The Nurse

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Description:

Cheryl is a registered nurse working in an intensive care unit that specializes in the treatment of premature infants. She frequently seeks out the sickest babies to care for, enjoying the challenge and the responsibility. She is confident in her ability to handle difficult cases. The stress and pressure of her job are coupled with a high level of both skill and autonomy.

Key Words:

• "... can handle the sickest patients ..."
• "... autonomy ..."
• "We race to see who gets to the child first."

Suggested Uses:

This film is useful for promoting discussion of job design and stress management.

I. Job design

Use the video to illustrate different models of job design.

This film can be used as a basis for presenting Hackman and Oldham's Job Design model (Richard Hackman and Greg Oldham, Work Redesign, Reading, MA: Addison Wesley, 1980).

Discussion Questions:

1. How would the class rate Cheryl's job on the Core Job Characteristics? To what other jobs or occupations is this work similar? Are the psychological states and outcomes likely to be the same? The fact that the "client/customer" is an infant makes issues of responsibility and meaningfulness particularly salient.
   
   
2. What changes in the broader environment (within the neonatal unit, hospital, health care industry, or technology) might alter the nature of Cheryl's job? The sociotechnical features of technology, work groups, and environmental factors can alter the nature of the job and thus the underlying motivations associated with it.

II. Stress Management:

Use the video to illustrate different forms of work-related stress and different coping strategies.

The risk of failure is high in neonatal intensive care units. Modern technology makes saving the lives of some infants more possible today than even a few years ago. But as expectations for success rise, caregivers can experience considerable stress in dealing with high risk patients.

Stress management involves a variety of coping mechanisms. Coping can involve behavioral adjustments as well as cognitive and attitudinal changes.

What are the different sources of stress in this job?

1. To what extent does Cheryl experience stress on the job? How does Cheryl cope with the stress and possibility of failure? Behaviorally? Cognitively?
   
   
2. There is a high burn-out rate in intensive care nurses. Do you think that Cheryl will burn out? How does the demanding job of a neonatal intensive care nurse compare to other high-performance occupations (e.g., executives, air traffic controllers, star athletes)? What factors contribute to burnout or resistance to it?
   
   
3. Are there any negative consequences from the stress in Cheryl's job or from her coping strategies? Issues arise of becoming emotionally distant from patients, of becoming rigid in response to change, etc.
   
   
4. What role do the characteristics of Cheryl's work play in her reactions to the potential stressors on the job? Her level of skill and autonomy are particularly significant, because Cheryl is in a position to make important decisions surrounding the care of acutely ill infants. Evidence suggests that autonomy can reduce stress levels associated with high-risk work. Why might autonomy benefit workers psychologically in high risk settings?
   
   
   Copyright 1996, Paul S. Goodman and Denise M. Rousseau