Intensive Care Unit Nursing Stress: Measuring Heart Rate Variability and Workplace Trauma
Paula Levi,1 Peng Li,2 W Chance Nicholson,3 Karen Heaton,2 Pariya L Fazeli,2 Penni I Watts,2 Jacqueline Moss2 1College of Nursing, University of South Alabama, Mobile, AL, USA; 2School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; 3Nell Hodgson Woodruff School of Nursing, Emo...
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Dove Medical Press
2025-07-01
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| author | Levi P Li P Nicholson WC Heaton K Fazeli PL Watts PI Moss J |
| author_facet | Levi P Li P Nicholson WC Heaton K Fazeli PL Watts PI Moss J |
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| description | Paula Levi,1 Peng Li,2 W Chance Nicholson,3 Karen Heaton,2 Pariya L Fazeli,2 Penni I Watts,2 Jacqueline Moss2 1College of Nursing, University of South Alabama, Mobile, AL, USA; 2School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; 3Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USACorrespondence: Paula Levi, College of Nursing, The University of South Alabama, 5721 USA Drive North, Office 2039A, Mobile, AL, USA, 36688, Tel +1.251.445.9400, Fax +1.251.445.9416, Email plevi@southalabama.eduPurpose: Intensive care unit (ICU) nurses work in a demanding environment and face repeated encounters with traumatic and ethical issues, which may negatively impact their psychological and physical health, patient care, and hospitals’ bottom line. The purpose of this study was to investigate stress among ICU nurses performing workplace activities/events by measuring fluctuations in heart rate variability (HRV), a reliable indicator of stress-related physiological changes.Methods: Real-time HRV was measured using a wearable, wireless electrocardiogram for 30 ICU nurses while at work in this cross sectional, observational study. Workplace events were categorized (Routine Care, Stat (urgent) Care, and Interpersonal) and assigned numerical code labels. HRV time- and frequency-domain indices of SDNN, RMSSD, HF, and LF were calculated and accurately linked to participants’ corresponding physiological HRV responses to workplace events on an observational data collection tool, accessed on a portable electronic tablet. The association of HRV with ICU workplace events and psychological and clinical outcomes was explored.Results: Nurses’ HRV parameters of SDNN, RMSSD, and HF tended to have the greatest reduction to both Stat (urgent) and Routine care events. New nurses tended to have lower HRV than experienced nurses. We found high rates of perceived stress and peritraumatic dissociative experiences and low resilience in the ICU nurses.Conclusion: HRV can be used as a contemporary index of workplace stress and trauma in ICU nurses. Study nurses were vulnerable to potential long-term physiological and psychological health issues. Understanding stress and trauma ICU nurses face at work will allow for strategies for interventions to reduce the development of post-traumatic stress disorder, peritraumatic dissociation, and other psychological outcomes.Keywords: post-traumatic stress, PTSD, peritraumatic dissociative experiences, workplace stress |
| format | Article |
| id | doaj-art-d228b6b4b45d495a9510450fa44dd79b |
| institution | DOAJ |
| issn | 2230-522X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Dove Medical Press |
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| series | Nursing: Research and Reviews |
| spelling | doaj-art-d228b6b4b45d495a9510450fa44dd79b2025-08-20T03:15:27ZengDove Medical PressNursing: Research and Reviews2230-522X2025-07-01Volume 15Issue 191109105150Intensive Care Unit Nursing Stress: Measuring Heart Rate Variability and Workplace TraumaLevi P0Li P1Nicholson WC2Heaton K3Fazeli PLWatts PI4Moss JCollege of Nursing/ Adult HealthSchool of NursingOffice of Clinical ResearchSchool of NursingAcute, Chronic, and Continuing Care, School of NursingPaula Levi,1 Peng Li,2 W Chance Nicholson,3 Karen Heaton,2 Pariya L Fazeli,2 Penni I Watts,2 Jacqueline Moss2 1College of Nursing, University of South Alabama, Mobile, AL, USA; 2School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; 3Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USACorrespondence: Paula Levi, College of Nursing, The University of South Alabama, 5721 USA Drive North, Office 2039A, Mobile, AL, USA, 36688, Tel +1.251.445.9400, Fax +1.251.445.9416, Email plevi@southalabama.eduPurpose: Intensive care unit (ICU) nurses work in a demanding environment and face repeated encounters with traumatic and ethical issues, which may negatively impact their psychological and physical health, patient care, and hospitals’ bottom line. The purpose of this study was to investigate stress among ICU nurses performing workplace activities/events by measuring fluctuations in heart rate variability (HRV), a reliable indicator of stress-related physiological changes.Methods: Real-time HRV was measured using a wearable, wireless electrocardiogram for 30 ICU nurses while at work in this cross sectional, observational study. Workplace events were categorized (Routine Care, Stat (urgent) Care, and Interpersonal) and assigned numerical code labels. HRV time- and frequency-domain indices of SDNN, RMSSD, HF, and LF were calculated and accurately linked to participants’ corresponding physiological HRV responses to workplace events on an observational data collection tool, accessed on a portable electronic tablet. The association of HRV with ICU workplace events and psychological and clinical outcomes was explored.Results: Nurses’ HRV parameters of SDNN, RMSSD, and HF tended to have the greatest reduction to both Stat (urgent) and Routine care events. New nurses tended to have lower HRV than experienced nurses. We found high rates of perceived stress and peritraumatic dissociative experiences and low resilience in the ICU nurses.Conclusion: HRV can be used as a contemporary index of workplace stress and trauma in ICU nurses. Study nurses were vulnerable to potential long-term physiological and psychological health issues. Understanding stress and trauma ICU nurses face at work will allow for strategies for interventions to reduce the development of post-traumatic stress disorder, peritraumatic dissociation, and other psychological outcomes.Keywords: post-traumatic stress, PTSD, peritraumatic dissociative experiences, workplace stresshttps://www.dovepress.com/intensive-care-unit-nursing-stress-measuring-heart-rate-variability-an-peer-reviewed-fulltext-article-NRRpost-traumatic stressPTSDperitraumatic dissociative experiencesworkplace stress |
| spellingShingle | Levi P Li P Nicholson WC Heaton K Fazeli PL Watts PI Moss J Intensive Care Unit Nursing Stress: Measuring Heart Rate Variability and Workplace Trauma Nursing: Research and Reviews post-traumatic stress PTSD peritraumatic dissociative experiences workplace stress |
| title | Intensive Care Unit Nursing Stress: Measuring Heart Rate Variability and Workplace Trauma |
| title_full | Intensive Care Unit Nursing Stress: Measuring Heart Rate Variability and Workplace Trauma |
| title_fullStr | Intensive Care Unit Nursing Stress: Measuring Heart Rate Variability and Workplace Trauma |
| title_full_unstemmed | Intensive Care Unit Nursing Stress: Measuring Heart Rate Variability and Workplace Trauma |
| title_short | Intensive Care Unit Nursing Stress: Measuring Heart Rate Variability and Workplace Trauma |
| title_sort | intensive care unit nursing stress measuring heart rate variability and workplace trauma |
| topic | post-traumatic stress PTSD peritraumatic dissociative experiences workplace stress |
| url | https://www.dovepress.com/intensive-care-unit-nursing-stress-measuring-heart-rate-variability-an-peer-reviewed-fulltext-article-NRR |
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