Hello Behrooz. I think so. Much of the stress could be caused by the lack of knowlegde. Improving the competence could help nurses to overcome issues and deal with chalanges.

Definately, it follows that greater confidence in abilities equals much less anxiety and stress.

Dear Behrooz,

This can be seen as a multifaceted issue, The clinical preparation and learning support during their undergraduate studies and quality and support occurring clinical placements can have a significant impact on confidence of beginning healthcare clinicians.  Also the support offered by health services at an organisational and local level is known to affect the confidence and clinical practice,( e.g. matters such as quality clinical supervision, mentoring and in service and other training opportunities), Also important to look at the work culture and unwritten rules operating within the workplace. There is a signifcant amount of research literature in relation to work stress and confidence. 

References:

McVicar, A. (2003). Workplace stress in nursing: a literature review. Journal of Advanced Nursing. 44(6),  633–642. DOI: 10.1046/j.0309-2402.2003.02853.x

GOLUBIC R., MILOSEVIC M., KNEZEVIC B. & MUSTAJBEGOVIC J. (2009) Work-related stress, education and work ability among hospital nurses. Journal of Advanced Nursing. 65(10), 2056–2066 doi: 10.1111/j.1365-2648.2009.05057.x

http://s3.amazonaws.com/academia.edu.documents/43019968/work_stress.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1495279100&Signature=LKV4CZ6tp%2FgXmvGsFTEX7iiuVds%3D&response-content-disposition=inline%3B%20filename%3DWork-related_stress_education_and_work_a.pdf

Quine, L. (2001). Workplace Bullying in Nurses. Journal of Health Psychology. L 6(1), 73–84. https://www.researchgate.net/profile/Lyn_Quine/publication/51766216_Workplace_Bullying_in_Nurses/links/02bfe50d1e59d7ced6000000.pdf

Chang et al (2005). Role stress in nurses: Review of related factors and strategies for moving forward. Nursing and Health Sciences. 7, 57–65. http://s3.amazonaws.com/academia.edu.documents/46648841/j.1442-2018.2005.00221.x20160620-22436-1amnm3.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1495279320&Signature=ZJXZRbWtN%2B02hNTecawriTsoOVU%3D&response-content-disposition=inline%3B%20filename%3DRole_Stress_In_Nurses_Review_of_Related.pdf

Ulrich et al (2007). Ethical Climate, Ethics Stress, and the Job Satisfaction of Nurses and Social Workers in the United States. Soc Sci Med. 65(8), 1708–1719. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2442035/

James

Article Workplace Bullying in Nurses

Dear Behrooz.

You ask if I think that if the clinical competence of nurses improves, then their level of stress will be change. 

As it seems relatively obvious, the more nurses are competent in their profession, the less they are likely to experience stress and anxiety in their daily professional practice. Note that one's competence in his/her profession increases one's sense of self-confidence, self-esteem, self-efficacy, and the like (see, for this respect Bandura's theorizing on social learning and social cognitive learning)

In other words, the more nurses (or other professionals) trust on their competence to deal with the problems inherent to their profession, the less stress and anxiety they will feel when confronted even with difficult issues in their job or professional practice. 

Of course, other variables than competence may be at issue regarding nurses' stress while dealing with their patients. Some of these variables are personal, and some are situational. As for the latter, there is accumulated evidence that shows that, say, an authoritarian environment provokes in any professional more stress and anxiety than an authoritative milieu. As for the former, there is also amassing evidence that shows that, regardless of their competence, anxiety-oriented people, nurses, for instance, experience more stress and anxiety in their daily professional practice than their non-anxiety-oriented counterparts.

Much more could the said about the multitude of variables that impact on nurses' stress and anxiety while they perform their job or profession. This, however, goes much beyond your question, which has to do with the relation between nurses' level of professional competency and their stress while performing their job or profession.

So, my answer to your question is, say, a short answer. Even so, I hope that the answer may be of some help for you.

Best regards

There is a great deal of research that discusses the major areas that cause stress to nurses in their practice: (1) very little control over their practice and how it is carried out, (2) too many demands from patients or the organization for the amount of time they have available to complete the tasks required, (3) not enough resources to complete the required tasks, (4) conflict with other nurses or physicians, (5) poor communication with other healthcare workers, (6) often dealing with uncooperative families or patients, (7) little confidence in the nurse's own ability in the situations exposed,  (8) continual unrelieved suffering of the patients, (9) poor relationships with coworkers, (10) the impact of sadness on the patient group, (11) inadequate education for the situations assigned, and (12) too little support from coworkers and supervisors. Therefore, there are many areas that could be causing the stress of the nurses. Perhaps input from the perspective of the nurses could help to narrow down the source of their stress.

In my research there is a positive correlation between clinical competence and occapational stress in nurses, meaning that  with increasing clinical copmetence, the occapational stress increased in nurses.  this is an unexpected finding and unsimilar with prior researches, so i like know your opinion about this finding.

thanks / best regards

I strongly agree with James above that this is maltifactoral as not just nurses'competence could reduce their stress levels but could contribute to its reduction. However not knowing what your research questing was I am going to give general answers from my personal experience working as a nurse. The following factors have made my working experience on the floor less or more stressful.

• Staff versus patient levels; where there are less nurses aompared to patients, this has created stressful work experience; worsestill when the patients are complex. However, the competence could sometimes minimise the stress levels.
• Patient complexity and skill mix, because no matter how competent one is, they can not be expertise in everything that goes on around them.
• Availability/non-availability of material resources,could make the work easy or difficult, therefore stressful.
• The set-up of the working environment and processes, a working environment that is well organised with clear processes that are well communicated makes the work easy, less stressful and enjoyable.
• Training availability and time could be explained in combination with the above statement and possibly your findings.
• Other personal issues and availability of support systems; could indirect impact on one's work life. A nurse with personal problems but good support system, their stress levels could be well controlled while the opposite could could be true and have a negative impact on one's performace even when they are competent. These support systems could be grouped into two; support systems in ones' personal life and at work.

Dear Behrooz Rezaei

I totally agree with all previous comments. In my opinion, the competency factor is very important in improving performance, and it may help, but this is not enough to relieve or tension or stress among nurses, for example midwives, and their skills and talents will increase their confidence and improve their performance, but their number is low compared to the large number of patients, in addition to dealing with a pregnant woman during labor, it requires a long time of follow-up and attention during and after childbirth, there is difficulty in dealing with many patients during childbirth especially in primigravida and young age patients, as well as a lack of resources, and ill-treatment between the patient’s family and nurses or between the nurses and other health team all these factors increase the stress of nurses during their job

Not just the clinical competency, but the reduced patient's work load and tolerable working hours may help in alleviating level of stress significantly amongst the nurses..

I ,agree with,James_Shanahan.

Dear Ekhlas A. Hussein and Dear Amina Sultan

Thank you for your good participation in this discussion. Nurses face numerous stressors in the workplace. Unfortunately, these stressors are more severe in some countries. For example in my country, the high workload due to the large number of patients have made nurses more stressful than other countries. Increased professional competence can lead to the reduction of stress in nurses. But when there are multiple factors of severe stress in the workplace, nurses' stress will not decrease with the improvement of their professional competence.

Important and interesting question that provoked several valuable comments from our RG colleagues

Ofcourse clinical competence can make nursing professionals more confident about their skills and once if we gain confidence then work will be change in to passion and passion is always without any stress , becoZ professionals always enjoy their passion with full satisfaction but without stress.

Dear Atul Dwivedi

Thank you for your helpful reply. If employees' professional competence is increased, their self-esteem increase and so they will perform their duties with greater mastery and accuracy. This reduces staff job stress. But in the nursing profession, this does not seem to be the case. Because nurses face the most stressful job stressors in their workplace, these stressors cause the stress level of nurses to be much higher than other jobs. For this reason, promoting nurses' professional competence may not have a significant impact on their stress reduction.

Thank you Zainab Nizar Jawad and Balqees Al-Musawi for your contribution in this issue. I think, If employees' professional competence is increased, their self-esteem increase and so they will perform their duties with greater mastery and accuracy. This reduces staff job stress. But in the nursing profession, this does not seem to be the case. Because nurses face the most stressful job stressors in their workplace, these stressors cause the stress level of nurses to be much higher than other jobs.

Dear Dr. Rezaei,

Hello

First and foremost, I would like to thank you for the sake of this discussion!

Needless to say that providing valid answers to such questions need conducting statistical experiments. However, maybe some intuitive answers could be provided.

As we know, the stress (/job stress) symptoms may stem from several factors including skill, knowledge, competence, and so forth. For this point of view, it seems that in case of addressing job stress of nurses, their competences!

could be affect their stresses to some extent.

Best wishes,

Ali

Many thanks Dr. Ali Mollajan for your helpful contribution in this issue.

I did some research in 2016. I expected to find an indirect correlation between competence and job stress. But the result was surprising. My results showed that there was a direct relationship between nurses' clinical competence and their job stress. It was a little difficult for me to interpret this interesting finding. But it seems that because the nurses' work environment is very stressful and nurses are high-responsibility staff, despite their high competence, they still experience high stress in this stressful environment. In other words, occupational competence in a high stress job environment does not have a moderating effect on their stress. you see my research in following article (attached file)

Dear Dr. Rezaei,

Thank you so much for your kind words!

Best,

Ali

Polished!!

"

Dear Dr. Rezaei,

Hello

First and foremost, I would like to thank you for the sake of this discussion!

Needless to say that providing valid answers to such questions requires designing and performing some accurate statistical experiments. However, in order to contribute to this interesting question, here some intuitive answers might be given.

As we know, the stress (/job stress) symptoms may stem from several factors including skill, knowledge, competence, experiences, etc. of human workers. From this point of view, it seems that job stresses of nurses may not be exception! In fact, it seems that their competences could be influence their stresses to some extent. So, this recent factor for this concerned case (nurses) can be taken into the play!

"

sincerely,

Ali