Unique Stress for Critical Care and ED Nurses

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Unique Stress for Critical Care and ED Nurses

New studies identify concerns

By Working Nurse
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It used to be called “burnout.” Now, it’s sometimes known as “compassion fatigue.” Both terms capture a familiar reality: While nursing can be a highly satisfying profession, it can also leave nurses feeling emotionally spent. Two recent studies examine the stressors that contribute to compassion fatigue in two specific specialties: critical care and emergency nursing.


The first study, published in the August issue of Critical Care Nurse, the journal of the American Association of Critical-Care Nurses, is based on a cross-sectional survey of 221 critical care nurses at an academic medical center in western New York.

The results suggest that compassion fatigue and satisfaction depend on many factors, including gender, age and education level. Surprisingly, the older nurses surveyed — those over 50 — had much lower stress and compassion fatigue levels than did their colleagues aged 40–49.

When it comes to work environment, consistency and stability seem to be particularly important. Nurses who had experienced recent unit redesigns or leadership changes reported significantly higher stress and fatigue levels than did nurses whose units were more stable. Similarly, nurses whose patients were of a consistent acuity level reported greater satisfaction and lower levels of burnout than did nurses on mixed-acuity units.

Lead author Tara Sacco, RN, CCRN, AGCNS-BC, ACCNS-AG, suggests that nursing leaders in critical care settings use these findings “to implement changes to improve the work environment with a culture of caring, recognition, professional development and debriefing.”


The second study, conducted by the Emergency Nurses Association and published in the online edition of the Journal of Emergency Nursing in September, looks at the problem of moral distress among emergency room nurses, an issue that has been largely overlooked in previous research.

Most nurses at least occasionally experience moral distress, which arises when the realities of the moment prevent nurses from doing what they believe is right. However, the unique environment of the emergency department can make this stress particularly acute.

In the ED, life-or-death situations are frequent occurrences, which leaves ED nurses little time to build compensatory relationships with patients (whom the nurse may only see for a few minutes) or to process the aftermath of each incident. Short staffing and lack of space only add to stress levels.

The study’s authors say the healthcare profession needs to look more closely at ways to assess and mitigate moral distress for ER nurses. “The implications for emergency nurses as individuals, as well as for the profession, are significant,” says coauthor Lisa A. Wolf, RN, Ph.D., CEN, FAEN, “and demand attention [not only] from ED and hospital administrators, but also from staff.”

This article is from workingnurse.com.

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