Factors preceding occupational distress in emergency nurses: An integrative review

Abstract

Aims and Objectives: This integrative review aimed to synthesise current evidence on the factors that precede and contribute to the occupational distress of emergency nurses.Background: Emergency nurses practice within an environment challenged by demand exceeding capacity, an inability of staffing to meet this demand in addition to limited resources which contribute to form a unique risk to clinician and patient safety.The risk of occupational distress, while demonstrated across specialties, is noted to be highest in emergency nurses with subsequent impacts for clinicians, organisations and patients being explored. While previous studies have examined singular outcomes or elements, a comprehensive review that considers the factors and components of the overarching occupational distress is not evident in the current published literature.Design: Whittemore and Knafl's integrative review methodology enabled a structured format for synthesis and analysis of literature. Methods: A review of CINAHL, MEDLINE, Psych INFO, Embase, Australian Digital Thesis Network, University Microfilm International and Google Scholar between 2014 and 2021 was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Search terms explored the contributions of compassion fatigue, burnout, acute and post-traumatic stress disorder, and secondary traumatic stress/vicarious trauma to occupational distress. This search resulted in sixteen publications included for synthesis. Results: Literature for inclusion was identified as quantitative (seven), qualitative (six) and mixed-methods (three) studies. Factors identified as contributing to the development of occupational distress arise from the characteristics and situations of individual nurses, local organisational governance and the inherent nature of the emergency nurse role. Consequentially, there are negative impacts on patients, clinicians and healthcare organisations.

Impact of mental health boarding on clinicians at a children's hospital: A qualitative analysis

“…Clinicians working with patients experiencing mental health crises are at risk of suffering from vicarious or secondary trauma from mental health patients 22,29,30 . Many participants in our study noted that the home lives of their patients are not conducive to healing and could be traumatizing, resulting in repeat admissions.…”

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“…On a similar note, Caulfield et al. (2022) reported that excessive workload in emergency departments led to job distress in emergency nurses, with a negative impact on the quality of patient care and patient safety. According to the sensitive nature of emergency care, senior emergency department managers should take measures to recruit nurses who have the necessary professional capabilities.…”

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