Cognitive Burden in Emergency Care: A Qualitative Exploratory Study of Emergency Nurses

This study explores emergency nurses' lived experiences of cognitive mental workload (CMW) within high-pressure, resource-limited environments, where excessive mental demands may compromise both clinician well-being and care delivery.

An exploratory qualitative research design was used with registered nurses (n = 10) working in Australian rural emergency departments. Online semistructured interviews were conducted in 2023. The collected data were analysed using reflective thematic analysis.

The data analysis revealed four primary contributors of high CMW among nurses during care delivery, namely, external demands, excessive cognitive processing, emotional demands and individual characteristics. Despite challenges in describing the phenomenon, participants clearly associated their high CMW to adverse patient outcomes like patient harm and near misses as well as negative impacts on their own welfare, such as burnout, compassion fatigue and intention to leave profession.

This study offers new perspectives on emergency nurses' CMW experiences, foregrounding their lived experience in high pressure, emotionally charged and dynamic clinical settings. By giving voices to the often overlooked phenomenon in nursing, it has revealed the critical impact of the health professional's CMW on their well-being, patient safety and care quality.

In depth knowledge about the phenomenon can inform tailored measurement tools and targeted strategies for nurses, to reduce errors and enhance care delivery.

Policymakers can integrate the insights to strengthen healthcare infrastructure and policies that reduce error-related patient harm and support nurse well-being for reducing resource and financial expenditure.