Occupational stressors, coping strategies, and general health of critical care nurses during COVID-19 pandemic: a scoping review

BACKGROUND: The COVID-19 pandemic placed critical care nurses at the forefront of patient care, exposing them to high levels of occupational stress, which can negatively affect physical and psychological well-being. Coping strategies are essential to mitigate stress and support nurses’ overall health. OBJECTIVE: This scoping review aimed to map the existing literature on occupational stressors, coping strategies, and general health among critical care nurses during the COVID-19 pandemic. METHODS: A systematic search of CINAHL, PubMed, and Medline was conducted for studies published between 2019 and 2024. Keywords included COVID-19, occupational stressors, coping strategies, general health, and critical care nurses. All study designs reporting on relevant outcomes were considered. Data on stressors, coping mechanisms, and health outcomes were extracted and synthesised narratively. RESULTS: Twenty-six studies involving 6,877 nurses from 17 countries were included. Common occupational stressors were high workload, fear of infection, and inadequate personal protective equipment. Stress levels ranged from moderate to high in 85% of studies. Nurses employing task-oriented coping strategies, such as problem-solving and planning, reported better psychological outcomes compared with those using emotion-focused approaches like avoidance or self-blame. Stressors and coping mechanisms varied across cultural, organizational, and individual contexts, highlighting the complex interplay between environment and personal factors in shaping health outcomes. CONCLUSION: Critical care nurses experienced significant occupational stress during the COVID-19 pandemic, with coping strategies influencing well-being. Evidence gaps remain regarding longitudinal relationships between stress, coping, and health outcomes, particularly across different cultural and organizational contexts. Future research should address these gaps and inform interventions to enhance resilience, support mental health, and optimise workforce sustainability in critical care settings.