Concepts are the fundamental building blocks of a theory. Nursing theory refers to a blueprint formed to organize skills, interpret occurrences in nursing at a more specific, and concrete level. Nursing theory entails a set of designations, postulations, propositions, links and more importantly concepts attained from nursing models. A nursing concept refers to a word that derives meaning, feelings or understanding amid persons within the nursing profession. Concept analysis refers to a prescribed linguistic exercise that functions to identify certain attributes. Apparently, nurses hold little control of the conditions surrounding their work. These work conditions are responsible for many nurses who abandon their nursing profession. Presently, a new concept that scores of nurses use to define stress in nursing is compassion fatigue. The purpose of this paper is to assess the concept of stress and its comparative attributes and upshots with the aim of acknowledging the required antecedents necessary for creation of improved conditions for practicing nurses at their workplace.
The concept of compassion fatigue or stress is derived from the interaction theories of nursing. Interaction theories enhance the links between patients and nurses. The concept is attached to Nueman's nursing model that reflects general system theory that provides that all the components are in interaction in a complex organization. Neuman considered nursing as a system given that the nursing practice involves elements of interaction with one another. The responsibility of a nurse with respect to Neuman system model entails the extent of reactions to stressors as well as the utilization of tertiary, secondary and primary interventions aimed at maintaining the steadiness of the system. Neuman considers stressors to be interpersonal forces that takes place within an individual, or interpersonal forces taking place between one or more persons. Neuman also views stressors as extra-personal forces taking place outside a person. Stressors might enter both a clients normal or flexible defense line and the potential upshot of an interaction may lead noxious or positive upshots.
According to Keil (2004), stress refers to tension, pressure, mental or physical strain. The use of stress as a semi-psychological term in the sense of coercion or hardship has its roots from the 14th Century. Stress is viewed as a development towards structural failure and can only get measured through referring to its impacts on a structure. Stress is a measure of tendency of a force to instigate change or destruction of a structure's state. Keil (2004) confirms that the concept of stress got examined as physical occurrence in different biomedical specialism. She suggests that there is a link between physical health and psychosocial life events. Keil explores the use of stress and coping application via conceptual analysis method that analyzed the two terms. She reviewed an extensive body of literature to underline the difference between stress and coping. The results of study revealed that coping and stress are employed in nursing and they lack clarity over their accurate use and meaning.
In a study seeking to explore the reasons why nurses abandon their nursing profession MacKusick and Minick (2012) utilizes a phenomenological research design to discover the intricate occurrences that influences nurses to leave their clinical practice. According to MacKusick and Minick (2012), the shortage of nurses in the United States may go beyond 500, 000 by 2025. Experiences of newly licensed nurses hold a direct impact on personal views about the nursing profession. Thirty to fifty new nurses leave the nursing profession during their first three years of clinical practice. MacKusick and Minick (2012) confirm that numerous aspects influence the decision to abandon clinical nursing. To understand the nurses' decision to leave their profession, the authors performed a qualitative research. The results from the study indicated that emotional distress linked to patient care, fatigue and exhaustion and unfriendly workplace were the major themes that cause nurses to abandon their profession. Belittling confrontations, lack of collaboration between staff and physicians, lack of respect to family and patient wishes causes emotional distress. Fatigue and exhaustion is due to unfriendly workplace and exposure to emotionally distressing dilemmas.
Riahi (2011) asserts that role stress has become a crucial concern for nurses. Stress triggers distress that causes burnout of scores of nurses. Riahi (2011) used a modified method to assess the concept of stress and the findings indicated that nurses are vulnerable to distress and burnout caused by stressors. Riahi (2011) asserts that nursing is an occupation with high extent of stress. This is because nurses confront grief, death and stark suffering. Scores of nursing roles are unrewarding, mundane, frightening and distasteful. With respect to UN and WHO, job stress has become a global epidemic. Riahi (2011) conducted a thorough literature review to understand the concept of stress. She states that stress happens when demands placed upon a person exceed the present resources the individual encompasses to manage.
Leiter & Maslach (2009) assert that stress or is a product of a cumulative and progressive procedure prompted by prolonged, intense and continuous contact with patients. It emerges from a state of compassion discomfort, not effaced through enough rest, triggers compassion stress that goes beyond the endurance level leading to stress. The state of stress manifests through marked emotional, social, intellectual, Spiritual and physical changes that augments in intensity with each progressive condition.
The concept of stress is utilized in its precise physical sense by physiologists who study separated muscles in which reaction can be readily measured as physical strains or stress. Organ physiologist whose application of the term is obscure or incompatible with physical definitions utilizes the term stress, for instance contractility of the heart. Psychologists working with whole animals where the concept of stress holds a metaphorioc link to the physical concepts also use the term. The idea of stress is used by social scientists who apply it to nations such economies in contexts where it appears more like a hyperbole than a scientific concept. However, as psychology, medicine and physiology evolved from intuitive to logical scientific and clinical disciplines, numerous clinical problems emerged for which the concepts of stress appeared useful.
Walker & Avant (2005) identified attributes as general qualities of a concept, which facilitate recognition of occurrence of a certain phenomenon. The attributes of stress include perceptual incongruence that identifies how a person views his role in connection to resources and abilities. Another attribute of stress is multidimensionality, which encompasses psychological and physiological impacts on a person. Interactional response, response blueprint burnout and hardiness utilized by persons to rise in stressful conditions are stress attributes identified by Riahi (2011). According Knobloch & Klopper (2010), risk factors, process, manifestations and causes were identified as the main categories of stress. Risk aspects and causes are the antecedents of stress. Risk refers to a danger while cause refers to the aspect that produces an impact. The process category highlights the series of events of the course of stress while manifestations entail the upshots of stress. It demonstrates the social, emotional, intellectual, spiritual, physical impacts of stress. Knobloch & Klopper (2010) assert that spiritual refers to the ability of a nurse to seek meaningfulness via interpersonal, intrapersonal and transpersonal link..
A Model Case
According to Walker & Avant (2005), a model case incorporates all the describing attributes of a concept. It demonstrates all the defining qualities of a stress as a concept to offer insight into the internal organization of the concept and permit clarification of the meaning of the concept.
Rose takes charge of a 20-bed terminally ill male medical ward for over ten years. She has regular contact with different patients in her work schedule, 8 hours daily. Every patient in the ward has special needs that Rose must fulfill. The ward is busy, but with a shortage of nurses and inadequate resources. Rose must fulfill all her duties and ensure adequate and equitable care to all her patients. These aspects stress Rose as she tries harder to meet the need of the patients and needs of the organizations. Her work condition changes due to the increased challenges. Rose feels physically, intellectually, mentally, spiritually, and emotionally challenged. She is worn out and feels the need to take a break from the practice. After a few months, Rose cites apparent shifts in her life. She feels weak and drained and her stress level exceeds her survival limit. She feels emotionally overpowered, gradually withdrew her support to patients, gets bored with her duties and become emotionally unstable leading to the desire to quit. She is stressed.
Alternative cases entail borderline, contrary, related, illegitimate and invented cases. Alternative cases allow researchers to differentiate between concepts that were akin and contrary to stress concept. Such cases hold scores of defining qualities of a concept, but not all the concepts.
Antecedents are occurrences that take place prior to occurrence of a concept. Within the concept of stress amid nurses, there is a wide spectrum of incidents and events before stress and it is personalized for nurses. There are preventive techniques that include…