Emergency Department » Stress in the Workplace


Hospital work often requires coping with some of the most stressful situations found in any workplace. Emergency department workers need to deal with emergencies that may involve life-threatening injuries and illnesses. Their work is complicated by overwork, understaffing, tight schedules, intricate or malfunctioning equipment, complex hierarchies of authority and skills, dependent and demanding patients, and patient deaths. All of these factors can contribute to stress.

Health Effects

Stress has been associated with loss of appetite, ulcers, mental disorders, migraines, difficulty in sleeping, emotional instability, disruption of social and family life, and the increased use of cigarettes, alcohol, and drugs. Stress can also affect worker attitudes and behavior. Some frequently reported consequences of stress among hospital workers are difficulties in communicating with very ill patients, maintaining pleasant relations with coworkers, and judging the seriousness of a potential emergency.

Recognized Controls and Work Practices

Some methods that have successfully reduced hospital worker stress include:

  • Providing adequate staffing
  • Educating employees and management about job stress.
  • Addressing work-related stressors, such as inadequate work space, unreasonable work load, lack of readily available resources, and inadequate and unsafe equipment.
  • Establishing regular staff meetings and discussions to communicate feelings, gain support, and share innovative ideas.
  • Establishing stress management programs.
  • Providing readily available counseling from a nonjudgmental source.
  • Being flexible in allowing workers to employ alternative job arrangements.
  • Providing reasonable shift schedules that allow workers adequate time for sleep each day.
  • Providing group therapy for staff confronting particularly difficult professional issues such as treating patients with cancer or other chronic illness and patient death.
  • Providing an organized and efficient work environment.
  • Recognizing and taking action on legitimate complaints regarding overbearing physicians and supervisors.
  • Using individual approaches, such as relaxation exercises and other techniques (e.g., biofeedback), to relieve symptoms of stress and learn how to change physiological activity to improve health and performance.
  • Providing systematic educational sessions and other opportunities to improve skills and confidence.
  • Scheduling rotation of unit assignments.
  • Ensuring that the workload is in line with workers' capabilities and resources.
  • Designing jobs to provide meaning, stimulation, and opportunities for workers to use their skills.
  • Clearly defining workers' roles and responsibilities.
  • Giving workers opportunities to participate in decisions and actions affecting their jobs.
  • Establishing programs to address workplace stress, such as Employee Assistance Programs (EAPs) or Organizational Change Programs.
    • An Employee Assistance Program (EAP) can improve the ability of workers to cope with difficult work situations. Stress management programs teach workers about the nature and sources of stress, the effects of stress on health, and personal skills, such as time management or relaxation exercises that help reduce stress. EAPs also provide individual counseling for employees for both work and personal problems.
    • Organizational Change Programs are used to change hospital policies and procedures to reduce organizational sources of stress by bringing in a consultant to recommend ways to improve working conditions. This approach involves the identification of stressful aspects of work (e.g., excessive workload, conflicting expectations) and the design of strategies to reduce or eliminate the identified stressors.

Additional Information