Stress, Burnout, and Low Self-Efficacy of Nursing Professionals: A Qualitative Inquiry
1.1. Purpose and Background of the Study
- How does the career pathway of the nursing profession impact the stress, burnout, social bias, and stigma of women nursing professionals in South Korea?
- What are the sources of stress and burnout that reduce the self-efficacy of women nursing professionals in South Korea?
1.2. Brief Literature Review
1.3. Theoretical Framework: Self-Efficacy Approach
2. Methodology and Its Application
2.1. Application of the Phenomenological Approach
2.2. Participants and Recruitments
2.3. Data Collection
2.4. Data Analysis
2.5. Human Subject Protection
3. Results and Discussions
3.1. Workplace Bullying
3.1.1. Discrimination from Doctors, Therapists, and Organizational Leaders
I have a family and I have many family responsibilities…. I have to take care of my family and my children…. I have two children; they are still in kindergarten…. I can work overtime, but I have to tell my mother in advance to take care them. However, my employer forced me to stay at the office without asking me…. I needed to go…, but if I left, I would have lost my job in three months… after working my notice…. (P#4)
I do not want to work overtime as I have other responsibilities after working hours…, but my supervisor did not ask my approval or ideas…. I just need to cover the next eight hours without any agreements…. This is not a single case…. It always happens in Korea…. We have no rights as nurses…. (P#47)
It is so unfair because the upper leadership always asks us to contribute and spend time with our patients…, but we are not machines…. I have parents and family members…. I still need to spend my time and my energy with my family…. I cannot always work overtime without any rewards…. (P#50)
I don’t understand how come management cannot ask us first…. Of course, we can work overtime in this situation…, but I need to call my mother to ask her to take care of my children…. She needs to go over to my house to take care of my children…. This is a basic responsibility…, but management just forced us to work 24/7 in the office…. I always call my mother. At least management should call me…, allow me to make arrangements…. (P#6)
It would have been fine if the doctor had asked me to go to the ward to see to reports and patients…, but the doctor I am partnered with asked me to give him a massage after work…. I think this is totally beyond my responsibilities…. He didn’t do it politely; he forced me to do it…. I refused…. Then, I was transferred, partnered with another doctor…. (P#11)
My partnered doctor always asks me to make him coffee in the morning and afternoon…, but I have patients and my break time is only less than 60 min…. I have to eat and rest…, but it seems like many doctors and male management love to take advantages from female nurses and other female staff…. (P#47)
In this extreme situation, my responsibility is to take care of the patients…. The workload was still extremely high due to the panic in the community…, but the doctor I am partnered with asked me to wash his shoes and uniform as he dropped coffee on himself…. It was an immediate request…. Should I take care of my patients or the doctor? (P#15)
Everyone wants to have a high level of protection. We all knew the nasal and oral openings and secretions could be very dangerous…, but we, as medical professionals, should take care of our patients under the guidelines from the department…. If need be, we should transfer the patients to the designated hospital…, but to keep asking others to do the dirty jobs they don’t want to do, such as cleaning nasal secretions on the floor…, this is totally beyond my understanding…. (P#25)
Taking care of our patients is one of the most important jobs as public health professionals…. However, some staff always take advantages of nursing professionals as they don’t want to take any risks…, but if you don’t want to take risks…, why would you ask other people take these risks for you? I have family too. Is it because my life is cheaper as a female nursing professional? (P#41)
Doing voluntary work is meaningful…. I love it…, but I should only do it if I want to…. I still have other personal arrangements after work…. I can do whatever I want after work…. It is my right to decline doing voluntary work…. It is not in my contract…, but my director forced me to do so without asking me at all…. He told me that this is a Korean practice…. (P#33)
3.1.2. Discrimination from Other Nursing Professionals
Although I did not need to work with children…, community members…, it did not mean I was free…. I still had to do a lot of health promotion and community health activities for the public…. We all work in different positions in the city…. I don’t understand why people think we have it easier…. (P#31)
For the coming three years, I am taking duties as the health promotional nurse at the community level…. Usually, I go to the community centers and schools for health promotion…; however, some of my coworkers always look down me because they think my duties are easier than theirs…. It is not easier to work with community members…. I don’t understand why people love to discriminate people based on their units…. (P#43)
I don’t know why peers in the hospitals like to blame us or discriminate against us…. We are working for the community…. We should not pigeonhole people…, but in Korea…, people like to pigeonhole others…. I was discriminated against…, but I will not discriminate against other people and other nursing professionals…. (P#34)
3.2. Family Stress
3.2.1. Discrimination and Blaming from Family Members
Even if I finished work at the hospital…, when I returned home, my mother-in-law, my husband, and my sons asked me to eat alone in the kitchen and asked me to sleep in the storage room as I am a dirty person…. Society called us heroes, but this is not true…. Society always discriminated against us because of our occupation, our contact with patients…. (P#28)
My mother-in-law and my husband always look down me because I need to work in the dangerous unit…. When I enter my house, my mother-in-law asks me to wash my body before touching anything in the home…. My husband even asks me to isolate myself before I go to the bedroom…. (P#44)
My mother-in-law called me a dirty woman because I was sent to the infectious disease patients testing unit…. After I leave the unit, I even… clean up my body… in order to ensure my safety and the safety of my family…, but when chatting with my family online, I heard my mother-in-law calling me a dirty woman…. She used this term to describe my occupation in front of my sons…. (P#23)
It is all about my occupation as a nursing professional…. I feel I am working for the good of my region…. Although I don’t make additional money or whatever, I serve the patients in need and provide help to those who need me…, but my mother-in-law does not understand…. She told me to go into rural housing for at least a month before returning…. (P#20)
I have worked ever since my marriage in order to compensate for my husband’s low earnings…. I do not complain as I want to support my family…. Even if he doesn’t support the fact that I work after our marriage, I think working for patients as a nurse is very meaningful…, but now, he thinks I am a dirty woman because I have to touch patients…. Once, he asked me not to come back home…. (P#10)
My husband called me a stupid girl as I want to spend my energy working in the public health system…. He said that we should be selfish as we have already paid enough tax to the government…. The government should have the ability to manage the manpower…. He continues to call me stupid girl…, but even if the government has money, how can they have enough manpower if we don’t work…. Even if the government never ever respects the public health system workers, I still want to work for my family…. (P#7)
My son did not talk to me because he thinks I am a dirty worker in the hospital…. I told my husband to tell him that my work is exclusively for the public health system and patients…, but my husband did not listen to me and said a lot of bad things to my son…. My parents…, the same…, they decided to keep their silence…. (P#22)
My children did not call me mother because I am a nursing professional in a hospital…. My mother-in-law and my husband always tell my children that I work in the dirty unit in the hospital…. I do not think working in a dirty unit is an ugly thing as a public health professional…. I am professional…. I work for people who are sick…. (P#26)
3.3. Being Misunderstood by Members of the Public
3.3.1. Blaming from the Public
Many newspapers like to catch their readers’ attention…, always printing negative and fake information about the public health system…. Korean people like to blame others in order to diminish their responsibilities… even in this public health disaster…. (P#1)
It is not uncommon for gender-based discrimination in Korea…, but I feel so negative because society discriminates us based on our gender and occupation…. I do not think nursing professionals should be discriminated…. We work so hard to help the patients…, but the rewards from the community are negative. (P#38)
In our building, we have a social media chat group…; however, my family members… and my neighbors… were forced to leave the chat room… as Koreans like to pigeonhole people… in this case, based on this public health situation…. (P#3)
I understood why my neighbors forced us to leave their chat room as we used to force other disabled, senior citizens, and families with special needs children to leave us…. This is the Korean way…. I do not wish to change this behavior as I think it is not essential. I will discriminate against others in return in the future in order to reassert my social status…. (P#17)
3.4. Personal Development and Career Enhancement
If I graduated with a master’s degree nursing, I may be promoted as one of the team leaders…. My salary will be increased…. Also, I can escape from my current hospital… and look for a better working environment…. At least I have the chance to change my job…. (P#47)
As I explained above, workplace bullying is not uncommon in South Korea…. I wish I can study a master’s degree or a doctoral degree… and become a better educated person…, but if my supervisor and organizational leaders knew I have a postgraduate qualification…. I am not sure about their reactions…. I fear actually…. (P#50)
4. Limitations and Potential Developments
Conflicts of Interest
|Name||Location of the Workplace||The Setting of the Workplace|
- Do you enjoy being a nurse? Why or why not?
- Is it hard to work as a nurse now? Why or why not?
- What would be the hardest thing or things you face as a nurse?
- What about now? What would be the hardest thing or things you face as a nurse?
- Further questions.
- Do you feel stress and burnout? What situations made you feel stress and burnout?
- How would you describe your current self-efficacy? Can you tell me more?
- Do any personal factors and elements, such as cognition, affect, and biological elements make you stressed and burnt out?
- Do any behavioral actions and ideas make you stressed and burnt out?
- Do any environmental elements and factors, such as working condition and issue, make you stressed and burnt out?
- Further questions.
- How would you describe being a nurse in South Korea based on your gender?
- How would you describe bring a nurse in South Korea based on your age?
- If possible, do you want to continue to work as a nurse? Why or why not?
- How would you describe the future development of the nursing profession in South Korea? For example, any improvements.
- Further questions.
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|Themes and Subthemes|
|Section 3.1||Workplace Bullying|
|Section 3.1.1||Discrimination from Doctors, Therapists, and Organizational Leaders|
|Section 3.1.2||Discrimination from Other Nursing Professionals|
|Section 3.2||Family Stress|
|Section 3.2.1||Discrimination and Blaming from Family Members|
|Section 3.3||Being Misunderstood by Members of the Public|
|Section 3.3.1||Blaming from the Public|
|Section 3.4||Personal Development and Career Enhancement|
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Dos Santos, L.M. Stress, Burnout, and Low Self-Efficacy of Nursing Professionals: A Qualitative Inquiry. Healthcare 2020, 8, 424. https://doi.org/10.3390/healthcare8040424
Dos Santos LM. Stress, Burnout, and Low Self-Efficacy of Nursing Professionals: A Qualitative Inquiry. Healthcare. 2020; 8(4):424. https://doi.org/10.3390/healthcare8040424Chicago/Turabian Style
Dos Santos, Luis Miguel. 2020. "Stress, Burnout, and Low Self-Efficacy of Nursing Professionals: A Qualitative Inquiry" Healthcare 8, no. 4: 424. https://doi.org/10.3390/healthcare8040424