Online College Courses for Credit

The Nurse Stress Index

The Nurse Stress Index

Author: Sophia Tutorial

The Nurse Stress Index

See More
Fast, Free College Credit

Developing Effective Teams

Let's Ride
*No strings attached. This college course is 100% free and is worth 1 semester credit.

46 Sophia partners guarantee credit transfer.

299 Institutions have accepted or given pre-approval for credit transfer.

* The American Council on Education's College Credit Recommendation Service (ACE Credit®) has evaluated and recommended college credit for 33 of Sophia’s online courses. Many different colleges and universities consider ACE CREDIT recommendations in determining the applicability to their course and degree programs.


what's covered
This lesson will describe the Nurse Stress Index (NSI). Specifically, it will cover:
  1. The Nurse Stress Index
  2. Domains

1. The Nurse Stress Index

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.

2. Domains

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.

The NSI is scored using a 1-5 Likert Scale with 1 representing no perceived stress and 5 representing extreme perceived stress. Found to be a reliable and valid method of identifying work-related stress for nurses in several studies, this scale has been widely used in the nursing profession. Researchers who have used this tool to measure stress in large samples of nurses report acceptable concurrent validity, internal reliability, and split-half reliability.

Authored by Elsie Crowninshield, RNP, DNP, CCRN, NE-BC and Adele Webb, Ph.D., RN, FNAP, FAAN