Morale, stress and coping strategies of staff working in the emergency department: a national and international comparison.

Can workplace stressors in emergency departments be better understood?

Grant ID: EMSS-410R22-2014

Lay Summary

The impact on staff morale from working in the stressful emergency department environment is relatively unknown. This study aims to describe and compare the impact of the working environment on emergency department medical and nursing staff as well as the varied coping strategies used by ED staff in a range of ED environments of varying sizes and locations in Australia and Sweden. The findings will enhance understanding of factors that may link specific stressors to the emergency department workplace environment and can assist ED staff and managers in tailoring support mechanisms, as required.


This project included surveys of 146 ED nurses and doctors from two geographical varied and sized hospitals. Both had similar demographic profiles in terms of age, sex and years of experience. Staff reported moderate levels of workload and self-realisation, but low levels of conflict or nervousness in the workplace. Nurses and physicians reported similar perceptions of the work environment, although nurses reported slightly higher median levels of workload. Staff rated the death or sexual abuse of a child as most stressful, followed by workplace violence and heavy workload. Staff used a large range of coping strategies, and these were similar across both sites.

The findings were the first multi-site and multidisciplinary examinations of Australian ED staff perceptions and help improve our understanding of staff stressors and coping strategies and highlighting similarities across different EDs. The research team believe their research supports the development and implementation of strategies to improve ED working environments to help ensure professional longevity of ED staff.

Key findings
> ED staff in two different-sized departments within the same healthcare system have similar perceptions of the stressors relating to their work environment. Stressors tend to revolve around system and resource concerns.
> Staff within the two departments utilise a wide range of (but similar) coping mechanisms, which mostly have a positive effect on the perception and management of stress in the workplace.

Leveraged Funds

- Griffith University Health Practice Innovation Member's research profile development funding; Emergency Medicine Australasia: $2,500
- Griffith University Internal staff development fund: $1,500


-Abraham, L. J., Thom, O., Greenslade, J. H., Wallis, M., Johnston, A. N., Carlström, E., Mills, D. and Crilly, J. (2018), Morale, stress and coping strategies of staff working in the emergency department: A comparison of two different-sized departments. Emergency Medicine Australasia. doi:10.1111/1742-6723.12895
- Johnston, A., Abraham, L., Greenslade, J., Thom, O., Carlstrom, E., Wallis, M., & Crilly, J. (2016). Review article: Staff perception of the emergency department working environment: Integrative review of the literature. Emerg Med Australas. doi: 10.1111/1742-6723.12522 Impact Factor: 1.296

Conference Proceedings/Abstracts:
- Abraham, L., Johnston, A.N.B., Thom, O., Greenslade, J., Wallis, M., Carlstrom, E., Mills, D., Crilly, J., "Morale, stress and coping strategies of clinical staff working in emergency departments: A comparison of two different departments", International Conference for Emergency Nurses; Sydney, Australia, Oct 2017.
- Crilly, J., Greenslade, J., Johnston, A.N.B., Carlstrom, E., Thom, O., Abraham, L., Mills, D., Wallis, M., "Staff perceptions of the working environment in the emergency department: an international cross-sectional study", ACEM ASM, Sydney, Australia, Nov 2017. (Oral presentation)
- Johnston, A.N.B. Abraham, L., Greenslade, J., Thom, O., Carlstrom, E., Wallis, M., Crilly, J.C. Staff perception of the ED working environment: integrating literature to support ED specific workplace interventions for clinical staff. 13th International Conference for Emergency Nurses, 2015, Brisbane, Australia. (oral presentation)
- Johnston, A.N.B., Abrahams, L., Greenslade, J., Thom, O., Wallis, M., Crilly, J. Staff perception of working environments in Emergency departments; strategies, techniques and outcomes for undertaking an integrative review of the literature. Inaugural Gold Coast Nursing and Midwifery Symposium, 5th Sept 2015, Gold Coast University Hospital, Southport QLD where it was awarded “Best research presentation”.


Amount Awarded


Grant Scheme


Principal Investigator:
Dr Ogilvie Thom

Co Investigators:
Prof Julia Crilly
Prof Marianne Wallis
A/Prof Eric Carlström
Dr Louisa Abraham
Dr Amy Johnston

Associate Investigators:
A/Prof Jaimi Greenslade


Collaborating Institutions


  • ICEN 2017: Morale, stress and coping strategies of clinical staff working in Emergency Departments: A comparison of two different departments

  • Media

  • Griffith Uni media_ 29 November 2017
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