ABSTRACT
Job
stress is a critical issue in the healthcare sector, particularly in
high-pressure environments like teaching hospitals, where employees face
numerous challenges that can affect their well-being and job performance. This
study investigates the effects of job stress on the performance of employees at
Abia State Teaching Hospital, Aba, Abia State, Nigeria, over the period from
2015 to 2020. The research aims to identify the primary sources of job stress
among hospital staff, assess the impact of these stressors on employee
performance, and explore potential strategies to mitigate stress and enhance
productivity. The study employs a mixed-methods approach, combining
quantitative data from surveys and qualitative insights from interviews with
employees across various departments, including medical, administrative, and
support staff. Data analysis focuses on the relationship between job stress
indicators—such as workload, work environment, and organizational demands—and
performance outcomes, including job satisfaction, absenteeism, and overall work
efficiency. Findings is expected to reveal that high levels of job stress,
particularly due to excessive workload and inadequate organizational support,
significantly contribute to reduced employee performance. The study also
highlights the exacerbating effects of external socio-economic challenges, such
as the COVID-19 pandemic, which intensified stress levels during the latter
part of the study period. Recommendations are provided for hospital management
to implement stress management programs, improve working conditions, and offer
better support systems to employees. This research will contribute to the
understanding of job stress in the Nigerian healthcare sector, providing
valuable insights for policymakers and hospital administrators aiming to
improve employee well-being and performance. The findings are particularly
relevant for similar healthcare institutions facing comparable challenges.
CHAPTER
ONE
INTRODUCTION
1.1 Background of the Study
Employees
are the quintessential and lifeblood of every organization whether public or
private. To conduct all the operations of the organization expeditiously it is
imperative that employees must perform well to achieve the organization’s
milestones. There are organizations that make serious efforts and devise
effective strategies to keep their employees satisfied and stress free. By
eliminating stressful factors from the work life and by making the provision of
motivational factors, organizational managers can make employees satisfied
which in turn increases the efficiency and effectiveness of employees’ work
output. In the views of Awadh, Gichinga and Ahmed (2016), stress is a universal
element experienced by employees around the globe. Stress has become major
problem for employers of labour particularly in developing nations where the
employers do not realize the impact of stress on employees’ performance.
Many
authors have characterized stress in various ways. For example, the World
Health Organization (2019) defined job stress as the harmful physical and
emotional responses that occur when the job requirements do not match the
worker's capabilities, responses, or needs. Work related stress (WRS) is simply
stress that is produced or exacerbated by one's job. Workers, their supporters,
companies, occupational health and safety regulators, and workers' compensation
programs are all concerned about job stress. In general, stress can be defined
as a psychological and physiological reaction to unpleasant situations known as
stressors (Al-Makhaita, Sabra and Aafez, 2014). The concept is more often
associated with negative outcomes (Epel, Crosswell, Mayer, Prather, Slauich,
Puteriman, and Mendes 2018). How it is handled could have a negative or
positive impact on the employee involved.
Workplace stress is a pervasive issue that has
garnered significant attention for decades due to its detrimental effects on
employees and organizations alike (Chufor & Obiagazie, 2021). It stems from
the confluence of two key elements: the "workplace" and
"stress," encompassing the stress derived from carrying out daily
activities within an organizational setting. While stress is an inherent part
of our lives, capable of fostering the development of new skills and behaviors,
excessive levels can lead to life-threatening diseases and adverse consequences
(Chukwuemeka et al., 2019). The dynamic nature of change itself can act as a
catalyst for distress, ultimately manifesting as stress (Gahlawat, 2022). The
impact of workplace stress on employees' overall well-being cannot be
overstated. When left unaddressed, it can precipitate a cascade of problems
within an organization, leading to dire financial and administrative
consequences, such as high turnover rates and burnout (Iskamto, 2021). The
manifestations of job stress are unique to each individual, arising from
physical, emotional, and psychological triggers triggered by emotionally
demanding scenarios (Iskamto et al., 2019). Factors contributing to stress can
originate from personal, organizational, job-related characteristics, and
interpersonal relationships.
Human
resources managers play a pivotal role in ensuring fairness, equality, and the
total well-being of employees within organizations. Failure to appropriately
manage workplace stress can result in a myriad of performance issues, ranging
from absenteeism and declining productivity to, in extreme cases, loss of life
(Guruge & Ban, 2021). Paradoxically, workplace stress can also be a driving
force for improved performance when employees perceive new opportunities as
challenges, such as a new appointment or promotion, leading to positive
workplace stress (Saravanakumar, 2019). The healthcare sector, in particular,
has been grappling with the widespread phenomenon of workplace stress among
caregivers, including nurses, on a global scale (Mohammed, 2019). The stressors
faced by medical employees, which can lead to high rates of job
dissatisfaction, burnout, absenteeism, turnover, and stress-related illnesses,
have a direct impact on their job performance, potentially putting patients'
lives at risk (Mohammed, 2019). Medical employees is widely regarded as one of
the most stressful occupations due to its demanding and complex nature, with
hospitals often expecting nurses to make significant sacrifices, leading to
exasperation. medical employees frequently find themselves in situations where
they require more decision-making opportunities, and these stressors can
ultimately contribute to underperformance (Babapour et al., 2022).
1.2 Statement
of Problem
Employee
performance, defined as the execution of tasks with the requisite skills and
experience within a specified timeframe to achieve the desired outcome (Ahmad et al., 2018), is critical to
organizational success. As such, organizations should invest in fostering
employee productivity, as it is a key factor contributing to their overall
success. Indeed, any extreme workplace stress will inevitably impact
performance, and workers are becoming increasingly aware of this reality (Sucharitha
& Basha, 2020). Despite the substantial investments made in workforce
performance, the root causes of workplace stress have yet to be fully
considered (Daniel, 2020). Scanty studies have been conducted to address this
problem, particularly in the context of public hospitals in the country. No
clear link has been established between workplace stress and performance in
this setting. Understanding this relationship would go a long way in aiding
hospital management in finding ways to ameliorate the stressors in the hospital
environment and invest in stress management strategies, enabling nurses to
reach their full potential and outperform themselves at work.
As
a result of the peculiar nature of the services that most organizations render,
they inadvertently end up saddling their employees with overload of work in
order to meet choking deadlines, and handling critical emergency situations
that might end up having negative psychological and physical effects on the
employees which may result to stress. The important role that health workers
play in the Nigerian health sector, already places on their shoulders,
responsibilities that are too heavy for them to handle effectively.
Towards
the twilight of the 9th National Assembly, there was an uproar in Nigeria’s Federal
House of Representatives over a bill that sought to stop Nigerian trained
medical and dental practitioners from being granted full licenses until they
have worked for a minimum of five years in the country. The idea behind the
bill was to arrest the brain drain in the health sector. As at 2018, Nigeria
had about 74,543 registered medical doctors and about 180,709 registered
nurses. Out of this figure, only about 40,000 medical doctors are practicing in
the country. The brain drain situation in the health sector in Nigeria can be
attributed to a number of factors. One of it is the issue of poor facilities in
many public health institutions in the country, another is poor remuneration
and conditions of service for medical practitioners, among other issues.
Besides, Nigeria cannot favourably compete with their counterparts in the
western world in terms of remuneration for health workers and facilities
available in their health institutions. The implication is that available health
workers are obviously overworked as a result of the moral obligation on them to
continuously fill the voids left by their colleagues who have migrated to other
climes in search of greener pastures.
In
addition to work overload, health workers in Nigeria are expected to operate
round the clock on 24 hours a day and seven days a week basis. This creates
room for shift duty that sees a health worker operate on morning shift for a
while, and move to night shift afterwards. These irregular work schedules have
medium- and long-term effects on sleep patterns, and lifestyle of the health
workers and contribute to the stressors that affect health workers in Nigeria.
Added to the twin issues of excess workload and irregular work schedules,
health workers in Nigeria are burdened with the task of responding to medical
emergencies as they arise, irrespective of the time of the emergency. These
could be accidents, gunshot injuries, urgent or emergency surgeries, etc.
Given
the crucial role of Abia State Teaching Hospital in the healthcare system, it
is important to understand how job stress affects its employees’ performance.
The period from 2015 to 2020 is particularly significant, as it encompasses
various socio-economic challenges in Nigeria, including economic recessions,
inflation, and the COVID-19 pandemic, all of which could have exacerbated job
stress among healthcare workers. This study aims to explore the extent of job
stress experienced by employees of Abia State University Teaching Hospital (ABSUTH)
during this period and assess its impact on their job performance.
1.3
Objectives of the Study
i.
ascertain the nature of relationship
between work overload and health service quality of health workers in the Abia
State University Teaching Hospital (ABSUTH).
ii. examine
the nature of relationship between irregular work schedules and service culture
of health workers in the Abia State University Teaching Hospital (ABSUTH).
iii. establish
the nexus between frequent response to medical emergencies and commitment of
health workers in the Abia State University Teaching Hospital (ABSUTH).
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