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A Four-Site Study of Stress, Strain, and Coping for Inpatient Registered Nurses: Baby Boomer Nurses Bearing the Burden of Care

Santos, Susan R. PhD, RN; Simon, Stephen D. PhD; Carroll, Cathryn A. PhD, MA, MBA, RPh; Bainbridge, Lynda MBA, RN C; Cox, Karen S. PhD, RN, CNAA; Cunningham, Marion MBA, MN, RN; Teasley, Susan L. RN; Ott, Lynn MSN, RN

Journal of Nursing Administration: April 2003 - Volume 33 - Issue 4 - p 243–250

Objective: Because today's nursing workforce faces a multitude of stressors, the objective of this study was to describe stress, strain, and coping across institution types for inpatient registered nurses (n = 694), and to identify the influence of age on these findings.

Methods: This study, using a multi-site, mixed methods approach, provides data to support more focused interventions that address the challenges of specific types of stressors and age cohort needs.

Results: The worst scores for sub-scales addressing stress and strain for this sample of inpatient nurses were problems associated with physical environment and responsibility. Consistency was found across the four institutions for the sub scale of responsibility. Baby Boomer nurses (born between 1946 and 1964) had significantly worse scores than other age cohorts, specifically with the stress and strain sub-scales of role overload, role insufficiency, role ambiguity, role boundary, and interpersonal strain.

Conclusion: The authors outline specific ways to support registered nurses by using staffing metrics that factor in unit activity as well as supporting the Baby Boomer nurse, both physically and psychosocially.

Authors' affiliations: University of Missouri-Kansas City School of Nursing, Kansas City, Mo (Dr Santos); Children's Mercy Hospitals and Clinics, Kansas City, Mo (Dr Santos, Dr Cox, Ms Teasley, Dr Simon, and Ms Bainbridge); University of Missouri-Kansas City College of Arts & Sciences, School of Pharmacy & Department of Economics, Kansas City, Mo (Dr Carroll); North Kansas City Hospital, Kansas City, Mo (Ms Cunningham); Fitzgibbon Hospital, Marshall, Mo (Ms Ott).

Corresponding author: Susan Santos, PhD, RN, Patient Care Services Research, Children's Mercy Hospital and Clinics, 2401 Gillham Rd, Kansas City, MO 64108 (

© 2003 Lippincott Williams & Wilkins, Inc.