Other Titles
The “Days Like These” (DLT) Study: Post-pandemic Stress, Depression, and Anxiety After Difficult and/or Distressing Shifts in the ED [Title Slide]
Abstract
Introduction: The emergency department (ED) has always been complex and stressful. Nurses face unique causes of stress from the physical, psychological, and social features of ED practice (Alomari, et al., 2020). Browning, et al. (2007) found ED nurses had more distressing work environments than other nurses resulting in higher persistent stress. In a review of 25 years of research, Adriaenssens, et al. (2015) found a 25% burnout rate in ED nurses. Prior to the pandemic, the WHO estimated that one-third of ED staff were at high risk for stress disorders (Stéphane, et al. 2016). Moukarzel, et al. (2019) found 50.7% of ED physicians and 32.1% of staff had burnout. The pandemic added an additional stress to the ED underscoring the need for intervention. The purpose of this study was to assess post-pandemic stress in 2 community hospital EDs to identify opportunities to improve workforce health.
Methods: Rather than a cross-sectional snapshot at a single point in time, targeted data collection in response to difficult or distressing shifts was conducted over a year. During three 3-month periods data was collected from ED staff per an anonymous online survey. All staff were encouraged to complete the survey after each shift they perceived as difficult or distressing. The survey included six demographic items, a rating of life busyness, a rating of shift difficulty, the DASS-21 (Depression, Anxiety and Stress Scale - 21, 2002) a valid and reliable self-report measure of depression, anxiety, and stress, and 3 open-ended questions.
Findings: Forty-six (46) surveys were completed by nurses, physicians, techs, and other ED staff. Respondents were 91% female, 91% White, had a mean age of 35.9, and a mean ED practice length of 10.78 years. Mean life busyness was 7.87 (0-10, 10 = most busy, SD = 1.68). Mean shift distress was 8.96 (0-10, 10 = most distressing, SD = 1.6). The DASS-21 revealed aggregate moderate (14-20) depression at 17.54, severe (15-19) anxiety at 15.18, and moderate (19-25) stress at 23.62 after the difficult shift. Eighty (80) comments described distress and needs.
Implications for Nursing Practice: The data reflect life busyness and the effect of difficult or distressing shifts with moderate stress and depression, and severe anxiety reported. The ability to identify particularly difficult periods in the ED creates the opportunity to surge resources and create post-shift interventions to support ED workforce health.
Notes
References:
1. Alomari, A. H., Collison, J., Hunt, L., & Wilson. N. J. (2020). Stressors for emergency department nurses: Insights from a cross-sectional survey. Journal of Clinical Nursing, 30, 975–985. https://doi: 10.1111/jocn.15641
2. Browning, L., Ryan, C., Thomas, S., Greenberg, M., & Rolniak, S. (2007). Nursing specialty and burnout. Psychology, Health & Medicine, 12(2), 148–154. https://doi.org/10.1080/13548 50060 0568290
3. Adriaenssens, J., De Gucht, V., & Maes, S. (2015). Determinants and prevalence of burnout in emergency nurses: A systematic review of 25 years of research. International Journal of Nursing Studies, 52(2), 649–661.
4. Stéphane, L., Talbot, L. R., Mathieu, L., Dallaire, C., Dubois, M. F., & Courcy, F. (2016). An exploration of factors associated with posttraumatic stress in ER nurses. Journal of Nursing Management, 24, 174–183.
5. Moukarzel, A., Michelet, P., Durand, A., Sebbane, M., Bourgeois, S., Markarian, T., Bompard, C., & Gentile, S. (2019). Burnout syndrome among emergency department staff: Prevalence and associated factors. BioMed Research International, 646247. https://doi.org/10.1155/2019/6462472
6. Depression Anxiety Stress Scales (DASS) (2022). https://www2.psy.unsw.edu.au/dass/#
Sigma Membership
Gamma Tau at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Stress and Coping, Workforce, Acute Care, Emergency Departments, Post-pandemic, Stress
Recommended Citation
Daroszewski, Ellen Beth; Zakzesky, Dawn; Cole, Terrie; Mellgren, Katie; Schoenbeck, Sue; and Semrad, Mark, "Post-Pandemic Stress, Depression, and Anxiety After Difficult or Distressing Shifts in the ED" (2025). International Nursing Research Congress (INRC). 151.
https://www.sigmarepository.org/inrc/2025/presentations_2025/151
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Post-Pandemic Stress, Depression, and Anxiety After Difficult or Distressing Shifts in the ED
Seattle, Washington, USA
Introduction: The emergency department (ED) has always been complex and stressful. Nurses face unique causes of stress from the physical, psychological, and social features of ED practice (Alomari, et al., 2020). Browning, et al. (2007) found ED nurses had more distressing work environments than other nurses resulting in higher persistent stress. In a review of 25 years of research, Adriaenssens, et al. (2015) found a 25% burnout rate in ED nurses. Prior to the pandemic, the WHO estimated that one-third of ED staff were at high risk for stress disorders (Stéphane, et al. 2016). Moukarzel, et al. (2019) found 50.7% of ED physicians and 32.1% of staff had burnout. The pandemic added an additional stress to the ED underscoring the need for intervention. The purpose of this study was to assess post-pandemic stress in 2 community hospital EDs to identify opportunities to improve workforce health.
Methods: Rather than a cross-sectional snapshot at a single point in time, targeted data collection in response to difficult or distressing shifts was conducted over a year. During three 3-month periods data was collected from ED staff per an anonymous online survey. All staff were encouraged to complete the survey after each shift they perceived as difficult or distressing. The survey included six demographic items, a rating of life busyness, a rating of shift difficulty, the DASS-21 (Depression, Anxiety and Stress Scale - 21, 2002) a valid and reliable self-report measure of depression, anxiety, and stress, and 3 open-ended questions.
Findings: Forty-six (46) surveys were completed by nurses, physicians, techs, and other ED staff. Respondents were 91% female, 91% White, had a mean age of 35.9, and a mean ED practice length of 10.78 years. Mean life busyness was 7.87 (0-10, 10 = most busy, SD = 1.68). Mean shift distress was 8.96 (0-10, 10 = most distressing, SD = 1.6). The DASS-21 revealed aggregate moderate (14-20) depression at 17.54, severe (15-19) anxiety at 15.18, and moderate (19-25) stress at 23.62 after the difficult shift. Eighty (80) comments described distress and needs.
Implications for Nursing Practice: The data reflect life busyness and the effect of difficult or distressing shifts with moderate stress and depression, and severe anxiety reported. The ability to identify particularly difficult periods in the ED creates the opportunity to surge resources and create post-shift interventions to support ED workforce health.
Description
This study assessed post-pandemic stress over a year in 2 community hospital EDs via targeted data collection after difficult or distressing shifts. Forty-six respondents with an average ED practice of 10.78 years reported mean shift distress as 8.96 (0-10, 10 = most distressing), aggregate moderate (14-20) depression at 17.54, severe (15-19) anxiety at 15.18, and moderate (19-25) stress at 23.62 after the difficult shift. Eighty comments to open-ended questions described distress and needs.