The causes and management of occupational stress amongst Maltese nurses

Abstract

This study investigates the causes and management of occupational stress among nurses at Malta`s primary public hospital, Mater Dei Hospital. While earlier local studies have mainly concentrated on quantitative metrics like absenteeism and turnover rates, this research employed a qualitative method to reveal the experiences that inform these statistics. The goal was to pinpoint key contributors to occupational stress, evaluate coping strategies at both personal and organisational levels, and comprehend nurses' professional perceptions of stress. Semi-structured interviews were conducted with eight nurses from the medical and surgical wards. Thematic analysis, guided by Braun and Clarke`s (2021) framework, was used to analyse the data. Several interrelated themes emerged, including excessive workload, staff shortages, rigid shift systems, poor managerial practices, logistical inefficiencies, and limited support from formal systems. Cultural and interpersonal stressors were also highlighted, such as communication barriers with foreign colleagues and workplace conflict. Notably, personal factors such as family responsibilities and health concerns compounded work-related stress. Despite the high-pressure environment, nurses demonstrated resilience through personalised coping strategies such as physical activity, spiritual engagement, and reflective routines. However, formal support systems were underutilised, often due to concerns around confidentiality and accessibility. The study concludes that OS is an evolving and multifactorial issue requiring systemic reform and culturally sensitive, informal support mechanisms. The findings contribute to local qualitative research, offering suggestions for policymakers and hospital administrators. These include increasing shift flexibility, enhancing infrastructure, improving staff integration, and fostering support systems to protect nurses` well-being and sustain Malta`s healthcare workforce.