Psychologic stress in intensive care unit and non-intensive care unit nursing: A review of the past decade

Our knowledge base for understanding the day-to-day stresses on ICU nurses has greatly expanded during the last decade, far beyond that based on the conclusions of a fledgling study published in this Journal. Some of the research issues addressed in that study have been resolved (e.g. differences in stress experienced by ICU vs. non-ICU nurses); other research issues have only just been introduced (e.g., impact of situational factors and personality differences on individual coping strategies employed by nurses). We have also entered into the 'age of empiricism and scientific study' as regards psychologic stress-strain in nursing and are no longer dependent on the idiosyncratic, anecdotal experiences of nurses and consultants working in the critical care field. The biases and fears attached to such research, once a potential problem, now seem to have faded with the passing of time and our advances in knowledge. And, perhaps most importantly, recent research efforts have defined and evaluated a variety of techniques for alleviating psychologic stress in the ICU environment and, as such, can only provide us with a sense of hope and promise for the future. Psychologic stress obviously affects the nurse, the nurse-patient relationship, and the patient's morbidity/mortality; reduction of that stress thus can only serve to improve all three equally.