Secondary traumatic stress in emergency room nurses: A cross-sectional study

Emergency room nurses care for patients during the worst times in their lives: motor vehicle accidents, violence, rape, trauma, death, etc. Continuous exposure puts nurses at risk for secondary traumatic stress (STS): the negative emotional, psychological, and/or physical reaction experienced by someone who had an indirect exposure to trauma. This can impair a nurse's ability to cope, increase levels of anxiety/depression, and intention to leave the profession.

Using a cross-sectional design, 169 nurses completed a survey between February - June 2023. Data were collected using a demographic form, Secondary Traumatic Stress Scale, Brief-COPE Inventory, and a Visual Analog Scale for Perceived Stress.

159/169 (94%) participants scored at least mild STS, with over 55% experiencing severe levels of STS. Four relationships were significant when compared to reported STS level: education level (p = 0.004), avoidant coping (p < 0.001), emotion-focused coping (p < 0.001), and change in perceived stress (p < 0.001). The relationship between STS and experience, hospital trauma level, shift worked, and employment status were not significant (p > 0.05).

Nurses experience severe levels of STS, putting them at high risk of negative effects. Hospitals should introduce the concept of STS during nursing orientation: descriptions of what STS may look like, measuring current stress levels, and identify coping strategies. By identifying signs of STS early, nurses may be able to implement coping strategies before the emotional, physical, or psychological toll gets to be overwhelming.