Understanding Traumatic Stress in Emergency Nurses: A Systematic Review

Abstract

Aims

To understand how emergency nurses experience traumatic stress and clarify the impact of traumatic stress on emergency nurses, patients, and healthcare organisations.

Design

Systematic review without meta-analysis.

Methods

Three hundred and eighty-three articles were screened with pre-specified criteria. Included articles represented primary research conducted with samples of emergency nurses only and described traumatic stress. We extracted (1) impacts on the emergency nurse, (2) impacts on patients and healthcare organisations, and (3) antecedents. Covidence was used for screening and data extraction, and the Joanna Briggs Institute Appraisal Checklists were used for quality assessment.

Data Sources

Cumulative Index of Nursing and Allied Health Literature, PubMed, and PsycINFO were searched 13 July 23 and 16 September 24 for peer-reviewed articles published in English between 2010 and 2024.

Results

Twelve studies conducted in seven countries were included. Traumatic stress has the potential to impact patient safety and satisfaction, care quality, absenteeism, turnover, and organisational commitment. Identified antecedents included specific populations, clinical events, workplace violence, work environment factors, and personal/interpersonal factors.

Conclusion

Unavoidable antecedents could become points for organisational screening and secondary prevention. Modifiable antecedents like workplace violence could be targets for primary prevention.

Implications for the Profession/Patient Care

Organisations have a responsibility to support emergency nurses in preventing and managing occupational traumatic stress. System-level policies, interventions, and resources may mitigate the negative impacts of traumatic stress.

Impact

Existing literature lacks a comprehensive understanding of traumatic stress in emergency nurses. This review clarifies how traumatic stress impacts emergency nurses, patients, and organisations, highlighting organisational/system-level intervention points. Traumatic stress harms emergency nurses, patients, and organisations. Organisations should focus on modifiable antecedents for prevention and screening resources. These findings challenge the idea of traumatic stress as an individual issue, emphasising the role of systems/organisations to provide safe work environments for the benefit of all.

Reporting Method

We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines.

Patient or Public Contribution

No patient or public contribution.