While the role of a nurse may seem straightforward, the reality is that the professional and social responsibilities and expectations associated with the profession of nursing mean that a single nurse actually serves several roles (Blais & Hayes, 2016). Nurses regard themselves and are regarded as health promoters and care providers, learners and teachers, leaders and managers, quality and safety monitors and assessors, political advocates, researchers, and colleagues and collaborators (Blais & Hayes, 2016). Because of both the explicit demands of the job – that is, the actual care nurses provide in clinical settings – and the less-explicit ones – like being political advocates and leaders – nurses can experience role stress and role strain.
Role stress is “any physical or psychological strain experienced by an individual who needs greater abilities or resources than those that are available in order to perform that role” (Sun, Gao, Yang, Zang, & Wang, 2016, p. 2). In other words, there is a gap between what the individual is expected to do and their ability to do it which may be a consequence of their own limitations or the resources available to them on the job. There are several frameworks which have helped conceptualize role stress. One is the Role Episode Model which indicates relationships between role conflict, role overload, and role ambiguity (Sun et al., 2016). Other researchers have added sub-dimensions to these big three elements including role incompetence, role incongruity, and role over-qualification (Sun et al., 2016). Given the number of roles a nurse serves and the challenges they face, role stress is of significant importance to the nursing profession. Role stress can contribute to burnout and turnover (Sun et al., 2016), both of which negatively impact the nursing workforce and the quality and safety of patient care. A key element of role stress management is the element of professional identity (Sun et al., 2016). Having and maintaining high levels of professional identity have been associated with lower levels of stress; additionally, the quality of the nursing program an individual went through can contribute to that as well, so programs that are explicit about expectations and about the realities of the profession seem to produce professionals who experience less role stress (Sun et al., 2016). However, the nurse must also take responsibility and speak up when they have insufficient resources to do their job, whether that means keeping their skills and knowledge up-to-date or having the right physical tools and materials to do their jobs.
Role strain can be related to role stress, but role strain is defined as “the feeling of discomfort, embarrassment or shame that influence a person’s aspirations for choice of occupation, leadership goals and career advancement and include the four causes of role strain” (Carte & Williams, 2017). Those four causes are role ambiguity, role conflict, role incongruity, and role overload (Carte & Williams, 2017). In nursing, role strains seems to particularly affect male nurses, since nursing has been and continues to be a female-dominated profession (Carte & Williams, 2017). Mitigating this phenomenon involves a better understanding of those individuals, like male nurses, who may be regarded as “invisible” individuals within the profession (Carte & Williams, 2017), which suggests increasing the diversity of the workforce. This means actively recruiting and supporting those individuals who represent minorities within the procession (Carte & Williams, 2017). There is also evidence that nursing leadership needs to be involved in the mitigation or reduction of role strain, yielding recommendations which render job orientation process as more gender-neutral, job descriptions which clearly outline the nurse’s responsibility and the expectations associated with the job, recruitment focused on increasing diversity in the nursing workforce, and “offering support for employees who may have concerns for discrimination and support post-secondary education to promote an interest in nursing as a career” (Carte & Williams, 2017, p. 85).
- Blais, K. K. & Hayes, J. S. (2016). Professional nursing practice: Concepts and perspectives (7th). Boston, MA: Pearson.
- Carte, N. S., & Williams, C. (2017). Role strain among male RNs in the critical care setting: Perceptions of an unfriendly workplace. Intensive & Critical Care Nursing, 43, 81-86. doi:10.1016/j.iccn.2017.08.009
- Sun, L., Gao, Y., Yang, J., Zang, X., & Wang, Y. (2016). The impact of professional identity on role stress in nursing students: A cross-sectional study. International Journal Of Nursing Studies, 631-8. doi:10.1016/j.ijnurstu.2016.08.010
