Study analyzes factors that contribute to employee stress in the critical care environment

Reviewed by Emily Henderson, B.Sc.Nov 25 2021

Hospital can be very challenging and stressful places in which to work. They are equipped to treat seriously ill patients who need constant monitoring, such as patients with severe COVID-19,those who require organ support or who are recovering from a major operation. Reducing the negative psychological impacts on critical care staff can have a range of positive outcomes, including improved job satisfaction and a higher quality of patient care.

Kate Grailey from the at Imperial College London, UK, along with her colleagues, conducted a study of the factors in the workplace environment that contribute to employee stress in critical care units. Their aim was to identify those factors that are modifiable, and how these can be addressed,in order to reduce staff stress. They present their conclusions in a in Elsevier's journal .

A comprises various factors including the physical space itself and its conditions and facilities, the social interactions and atmosphere, the support and recognition an employee receives, and the processes and procedures of the organisation.

The critical care workplace can be a challenging and fast-paced environment with its ongoing need to provide exemplary care for the sickest patients in the hospital."

Kate Grailey, Imperial College London, UK

Moreover, since the onset of the COVID-19 pandemic, the profile of critical care has been raised, highlighting the role it plays in the delivery of a functioning healthcare system. Nevertheless, critical care units remain faced with substantial challenges, such as limited resources, and organisational problems that can lead to elevated job demands and stress.

Grailey and her colleagues recruited participants from a cross-section of professional disciplines and seniority who worked at three critical care units in a London healthcare trust. The multidisciplinary makeup of the participants was a new departure as existing publications, have focused on nursing staff only. The researchers performed , in which they asked the participants a series of predetermined but open-ended questions, enabling the participants to freely discuss the topic, leading to the emergence of new ideas.

Using a thematic analysis technique to analyse the data, Grailey and her colleagues mapped the resultant themes and ideas onto a well-established model called the . This model holds that stress is highest when staff are faced with a high workload and a lack of control over their tasks and conduct (also known as low ''). This mapping highlighted the most significant stressors in the critical care workplace environment, and the negative psychological impacts these created on staff.

These results corroborated the existing literature regarding the impact of stressors and organisational challenges. They also provided new insights into significant factors in the critical care working environment, such as a feeling of isolation experienced when working in single-patient rooms and a lack of support from senior staff. These factors led to increased stress and perceptions of inadequacy.

From this analysis, Grailey and her colleagues created a framework for decision-makers (such as hospital managers and team leaders) to help them to identify the most significant stressors, and to implement mitigating solutions. "This research highlights ways in which team leaders can address modifiable aspects within the workplace environment, such as giving individuals control over their workload, that can reduce psychological strain."