Reactions to increased workload: effects on professional efficacy of nurses

Research findings support the idea that workload is a significant stressor associated with a variety of deleterious psychological reactions, including burnout, in several different samples of workers. A theoretical model is put forth in the present study in which workload is seen as contributing to distress and depression. Increasingly, organisations are experiencing changes as a result of extensive downsizing, restructuring, and merging. As a result of fiscal restraint, hospitals have been forced to merge, close, downsize, and restructure. Workloads have increased among hospital staff, particularly nurses. This study applies a theoretical model to the understanding of the impact of workload on nurses employed in hospitals experiencing downsizing, particularly on their distress, burnout, and depression. Respondents were 488 nurses who were employed in hospitals that were undergoing restructuring and in which units had already been closed as a result of restructuring. Results of structural equation modeling showed that the data partially fit the model and that workload contributed substantially to levels of depression through distress reactions. Further results showed that cynicism, anger, and emotional exhaustion significantly operationalised distress reactions. This study is unique theoretically in linking anger, cynicism, and emotional exhaustion in a single model that predicts distress levels from workload. The findings that anger, cynicism, and emotional exhaustion operationalised distress indicate the importance of studying patterns of negative reactions and their consequences for depression. Implications of the results are discussed for interventions that can be taken by organisations in order to reduce workloads.