Occupational Stress in the Intensive Care Unit and Intensive Cardiology

Care Unit of the Rumah Sakit Umum Daerah Dr. Zainoel Abidin

Banda Aceh

Liza Salawati

, Rachmad Suhanda

, Raudhatul Jannah

Department of Public Health, Faculty of Medicine, Universitas Syiah Kuala, Aceh, Indonesia

Faculty of Medicine, Universitas Syiah Kuala, Aceh, Indonesia

Keywords: Occupational stress, ICU, ICCU, RSUDZA.

Abstract: Occupational stress is the second largest health problem associated with work after musculoskeletal disease.

Occupational stress can be caused by an imbalance between the personality characteristics of workers and

aspects of their work, many work-related diseases are experienced by nurses who work in intensive care

hospitals. The purpose of this study was to determine the description of occupational stress on nurses of the

Intensive Care Unit (ICU) and Intensive Cardiology Care Unit (ICCU) of Rumah Sakit Umum Daerah Dr.

Zainoel Abidin (RSUDZA) Banda Aceh. This research is an observational study, the sampling technique

used was total sampling (54 respondents). The result showed that the ICU and ICCU nurses at RSUDZA

Banda Aceh experienced mild occupational stress (62.96%), and 1.85% experienced severe occupational

stress. 61.11% of nurses stated that a lot of work had to be done, only 38.52% of nurses were skilled at

work, and 47.78% of nurses received an award for good work performance. The conclusion of this study is

that ICU and ICCU nurses at RSUDZA Banda Aceh experienced mild occupational stress. Nurses

workload is quite high, there are still nurses who are less skilled at work and the majority of nurses have a

working period of <5 years.

1 INTRODUCTION

Every worker has experienced stress without

recognizing social status, economic, and job position

(Martin, 2011). Among all of the health workers, the

most stressful occupational health workers

experienced by nurses (Lua, 2011) Nurses who work

in emergency situations are more susceptible to

stress (Duffy, 2014). Stress experienced by nurses

can affect physical and emotional conditions, it

greatly affects the performance of work and health

services provided to patients (Moustaka, 2010;

Arbabisarjou, 2013). According to the theory of

General Adaptation Syndrome Selye in Safaria

(2009) the stages of stress are as follows: a)

Reaction alarm; this stage explains the sympathetic

system and glands of the body begin to secrete

adrenaline, epinephrine, norepinephrine which give

rise to symptoms such as tachycardia, tachypneu,

cold sweat, sensitivity to reduced pain, increased

muscle contraction, and digestive disorders. b)

Resistance; this stage is where the body begins to

release adrenaline, noradrenaline and cortisol which

are used to energize the body when fighting tension.

At this stage physiological disorders have begun. c)

Exhaustion: in this stage the body has run out of

energy to constantly fight tension, if this condition

continues then the system in the body will be

damaged so that a person can suffer from heart

disease, gastritis, hypertension, migraine, diabetes

mellitus and so on. According to Rasmun (2004)

stress is divided into three levels, namely: a) Mild

stress, not damaging to the physiological aspects of

the individual. Mild stress it is occurs in a few

minutes or several hours; b) Moderate stress,

occurring from several hours to several days.

Moderate stressful situations can be caused by some

situations such as an unfinished agreement,

excessive workload, and expecting new work; c)

Severe stress, occur from several weeks to several

years. Prolonged stress can cause tensions and

worries that continue to destroy the physical,

psychological and entire life of the patient slowly.

According to Dewe (2010) the source of

occupational stress on nurses is divided into five,

namely: a) Excessive workload; b) Difficulties in

establishing relationships with other nurses; c)

Difficulties in treating patient's with critical

conditions; d) Have responsibility for treatment or

patient care; e) Caring for patients who are difficult

Salawati, L., Suhanda, R. and Jannah, R.

Occupational Stress in the Intensive Care Unit and Intensive Cardiology Care Unit of the Rumah Sakit Umum Daerah Dr. Zainoel Abidin Banda Aceh.

DOI: 10.5220/0008789501210124

In Proceedings of the 2nd Syiah Kuala International Conference on Medicine and Health Sciences (SKIC-MHS 2018), pages 121-124

ISBN: 978-989-758-438-1

121

to improve. According to Robins (2002) the impact

of stress is as follows: a) Physiological symptoms

such as: Changes in body metabolism, increase heart

rate and respiration rate, increase blood pressure,

cause headaches, and heart attacks; b) Psychological

symptoms: dissatisfaction. c) Behavioral symptoms

such as: decreased productivity, absenteeism, the

level of employee turnover, changes in eating habits,

increased smoking and consumption of alcohol,

quick talk, anxiety, and sleep disorders. According

to Durai (2010) Management of occupational stress

can be done through:

1. Psychological management such as increasing

self-awareness, reducing tension, counseling and

psychotherapy

2. Physiological management such as exercising

physical health, regulating diet, and quitting

smoking

3. Affective communication between managers and

workers, so that there will be clear lines between

tasks and responsibilities

4. Work performance evaluation system

5. Increasing participation to reduce role ambiguity

and conflict

6. Develop skills, personality and work that are in

accordance to the needs of employees and

organizations that can support work development

efforts both in quantity and quality to reduce

stress.

2 METODOLOGI

This study is an observational study place at the

ICU and ICCU RSUDZA Banda Aceh. The sample

in this study was all nurses of the ICU and ICCU

RSUDZA Banda Aceh, totaling 54 nurses. To

measure occupational stress, the data were collected

by interview with Workplace Stress Scale

questionnaire, the results were divided into five

categories: 8-15 (normal), 16-20 (mild stress), 21-25

(moderate stress), 26-30 (severe stress) and a score

of 31-40 (very heavy stress).

3 RESULTS AND DISCUSSION

3.1 Characteristics of Nurses

Table 1: Characteristics of Nurses of ICU and ICCU

RSUDZA Banda Aceh

Characteristics N %

21-30

31-40

41-50

57,41

31,48

11,11

Gender

Male

female

24,07

75,93

Education

D III/Academy

S 1

44,44

55,56

Room

ICU

ICCU

62,96

37,04

Length of work (year)

˂ 5

6-10

˃ 11

48,15

31,48

20,37

Based on Table 1, it shows that the ICU and ICCU

nurses at RSUDZA Banda Aceh were at most 21-30

years old at 57.41%. This age group is considered

capable of getting a job, able to face high physical

burdens and agile to move in work (Eriawan, 2013).

The result of this study indicates that the majority of

nurses are female, that is equal to 75.93%. This is

similar with Burgess's (2010) study which states that

78.3% of female nurses work in intensive services,

as well as in Inoue (2013) who stated that the high

percentage of female nurses compared to male

nurses. This is estimated that during the education

process and looking for work period, the majority of

women choose occupations related to health because

women tend to have sense of caring and caring

feelings such as maintaining the health of their

children. Nurses and midwives are considered as

women's jobs because providing care is an

appropriate task for women (Sudarma, 2008). The

results of this study indicate that 55.56% of nurses

with S 1 education, most of them work in the ICU,

are 62.96%. This is in line with the research

conducted by Inoue (2013) in Brazil, the majority of

nurses work in the ICU is 61.7%. ICU is an

intensive room that serves adult patients with

various types of diseases. This is different from

other intensive spaces that deal with diseases more

specifically, such as ICCU, which deals with

patients with special heart disease, so that there are

more nurses in the ICU than other rooms. The

results of this study also showed that the majority of

ICU and ICCU RSUDZA nurses in Banda Aceh had

a working period of <5 years which was 48.15%.

This is similar with Monte (2013) research in Brazil

and Pawar (2014) in Mumbai which states that the

majority of nurses have a <5 year working period in

the ICU.

SKIC-MHS 2018 - The 2nd Syiah Kuala International Conference on Medicine and Health Sciences

122

3.2 Occupational Stress

Table 2: Frequency Distreibusi of Occupational

Stress of Nurses in ICU and ICCU RSUDZA Banda

Aceh

Occupational Stress N %

Normal 13

24,08

Mild 34 62,96

Moderate 6 11,11

Severe 1

1,85

Total 54 100,00

Based on table 2, it shows that the ICU and ICCU

nurses at RSUDZA Banda Aceh experienced mild

occupational stress, which is equal to 62.96%, and

1.85% who experienced severe stress are nurses who

worked in the ICU. The profession as a nurse in an

intensive room is a job that is prone to stress, this is

because the work is full of tension in dealing with

patients with various medical complaints. According

to Bahadori (2014) and Saleh (2013) nurses who

work in intensive spaces tend to experience stress

because they have to deal with critical patients with

a heavy workload, so that a lot of pressure arises.

This happens because nurses are not only faced with

patients with critical conditions but also the

necessity to work with high responsibility.

According to Gulavani (2013), nurses who

experience occupational stress have a negative

influence on emotional health and physical health,

such as easy to have headaches, fatigue, mood

changes and other illnesses.

Table 3: Occupational Stress Items of Nurses in ICU

and ICCU RSUDZA Banda Aceh

Occupational Sres Item %

The workplace is unsafe and unpleasant 36,67

Work is bad for health and emotions 45,56

A lot of work needs to be done 61,11

Difficult to convey the conditions of work

faced to su

eriors

46,30

Work interferes with famil

and

ersonal life 38,52

Have ade

uate control of the task 53,33

Get an awar

47,78

Skilled and talente

38,52

Based on table 3 above, 61.11% nurses of ICU and

ICCU RSUDZA Banda Aceh stated that a lot of

work had to be completed. According to Gurung

(2014) mind and physical burden due to work causes

a person to feel tired and bored so that it is easy to

feel and give negative emotions to oneself and to the

people closest to them that cause saturation and

discomfort interaction with others. Bahadori (2014)

states that intensive care space nurses who

experience occupational stress are associated with

high workloads, the high workload can be in the

form of an imbalance in the number of nurses and

patients that must be addressed. Nurses who handle

too many patients will experience difficulties when

they work. Workloads that involve mental and large

responsibilities can cause high stress compared to

physical workload. The results of this study also

showed that only 38.52% of Banda Aceh ICU and

ICCU nurses were skilled and gifted in their work,

this was related to their working period which was

still <5 years old. The duration of the nurse's work is

related to the learning process of the skills practiced,

the longer a person works in an institution the better

the learning process is to improve the quality of

skills. Difficulties in caring for patients with critical

conditions, whether to carry out treatment for

patients with unknown equipment, manage

procedures of new actions in working with doctors

who demand quick answers and actions. If This is

left unchecked, it can reduce work performance,

increase medical errors, and reduce service quality

and patient satisfaction. The result of this study also

showes that only 47.78% received an award for good

work performance. This shows that the coverage of

awards received by ICU and ICCU RSUDZA nurses

in Banda Aceh is still relatively low.

4. CONCLUSION

The conclusion of this study is that ICU and ICCU

nurses at RSUDZA Banda Aceh experienced mild

occupational stress. This happens because the

workload is high, there are still nurses who are less

skilled in working and the majority of nurses have a

working period of <5 years.

5. SUGESTION

Suggestions in this study are:

1. Management of RSUDZA Banda Aceh should:

a) Manage workload both physically and

mentally in accordance with the ability or work

capacity of nurses working in the ICU and ICCU

Occupational Stress in the Intensive Care Unit and Intensive Cardiology Care Unit of the Rumah Sakit Umum Daerah Dr. Zainoel Abidin

Banda Aceh

123

by avoiding excessive workloads or too light

loads; b) Improving the quality of the ICU and

ICCU swimmers by providing training in

accordance with their fields in a sustainable

manner and giving them the opportunity to take a

higher level of education; c) Give appropriate

rewards, and carry out refreshing programs

regularly.

2. Management of RSUDZA Banda Aceh should

carry out stress screening periodically for ICU

and ICCU nurses at least once a year.

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