Occupational Stress among Hospital-Based Nurses in Hawai'i during the COVID-19 Pandemic: A Cross-Sectional Survey

The Coronavirus Disease 2019 (COVID-19) pandemic has caused unprecedented disruption in health care systems and may continue to do so. Nurses, the largest contingent of the nation's health care workforce, have borne the brunt of those disruptions, which have caused increased workload and resultant occupational stress. This study identified differences in nurses' occupational stress by practice specialty, time spent caring for patients with COVID-19, and nurses' demographic characteristics. A descriptive cross-sectional online survey of RNs and APRNs (N=328) was conducted at a Level 1 Trauma Center on the island of O'ahu, Hawai'i in September and October of 2021. Participants completed the 57-item Expanded Nursing Stress Scale (ENSS). Nurses reported an average overall stress score of 2.11 out of 4. The ENSS subscales of workload, patients and their families, inadequate preparation, and uncertainty concerning treatment all had higher mean scores than the total scale. Nurses working in perioperative/procedural areas and obstetrics reported lower overall occupational stress scores than nurses in other specialties. Nurses who spent > 50% of their time caring for patients with COVID-19 reported higher overall occupational stress scores than nurses who spent ≤ 50% of their time caring for patients with COVID-19 (F = 8.21, P < .001). Nurses over the age of 50 reported less stress than their younger counterparts (F = 5.75, P = .004). Understanding how occupational stress impacts acute care nurses can aid employers in allocating resources to address the problem, and thus improve workforce retention.