Occupational stress, job satisfaction, and intent to leave: nurses working on front lines during COVID-19 pandemic in Zagazig City, Egypt

Environ Sci Pollut Res Int. 2021 Feb;28(7):8791-8801. doi: 10.1007/s11356-020-11235-8. Epub 2020 Oct 17.


During epidemics, the medical working environment is highly stressful especially for the nurses. The purpose of this study was to assess occupational stress, job satisfaction, and intent to leave among nurses dealing with suspected COVID-19 patients. A comparative cross-sectional study was conducted among 210 nurses from Zagazig Fever Hospital (ZFH) which is one of COVID-19 Triage Hospitals (Group I) versus 210 nurses from Zagazig General Hospital (ZGH) (Group II) which is neither triage nor isolation hospital; dealing only with suspected COVID-19 patients in emergency at Sharkia Governorate, Egypt, from 10th to 24th of April 2020. Assessment was done through online questionnaire formed of the Expanded Nursing Stress Scale, the McCloskey/Mueller Satisfaction Scale, and questionnaire assessing specific COVID-19-associated stressors and nurses' intent to leave. Three quarters of nurses (75.2%) in ZFH had high stress level versus 60.5% in ZGH. Workload (98.6%), dealing with death and dying (96.7%), personal demands and fears (95.7%), employing strict biosecurity measures (95.2%), and stigma (90.5%) represented the highest priority stressors in ZFH, while exposure to infection risk (97.6%) was the stressor of highest priority among ZGH according to Pareto analysis. More than half of nurses (51.0%) in ZFH reported low satisfaction level versus 41.9% in ZGH. Only 4.8% of nurses in ZFH definitely had no intent to leave their present job. Type of hospital and its related workload were the most significant predictor of all the studied outcomes.

Keywords: COVID-19 pandemic; Egypt; Front-lines; General hospital; Intent to leave; Job satisfaction; Nurses; Occupational stress; Pareto analysis; Triage hospital.

MeSH terms

  • Adult
  • COVID-19*
  • Cross-Sectional Studies
  • Egypt / epidemiology
  • Female
  • Humans
  • Job Satisfaction
  • Male
  • Middle Aged
  • Nursing Staff, Hospital*
  • Occupational Stress* / epidemiology
  • Pandemics
  • Personnel Turnover
  • SARS-CoV-2
  • Surveys and Questionnaires
  • Young Adult