Individual and Organizational Factors Associated With Secondary Traumatic Stress in Emergency Nurses: A Cross-Sectional Study.

INTRODUCTION: Emergency nurses routinely care for patients and families experiencing traumatic events, death, and violence. Repeated exposure to others' trauma may contribute to secondary traumatic stress, a type of psychological distress with symptoms similar to those of posttraumatic stress disorder. Although emergency nurses experience high levels of secondary traumatic stress, the individual and organizational factors that contribute to secondary traumatic stress require further exploration. Identifying these factors will contribute to the development of interventions that target secondary traumatic stress among emergency nurses.

METHODS: We report quantitative findings from a national cross-sectional survey of emergency nurses practicing in the United States. Measures included demographic and workplace characteristics, lifetime trauma history, work environment, organizational resources, and secondary traumatic stress. Variables associated with secondary traumatic stress were examined using hierarchical multiple regression.

RESULTS: In this self-selected sample, 84.4% of respondents met or exceeded the clinical cutoff score for secondary traumatic stress. In the final regression model, years of nursing experience, lifetime trauma history, hospital Magnet or Pathway status, and work environment were statistically significant correlates of secondary traumatic stress. The model explained 24.5% of the variance in secondary traumatic stress scores (P < .001), with the work environment contributing 9.7% of the variance.

DISCUSSION: Secondary traumatic stress was common among United States emergency nurses. The findings identify potentially modifiable workplace factors, particularly the work environment, and indicate substantial unexplained variance. Larger studies using approaches such as structural equation modeling are needed to examine this complex phenomenon. Emergency nurses and nurse leaders need to be empowered to advocate for changes that reduce the harm caused by nurses' exposure to trauma in their work environment.