The demoralisation of nurses and medical doctors working in the emergency department: A qualitative descriptive study

Abstract

Aim: To explore emergency department clinicians (nurses and medical doctors) perceptions of stressors and coping strategies in their work environment.

Methods: A descriptive qualitative design was adopted. Twelve semi-structured interviews were conducted with medical and nursing personnel working in one Australian emergency department. A thematic inductive approach was used for analysis.

Findings: Four key themes emerged regarding perceptions of and factors that influenced stressors around the emergency department working environment: i) workload and departmental activity, ii) lack of support; iii) inadequate resourcing; and iv) a mis-match between societal, organisational and staff expectations. The overlap between these themes is such that an overarching theme of 'demoralisation in the workforce' can be described. Staff reported both problem- and emotion-focussed coping strategies with varying levels of self-perceived effectiveness. The foci of solutions proposed by participants typically addressed the source of the stressors.

Conclusion: Exposure to occupational stressors remains problematic for emergency department clinicians. Continued exposure can, in some instances, result in demoralisation of the workforce. Immediate attention to causes and effects of occupational stress and demoralisation is warranted. Implementing tailored strategies has the potential to ameliorate effects of occupational stressors.

Keywords: Coping; Demoralisation; Emergency department; Medical officer; Nurse; Stress.