Life Experiences of Night Shift Emergency Room Nurses at Tacurong City

Being an emergency room nurse, you must be willing to face chaotic and stressful environment and must be good in handling such situations. According to Lainie Petersen 2018, emergency room nursing isn’t easy, but it does provide new challenges and constant surprises. Registered nurses who work in emergency rooms are responsible for evaluating patients, providing and assisting with medical treatments and educating patient on what they need to do once they have left the hospital. Emergency room nurses are in demand and can earn above-average income, particularly as they gain job experience. Being assigned to this area has a lot of pressure, you must have an active mind to handle emergency situations. You’re dealing with critical ones that should be managed immediately and also dealing with patient’s family who being hysterical is not easy. Stressful events taking place in the emergency department can have a profound effect in the staff members. Incidents involving aggression, violence, death of patients, or participating in resuscitation can be emotionally and physically challenging (Sarita Ahwal 2015).

As an emergency nurse, you are exposed to a lot of stressors and you must know how to cope up with all of these. Improper handling of stress can lead to burnout and might affect your performance at the area and your relationship with your colleagues. Social support is also important in dealing with stress, you and your colleagues must support and encourage one another. According to, Lewis et al. 2010, strategies should be formulated to recognized the work in a way to alleviate the physical and psychological stressors of the emergency department staff. This would help in channelizing their efforts towards providing quality care to patients and improve the retention of nurses in their clinical areas. The administrations should conduct periodic health assessments for both physical and mental dimensions of health. Interventions to support managers develop effective behaviors are required to reduce and manage stress at work.

The purpose of this study is to determine the life experiences of night shift emergency room nurses. Specifically, this study is also significant for the following:

1. Student nurse

This will help them get more knowledge about the stress experienced by the emergency room nurses and their strategies in coping up with those stress.

2. Clinical Instructor/ Classroom Instructor

They can make this study as an example in their lecture, especially when discussing about handling emergency situations and how to overcome stress.

3. Society

This will provide better understanding about coping up with stress not just for the nurses/student nurses but also for the society.

Scope and Limitation

This study is limited to (1) one emergency room nurse in each different hospital in Tacurong, Sultan Kudarat. The following terms are operationally defined as used in this study: Aggression Any behavior or attitude that reflects anger, rage, or hostility and the potential for physical or verbal abuse or destructiveness.

Behavior - A response of an individual or group to an action, environment, person or stimulus

Burnout - Physical or mental collapse caused by overwork or stress.

Charismatic - Exercising a compelling charm that inspires devotion in others.

Coping - In a state of complete confusion and disorder.

Emergency - Is a situation that poses an immediate risk to health, life, property, or environment.

Indisputable - Being unable to challenged or denied

Psychological Distress - Is a general term that is used to describe unpleasant feelings or emotions that impact your level of functioning.

Stress - Is your body way of responding to any kind of demand or threat.

Emergency Department Working Environment

While it was almost universally acknowledged that emergency department are stressful places to work, staff perceptions of stressors varied. Some studies suggested that exposure to emergency department stressors was often unsustainable, while others suggested that they are critical and crucial part of the job.

Emergency nurses experience work-related stress originating from a variety of sources including inadequate staffing and resources, too many non-nursing tasks, changing trends in emergency department use, patient transfer problems and also continual confrontation with patients and families who exhibited crisis or problematic behaviors (Hawley, 1992). Psychological demands of emergency department environment are high - with staff exposed to pain, distress, helplessness, anxiety, fear, hopelessness, feelings of abandonment and loss. Working conditions can be poor because of overcrowding, scarcity of resources, work overload and the fast pace of the work required of the professional providing care (Kogien and Cedaro, 2014). The most stressful demand on nurses was dealing with pain, suffering and grief and patient/family responses. Heavy workloads coupled with staff shortages and lack of resources also rated as highly stressful (Adeb-Saeedi, 2002).

Participants with lower confidence at the end of the first and fourth months showed significantly higher distress scorer than those with higher confidence levels (Williams, Dale, Glucksman and Welleslay, 1997, UK).

Coping Strategies to Stress

Two dimensions of coping are problem-focused and emotion-focused coping. Problem-focused coping consists of concrete attempts made to alter the stressful event while emotion-focused coping consists of attempts made to alter stressful feelings (LeSergenta, & Haney, 2005). There are certain inevitable stressful factors in nursing that can adversely affect nurses' minds and behaviors; it is important to find ways to deal with these factors before we can take measures to improve nurses' professional quality and teach them coping strategies (Lashonda, 2004). Gender difference in coping strategy: women tending to use emotion-focused strategies (self-controlling and positive reappraisal) and men used a more problem-focused approached (Gholamzadeh, Sharif and Rad, 2011). Effective use of humour, teamwork, and extracurricular activities in buffered the effects of stress (McFarlane, Duff and Bailey, 2004). Social support was associated with better psychological health and greater use of problem-focused coping. Emergency physicians, but not other emergency department staff, reported an increased risk of psychological distress. Increased psychological health was associated with the use of problem-focused coping strategies and higher levels of social support at work. Those reporting lower levels of psychological health were more likely to use maladaptive coping strategies (Yates, Benson, Harris and Baron, 2012). The first step to effective stress management is to understand oneself better and to appreciate what constitute stress and how one reacts to stressful situation. To cope according to the Online Dictionary is ''to face and deal with responsibilities, problems, or difficulties, especially successfully or in a calm or adequate manner'' (Dictionary.com 2015). In the case of Lockley et al. (2007), there is need to establish safe hour work limit for nurses in order to prevent the high rate of fatigue related medical errors and injuries. In other words, to be able manage the stress arising from long hours, there is need for management action on limiting the amount of hours done by nurses.

Many of the article reviewed agree that personal coping strategies like, fitness and relaxation techniques, self-controlling, planful and organized problem solving and recognizing limitations are effective stress coping strategies for nurses. Other personal strategies are mental and behavioral disengagement and escape/avoidance or emotion focused coping. The escape/avoidance strategy is considered not very effective and could be maladaptive (Emilia & Hassim 2007). Organizational management plans which include Organizational interventions like effective supervision, leadership training and workshops, charismatic and inspirational leadership with idealized influence are considered the most effective stress management strategy for nurses. Another singular most important coping strategy or management practice is social support. Most of the articles believe that seeking social support either by the individual nurses or by the organizational on behalf of the nurses is one indisputable and effective way of managing stress among nurses.

This chapter presents the process on how the study was conducted. This study includes the research design, locale of the study, respondents of the study, sampling technique, data gathering instruments and procedures of the data gathering, which were used to make effective data collection about life experiences of nightshift emergency room nurses.

This study is qualitative and descriptive in nature. Techniques such as individual in-depth interview, researchers observations, and voice recording is applicable in this study to obtain data on life experiences of night shift emergency room nurses.

The purpose of the study is to explain to the respondents prior to the conduct of in-depth semi structure interview supported by observations. The interview is recorded with the consent of the respondent to obtain detailed information about their life experiences as a night shift emergency room nurses.