Doctors nurses in teaching hospitals report widespread job stress and sleep deprivation

Despite recently mandated reductions in medical student workload hours, a new study reveals the widespread presence of job stress, and sleep deprivation among physicians and nurses in teaching hospitals.

When asked to keep a running account of work activity, patient load, and work stress using handheld computers, physicians reported much higher levels of work stress than nurses.

Both groups reported more stress during patient care activities compared with activities such as patient education, transit, or communication.

California researchers studied 185 physicians (attending physicians, residents, and interns), and 119 nurses working in four teaching hospitals over an 18-month period.

For one week, participants recorded their work activities and stress in handheld computers, whose content was sampled randomly over 90-minute intervals throughout each work day.

The participants also completed more than 9,500 internal surveys on work stress during the study.

Emotional stress scores among physicians were nearly 50 percent higher than those of nurses. Physicians reported feeling less alert and more worried, tense, fatigued, unhappy, tired, upset, and stressed.

Compared with physicians, nurses reported significantly higher levels of high physical demand and performance and lower levels of frustration. Direct and indirect care activities were associated with higher stress reports by both groups.

Approximately one-fifth of doctors and nurses sampled daily indicated five or fewer hours of sleep the previous night. Lower sleep quality and quantity were predictors of higher work stress scores.

Higher work stress and lower sleep quality were also associated with poorer memory performance. The study was supported in part by the Agency for Healthcare Research and Quality (HS14283).

More details are in “A real-time assessment of work stress in physicians and nurses,” by Thomas Rutledge, Ph.D., Erin Stucky, M.D., Adrian Dollarhide, M.D., and others, in Health Psychology 28(2), pp. 194-200, 2009.

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