Perceived Challenges of Working Environment Among Emergency Nurses

Abstract

Background: Emergency department (ED) nurses frequently encounter high patient turnover, complex clinical cases, and limited resources, creating an environment prone to stress, burnout, and attrition. These challenges are particularly acute in public sector hospitals of low- and middle-income countries, where understaffing, workplace violence, and resource scarcity compromise both staff well-being and patient outcomes. Despite their critical frontline role, little is known about the multidimensional challenges perceived by ED nurses in Pakistan. Objective: To examine the perceived challenges of the working environment among emergency nurses in a public sector hospital in Lahore, with emphasis on staffing, workload, workplace violence, resource availability, administrative support, and job satisfaction. Methods: A descriptive cross-sectional study was conducted at Govt. Kot Khawaja Saeed Teaching Hospital, KEMU, Lahore, with 171 registered emergency nurses selected through non-probability convenience sampling. Data was collected using a validated, self-administered questionnaire adapted from the Practice Environment Scale of the Nursing Work Index. Statistical analyses was performed using SPSS v25.0, with descriptive summaries and inferential tests applied to assess associations. Results: Staffing inadequacy was reported by 83.6% of nurses, 79.0% considered workload unmanageable, and 55.6% experienced verbal abuse. Lack of equipment delayed patient  care for 83.0%, (68.5%) believe that hospital management not paid  attention to their issues and 77.8% reported no access to regular workshops training. Overall, 59.6% were dissatisfied with their jobs, and 63.0% frequently considered leaving, though most (71.3%) indicated willingness to remain if workplace conditions improved. Conclusion: Emergency nurses in public hospitals face severe systemic and organizational challenges. Addressing staffing, safety, resources, and administrative support is essential for workforce retention and sustainable quality of care.