National Emergency Department Stress, Coping and Intention to Leave Survey: DESTRESS

The emergency department (ED) is a stressful workplace. The stressful work environment has resulted in high levels of psychological distress with some using mal-adaptive coping strategies. High staff turnover is evident in some EDs. To guide the development of strategies for clinicians, health services, policy makers, and emergency colleges, this research will provide a national picture regarding the impact of stressors on health and performance.

The well-being of staff is a priority for Emergency Medicine and Nursing colleges in Australia. Research reports have emerged highlighting concerns with post-traumatic stress, sleeping problems, cardiovascular disease and increasing rates of suicide among healthcare staff. This research is critical to address such concerning trends.

This multi-disciplinary research collaborative is new, consisting of expert clinical and academic leaders from emergency nursing and medicine coming together to provide a robust approach to understand, from a national perspective, where opportunities exist to enhance clinician wellbeing and the effectiveness of local, state, or national practice or policy measures, through the longitudinal design.

This research will provide a comprehensive Queensland, as well as a national understanding of the impact of stressors on the health and performance of ED staff. When applied longitudinally, the questionnaire can be used to evaluate the outcomes of interventions and policies that seek to promote positive coping strategies for ED clinicians.

Microcirculation in shocked patients

Microcirculation refers to very small blood vessels that control oxygen and nutrient delivery and removal of waste products from our tissues and organs. Previous research has shown that a decrease in either the number of vessels, or blood flow through these vessels, can be seen in patients who are very sick as a result of infections, blood loss or heart failure. Changes in microcirculation are associated with how sick a patient is and whether or not they recover from illness. However, only small numbers have been included in other studies.

The principle hypothesis of this research is that abnormalities of the microcirculation -- identified with sidestream dark field (SDF) imaging not necessarily discernable with global measure of perfusion -- will correlate with ongoing organ dysfunction in shocked critically unwell patients.