It is no surprise that nursing can be a stressful profession. In fact, up to 70% of nurses experience burnout during their careers.
Job stress in nursing can lead to fatigue, anxiety, increased blood pressure, angry behaviors and low job satisfaction.
However, there are certainly ways to manage stress to ensure that this remains a rewarding career.
The following 10 nursing positions are among the most stressful in my opinion and in the opinion of many of the nurses with whom I have worked.
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Most Stressful Nursing Jobs
1. Adult Critical Care Nursing
Critical care nursing is typically seen as the most stressful nursing job and is associated with the highest rate of burnout among nurses.
In fact, according to a report published by the Critical Care Societies Collaborative (CCSC), critical care nurses have the highest rates of burnout syndrome among their colleagues.
This can lead to emotional and physical exhaustion.
The report showed that up to 86% of critical care nurses have at least one major symptom of burnout syndrome and up to 33% of them had all of the symptoms of severe burnout syndrome.
As a former critical care nurse myself, I can attest to just how stressful this type of unit is.
Patients are often critically ill, and codes and patient deaths are more frequent in these units than you could imagine.
In addition, nurses here are faced with a wide range of ethical and traumatic dilemmas at every shift and never know what to expect when they walk through the unit doors.
Not all patient care scenarios will turn out the way you would like, and life-and-death decisions can sometimes lead to poor communication skills between physicians and nurses.
In my opinion, both day shifts and night shifts in any critical care unit are equally fraught with stress and tension.
While the day shift is filled with the stress of patients going to and from testing and the operating room, the night shift may be filled with unexpected dilemmas occurring after physicians have left for the day.
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2. Pediatric ICU Nursing
The pediatric ICU or PICU is another similarly stressful area for nurses to work in for many of the same reasons you would find in adult critical care.
However, added to the stress of very ill patients and traumatic situations is the fact that you are dealing with young children and teenagers, a fact that can easily pull on your heartstrings.
It can be quite difficult to administer what may seem like routine care to children who do not understand what is happening to them and why they need to have these painful treatments.
In addition, some nurses find it very difficult to deal with grieving families as communication in the PICU is incredibly important.
In fact, in one small study, PICU nurses spoke of unrelieved job stress as being the primary reason they chose to move on from the PICU.
They also noted the many dimensions of PICU nursing, a lack of resources for providing patient care and poor support from management as leading to increased tension in this unit.
Find pediatric ICU nursing positions on our job board.
3. Neonatal ICU Nursing
Neonatal ICU or NICU nursing is the third most stressful nursing position in my opinion.
While the cuteness of the babies and positive outcomes when babies are finally released to go home with their families are certainly positives in this area, there are plenty of sad stories as well.
It can be difficult to see babies suffer due to prenatal negligence on the part of the mother.
It can also be stressful to watch loving parents agonize over what their babies are going through with some not even being allowed to hold their little ones.
Ethical dilemmas can be huge in this field, which can lead to major amounts of emotional stress.
According to one study, stress is high in the NICU especially when babies die after nurses form emotional bonds with them or when nurses must prepare infants for traumatic procedures.
Find neonatal ICU nursing jobs on our job board.
4. Emergency Room Nursing
Emergency room nurses see the majority of patients when they first come into the hospital.
Therefore, they often see the worst of the worst as they work to stabilize patients before sending them to the floor or the ICU.
The environment is incredibly fast-paced, and many of the emergency room nurses I have had contact with talk about the combined excitement and frustration of never knowing what type of patient is going to walk in the door next.
These nurses may often go without breaks and may spend long hours on their feet.
Although some shifts may be slow, other shifts may throw more at them than they think they can handle.
In some, feelings of powerlessness abound as they rarely complete treatments but rather pass on care to other health care professionals.
In one multi-center study, emergency room nursing was found to be particularly stressful not only because of the emotional and physical demands of the job but also because nurses often witness aggressive or violent displays without being properly prepared to handle them.
Find ER nursing positions on our job board.
5. Operating Room Nursing
Operating room nursing is far different from floor nursing or even ICU nursing.
Nurses only have to focus on one patient at a time and usually have better regulated hours that let them take their breaks, make time for lunch and get out at the correct hour.
However, there are still some stressful downsides to the operating room, bringing it in at number five on my list.
First, it can take quite some time to train in to the OR, and some nurses may not feel that they have really hit their groove until they have spent at least a year in this unit.
Second, most of the stress comes from the high amount of vigilance that nurses must have as they work in a sterile environment.
In addition, the fast-paced atmosphere can leave some nurses stressed out as well.
Quick turnover is important in this unit as each hospital has a limited number of OR suites.
In addition, emergency surgeries on very ill individuals can leave nurses running on adrenaline as they attempt to save lives.
In one study, over 90% of nurses called working in the OR stressful or very stressful.
Find OR nursing jobs on the nursing job board.
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6. Critical Care Step-Down Nursing
Once you move out of the ICU, ER and OR, you may think that work will become far less stressful for the majority of nurses.
While the same life-and-death decisions may not be made as frequently in other parts of the hospital, this in no way decreases the amount of stress that nurses may feel.
One good example is the critical care step-down unit.
Here, patients are generally stable but require more hands-on care and regular monitoring than they would get on a medical/surgical floor.
Stress can come into play when the health of one patient suddenly deteriorates.
Because most nurses handle around four patients per shift in this unit, it can be difficult to monitor other patients sufficiently in this type of situation.
In addition, there is typically plenty of bed turnover here as patients are regularly moved between the step-down unit and either the ICU or a medical/surgical floor.
Find step-down nursing jobs on our job board.
7. Oncology Nursing
Some floor nursing can also be stressful depending on the type of patients being cared for and on their diagnoses.
For example, oncology nursing is difficult because nurses frequently see long-term patients with whom they have formed bonds pass away after long battles with cancer.
This is a highly emotional unit, and nurses are not frequently given opportunities to process verbally what they have experienced.
Oncology nursing can be just as stressful in the outpatient setting for similar reasons.
A study published in the Clinical Journal of Oncology Nursing found that high workloads and patient death are the two biggest stressors in these units, especially among older nurses.
Find oncology nursing jobs on our job board.
8. Medical/Surgical Nursing
Medical/surgical nursing may not have quite the same need for critical thinking in traumatic situations as you would find in the ICU or ER, but it is still an incredibly fast-paced unit thanks to the huge patient load that most nurses must carry.
When I have floated to this type of floor, I have typically felt very scattered as I am not used to caring for such a high patient load and keeping track of so many different patient needs.
Although patient treatments and general care are not as in-depth as they are in the ICU, they are often time-consuming and the amount of charting that must be done here is astronomical.
I have found that the biggest stressor for me on the medical/surgical floor is time. I often feel as if I am constantly behind even with CNAs helping out with certain activities of daily living for my patients.
While some of this stress will go away as you become accustomed to your work, some find that unhelpful colleagues, unresponsive nurse managers and an unappreciative work environment create an increasingly negative situation.
Find med-surg nursing jobs on the nursing job board.
9. Medical/Psychiatric Nursing
You may automatically assume that psychiatric nursing is a cinch with low-key days and plenty of time to talk with your patients.
However, when you are working on a medical/psychiatric floor, you will be dealing not only with the mental health concerns of your patients, but also with acute or chronic physical conditions that can make your daily work seem twice as difficult as it otherwise would be.
One of the biggest stressors on these floors is the potential for violence among unhappy or confused patients.
In one study at a large psychiatric hospital, nearly 70% of clinical staff members had been physically assaulted in the past year.
In addition, rough interactions among other staff members also lead to poor nurse wellbeing and an increase in depression along with worsening physical health.
The endless security precautions can also cause feelings of anxiety during each shift.
Pro Tip
As someone who has worked in mental health I can tell you from first hand experience that psychiatric nursing can be very stressful especially when you work a shift where you’re concerned about your physical well-being.
Not trying to scare you away from this important nursing specialty, but it is the harsh reality.
Find mental health nursing positions on the job board.
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10. Long-Term Care Nursing
Long-term care nurses are in high demand across the United States as the country’s population continues to age.
These nurses often care for the same patients for years but may find that the compensation, work environment and high job demands do not make up for the rewards that they would otherwise experience from their jobs.
Some of the most stressful parts of this type of nursing include dealing with patients diagnosed with dementia, constantly communicating with patients’ family members and feeling as if there is not enough staff to help with patient care.
The long-term care nurse is left feeling as if she must do all the work herself without having any time for breaks.
In addition, because of the high amount of medication passed out on these units, the stress over medication errors can be high.
The turnover rate of up to 75% in these units demonstrates how much of a problem burnout in long-term care can be.
Find LTAC nursing jobs on our job board.
Related: 10 Highest Paying Nursing Jobs for RNs
Final Thoughts
Although these 10 nursing positions can certainly be stressful, they can still be rewarding career choices for those who value meaningful and life-saving patient care.
Additionally, high-pressure work situations often appeal to many nurses who are looking for adventure and excitement.
To find job openings in any of these or other nursing positions, search our job board TODAY.
