The Mental Health of Emergency Nurses Exposed to Unexpected Death: An Integrative Review.

BACKGROUND: Emergency nurses face high-intensity situations that heighten their risk of mental health concerns, including compassion fatigue and post-traumatic stress symptoms. They report significantly higher levels of depression, anxiety, and secondary stress syndrome than other health care workers, which can negatively affect their well-being and patient care, leading to increased burnout and medical errors. This integrative review aimed to examine the mental health concerns of emergency nurses who care for patients who die unexpectedly.

METHODS: This integrative review followed Whittemore and Knafl's 5-step framework. A narrative synthesis was then completed, and data were analyzed using the Mixed Methods Appraisal Tool to mitigate biases. Four databases were systematically searched with specified search terms and without date restrictions.

RESULTS: Fifteen studies were included, focusing on clinical events such as traumas, gunshot wounds, and motor vehicle accidents. The themes identified throughout the studies included coping mechanisms, end-of-life care education, and peer and managerial support. Symptoms reported by nurses included avoidance, substance abuse, and sleep disturbances.

CONCLUSION: Emergency nurses are vulnerable to the psychological impact of unexpected or traumatic deaths, increasing their risk of mental health concerns that affect their own health and patient outcomes. There is a need for intervention studies to address these issues and improve outcomes for nurses facing unexpected death.