INTRODUCTION

Job stress promotes chronic fatigue in nursing staff, especially when working correlated day and night shifts, generating a tendency towards negative mood (stress, depression and anxiety) mediated by the association between shift type and energy intake. Negative mood is also associated with higher fat intake (Heath et al. 2019). This involves in the care practice, the nursing staff presents unfavourable situations in their lifestyle, in which it was found that work stress is a consequence of poor interaction with the environment in which they work; this staff that when they fail to cope with these situations originates negative effects that affect their well-being; triggering symptomatology such as exhaustion, depersonalisation and lack of fulfilment (León-Reyna et al. 2021).

On the other hand; it is proven that nursing professionals who are in the front line of care in front of COVID 19 face work-related stress to ensure the clinical well-being of patients admitted to the Intensive Care Unit (ICU), which causes comorbidities to appear, and several studies have shown that when subjected to a large amount of work-related stress, the appearance of cardiovascular diseases, violence, cancer, infectious diseases and skin problems have a higher prevalence of occurrence (Moncada et al. 2021).

In this way, Latin America is contextualised, where a study shows that nurses in 13 countries suffer from higher work stress, added to suffering from work overload, as well as excessive hours in their working day, all of these professionals mention that in the institutions where they work they unfortunately do not have psychological support (Del-Rosario-Retuerto et al. 2021).

In the same vein, nurses working in a critical care unit experience stress which releases skin complications that create prolonged scarring of wounds and acne due to the continuous use of masks and face shields. If we add to all these problems the extensive workload generated by the COVID19 pandemic, we can deduce that despite the vocation and dedication of the professionals, this emotional problem has various consequences at the psychosocial level, causing resignations, rejection by their families and by the same staff working in the hospital units (Vásquez-Mendoza & González-Márquez, 2022).

In addition to the above, it is identified that the complications of work-related stress faced by the nursing staff are related to the workload, apart from the specific care provided to patients, in addition to the fact that the most senior nurses had to teach the inexperienced professionals who joined the front line; If to all this is added the protocols that must be followed for the administration of intravenous medication with the appearance of SarsCov2, it is identified that the levels of work-related stress detonate in all areas of the health units (López-Izurieta & López-Izurieta, 2021).

In view of the above, it is important to know exactly what are the main complications that arise due to work-related stress for nurses working in the intensive care unit, since due to the pandemic, the protocol information on protective clothing did not have sufficient scientific basis to be followed, which generates moments of anguish, fear, anxiety, family and social rejection; family and social rejection, all these events followed by the lack of supplies and information about the new disease are a trigger for the increase of stress complications in nursing professionals (Soto-Rubio et al. 2020), (Giménez-Espert, et al. 2020).

In addition, when nursing staff experienced these situations in which they were involved every day in their work and saw patients dying day after day, it is more than evident that they developed complications due to work-related stress, and on many occasions several professionals fell into deep depression and even more so when they witnessed the death of someone close to them (Shahrour & Dardas, 2020).

Therefore, this study aims to review the main complications caused by work-related stress in intensive care nurses who worked during the health crisis of the COVID 19 pandemic, which generated fear, uncertainty, panic and even the thought of contagion and death on several occasions, due to the fact that patients admitted to these units do not have a favourable prognosis for life; The patients admitted to these units do not have a favourable prognosis for life, which is why work-related stress is triggered by complications such as high blood pressure, diabetes, heart failure, obesity, depression, anxiety and skin problems (Murat et al. 2021).

In consideration of the above, the research aims to identify work-related stress in intensive care nurses who worked during the health crisis of the COVID 19 pandemic.

METHOD

A literature review study was conducted that collected important information on work-related stress in ICU nursing staff, which allowed us to analyse the importance of knowing the complications of stress in the lives of nursing professionals, and also in the literature that was found, the main stress triggers could be evidenced. It was retrospective because the information collected in the databases already existed before the study and was collected in the period from 2019 to 2021.

The key words used for the search of the bibliographic information were work stress, COVID-19, nursing staff, intensive care, which will be found throughout the subject that has been written. Using databases such as: PubMed, Scielo, Bvsalud, Latindex 2.0.

Twenty-seven research articles related to the research topic were interpreted, applying the content analysis technique to compile the relevant information in order to construct a theoretical synthesis of the research results.

ANALYSIS OF THE RESULTS

Work stress has become a complex phenomenon originating from physical and psychological stimuli, which predispose young men, women and adults to generate physical and mental fatigue producing as a consequence internal and external agents which have endangered the welfare of nursing professionals, so it is essential to mention that the consequences of stress in times of COVID takes a very large toll on health personnel; since presenting emotional inconvenience produces complications in the development of work (Navinés et al. 2021), (Shen et al. 2020), (Rahman & Plummer, 2020).

This means that the work performed daily is not carried out properly, because the exhaustion of the staff is affected not only emotionally but also psychosocially. One evidence of this is the studies carried out in different countries around the world that show that the amount of work-related stress affects all the nursing staff working in intensive care; but why is the staff in this area the most affected if the entire healthcare system works with COVID patients, from the bibliographies reviewed and analysed it can be deduced that as this is a closed and critical area, the patients admitted to this unit have a poor prognosis for life (Heitzman, 2020).

Work stress is any situation that puts the body in a state of alertness, which is accompanied by emotional alterations (Yuanyuan et al. 2020), which interfere with social activities according to (Zhan et al. 2020), which defines that physiological, cognitive, emotional and behavioural emotional reactions experience a negative consequence in health professionals, which has an impact on performance, motivation and job satisfaction.

The most important factors for the occurrence of work stress in nursing staff are work overload, long working hours; therefore (Friganović et al. 2019), agrees with what is manifested, as it adds that nurses who worked in the pandemic have a low performance in their work, due to long working hours; however; evidence that this work overload directly affects the central nervous system (Bogue & Bogue, 2020).

On the other hand; the main morbidities that appear in the face of work-related stress in nurses working in the intensive care unit in the COVID 19 pandemic are those related to emotional exhaustion generated by anguish, fear and anxiety, all of which result in patients having psychiatric problems (Green & Kinchen, 2021), (Okuhara, et al. 2021).In addition, cardiovascular problems have increased in people suffering from stress, resulting in high blood pressure, gastrointestinal problems, skin and immune system problems. All this has been felt because at the time of the pandemic the eyes of the health systems were focused on the evolution of the new virus, so that the health of health workers was neglected and as the months went by it was only taken into consideration that health workers working in critical units were suffering from work-related stress (Li et al. 2021).

Therefore, it began to take corrective measures to alleviate the work of these professionals by placing more accessible schedules for those who worked in the intensive care unit, but there is a drawback that the help came from other areas outside the ICU and there the workload and stress grew as the senior nurses taught their colleagues and that made that for several months the burden for the oldest nurses of the unit grew by putting on their shoulders a work overload.

On the other hand; (Trujillo-Ramírez & Quispe-Arana, 2021), agree that the excess of information on social networks, news and official and unofficial channels caused panic to increase when hearing the official figures of deaths and contagions that were given daily, Therefore, when they heard that the number of infections was increasing, the nursing staff were more afraid for themselves than for their families, as they did not want to be the cause of the infection of their loved ones, and therefore they were terrified that one of them might die (Labrague & de-Los-Santos, 2021).

In addition, it is pertinent to mention that (León-Reyna et al. 2021), say that the situations that cause stress in the workplace go beyond working hours or the stressful environment in which they develop, because it is worth mentioning that one of the most uncomfortable situations is seeing patients die or not having enough medical supplies to save the life of each of the patients and of course all health professionals felt frustrated and how could they not if they did not have the information on how exactly the virus affected the patients and they did not have the necessary knowledge to combat it.

CONCLUSIONS

With the outbreak of the COVID-19 pandemic, health professionals working in the intensive care unit were under stress because they did not have all the biosecurity measures required to protect their staff, and because of the health crisis, medical supplies ran out and were scarce.

FUNDING

Non-monetary

CONFLICT OF INTEREST

There is no conflict of interest with persons or institutions involved in the research.

ACKNOWLEDGEMENTS

To the participants of the critical care nursing course at the Universidad Regional Autónoma de Los Andes. UNIANDES.

REFERENCES

Bogue, Terri & Bogue, Robert. (2020). Extinguish Burnout in Critical Care Nursing. Critical care nursing clinics of North America, 32(3), 451–463. https://doi.org/10.1016/j.cnc.2020.05.007

Del-Rosario-Retuerto, Fátima, Cuba-Capcha, Susan & Sinti-Chasnamote, Doriana. (2021). Estrés del personal de enfermería durante la pandemia COVID-19, en hospitales de Lima Norte [Nursing staff stress during the COVID-19 pandemic in hospitals in northern Lima]. Revista Científica Ágora, 8(2), 27–32. https://doi.org/10.21679/ arc.v8i2.215

Friganović, Adriano, Selič, Polona, Ilić, Boris, & Sedić, Biserka. (2019). Stress and burnout syndrome and their associations with coping and job satisfaction in critical care nurses: a literature review. Psychiatria Danubina, 31(Suppl 1), 21–31.

Giménez-Espert, María, Prado-Gascó, Vicente, & Soto-Rubio, Ana. (2020). Psychosocial Risks, Work Engagement, and Job Satisfaction of Nurses During COVID-19 Pandemic. Frontiers in public health, 8, 566896. https://doi.org/10.3389/fpubh.2020.566896

Green, Alyssa & Kinchen, Elizabeth. (2021). The Effects of Mindfulness Meditation on Stress and Burnout in Nurses. Journal of holistic nursing: official journal of the American Holistic Nurses' Association, 39(4), 356–368. https://doi.org/10.1177/08980101211015818

Heath, Georgina, Dorrian, Jillian, & Coates, Alison. (2019). Associations between shift type, sleep, mood, and diet in a group of shift working nurses. Scandinavian journal of work, environment & health, 45(4), 402–412. https://doi.org/10.5271/sjweh.3803

Heitzman Janusz. (2020). Impact of COVID-19 pandemic on mental health. Wpływ pandemii COVID-19 na zdrowie psychiczne. Psychiatria polska, 54(2), 187–198. https://doi.org/10.12740/PP/120373

Labrague, Leodoro, & de-Los-Santos, Janet Alexis. (2021). Fear of COVID-19, psychological distress, work satisfaction and turnover intention among frontline nurses. Journal of nursing management, 29(3), 395–403. https://doi.org/10.1111/jonm.13168

León-Reyna, Patricia, Lora Loza, Miryam, & Rodríguez Vega, Juan. (2021). Relación entre estilo de vida y estrés laboral en el personal de enfermería en tiempos de COVID-19 [Relationship between lifestyle and work stress in nurses in times of COVID-19]
. Revista Cubana de Enfermería, 37(1). https://revenfermeria.sld.cu/index.php/enf/article/view/4043

Li, Xue, Jiang, Ting, Sun, Jian, Shi, Lingyun, & Liu, Jiwen. (2021). The relationship between occupational stress, job burnout and quality of life among surgical nurses in Xinjiang, China. BMC nursing, 20(1), 181. https://doi.org/10.1186/s12912-021-00703-2

Liu, Cindy, Zhang, Emily, Wong, Ga, Hyun, Sunah, & Hahm, Hyeouk. (2020). Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health. Psychiatry research, 290, 113172. https://doi.org/10.1016/j.psychres.2020.113172

López-Izurieta, Indira, & López-Izurieta, Ignacio. (2021). La salud mental del personal sanitario ante la pandemia del COVID-19 [Health workers' mental health in the face of the COVID-19 pandemic]. Enfermería Investiga, 6(1), 47–50. https://doi.org/10.31243/ei.uta.v6i1.1026.2021

Moncada, Betzy, Suárez, Mónica, Duque, Luis & Escobar, Kenny. (2021). Job stress in primary care medical and nursing personnel in the COVID-19 health emergency. Perfiles, 1(25), 13-23. https://doi.org/10.47187/perf.v1i25.109

Murat, Merve, Köse, Selmin, & Savaşer, Sevim. (2021). Determination of stress, depression and burnout levels of front-line nurses during the COVID-19 pandemic. International journal of mental health nursing, 30(2), 533–543. https://doi.org/10.1111/inm.12818

Navinés, Ricard, Olivé, Victoria, Fonseca, Francina, & Martín-Santos, Rocío. (2021). Work stress and resident burnout, before and during the COVID-19 pandemic: An up-date. Medicina clínica, 157(3), 130–140. https://doi.org/10.1016/j.medcli.2021.04.003

Okuhara, Mihoka, Sato, Kana, & Kodama, Yoshimi. (2021). The nurses' occupational stress components and outcomes, findings from an integrative review. Nursing open, 8(5), 2153–2174. https://doi.org/10.1002/nop2.780

Rahman, Ashikur, & Plummer, Virginia. (2020). COVID-19 related suicide among hospital nurses; case study evidence from worldwide media reports. Psychiatry research, 291, 113272. https://doi.org/10.1016/j.psychres.2020.113272

Shahrour, Ghada, & Dardas, Latefa. (2020). Acute stress disorder, coping self-efficacy and subsequent psychological distress among nurses amid COVID-19. Journal of nursing management, 28(7), 1686–1695. https://doi.org/10.1111/jonm.13124

Shen, Xin, Zou, Xiaovue, Zhong, Xiaofeng, Yan, Jing, & Li, Li. (2020). Psychological stress of ICU nurses in the time of COVID-19. Critical care (London, England), 24(1), 200. https://doi.org/10.1186/s13054-020-02926-2

Soto-Rubio, Ana, Giménez-Espert, María & Prado-Gascó, Vicente. (2020). Effect of Emotional Intelligence and Psychosocial Risks on Burnout, Job Satisfaction, and Nurses' Health during the COVID-19 Pandemic. International journal of environmental research and public health, 17(21), 7998. https://doi.org/10.3390/ijerph17217998

Trujillo-Ramírez, Carmiña, & Quispe-Arana, Adbel. (2021). Estrés laboral en personal de enfermería del Centro de Salud Alberto Barton del Callao, 2021 [Work-related stress in nursing staff at the Alberto Barton Health Centre in Callao, 2021.]. Revista Cuidado Y Salud Pública, 1(2), 46–53. https://doi.org/10.53684/csp.v1i2.25

Vásquez-Mendoza, Sara, & González-Márquez, Yaritza. (2022). El estrés y el trabajo de enfermería: factores influyentes [Stress and nursing work: Influencing factors]. Más Vita, 2(2), 51–59. https://doi.org/10.47606/ACVEN/MV0010

Yuanyuan, Mo, Deng, Lan, Zhang, Liyan, Lang, Qiuyan, Liao, Chunyan, Wang, Nannan, Qin, Minggin, & Huang, Huiqiao. (2020). Work stress among Chinese nurses to support Wuhan in fighting against COVID-19 epidemic. Journal of nursing management, 28(5), 1002–1009. https://doi.org/10.1111/jonm.13014

Zhan, Yufang, Ma, Shuang, Jian, Xiangdong, Cao, Yingjuan & Zhan, Xiangqiao. (2020). The Current Situation and Influencing Factors of Job Stress Among Frontline Nurses Assisting in Wuhan in Fighting COVID-19. Frontiers in public health, 8, 579866. https://doi.org/10.3389/fpubh.2020.579866

Licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Attribution-NonCommercial-ShareAlike 4.0 License.