The Psychological Impact of Dealing with Death and the Risk of Dying Among Nurses Working in ICU and NICU: Specificities in Mediating and Moderating Variables

<b>Background/Objectives</b>. This study applied the <i>Demands-Resources-and-Individual-Effects(DRIVE)-Nurses-Model</i> to explore and compare the experiences of nurses working in Intensive Care Units (ICUs) and in Neonatal Intensive Care Units (NICUs), by investigating the effects of the interplay (main/mediating/moderating effects) of perceived stress related to dealing with death/critically ill patients (<i>Death-and-Dying-Stressor</i>)-which unavoidably features in the daily life of nurses working in ICU/NICU-with further potential <i>Stressors in Nursing</i> (Conflicts-with-Physicians, Peers, Supervisors, Patients/their families, Uncertainty-Concerning-Treatment, Inadequate-Emotional-Preparation, Discrimination, Workload), <i>Work-Resources</i> (Job-Control, Social-Support, Rewards), and <i>Coping-Strategies</i> (Problem-focused, Seek-Advice, Self-Blame, Wishful Thinking, Escape/Avoidance) on nurses' psychological health conditions according to the working unit (ICU/NICU). <b>Methods</b>. Overall, 62 critical care nurses (ICU = 35; NICU = 27) completed self-report questionnaires. Main/mediating/moderating effects were tested by using Correlational-Analyses and Hayes-PROCESS-tool by working unit. <b>Results</b>. Nurses working in NICU reported higher <i>Psychological Disease</i> than nurses working in ICU. The detrimental psychological impact of <i>Death-and-Dying-Stressor</i> was mediated by <i>Conflicts-with-Supervisors</i>-<i>Stressor</i> among ICU nurses and by <i>Uncertainty-Concerning-Treatment</i> and <i>Conflicts-with-Physicians</i> stressors among NICU nurses. The recourse to <i>Self-Blame</i> and <i>Escape/Avoidance</i> coping strategies exacerbated the psychological risk among ICU nurses, while perceived <i>Work-Resources</i> (Job-Control/Social-Support) played a protective moderating role among NICU nurses. <b>Conclusions</b>. The application of the <i>DRIVE-Nurses-Model</i> to deepen the experience of nurses working in ICU/NICU could advance the understanding of the mechanisms underlying the relationship between <i>Death-and-Dying-Stressor</i> and nurses' psychological health, suggesting tailored risk profiles and accounting for key protective factors, to provide nurses with the necessary resources for adjusting to their challenging and emotionally demanding work-related duties and experiences.