The Nurse Stress Index (NSI) was developed in 1989 by P. E. Harris to evaluate the perceived sources of work-related stress for nurses with managerial responsibilities and those in charge of nursing and nurses. While historically work-related stress for nurses was measured by staff morale, job performance, absence, and turnover, this scale focuses on other domains for work-related stress.
The NSI is a 30-item self-report instrument that consists of six sub-scales, each of which measures a different domain of work-related stress. Each domain is described below. Note that there are two domains of “managing workload”–Domains 1 and 2.
| Domain | Description | Sample Items |
|---|---|---|
| Domain 1 and 2: Managing Workload | Measures pressure due to feelings of insufficient time and resources to complete tasks and meet deadlines |
I have too little time in which to do what is expected of me. The demands of others for my time at work are in conflict. I spend my time fighting fires rather than working to a plan. |
| Domain 3: Organizational Support and Involvement | Assesses the pressures perceived due to lack of involvement in planning and decision-making at work and issues concerning inadequate, or lack of, feedback |
I only get feedback when my performance is unsatisfactory. Decisions or changes that affect me are made above, without my knowledge or involvement. Management misunderstands the real needs of my department. |
| Domain 4: Dealing with Patients and Relatives | Evaluates the patient’s and family’s relationship with the nurse and the nurse’s feelings about required patient care, ethics and death and dying |
I am involved daily in life or death situations. I am dealing with aggressive patients and families. |
| Domain 5: Home-Work Conflict | Measures stresses due to the conflicting demands of work and personal life |
I need to absent myself from work to cope with domestic problems. My superiors do not appreciate my home pressures. My family demands inhibit promotion. |
| Domain 6: Confidence and Competence in Role | Measures the difficulties experienced by nurses with the role that they are required to fill, including coping with change and responsibility |
I don’t feel adequately trained for the job I have to do. I have uncertainty about the degree or area of my responsibility. I have not been trained on new technology. |
Authored by Elsie Crowninshield, RNP, DNP, CCRN, NE-BC and Adele Webb, Ph.D., RN, FNAP, FAAN
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