What are the elements that influence stress level in registered nurses who work in the intensive care
unit? Is there any difference in stress level between the nurses working in nightshift and day shift in the
intensive care unit?
Literature review for nursing research
Given below is the essay for literature review:
Registered nurses work in variety of clinical settings or health care fields. Critical care nursing is one of
the major and complex nursing specialty areas where nurses deal with life-threatening problems.
Delivering high intensity therapies and interventions, critical care nurses ensure optimal care to
critically ill patients and their families. It is their prime responsibility and the job requires extreme
Stress as a phenomenon or problem within the discipline of nursing
Providing delicate care to acutely ill patients in such above mentioned environments, nurses are
exposed to most stressful events or situations and it can cause them feel stressed or burnout.
Therefore, stress is a common problem or phenomenon critical care or intensive care unit nurses face
frequently. Stress can be defined as a state of mental or emotional strain or tension resulting from
adverse or very demanding circumstances (Linda, 2013). Thus, stress produces a negative condition that
exerts pressure on a person’s physical or mental well-being. Examining the causes of stress experienced
by critical care nurses provides a clear picture of how intense the problem is.
Causes of stress in critical care nurses
The nature of critical care nursing itself requires highly physical and emotional efforts. This would mean
working in a stressful environment all the time. Patients in the intensive care units are critical, mortality
rates are high compared to other clinical settings and nurses face ethical dilemmas very often. They
encounter morally distressing situations on ethical practice or professional values. Sometimes nurses
are forced to act contrary to their ethical belief. For example, unnecessary prolongation of life is one of
the most stressful situation nurses face.
Intensive care nurses provide health care to patients as well as their families. This would make them
emotionally exhausted. Taking over of advancing technology in the hospital settings demands higher
job expectations and positive patient outcomes and this add stress to critical care nurses. ICU nurses
are required to perform highly technical jobs with compassion while working long hours under the
influence of nursing shortage also make them exhausted and burnout. Feeling of ineffectiveness and lack
of personal accomplishment is another contributing factor that adds stress to the nurses. For example,
when doctors do not consider nurses’ point of views or ways of approaching a particular situation make
them feel ineffective or feel personally unaccomplished. These are some of the factors that cause stress
in critical care nurses.
The setting is an Intensive Care Unit of a 560 bedded community hospital. The intensive Care Unit is
divided into medical ICU with 8 bed capacity and coronary care unit having 9 bed capacities. A total
number of 42 registered nurses are employed in these two units for day and night shifts and eight
nurses work for each shift. These registered nurses are from multicultural and different ethnic
backgrounds. Patient population also has multicultural background and speaking different languages.
1. What are the elements that influence stress level in registered nurses who work in the intensive care
2. Is there any difference in stress level between the nurses working in nightshift and day shift in the
intensive care unit?
3. What can be done to decrease stress level in nurses who work night shift in the intensive care unit?
4. Is there any relationship between stress and job satisfaction?
Linda L, Chlan (2013, December) Burnout Syndrome among critical care professionals: A cause for Alarm,
Critical care Alert, Vol. 21, Issue 9.
A. Write an essay (Please copy or refer to the above essay) in which you document your process of
finding a research topic, deciding on sources, developing a search strategy, and summarizing
references. Include the following:
1. Provide a problem in your field of interest that has a scope that can be studied within a typical
master’s program. (Stress as a phenomenon or problem within the discipline of nursing)
2. Describe at least three symptoms of the problem or pieces of evidence that illuminate the problem.
B. Literature Search: Find materials relevant to the problem you have chosen.
1. List at least seven keywords that are representative of the problem and that you will use to guide
your information search.
2. List at least two resources that you will use to find your information.
3. After performing your searches and considering your results, describe how you modified your
keyword or source searches to retrieve the best results.
Note: If you did not need to modify your searches, discuss why your search was successful without
4. Discuss which keywords yielded the most fruitful searches.
C. Data Evaluation: Using the CARS checklist (credibility, accuracy, reasonableness, and support),
determine which literature makes a significant contribution to the understanding of the problem you
1. In APA format, cite at least 10 recent (published within the last 5 years) journal articles, dissertations,
or scholarly books that you have determined to be appropriate (credible, accurate, reasonable, and
2. Using the elements of the CARS checklist, justify your determination that each of the sources is
uniquely appropriate for every aspect of the CARS checklist.
Note: It may be useful to provide your CARS checklist information in a table format.
D. Annotated Bibliography: Review and organize the sources by completing parts 1–6 below for each of
the sources you have cited.
Note: An annotated list is a list to which you add (in your own words) other relevant information and
comments about the book for future reference. For this assignment, your annotations should include
the information listed below:
1. Describe the content (focus) of the source.
2. Describe the usefulness of the source.
3. Discuss any limitations that the source may have.
4. Describe the audience that the source is intended for.
5. Discuss the authors’ conclusions.
6. Describe your reaction to the source.
E. When you use sources, include all in-text citations and references in APA format.
Note: Often in research, the words source and resource can be used interchangeably based on a
person’s perspective. For the purpose of this task, source refers to the individual article or dissertation
that you are using. Resource refers to where you find that source, either in a journal or in an electronic