Workload and Work-Related Stress among Intensive Care Unit Nurses: A Systematic Literature Review
DOI:
https://doi.org/10.37287/ijghr.v8i6.2840Keywords:
ICU nurses, workload, work-related stressAbstract
Nurses in intensive care units (ICUs) face substantial physical, cognitive, and emotional demands that may contribute to work-related stress, although evidence on this relationship remains inconsistent. This review aimed to synthesize recent evidence on the association between workload and work-related stress among ICU nurses and identify factors explaining differences in findings. Methods: This review followed PRISMA 2020 and the Population–Exposure–Outcome (PEO) framework. PubMed/MEDLINE, Scopus, and Google Scholar were searched for English or Indonesian studies published between 2023 and 2026. Quality was appraised using the Joanna Briggs Institute checklist for analytical cross-sectional studies. Of 45 records identified, eight observational studies were included. Five of eight studies reported significant associations between higher workload and greater work-related stress or burnout. One study identified workload as the most prominent source of stress, whereas another found no significant association. Differences in workload measures, outcomes, staffing, and work environments may explain this variation. Higher workload was frequently associated with work-related stress or burnout among ICU nurses, although findings were not uniform. Because the evidence was observational, causality cannot be established. Workload management should integrate objective monitoring, psychological assessment, adequate staffing, and organizational support.
References
Al Hasan, M. S. (2025). Hubungan Beban Kerja Perawat Intensive Care Unit (ICU) dengan Tingkat Stres Perawat. Media Husada Journal Of Nursing Science, 6(3), 173–179. https://doi.org/10.33475/mhjns.v6i3.806
Bae, S. H. (2024). Nurse Staffing, Work Hours, Mandatory Overtime, and Turnover in Acute Care Hospitals Affect Nurse Job Satisfaction, Intent to Leave, and Burnout: A Cross-Sectional Study. International Journal of Public Health, 69(April), 1–9. https://doi.org/10.3389/ijph.2024.1607068
Bruyneel, A., Dauvergne, J. E., Bouckaert, N., Caillet, A., Sermeus, W., Poiroux, L., & Van den Heede, K. (2025). Association of Burnout and Intention-To-Leave the Job With Objective Nursing Workload and Nursing Working Environment: A Cross-Sectional Study Among Intensive Care Nurses. Journal of Clinical Nursing, 34(10), 4281–4292. https://doi.org/10.1111/jocn.17650
Cerela-Boltunova, O., & Millere, I. (2025). Exploring the Relation Between Nursing Workload and Moral Distress, Burnout, and Turnover in Latvian Intensive Care Units: An Ecological Analysis of Parallel Data. International Journal of Environmental Research and Public Health, 22(9). https://doi.org/10.3390/ijerph22091442
Dall’ora, C., Ejebu, O. Z., Ball, J., & Griffiths, P. (2023). Shift work characteristics and burnout among nurses: cross-sectional survey. Occupational Medicine, 73(4), 199–204. https://doi.org/10.1093/occmed/kqad046
Fitria, N. D. G., Asmuji, & Haryanti, D. Y. (2025). Hubungan Workload dengan Occupational Stress Level Perawat Ruang. 17(1), 1–9. https://doi.org/10.32528/tijhs.v17i2.3413
Gündüz, E. S., & Öztürk, N. K. (2025). Mental workload as a predictor of burnout in intensive care nurses. Nursing in Critical Care, 30(2), e13173. https://doi.org/10.1111/nicc.13173
Kertabudhi, D. Z., Makaginsar, C., & Rosady, D. S. (2025). Hubungan Beban Kerja dengan Stress Kerja Perawat ICU di RSUD Al-Ihsan Provinsi Jawa Barat. Bandung Conference Series: Medical Science, 5(1), 1377–1384. https://doi.org/10.29313/bcsms.v5i1.17905
Li, L., Zou, X., & Chen, H. (2025). Workload in ICU nurses: A systematic review and meta-analysis of the Nursing Activities Score. Intensive & Critical Care Nursing, 91, 104086. https://doi.org/10.1016/j.iccn.2025.104086
Mathew, M., John, A., & Vazhakkalayil Ramachandran, R. (2025). Nurse stress and patient safety in the ICU: Physician-led observational mixed-methods study. BMJ Open Quality, 14(2). https://doi.org/10.1136/bmjoq-2024-003109
Meneguin, S., Ignácio, I., Pollo, C. F., Honório, H. M., Patini, M. S. G., & de Oliveira, C. (2023). Burnout and quality of life in nursing staff during the COVID-19 pandemic. BMC Nursing, 22(1), 1–8. https://doi.org/10.1186/s12912-022-01168-7
Moola, S., Munn, Z., Tufunaru, C., Aromataris, E., Sears, K., Sfetc, R., Currie, M., Lisy, K., Qureshi, R., Mattis, P., & Mu, P.-F. (2024). Systematic reviews of Aetiology and risk. In JBI Manual for Evidence Synthesis. JBI. https://doi.org/10.46658/JBIMES-24-06
Nababan, T. (2025). The Relationship between Nurse Workload and Nurse Stress Level. Jurnal Keperawatan Priority, 8(1), 152–157. https://doi.org/10.34012/jukep.v8i1.6406
Reshia, F. A. A., Abo Seada, A. I., Salameh, B., Abdallah, J., Alruwaili, E. M. R., Salama, E. S. S., Alrumieh, W. G., & Elnosary, A. M. A. (2025). Work-related stress in intensive care unit night shift nurses: A cross-sectional analysis of prevalence and determinants. Plos One, 20(11 November), 1–13. https://doi.org/10.1371/journal.pone.0336041
Saravanan, P., Nisar, T., Zhang, Q., Masud, F., & Sasangohar, F. (2023). Occupational stress and burnout among intensive care unit nurses during the pandemic: A prospective longitudinal study of nurses in COVID and non-COVID units. Frontiers in Psychiatry, 14(March), 1–9. https://doi.org/10.3389/fpsyt.2023.1129268
Seok, Y., Cho, Y., Kim, N., & Suh, E. E. (2023). Degree of Alarm Fatigue and Mental Workload of Hospital Nurses in Intensive Care Units. Nursing Reports, 13(3), 946–955. https://doi.org/10.3390/nursrep13030083
Xavier, T., Hittle, B. M., Rojas-Guyler, L., & Lee, R. C. (2024). Resilience in Intensive Care Unit Nurses: An Integrative Review. Critical Care Nurse, 44(6), 52–63. https://doi.org/10.4037/ccn2024753.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
