom teachmg with student advisement Seventeen per cent was spent m research and pubhcation, and 11% m community service Table 4 presents the percentage of work week adivities of the respondents These findmgs resemble those of
Occupational stress
Table 2 Rank order per category of occupational stressors with > 4 degree of perceived stress*
Selected by respondents Occupational stressor
SD
n
%
X
29/44 29/58
660
3 95 101 3 43 I I I
Teaching
Classroom Retain failing students Work with faculty of conflicting values/work habits Clinical Heavy workload (clinical, classroom) Provide individual supervision Fail unsafe students Lack of clinical exp»enence
50 0
45/58 39/63 37/60 26/48
619 616
54 1
4 14 3 63 3 72 2 63
38/69
55 0
3 65 123
79 3
110 102 124 130
Research
Meet research requirements 'Range of ijercei ved stress =1—5
Table 3 Rank order by mean of occupational stressors with highest degree (> 4)' of perceived stress Stressor
study spent an average of 55% of their time in teaehmg, 13% in research, 9% in publication and 26% m institutional and public serviee
SD
Research Questions 2 and 3 Heavy workload (dinical, classroom) Retain failing students Fail clinically unsafe students Meet researeh requirements Provide individual clinical supervision
414 3 95 3 72 3 65 3 63
110 101 1 24 123 102
Coping strategies were as vaned as the number of choices m the instrument To be eonsidered effeetive, the degree of effeetiveness was set at > 4, ranked by over 50% of respondents Coping sfrategies most frequently selected as efiFective for > 4 stressors usmg this standard are presented m 'Range of perceived stress = 1 - 5 Table 5 Of interest were the eopmg sfrategies for 'meeting researeh requirements', pereeived as a high stressor ( > 4) Table 4 Mean percentage of faculty work week activities by 55% of 69 respondents 'Upgrading researeh shUs', 'jommg m eollaborative research' and 'setting short and long-term goals' were pereeived as efifeetive Barger's SD P/o Activity (1987) findmgs showed usmg a eomputenzed database and ideas and perspeetives generated by faculty and students 17 24 2665 Classroom to be effective Nieswiadomy (1984) found that faculty 16 58 24 28 Clinical who did not engage in research and publication, coped by 7 70 1011 Research attnbuting this to lack of time, sblls, mterest, funds, facili5 77 669 Publication ties and adminisfrative support However, this was seen as 8 26 1152 Community a least effedive copmg sfrategy by 35% of the respondents 1722 14 75 Administration m the current study 6 69 738 Advisement Noteworthy was the most effective copmg strategy for 101 38" the highest ranked stressor, 'heavy workload, combined Total dmieal and dassroom teachmg and feelmg of mequity' The sfrategy selected was 'seekmg support from faculty 'Numbers exceed 100% because of rounding and admmistrators' which concurs with the results of Beyer Venn (1984) who surveyed faeulty of nursmg programmes & Marshall (1981), Langemo (1988), Caplan et al (1975), aeaedited by the National League for Nursmg withm Firth rffl/ (1987), Maslach (1979) and PhiUips (1984) Soaal research uruversities m the United States Faculty m Verm's support and collegiahty, that is, expressing, analyzing and 537
D Goldenberg and J Waddell
Table 5 Coping strategies most frequently selected as effective ( > 4)" for ( > 4)'' stressors Selected by respondents Stressor
Copmg strategy
n
%
Consult with peers/dean Adhere to regulations Employ sense of humour Engage m RDE'
37/49 21/41 39/59 22/43
75 5 58 5
Seek faculty/admin support Engage in RDE Use preceptors, peers Have RNs supervise/comment Give students feedback Assess by colleagues Update knowledge & skills Work on ward, increase skills
25/46 22/42 38/49 31/56 56/63 40/51 39/44 31/37
54 3 52 3 77 5 55 3 88 9 78 9 88 8 83 8
Upgrade research skills Collaborate in research
34/55 36/61
618
Classroom Teaching
Retain failing students Work with faculty of conflicting values
611 511
Clinical Teaching
Heavy workload (classroom, clinical) Provide individual supervision Fail unsafe students Lack of clinical expenence Research
Meet research requirements
59 0
Range of perceived effectiveness = 1-5 "Range of perceived stress = 1—5 Recreation diversion exerase
shanng personal feelings with others, have been desaibed as deaeasmg tension and stress, lessening pressures and providing a sense of control over professional behaviour In O'Shea's (1982) study involving clinical teaching, the most frequent causes of role strain were overload of students, conflicts with agency personnel and patient care beyond the ability of students The most effective coping strategies were providing a better onentation, maeasmg practice skills, altenng the teaching approach, attempting to do more work, assuming more responsibility and verbal confrontation with persons involved These copmg strategies were consistent with those selected as effective by the majonty of respondents m this study for the perceived clinical stressors of 'fulfilling liaison role with agencies', 'handling conflicts between student and staff nurse' and 'heavy workload (combined clmical and classroom teaching)' Other dmical stress-reduang mechanisms have been offered by Jackson (1987), Fisher (1983) and Goode (1960) The least effechve copmg strategies for all stressors, perceived by the majonty of respondents, are worthy of mention Passive strategies such as 'assume posihon of affective neutrality', 'mtellectualize', 'employ sense of humour', 'resign to situahon or to lack of power to make a 538
difference', 'take mental health days', 'alter nutntional intake' and 'engage m use of alcohol, medication or smoking', were rated as non-applicable or least effective Corbett & Marsico (1981) and Storlie (1979) have classified these strategies as bumout behaviours It is possible, however, that the faculty in this study were responding to passive coping strategies as they beheved they should and therefore rated them as meffechve Although the respondents offered other coping strategies, many were a rewording of those already m the mstrument Those suggested were rated as bemg very effechve and most were achve copmg strategies One example, 'joint appointments between school and agency', was recommended as a coping strategy for the stressors of 'fulfyimg liaison role with clinical agencies', 'lack of clmical expenence' and 'unclear policy regarding substitute or relief faculty m the clinical area' There was much evidence of student advocacy m the proposed strategies for stressors assoaated with teaching, such as 'obtaining feedback from students after class to assure understanding of matenal', 'consulhng with students to ldenhfy ways of presentmg classroom matenal more effechvely', 'listenmg to student concems', 'designmg
Occupatumal stress Table 6 Mean and standard deviation of stressors related to selected faculty charactenshcs (FC) Category ofFC
Stressor
FC
Classroom Pressure for doctorate
Years in jjosihon Tenure status
I0 Tenure
Non 50 10 10 Tenure
Non Teaching students with low standards Clinical Heavy workload
Type initial nursmg education
Years in position
Dipl Bacc
Tenure status Age
Research Workmg with faculty perceived incompetent
Years of teaching Tenure status Type initial nursmg education
117* 132
133" 0-84 0 79* 136 124
127* 2 34 118 3 52 107** 300
257
2 68 3 50 3 56 2 73
123
115* 131
119* 127
Tenure
Non
Ali
>39
40-49
3 94 129** 4 07 0-85
>50
280
137
10 Tenure
Ii7 i66
131**
Non Meeting requirements
3 65 2 80 2 97 4-00 4 08 3 11 2 91
3 89 120* 4 61 0 6 0 3 4 6 126*
10
Failing unsafe students
SD
Dipl Bacc
103
129
3 54 131** 2-09 130 4 02 099** 3 29 132
"P 4 ) No other stressor was selected by as many respondents or rated as highly The effect of this and other stressors on faculty, on their ability to function or remain in their present position, could be considerable The fact that community service was not statistically significant may have been due to the placement of these stressors at the end of the instrument It is possible that faculty did not respond to these items in the same fashion Several respondents did comment on the length of the instrument Age, number of years of full-time teaching expenence and tenure status were most often significant factors relating to the level of stress In general, younger and more mexpenenced, untenured faculty perceived the occupational stressors to be higher Despite this, active coping strategies were seen as nearly equally effective by both groups One would wonder, however, why the stressors were rated highly stressful if the coping strategies were indeed effective Identification of occupational stressors and effective copmg strategies is important m nursing education The findings may contnbute to effecting positive changes m the academic setting of nursmg schools More research m an episodK tradition is necessary This includes studying actual behaviours as they occur m stressful situations and then mfemng coping processes inherent m the behaviour Prospective rather than retrospective studies are also
necessary if we are to provide more creative and productive instructional efforts (Hinds et al 1985, Jacobson & McGrath 1983) School administrators play tin important role m workload considerations They need to be realistic planners, assist and support faculty, espeaally those untenured and with less expenence, recogruze their unique qualities and needs, and reward their efforts (Corbett & Marsico 1981, Phillips 1984) The most important factor in the attraction and retention of qualified nurse educators is the work itself (Plawecki & Plawecki 1976) Limitations and recommendations Instruments were retumed on a voluntary basis No attempt was made to study charactenshcs of the non-respondents This, as well as the relatively small sample size would limit the generalizability of the results The study was also subject to limitahons inherent m the instrument design The stressors and coping strategies mduded m Part I of the instrument may not be all-indusive, despite inclusions from the literature, expenenced faculty and respondents At best, these responses were perceptions of stress and copmg strategies rather than actual There may also have been a tendency for the respondents to select the 'appropnate' coping strategy Some speafic reconnmendations include 1
Facilitation of effective coping strategies through (a) asserhveness workshops, (b) ongomg support/discussion groups, (c) a formal faculty networking system for research projects, (d) joint agency/faculty onentahon 2 Establishment of (a) construct validity and rehability of sechon I of instrument, (b) a theoretically-based taxonomy for copmg strategies 3 Replication of study with a larger, more geographically representative sample size, relatmg psychosociocultural veinables References Antonovsky A (1979) Health, Stress and Copmg Jossey-Bass, San Franasco Barger S (1987) The potenhal for research and research use m academic nurse-managed centers Nurse Educator 12(6), 19-22 Batey M (1969) The two normative worlds of the university faculty Nursmg Forum 8(1), 5—16 541
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