Shift-Based Emotional Stress Reactions in Emergency Nurses After Traumatizing Events

Emergency nurses experience multiple traumatizing events during clinical work. Early identification of work-related tension could lead to a timely intervention supporting well-being. We sought to discover whether there is an immediately measurable effect on emotional stress, as determined by changes between pre- and postshift survey scores, associated with exposure to traumatizing events during a single emergency nursing shift.

The Emotional Stress Reaction Questionnaire (ESRQ) is a real-time self-assessment tool based on positively, negatively, or neutrally loaded emotions. Participants voluntarily completed pre- and postshift ESRQs over a 6-month period at a quaternary academic emergency department and recorded the number of associated traumatizing events. Associations between number of traumatizing events and ESRQ scores were evaluated using Spearman rank correlation coefficients. Changes in positive-negative balance scores were compared between shifts using a 2-sample t-test.

There were 203 responses by 94 nurses. The mean preshift ESRQ score was 11.3 (SD = 5.2), mean postshift score 6.8 (SD = 7.4), and mean change -4.4 (SD = 8.2; t = -7.26; P < 0.001). The total number of traumatizing events was correlated with change in ESRQ scores (correlation coefficient of -0.31; P < 0.001). The mean change in positive-negative scores for shifts without traumatizing events was -1.4 (SD = 6.0) compared with -5.0 (SD = 8.5) for shifts with at least 1 event (t = 2.27; P = 0.03).

Our results suggest that repeated exposure to traumatizing events during a single clinical shift was associated with a measurable effect on negative emotional stress in emergency nurses as determined by ESRQ positive-negative balance scores.