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Strategies used to cope with stress by emergency and critical care nurses

10 January 2019
Volume 28 · Issue 1



developing coping strategies to use in stressful situations is an essential nursing skill. Prolonged and constant stress is harmful to nurses' health and leads to organisational inefficiency, high staff turnover and decreased job satisfaction.


to identify nurses' stress coping strategies and determine the relationship between coping strategies and sociodemographic factors.


a descriptive cross-sectional study using a self-administered questionnaire was undertaken at an emergency department and critical care units at the largest referral hospital in Brunei.


problem-solving and positive reappraisal were the predominant positive coping strategies identified. Those working in medical intensive care employed escape-avoidance behaviours more frequently. Married participants exhibited higher levels of confrontative coping behaviours.


to the authors' knowledge, this is the first study to examine job-stress coping strategies among nurses in Brunei. The authors examined the different strategies and the poor health outcomes associated with using negative coping styles. Future stress management interventions should target staff who employ negative coping strategies to promote positive strategies, enabling them to provide better quality care.

According to the World Health Organization (WHO) (2018) ‘work-related stress is the response people may have when presented with work demands and pressures that are not matched to their knowledge and abilities and that challenge their ability to cope’.

When work pressures become excessive or otherwise unmanageable, this leads to stress—and this can damage an employee's health and the organisation's performance (Abdul Rahman et al, 2017). Stress has been directly linked to seven of the ten leading causes of death in both sexes worldwide, and one of those causes, cardiovascular disease, is noted to have a distinct connection with occupational and organisational stress (Schnall et al, 2016).

Health is not merely the absence of disease or infirmity but a positive state of complete physical, mental and social wellbeing; a healthy working environment therefore is one in which there is not only an absence of harmful conditions but also an abundance of health-promoting elements (WHO, 2018). The WHO has urged all organisations to provide continuous assessment of risks to health, including appropriate information and training on health issues and the availability of health-promoting organisational support practices and structures, as work-related stress is not an acute or toxic condition that can be cured through treatment (Quick and Henderson, 2016).

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