title: Stress and work relationships in the neonatal intensive care unit: are they worse than in the wards?
abstract: OBJECTIVE
  To compare working conditions, sources of stress and professional relationships between a group of nurses working in neonatal intensive care units (ICU) and those working in general paediatric teaching hospital wards.
  
  
  METHODS
  Surveys were sent to 96 nurses working in general paediatric wards in three Sydney paediatric teaching hospital centres and to 291 nurses working in six major neonatal ICU in Sydney. The survey asked about work environment, patient care, decision-making, sources of stress and professional relationships. Thirty-one questions were identical in each survey. The survey also included the General Health Questionnaire (GHQ) as a measure of emotional health.
  
  
  RESULTS
  The response rate was ward nurses 86% and neonatal intensive care nurses 66%. Of the 31 identical statements, nine were significantly different between the two groups. Neonatal nurses were more likely to feel that their ward work areas were overcrowded and poorly laid out with little patient-free space. They had more concerns about inadequate staffing and conflict between nurses and doctors. The general ward nurses were more likely to feel that adequate priority was given to patient pain relief and that they had more influence in such decisions but experienced more stress in keeping up to date and were more likely to feel that communication problems between doctors and nurses were a major source of conflict. Forty per cent of general ward nurses and 32% of neonatal nurses had GHQ scores indicating possible psychological impairment, a significantly higher proportion than would be expected in the population.
  
  
  CONCLUSIONS
  Paediatric nurses perceive a variety of stresses in their work, with problems in communication between doctors and nurses being a prominent perception. The high GHQ scores may be a reflection of some of those problems. Attention to problems of under-staffing, better work environment and improved communication may help resolve some of these issues and may have implications for improving patient care.
authors.affiliation: University of Sydney Department of Paediatrics and Child Health, New Children's Hospital, Westmead, New South Wales, Australia.
authors.forename: P R
authors.initials: PR
authors.lastname: Oates
authors.forename: R K
authors.initials: RK
authors.lastname: Oates
mesh_terms: D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007400:Interprofessional Relations; D007588:Job Satisfaction; D017283:Neonatal Nursing; D009517:New South Wales / Q000453:epidemiology; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010371:Pediatric Nursing; D013315:Stress, Psychological / Q000453:epidemiology*; D017132:Workplace