What Are the Most Stressful Nursing Jobs? Ultimate Guide

OR nurse working at the bedside of a patient
Written by
Jenna Elizabeth
December 12, 2023

Table of Contents

Nursing is hard work. From finishing your nursing degree to remaining calm and composed when dealing with real-life emergencies, being a nurse requires a strong work ethic and a solid level of resilience. 

And while nursing is physically and emotionally challenging, working as a nurse can also be incredibly fulfilling. Every day, nurses show up to work with a desire to help others. Often, their efforts contribute to improving—and even saving—the lives of countless patients. 

Every job comes with a certain amount of stress, and if nurses don’t manage the pressures of their jobs correctly, heightened “nurse stress” can lead to compassion fatigue and burnout. With that in mind, whether you are a nurse who is already working or wants to work in the industry, the following are considered some of the most stressful nursing jobs.

Intensive Care Unit (ICU) Nurse

An intensive care unit (ICU) nurse is a registered nurse (RN) with extensive training and experience who cares for patients who are seriously ill or have life-threatening conditions. According to one study, ICU nurses are more susceptible to professional stress and burnout, which negatively impact their physical and mental health. Since the ICU is often the last resort for patients in critical condition, ICU nurses face a blend of medical emergencies daily while on the job. 

Why Is ICU Nursing Such a Tough Job? 

Overall, being an intensive care unit nurse is not for the faint of heart, and it just may be one of the hardest nursing specialties out there. From cardiopulmonary resuscitation (CPR) and intubation to sepsis management and blood transfusions, an ICU nurse delivers lifesaving treatment and care when a patient is in critical condition and may be too unstable to attempt transfer to the operating room. If you are considering a profession in ICU nursing, prepare for a challenging, fast-paced, and demanding environment that requires making critical decisions under pressure. On a positive note, the strong bonds formed with patients and their families while providing support and comfort during vulnerable times can be immensely rewarding.

Nurse Midwives

A nurse midwife is a registered nurse with a graduate-level nursing degree accredited by the Accreditation Commission for Midwifery Education (ACME). Nurse midwives offer prenatal and postpartum care and are generally present during a patient's labor and delivery. They may also provide gynecological services such as pelvic exams, pap screenings, and contraceptive counseling. 

Why Is Working as a Nurse Midwife Stressful? 

Because midwives offer comprehensive care to women through their pregnancy, labor, and the postpartum period, it’s easy to glamorize the work of a midwife. While assisting in delivering a healthy newborn earthside is an honorable feat, being a nurse midwife is arduous work. For instance, midwives may help induce labor and are sometimes in charge of providing pain relief once labor has begun. This role means a midwife must remain calm under pressure and respond to a patient’s concerns and demands while the birthing parent is vulnerable. A midwife must also use their best judgment about the health and well-being of both the mother and baby before, during, and after birth. Consequently, a midwife may be significantly affected by both positive and negative outcomes that directly relate to the care they provide. Finally, being a midwife means many hours of standing, which requires a midwife to have physical stamina. At the same time, being a midwife has many positives, including offering compassionate support for women through both challenging and joyful experiences.

Emergency Room (ER) Nurse

ER nurse taking care of a patient and monitoring vitals
ER nurse working on a monitor in the emergency department.

Similar to an ICU nurse, an emergency room (ER) nurse often cares for those who are suffering from traumatic, severe, and frequently life-threatening conditions. ER nurses are registered nurses who specialize in treating patients in an emergency room setting. Nurses working in an emergency nursing department must be able to handle high-stress situations and make quick decisions that can be critical to a patient’s well-being or—in some cases—survival.

Why Is Working as an ER Nurse Challenging? 

An ER nurse is typically the first point of contact for any patient with a medical emergency. As a result, emergency room nurses must be able to provide prompt medical care and make accurate medical judgments in high-stress situations. Many emergency room nurses are adept at working under tremendous pressure, and that may be why they chose the profession in the first place. With that in mind, ER nursing requires a high level of skill, resilience, and composure when emergencies strike. Ultimately, an emergency room nurse must have the selfless dedication to provide unwavering quality and compassionate care each time a patient walks into the emergency department.

Advanced Practice Psychiatric Nurses

A psychiatric mental health advanced practice nurse (PMH-APRN) is a nurse with a graduate degree in nursing who can screen, diagnose, and assist in treating people with psychiatric and substance use disorders. Psychiatric mental health nurses are in high demand, and they can work in various nursing departments, including hospitals, community mental health centers, and federal or state facilities. These professionals must be nonjudgmental, have strong communication skills, and thoroughly understand cognitive, social, and environmental factors that influence human behavior.

Why Is Working as a PMH-APRN Difficult?

Due to the nature of their work, advanced-practice psychiatric nurses often deal with the emotional toll of patients who are suffering from certain mental health afflictions. Although working as an advanced practice psychiatric nurse involves helping other people overcome mental health obstacles, this can sometimes come with a price. In other words, mental health practitioners frequently experience secondary traumatic stress (STC), burnout, and compassion fatigue. PMHNs may also come into contact with volatile or unpredictable patients who are coping with major mental health concerns. These experiences could be traumatic or emotionally distressing. It is critical, therefore, that PMH nurses (both at work and outside of work) maintain strict boundaries, exercise self-care, and seek professional help when necessary. 

Operating Room (OR) Nurses

An operating room nurse, often known as an OR nurse, works with other medical experts in the operating room, where most surgeries occur. In the operating room, patients entrust their lives to experienced medical specialists. Therefore, an operating room nurse must be comfortable working in fast-paced and high-adrenaline atmospheres. 

Why Is Working as an Operating Nurse Hard? 

Many operating room nurses care for patients during major surgical procedures. They may also assist surgeons during surgeries, which requires OR nurses to have a strong knowledge of medical procedures and equipment. Operating room nurses must also be able to handle situations with overarching pressure to get things done quickly and correctly. In addition, OR nurses may witness patients facing life-and-death situations. For these reasons, working in an operating room may be physically and mentally taxing, factors which may lead to burnout. It’s essential, therefore, that OR nurses have outlets to cope with day-to-day stress. While challenging, with the right amount of mental agility and experience, working as an operating room nurse can also be a great way to make a significant difference in patients’ lives. 

OR nurse holding the hand
OR nurse holding the hand of a patient after an operation.

What Are Some Other Stressful Nursing Professions?

Caring for patients daily as a nurse requires tenacity and the ability to work relentlessly for the health of others. According to a study done by the Labor Department’s Occupational Network, the following nursing careers have earned a spot on the list of some of the most stressful nursing jobs in the United States:

  • Nurse anesthetists
  • Registered nurses
  • Nurse practitioners
  • Clinical nurse specialists

Unfortunately, this list includes most nursing professionals. However, there are low-stress alternatives for nurses. Ever heard of per diem jobs? With Nursa, nursing professionals can find high-paying, flexible jobs near them, working only when and where they want to.

Is a Nursing Career Worth It? 

Despite the long hours, the stress, and the dedication to selflessly serve others—yes, a career in nursing is worth it. Plenty of nurses will agree that the best feeling in the world is providing compassionate care to patients during challenging times and witnessing the progress and recovery of patients firsthand. However, if you are a nursing professional beginning to experience feelings of burnout, inadequacy, or compassion fatigue, it may be time to reach out for some support—or it might be time for a change. 

If you’ve started searching for “office nurse jobs near me,” you may want to read about these 8 Non-Bedside Nursing Jobs

How Can I Kickstart My Nursing Career?

All in all, the day-to-day tasks that come with a career in nursing can be simultaneously challenging and exciting—ahem, you probably won’t have a lot of “boring” days at work. What counts most is that a nurse feels fulfilled while giving the best possible care to their patients. Are you ready to share your nursing skills with the world? Pick up a per diem nursing shift with Nursa and make a difference in a patient’s treatment and recovery today.

Blog published on:
December 12, 2023

Meet Jenna, a contributing copywriter at Nursa who writes about healthcare news and updates, empathy and compassion for nurses, how to show staff appreciation and increase retention, and guides that help nurses navigate career pathways.

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