Occupational Disappointment and Emergency Nurses: A Qualitative Descriptive Study

Abstract

Background: Occupational disappointment is a novel concept in emergency nursing. It is a feeling of disheartenment with career choice.  It results from prevalent, unaddressed verbal abuse in the emergency department directed towards nurses from patients and/or their visitors. Occupational disappointment is conceptually different from burnout and compassion fatigue. In the context of the COVID-19 pandemic, it is important to acknowledge this phenomenon and understand its implications while considering strategies to mitigate it.

Method: A qualitative descriptive methodology was used in this study. Nurses were interviewed to explore the question: How do emergency department nurses experience occupational disappointment as a result of verbal abuse?

Results: Three major themes with several subthemes were identified: (1) nurses’ experiences of occupational disappointment with sub-themes of powerlessness and normalizing; (2) nurses’ responses to occupational disappointment with sub-themes of changes in nursing practice, retention, and nurses’ mental health; (3) nurses’ concerns regarding occupational disappointment with sub-themes of nursing and organizational leadership.

Discussion: Policies addressing verbal abuse would help guide nurses when managing this violence. Failure of nurse leaders to implement such measures contributes to nurses’ occupational disappointment, consequently affecting nurses’ practice, mental health, and retention. While these implications are not new, the COVID-19 pandemic has exacerbated this phenomenon. The magnitude of verbal abuse that emergency nurses currently face has increased exponentially; a renewed urgency for strategic action is necessary.

Conclusion: Occupational disappointment is a direct result of verbal abuse and an indirect result of organizational failures to support nurses and empower them to mitigate this abuse.