Empowering Experienced Pediatric Nurses Working on General Medical and Surgical Units

Nursing shortages occurring in health care systems around the world have adverse impacts on the health and well-being of populations. Understanding work-related stressors is critical if organizations are to retain nurses. While all nurses experience work-related stressors, pediatric nurses may be at a particular risk, as they face emotional stress from taking care of sick children. Research on work-related stressors in pediatric settings has focused on nurses in critical care units, leaving a gap in knowledge regarding those working in medical and surgical units. While working conditions on pediatric medical and surgical wards are clearly stressful, the sources of that stress have not been identified. Experienced pediatric nurses caring for increasingly sick and vulnerable children on medical and surgical units may be at particular risk for work-related stress. They are expected to master the skills necessary to care for patients with a wide range of diagnoses and treatment issues, while accepting increased responsibilities. This can decrease the amount of time available for direct patient care and lead to job dissatisfaction. In view of their positive impact on quality of care, it is imperative to understand the work-related stressors these nurses encounter in order to develop effective organizational interventions to minimize stressors and promote retention. The purpose of this study was to explore experienced pediatric nurses’ perceptions of work-related stressors in medical and surgical units using a qualitative descriptive design with semi-structured interviews. The study took place in a medical and surgical units at a quaternary care pediatric hospital. Purposive sampling was used, and nurses recruited until data saturation was reached (n = 12). Experienced nurses described a strong sense of responsibility for providing excellent patient care, and identified stressors that negatively impacted their ability to do so. Stressors are reflected in three themes: (1) ‘‘The kids are getting sicker and sicker’’: Difficulty ensuring excellent patient care to an increasingly vulnerable population,(2) Feeling powerless to provide quality care, and (3) Being a ‘‘Jack-of-all-trades’’: Struggling with competing demands. The aim of this presentation is to identify experienced pediatric nurses’ perceptions of work-related stressors in medical and surgical settings and how they might be mitigated to promote healthy work environment. Managerial strategies for workplace empowerment will be discussed through the lens of Kanter's structural empowerment theory, Lee and Mitchell's unfolding turnover model and Benner's from novice to expert theory.