The Stress Experienced by Nurses Working in Acute Care : a descriptive literature review

Abstract

Nursing ranks among the world's most stressful professions, especially in acute care settings. This study aims to describe the stress experienced by nurses working in the acute care setting and to contribute to the development of more effective administrative and organizational strategies for managing stress and enhancing the wellbeing of nurses.

A qualitative descriptive literature review was conducted using the PICo framework to identify relevant articles. The inclusion criteria aimed at the quantitative and qualitative peer-reviewed research articles published in the years 2018-2024 which examined the stress within the context of acute care nurses. Analysis of data was conducted through inductive content analysis of text data to identify emerging themes and patterns.

This study identifies some of the major areas of concern that lead to stress among nurses in acute care facilities. Gender and nationality are important factors with female nursing personnel and those from a different ethnic background, experiencing high level of stress. Restrictions in their decision-making process and inability to use their professional judgement result in frustration and emotional exhaustion. The context in which the work is done, with poorly developed infrastructure, high patient acuity, and insufficient personnel contributes to stress and generates ethical problems. Moreover, heavy workload and inadequate rest experiences among the nurses cause physical and emotional exhaustion. Other practical matters maintain stress and an impression that nurses are not valued sufficiently, for instance, disparate policies, personnel shortage, and lack of personal protective equipment. The effects of this stress are so adverse that the nurses’ physical and psychological health deteriorates, they have sleeping disorders, get more sick and emotionally drained. Because of the overloaded work and ethical issues that arise in the patient’s treatment, nurses experience moral distress. In addition, long standing stress and continuous ethical dilemmas force many nurses to consider changing their line of work.

In conclusion stress in acute care nursing is multi-faceted and it depends on several variables which include demographic factors, lack of autonomy, challenging work environment, workload, and administrative issues. These stressors should be countered with particular administrative actions and organizational measures that would enhance the nurse well-being and patients’ treatment outcomes. It remains for future research to develop and implement interventions that help minimize these stressors and to enhance the working environment of the acute care setting to make it less stressful for the nurses.

Key words : nurse, stress, patient safety, acute care settings, burnout