The Psychological Impact of Dealing with Death and the Risk of Dying Among Nurses Working in ICU and NICU: Specificities in Mediating and Moderating Variables

Background/Objectives. This study applied the Demands-Resources-and-Individual-Effects(DRIVE)-Nurses-Model to explore and compare the experiences of nurses working in Intensive Care Units (ICUs) and in Neonatal Intensive Care Units (NICUs), by investigating the effects of the interplay (main/mediating/moderating effects) of perceived stress related to dealing with death/critically ill patients (Death-and-Dying-Stressor)—which unavoidably features in the daily life of nurses working in ICU/NICU—with further potential Stressors in Nursing (Conflicts-with-Physicians, Peers, Supervisors, Patients/their families, Uncertainty-Concerning-Treatment, Inadequate-Emotional-Preparation, Discrimination, Workload), Work-Resources (Job-Control, Social-Support, Rewards), and Coping-Strategies (Problem-focused, Seek-Advice, Self-Blame, Wishful Thinking, Escape/Avoidance) on nurses’ psychological health conditions according to the working unit (ICU/NICU). Methods. Overall, 62 critical care nurses (ICU = 35; NICU = 27) completed self-report questionnaires. Main/mediating/moderating effects were tested by using Correlational-Analyses and Hayes-PROCESS-tool by working unit. Results. Nurses working in NICU reported higher Psychological Disease than nurses working in ICU. The detrimental psychological impact of Death-and-Dying-Stressor was mediated by Conflicts-with-Supervisors-Stressor among ICU nurses and by Uncertainty-Concerning-Treatment and Conflicts-with-Physicians stressors among NICU nurses. The recourse to Self-Blame and Escape/Avoidance coping strategies exacerbated the psychological risk among ICU nurses, while perceived Work-Resources (Job-Control/Social-Support) played a protective moderating role among NICU nurses. Conclusions. The application of the DRIVE-Nurses-Model to deepen the experience of nurses working in ICU/NICU could advance the understanding of the mechanisms underlying the relationship between Death-and-Dying-Stressor and nurses’ psychological health, suggesting tailored risk profiles and accounting for key protective factors, to provide nurses with the necessary resources for adjusting to their challenging and emotionally demanding work-related duties and experiences.