STRESS AND WORK RELATIONSHIPS IN THE NEONATAL INTENSIVE-CARE UNIT - ARE THEY WORSE THAN IN THE WARDS

Objective: To compare working conditions, sources of stress and profes sional relationships between a group of nurses working in neonatal int ensive care units (ICU) and those working in general paediatric teachi ng hospital wards. Methodology: Surveys were sent to 96 nurses working in general paediatric wards in three Sydney paediatric teaching hospi tal centres and to 291 nurses working in six major neonatal ICU in Syd ney. The survey asked about work environment, patient care, decision-m aking, sources of stress and professional relationships. Thirty-one qu estions were identical in each survey. The survey also included the Ge neral Health Questionnaire (GHQ) as a measure of emotional health. Res ults: The response rate was ward nurses 86% and neonatal intensive car e nurses 66%. Of the 31 identical statements, nine were significantly different between the two groups. Neonatal nurses were more likely to feel that their ward work areas were overcrowded and poorly laid out w ith little patient-free space. They had more concerns about inadequate staffing and conflict between nurses and doctors. The general ward nu rses were more likely to feel that adequate priority was given to pati ent pain relief and that they had more influence in such decisions but experienced more stress in keeping up to date and were more likely to feel that communication problems between doctors and nurses were a ma jor source of conflict Forty per cent of general ward nurses and 32% o f neonatal nurses had GHQ scores indicating possible psychological imp airment, a significantly higher proportion than would be expected in t he population. Conclusions: Paediatric nurses perceive a variety of st resses in their work, with problems in communication between doctors a nd nurses being a prominent perception. The high GHQ scores may be a r eflection of some of those problems. Attention to problems of under-st affing, better work environment and improved communication may help re solve some of these issues and may have implications for improving pat ient care.