Posted: March 27th, 2023

Stress Levels of Nurses in Emergency Rooms

Stress Levels of Nurses in Emergency Rooms

Nurses are essential health care professionals who provide care and support to patients in various settings. However, nurses also face many challenges and risks in their work environment, especially in emergency rooms (ERs). ER nurses deal with high-pressure situations, unpredictable demands, emotional distress, and potential violence on a daily basis. These factors can contribute to increased stress levels and burnout among ER nurses, which can affect their health, well-being, and performance. Therefore, it is important to research the level of stress experienced by nurses working in ERs and identify the sources, consequences, and coping strategies of stress.

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Sources of Stress for ER Nurses

Stress is a psychological and physiological response to perceived threats or challenges that exceed one's resources or abilities. Stress can be acute or chronic, depending on the duration and intensity of the stressor. Acute stress is a short-term reaction to a specific event or situation, such as a trauma or a cardiac arrest. Chronic stress is a long-term response to ongoing or repeated stressors, such as workload, staffing, or organizational issues.

According to a systematic review by Adriaenssens et al. (2015), the main sources of stress for ER nurses are:

- Workload: ER nurses often face high patient volumes, acuity, and complexity, which can lead to increased workload and time pressure. Workload can also be influenced by factors such as staffing levels, skill mix, shift length, and overtime.
- Violence: ER nurses are exposed to various forms of violence from patients, relatives, or colleagues, such as verbal abuse, physical assault, sexual harassment, or bullying. Violence can cause fear, anger, frustration, and anxiety among ER nurses.
- Death and dying: ER nurses frequently encounter death and dying situations, such as resuscitation attempts, terminal illnesses, or sudden deaths. Death and dying can trigger emotional reactions such as sadness, grief, guilt, or helplessness among ER nurses.
- Ethical dilemmas: ER nurses may face ethical dilemmas or conflicts in their practice, such as resource allocation, informed consent, end-of-life decisions, or cultural differences. Ethical dilemmas can cause moral distress or uncertainty among ER nurses.
- Organizational factors: ER nurses may experience stress related to organizational factors such as policies, procedures, communication, leadership, teamwork, or feedback. Organizational factors can affect the work environment and culture of the ER.

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Consequences of Stress for ER Nurses

Stress can have negative consequences for ER nurses at individual and organizational levels. At the individual level, stress can affect the physical and mental health of ER nurses. For example,

- Physical health: Stress can cause physiological changes such as increased heart rate, blood pressure, cortisol levels, or inflammation. Stress can also increase the risk of developing chronic diseases such as cardiovascular disease, diabetes, or obesity.
- Mental health: Stress can cause psychological problems such as depression, anxiety, post-traumatic stress disorder (PTSD), or substance abuse. Stress can also impair cognitive functions such as memory, attention, or decision making.
- Well-being: Stress can reduce the quality of life and satisfaction of ER nurses. Stress can also affect the personal and professional values and beliefs of ER nurses.

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At the organizational level, stress can affect the performance and retention of ER nurses. For example,

- Performance: Stress can reduce the productivity and efficiency of ER nurses. Stress can also compromise the quality and safety of patient care and increase the risk of errors or adverse events.
- Retention: Stress can increase the turnover and absenteeism of ER nurses. Stress can also reduce the commitment and engagement of ER nurses.

Coping Strategies for ER Nurses

Coping strategies are the actions or behaviors that individuals use to manage or reduce stress. Coping strategies can be classified into two types: problem-focused coping and emotion-focused coping. Problem-focused coping involves addressing or solving the source of stress directly. Emotion-focused coping involves regulating or expressing the emotions associated with stress.

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According to a qualitative study by Healy and Tyrrell (2013), the coping strategies used by ER nurses are:

- Problem-focused coping: ER nurses use problem-focused coping strategies such as prioritizing tasks, delegating responsibilities,
seeking information or resources,
planning ahead,
or using protocols or guidelines.
- Emotion-focused coping: ER nurses use emotion-focused coping strategies such as seeking social support from colleagues,
family,
or friends,
using humor,
relaxation techniques,
or hobbies,
or venting emotions.

However,

not all coping strategies are effective or adaptive for ER nurses. Some coping strategies may be maladaptive or harmful,

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such as denial,

avoidance,

or substance use.

Therefore,

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it is important for ER nurses to identify and use appropriate coping strategies that suit their needs and preferences.

Conclusion

Nurses working in emergency rooms experience high levels of stress due to various sources,

such as workload,

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violence,

death and dying,

ethical dilemmas,

or organizational factors. Stress can have negative consequences for ER nurses,

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such as physical and mental health problems,

reduced well-being,

impaired performance,

or increased turnover. ER nurses use different coping strategies to manage or reduce stress,

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such as problem-focused coping or emotion-focused coping. However,

some coping strategies may be ineffective or detrimental for ER nurses. Therefore,

it is essential for ER nurses to recognize and address their stress levels and adopt effective and adaptive coping strategies.

References

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Adriaenssens, J., De Gucht, V., & Maes, S. (2015). Determinants and prevalence of burnout in emergency nurses: A systematic review of 25 years of research. International Journal of Nursing Studies, 52(2), 649-661.

Healy, S., & Tyrrell, M. (2013). Stress in emergency departments: Experiences of nurses and doctors. Emergency Nurse, 21(4), 16-21.

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