Stress: How is it Affecting Service Delivery and Health of Nurses? A Qualitative Study from Pokhara Metropolitan, Nepal

Introduction: Stress among health care professionals is harmful because of adverse psychological and physiological changes, which lead to decrease productivity. This study aimed to explore the experienced causes of stress, its effects and coping strategies among nurses. Methods: In-depth interview was conducted among nurses working in different hospitals of the Pokhara metropolitan, Nepal. The nurses were selected purposively.  Data saturation was gained with fifteen interviews. Data analysis was done by adopting the Conventional Qualitative Content Analysis technique and summative analysis process. Results: Three domains were identified from the study – causes of stress, effects of stress, and coping strategies for stress. The causes of stress were workload, lack of proper logistics, insufficient staffs, undesirable relation among colleagues, patient’s condition, patient’s relatives, and visitors, being blamed for other’s mistakes, senior’s behaviors, workplace violence, work- shift, patient’s death, and sufferings, job positions, work-life balance, health condition, job dissatisfaction, dignity and social status, family problems and lack of experience. The effects of stress experienced by the nurses were medication errors, delay of services, loss of concentration in work, degradation of the hospital’s goodwill, headache, insomnia, frustration and depression, lethargy, and loss of appetite. Nurses adopted listening to music, playing games, surfing the internet, watching television, doing household chores, sharing events and incidents, calm down, and crying as the coping strategies for the stress they experienced. Conclusion: Due to several stress factors and their effects, the performance of nurses in a hospital setting was challenging. It was affecting the physical, mental, and social aspects of nurses’ life. However, they adopted coping strategies to help themselves in reducing the level of stress. An environment must be created by family members, organization, management team, nation, concerned authority, and possible stakeholders so that the nurses will be able to work with total concentration, devotion, and commitment.