Abstract
STRESS AND COPING STRATEGIES OF NURSES WORKING IN NEPHROLOGY UNITS: A REVIEW FROM LITERATURE

Nurses working in nephrology and hemodialysis units have positive interactions with their patients as they perform dialysis three times a week and it may extend up to many years to sustain their bodily functions. Objective: This paper explores previous research to identify factors which lead to stress among nurses working in nephrology, hemodialysis units’ and study various coping strategies useful to reduce stress and to lead a healthy balanced life. Method: An electronic search strategy was conducted using the following databases: CINAHL, MEDLINE, Academic search complete, Psych INFO, Psych articles, and Psychology and Behavioral Science collection. Scholarly peer reviewed papers published in English were included. The Boolean operators ‘stress’ or job stress ‘stress and coping’ or ‘job related stress. ‘stress and nephrology, hemodialysis nurses, ‘job related stress or stress and Hemodialysis nurses’ ‘Impact of stress’ ‘factors contributing to stress’ were combined to explore the stress and coping strategies of nurses working in nephrology and hemodialysis units. Twelve studies met the inclusion criteria, which includes descriptive studies, systematic reviews, cross- sectional studies, qualitative studies and a prospective cohort study. Results: Nurses working in Hemodialysis are in a complex, technologically advanced and demanding situation. Job dissatisfaction, stress and burnout are linked to high rates of nurses leaving the profession, poor morale and poor patient outcomes. Work-related stress among nephrology nurses is increasing and it is multifactorial. Some of the identified factors are poor interpersonal relationships with physicians, time-consuming patient care activities, violence and abuse from patients, organizational factors and a lack of access to ongoing education. In addition to that, the effective use of communication skills, individualized health care, and prioritization of patient’s needs put a tremendous amount of stress on the nurse. As per a study done in Israel on 2011 revealed that stress and burnout leads to high job turnover, absenteeism, tardiness, prescription drug use, ineffectiveness at work, reduced morale, and various personal difficulties. Problem solving, self-control, positive re-appraisal and seeking social support are the most frequent coping strategies used by nurses working in hemodialysis units to cope with their job-related stressors. Adding to that, employers should train and encourage nurses to support each other to manage their difficult situations