2.1.4 More complex less control


2.1.4 More complex less control

Topic Progress:

According to studies, the average human makes about 612 decisions a day. This equals to 4,900 decisions in a week and 254,800 in a year.

And it is the same in nurse management.  Nurse managers are expected to know more, do more, and be responsible for more parts of the business than ever before – and that is because they have the greatest impact on the most people in the organisation. Also add to this the “increasing red tape, interpersonal conflict, changing regulatory requirements, multiple on-going hospital initiatives occurring simultaneously, and system inefficiency as factors that increased stress.” (Maria R. Shirey, et al. 2010. Understanding Nurse Manager Stress and Work Complexity: Factors That Make a Difference )

The work of nurses is characterised by high work demands, the need to learn new technologies, to work to increasingly intensified schedules, and to respond to emergencies. In many cases their work is performed in both a bureaucratic and professional hierarchy, and some nurses may experience a lack of control. This may be the case for nurse managers. This is known as Karasek’s Demand-Control approach to stress (Karasek, 1979, 1981). That is, stress occurs when a person experiences a lot of work demand but has a relatively small amount of control. Excessive hours worked and shift work with its changing routine also exacerbates stress. Poor management and supervisory practices have also contributed to stress outcomes. For nurses it may be the structure of work relations and their position in the power hierarchy that contributes to increased stress. (Nursing: A Challenging Profession, Chris L Peterson School of Social Sciences, La Trobe University, Victoria – Downloadable)

This program is really about taking control of how you spend the time you have and how you feel about it. As a manager, you also need to consider how your demands on your team are impacting on their levels of stress and their well-being.  Paradoxically, giving your team more control will not only reduce your own stress, but as you can see from this discussion, will actually reduce theirs!  We will discuss this further later when we are talking about delegation.


  • How has your work and the workload changed over the past year?
  • What in your work can you control, and what can’t you?


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