Work related stress is growing worldwide and producing serious concerns for both workers and organizations, as it can lead to complaint, absenteeism, turnover and reduced work performance.1 While it is a highest concern for organizations because of its adverse consequences, it may be a more insistent concern for health care professionals, especially nurses, who face amazing stress in clinical health settings.
Nurses are susceptible to work-related stress because they are at the frontline of a health care service. The nursing profession is supposed as hard, complicated, and having high demands. These demands, along with many other work responsibilities, are the major causes of work related stress among nurses.Furthermore, factors, such as work overtime, understaffing, and job satisfaction, may possibly generate high stress levels that may affect negatively the holistic well-being of nurses.
A study recounted that about 35.1% (350) of nurses’ experience a high stress level in hospitals global. Another study in the United Kingdom revealed that heavy workload, extrinsic effort, turnover and absenteeism are related to high stress levels. In KSA, the majority of nurses in hospitals are migrant workers with diverse cultural backgrounds and they experienced a various stressors in work place setting. Nurses are exposed to numerous stress factors because they are answerable for the health and care of patients.
In KSA cultural diversity may also increase nurses’ stress levels. Some of the health care facilities in KSA are acute health care, which includes promotive, preventive, curative, and rehabilitative care. This kind of health care pursues to improve health in a time-sensitive manner.9 the majority of nurses in the KSA originate from other countries with different cultures (Indians, Filipinos, Sudanese, and Egyptians),10 and consequently may be unaccustomed with the sensitivity of Saudi culture.
Consequently, they may feel disrespected, insulted and reprimanded, which leads to them experiencing work related stress.
Alanazi (2019) studied the nurses working at two primary health care centers in KSA, and he concluded that migrant nurses experience heavy workload and uncooperative colleagues, who cause them to experience medical errors, anxiety, and stress. Moreover, acute health care centers are deliberately situated across the country to deliver preventative and curative services. Conversely, compared with other health care systems, acute care is supported inadequately.
Henceforth; nurses working in acute health care settings may have high levels of work related stress, which may cause sub-optimal patient care.
In the light of the previous study we can conclude that the work related stress is increasing worldwide and leading to thoughtful concerns for both workers and organizations, as it can lead to physical illness, turnover, absenteeism, and reduced work performance. In response to these challenges, the World Health Organization (WHO) has suggested a series of evidence-based international policy recommendations, and this recommendation is applied in KSA in order to increase access to health workers in KSA through decrease the turnover rate and improved retention rate.
Presently, health workforce turnover in KSA is an overpriced issue, which exists not only in Makkah region but also in all Saudi Arabia rural or urban regions. Turnover intention is an effective representation predictor of the actual turnover behavior of the health care workers especially the nurses. A numerous predictors stated in various studies influencing the turnover and turnover intentions of the health care workers have been recognized.
Work stress is significant predictor in Saudi Arabia as stated by Almutairi, Moradi, , & Idrus, (2010) in there study about Factors influencing turnover among Saudi nurses, and also it has been confirmed as a significant inverse association with turnover intentions of health workers in previous studies conducted by Bonenberger, et al (2014) in Ghana, also a similar study conducted by Steinmetz, de Vries, & Tijdens, (2014) at Belgium, Germany, and the Netherlands about The impact of working time and wages on retention in the health workforce and it showed a significant relation between work related stress and turnover. Moreno-Jiménez, et al (2012) in his study of about the physicians’ intention to quit in Madrid concluded that work stress is considered the main predictor of turnover in all health care professionals.
Moreover a study in China conducted by Chen, et al (2016) on the effects of social support and job satisfaction on intention to stay in nurses he found that the work related stress is the major factor affecting the nurses intention to stay in. In England a cross sectional study conducted by Dale, et al (2015) on retaining the general practitioner workforce in England which revealed that work related stress is considered as dominant factor that affecting the nurses retaining in England.
A study done by Dotson et al on empirical analysis of nurse retention in United States, he founded that work stress is main factor affecting the nurses’ retention level. Finally a study done by Al-Khasawneh, & Mohammed, (2013) investigating the relationship between job stress and nurses performance in the Jordanian hospitals concluded that work related stress lead to lack of performance and consequently lead to nurses turnover.
Additionally, previous studies that explain the stress phenomenon among staff nurses in clinical settings in KSA are only rare. Numerous studies have focused on nurses’ stress and job satisfaction, but only insufficient studies have examined its impact on nurses’ turnover. The last is important to maintain a competent and safe health care practice in Saudi Arabia where population is increasing and nursing shortage is experienced. The factors affecting nurses’ stress in acute clinical care settings, especially in the Arab countries, have not been investigated thoroughly, although questions about the effect of stress on nurses in clinical practice and on the delivery and quality of health care have been raised.
Therefore, determining the stress levels of nurses and its effect on nurses turnover is crucial issue must be investigated. So this study aimed to explore the relation between job stress among nurses and turnover.