Occupational stress in hospice care: causes and coping strategies.

Thirty-three nurses from three hospice services in a large Midwestern city participated in this study, which investigated responses to difficult or demanding work-related situations. Three tools (the Self Inventory of Situational Responses-TC questionnaire, the Spielberger State Anxiety Inventory questionnaire and rank-ordered listing of likely causes of difficult or demanding situations) were used to collect data. Findings indicated that anxiety is an issue for hospice workers but that difficult or demanding situations were viewed as challenges rather than threats. Management of intractable symptoms and communication issues were of primary concern. Administrative concerns were identified as the third-ranking source of difficult situations. Issues related to death and dying were of notably less concern. Strategies for staff support also are identified.