Nursing Stress: Ethical and Cultural Perspectives

In the research, regarding the ethical dimension, is necessary to answer the question “What laws govern or pertain to the issue?” since some moral laws, which govern the clinics, affect the level and frequency of stress experienced by nurses. For unveiling the dynamics between stress and ethics, the following secondary questions can be used:

  • How do the ethics of patient care define the stress levels?
  • What is the relationship between staff interaction and stressful experiences?
  • Which ways of improvement can be used to reduce ethics-caused stress?

The question “Which cultural values and/or norms influence the issue?” is to be answered in the cultural dimension. The cultural and corporal environment plays a significant role in job performance, therefore, one can realize that several secondary questions must be explored in the subtopic:

  • How does the local culture tend to correlate with nursing stress?
  • Which features of the professional environment can become stressing factors?
  • Which methods or reforms enable to reduce the stressful influence?

Nursing Ethics: Producing Stress

First, one must emphasize the role of nursing practice as a receptive ethical field for stressful occurrences. According to Kim, Han, and Kim (2014), nurses often face the dilemmas of dealing with patients, the cost of healthcare, technological advancements, or the conflicts of values. The said number of problems is stressful enough to cause mental consequences for the employees. However, the list is also reinforced by the interaction between collective members, which does not always go smoothly. Thus, the position and conditions within the clinic structure can act as an additional risk.

The ethical choices during patient care appear as a fundamental feature of nursing functions, as well as the influences of the patient’s stress levels. Researchers state in the surveys that “The secondary traumatic stress of the nurses was positively correlated with the experience of ethical dilemmas” (Kim et al., 2014, p. 477). In other words, the quantity of ethical dilemmas during the practice becomes a trigger for stress induction. Moreover, the amount relates to the number of disorders, which are the result of the stressful moments, according to Kim et al. (2014). Thus, ethical questions seem significantly harmful throughout the job performance of nurses.

Other questions which pose as a stressful treat consist of the connections established within the nursing staff. Conflicts and misunderstandings can often arise between the personnel, including all the levels of the hierarchy. According to Moreland and Apker (2015), nurses report on the problems of support absence, ignorance of their voice, and disrespectful communication. Thus, the nurses may feel that their role is diminished and underused compared to other jobs. All these causes lead to the creation of tension between the personnel of clinics, which not only produces disorder but leaves a heavy toll on the nurses’ mental capacity.

It is hard not to underestimate the value of both patient and collective ethics. In the end, the clinics need to develop the tools for the resolution or the reduction of risks. According to Preshaw, Brazil, McLaughlin, and Frolic (2016), one might concentrate on a communication-based strategy to assist nurses in facing ethical dilemmas. Also, it is possible to enhance the professional capacity of the staff by organizing courses on medical ethics. As for the internal conflicts, Moreland and Apker (2015) recommend establishing “a systemwide culture more supportive of conflict discussion” (p. 822). Since the system needs a while to stabilize, one can additionally stimulate the positive dynamics between personnel through non-formal means.

Cultural Aspect: When the Environment Matters

Certain cultural circumstances may be the further component of stress accumulation. One can divide the conditions into two areas which offer their sets of stressors. The first one is the cultural community which lives with a set of habits and traditions, frequently resulting in discrepancies. The second one can be explained as the culture of medics, a professional system that also brings forth imperfections likely to become stressful.

The cultural impact on the stress levels may be exemplified through the case of India. According to Sharma, Dhar, and Tyagi (2016), India traditionally remains a country where the maximum weight of family care is shouldered by women. However, nursing employees mainly consist of women as well, creating a dissonance. The consequence of such a tendency is the conflict between family and work duties held by the women. In the struggle to keep both sides of life active, Indian nursing women tend to exhaust themselves, which endangers their mental health. Moreover, personal cultural values, as the researchers state, also play a role in problems and receiving stress as a result (Goh, Lee, Chan, and Chan, 2014).

In the second part, the stress level is dependent on the culture of medicine as a professional environment. The clinics have developed a thorough system of performance, but a variety of disadvantages still overshadows the progress. Among them, according to Yeun, and Han (2016), one can note the hierarchical organizational atmosphere which limits the employee’s possibilities and decisions and even causes bullying. As mentioned in the previous section, conflicts with the colleagues also remain a significant matter. However, they often happen due to the internal competition between the employees as per professional culture. In the end, the nurses mentally suffer from tension and absence of comfort, which contributes to the stress increase.

Hence, the issues of local and professional culture affect the daily life of nurses and their accumulation of stress. The answer requires the development of resolution policies to effectively reduce the tension of both the local environment and the clinical system. The possible measures can include social support on the regional or the state level – additional funding or social programs. Another option would be the decentralization of the medical hierarchy and repercussions for unethical behavior.


To sum up, the stress-inducing scenarios for the nursing staff are heavily influenced by ethical and cultural fields. The main challenges in the area of ethics may be the two factors. They include frequent ethical dilemmas, which happen during patient care, and the conflicts, along with tension and hostility, within the personnel. One would be able to resolve the issues by focusing on nursing support and creating a system of measures that can respond to the challenges. Also, it is required to decrease conflicts between fellow workers through initiating non-formal interactions.

Regarding the cultural side, the traditions and habits of each country can also pose stressors to nurses. As an example, in India, women receive more stress in nursing due to their family duties, which interfere with their job. Furthermore, the professional clinical culture and its limitations, such as the strict hierarchy, might add mental pressure for the employees. Nonetheless, the possible changes in social policy and medical management would be able to reduce these shortcomings.


Goh, Y. S., Lee, A., Chan, S. W. C., & Chan, M. F. (2014). Profiling nurses’ job satisfaction, acculturation, work environment, stress, cultural values and coping abilities: A cluster analysis. International Journal of Nursing Practice, 21(4), 443-452.

Kim, K., Han, Y., & Kim, J. (2014). Korean nurses’ ethical dilemmas, professional values, and professional quality of life. Nursing Ethics, 22(4), 467-478.

Moreland, J. J., & Apker, J. (2015). Conflict and stress in hospital nursing: Improving communicative responses to enduring professional challenges. Health Communication, 31(7), 815-823.

Preshaw, D. H., Brazil, K., McLaughlin, D., & Frolic, A. (2016). Ethical issues experienced by healthcare workers in nursing homes. Nursing Ethics, 23(5), 490-506.

Sharma, J., Dhar, R. L., & Tyagi, A. (2016). Stress as a mediator between work-family conflict and psychological health among the nursing staff: Moderating role of emotional intelligence. Applied Nursing Research, 30, 268-275.

Yeun, Y. R., & Han, J. W. (2016). Effect of nurses’ organizational culture, workplace bullying and work burnout on turnover intention. International Journal of Bio-Science and Bio-Technology, 8(1), 372-380.