‘We're All in It Together’: Emergency Nurses' Experiences of Secondary Traumatic Stress Within the Practice Environment

AIMS: This study aimed to describe how emergency nurses (ENs) experience secondary traumatic stress (STS) within their practice environments, focusing on the strategies they use to cope and the supportive resources they draw upon to manage its impact on their lives. DESIGN: This paper presents the qualitative findings from a larger mixed-methods survey study on STS among ENs. METHODS: A geographically diverse U.S. sample of ENs was recruited through social media to participate in an online survey. All participants (n = 275) were asked to respond to open-ended survey questions, and 118 of these participants provided answers to at least one open-ended question. A self-selected sample of 20 ENs completed semi-structured interviews. Inductive content analysis was used to analyse open-ended survey responses and interview transcripts. RESULTS: Three themes reflected ENs' experiences with STS: STS Is Real-It's Going to Affect Your Life; Something Must Be Wrong With Me: A Culture of Disconnection; and It's a Systems Issue, but We're in It Together. Participants described individual, unit, and organizational factors that influenced their experiences of STS and their access to and use of coping strategies and supportive resources. CONCLUSION: ENs and nurse leaders acknowledged the impact of STS on their personal and professional lives and emphasized how the practice environment shaped their experiences. They perceived the accessibility of organizational resources, leadership behaviours, and team culture as influencing the individual strategies ENs use to manage the effects of repeated exposure to others' traumatic experiences. STS is a predictable occupational hazard for ENs; thus, healthcare organizations must invest in nurse-identified supports to preserve workforce well-being and clinical expertise. IMPLICATIONS FOR THE PROFESSION: Assessing organizational readiness to address STS is recommended to ensure ENs receive effective, timely support. In response to these assessments, healthcare organizations should develop and implement policies that prioritize the mental health and well-being of ENs, including proactive support systems and accessible mental health resources. IMPACT: This study identifies participant-perceived individual, team, leadership, and organizational conditions that may hinder or support ENs' management of STS. These findings identify potential targets for organizational assessment and support strategies intended to foster healthier practice environments and promote safe, high-quality care. REPORTING METHOD: Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient or public involvement in its design, conduct, or reporting.