Exploring how nurses experience, perceive and cope with occupational stress in major Saudi Arabian hospitals

The nursing profession is generally considered a stressful occupation. The stressful nature of the nursing profession has been associated with long working hours, complex work environment and exposure to various physical and mental health stressors. There is a growing body of evidence on the various factors associated with occupational stress. While most of this evidence come from studies in Western countries, only a few research studies have provided some understanding of occupational stress among nurses in Saudi Arabia and neighbouring countries. Unfortunately, very few of these studies have explored occupational stress from the perception and experience of the nurses affected. Also, there is limited understanding of coping strategies adopted by nurses and the relative effectiveness of these coping strategies. This study therefore intended to employ a mixed method study to investigate the various factors resulting in stress for nurses working in Saudi emergency departments, explore these nurses' perceptions and experience of stress and the coping strategies they find helpful. The study sampled all nurses working in the emergency departments of three large Saudi Arabian hospitals (n=441). A questionnaire with 86 items across four domains was developed, pilot-tested and validated for this study and used to collect quantitative data. A purposive sample of 35 nurses expressed interest to be interviewed using a semi-structured interview guide to collect qualitative data. IBM SPSS was used to analyse the quantitative data, while Nvivo QSR was used to manage, code, and analyse the qualitative data. A total of 296 nurses returned completed questionnaires analysed for the study and 21 nurses were interviewed for the qualitative phase of the study. For the quantitative phase, 89.5% (n=265) of the sample were females, 51% aged 20-29 (n=151), 83% non-Saudi citizens (n=246), 49% married (n=145) and 82% hold a Bachelor's degree as their minimum educational qualification (n=245). Work overload, staff shortages and inadequate pay were reported as the most significant causes of occupational stress. Five major themes emerged from the qualitative phase data which supports high work volume, rising costs of living despite same pay and staff shortages as major stressors. Also, the study found strong working and supporting relationships exist among the nurses, and that praying and spending time with friends/family are the predominant coping methods among the nurses. The findings of this study contribute to better understanding of the work conditions of nurses in tertiary and secondary Saudi hospitals and can help to inform policy development and practice reforms geared towards improving the welfare, health and overall work experience of nurses in the Kingdom of Saudi Arabia.