A scoping review of resilience among intensive care nurses: Exploring strengths that mitigate secondary trauma

The stressful and traumatic nature of nursing jobs, especially in specialized units such as the intensive care unit (ICU), puts nurses at higher risk for psychological distress or more severe diagnoses like posttraumatic stress disorder. The purpose of this study is to conduct a scoping review on resilience among ICU nurses, using the resilience portfolio model as a framework.

We searched PubMed and APA PsycInfo for articles that included the terms "ICU nurses" and "resilience," which resulted in 302 articles. After excluding duplicates and articles that focused only on workplace performance, lacked data, or focused on the COVID-19 pandemic, 43 articles remained.

Mindfulness, spirituality/religion, and social support were frequently mentioned as sources of resilience. The importance of social leisure-simply relaxing with friends and family outside of work-emerged as distinct from social support in terms of comfort during times of stress. Support from leadership and mentors was also an important interpersonal resource.

One important adversity among ICU nurses is moral injury, which occurs when people are faced with demands that conflict with their ethical principles (Burton et al., 2020). In the ICU context, nurses can experience moral injury when hospitals, insurers, and patients' loved ones have different desires or expectations. The adversity of moral injury needs more consideration in research on trauma and resilience. Interventions such as a sacred pause after a death hold promise for supporting ICU nurses. This review indicates that a variety of ongoing supports are needed to sustain nurses working in highly stressful environments. (PsycInfo Database Record (c) 2025 APA, all rights reserved).