Experiencing Stress among Nurses during Resuscitation Procedure and Legal Obligations for Healthcare Workers in Slovenia

  • Anton Koželj University of Maribor, Faculty of Health Sciences
  • Maja Strauss University of Maribor, Faculty of Health Sciences
  • Matej Strnad University of Maribor, Faculty of Medicine
Keywords: basic life support, advanced life support, workloads, resuscitation team, feelings, healthcare workers


Nurses are always part of the team that performs resuscitation procedures. In this paper the authors explore the influence that resuscitation procedures on nurses who perform them. For data collection, the authors used a survey with a convenience sample of nurses who work in emergency settings. For statistical processing of data, the authors used the calculation of frequency, standard deviation, means, and median. Authors used Spearman's rank correlation coefficient and calculated the p-value. The respondents in the survey completed the Post-Code Stress Scale. The results show that the majority of the respondents experienced resuscitation cases as burdensome situations; however, the level of stress was moderate. Nurses still experience some physical and psychological symptoms during resuscitations.


Download data is not yet available.

Author Biographies

Anton Koželj, University of Maribor, Faculty of Health Sciences

Maribor, Slovenia. E-mail: anton.kozelj@um.si.

Maja Strauss, University of Maribor, Faculty of Health Sciences

Maribor, Slovenia. E-mail: maja.strauss@um.si.

Matej Strnad, University of Maribor, Faculty of Medicine

Maribor, Slovenia. E-mail: strnad.matej78@gmail.com.


Balažic, J. (2006) Pravni in etični vidiki prve pomoči, In: Ahčan, U. (eds.) Prva pomoč (Ljubljana: Rdeči križ Slovenije), pp. 3-4.

Ballew, K. (1997) Cardiopulmonary resuscitation, Recent advances, British Medical Journal, 314(7092), pp. 1462–1466.

Bhanji, F., Mancini, M. E., Sinz, E., et al. (2010) 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, Circulation, 122(18_S3), pp. S920–S933, doi: 10.1161/CIRCULATIONAHA.110.971135.

Buurman, B. M., Mank, A. P. M., Beijer, H. J. M., & Olff, M. (2011) Coping with serious events at work: a study of traumatic stress among nurses, Journal of the American Psychiatric Nurses Association, 17(5), pp. 321-329, doi: 10.1177/1078390311418651.

Chang, S. H. et al. (2009) Who survives cardiac arrest in the intensive care units?, Journal of Critical Care, 24(3), pp. 408-414, doi: 10.1016/j.jcrc.2008.10.006.

Cole, F., Slocumb, E. M. & Muldoon Mastey, J. (2001) A measure of critical care nurses' post-code stress, Journal of Advanced Nursing, 34(3), pp. 281-288, doi: 10.1046/j.1365-2648.2001.01756.x.

Couper, K., Kimani, P., Abell, B., et al. (2015) The System-Wide Effect of Real-Time Audiovisual Feedback and Post-event Debriefing for In-Hospital Cardiac Arrest: The Cardiopulmonary

Resuscitation Quality Improvement Initiative, Critical Care Medicine, 43(11), pp. 2321–2331, doi: 10.1097/CCM.0000000000001202.

Desbiens, J. & Fillion, L. (2007) Coping strategies, emotional outcomes and spiritual quality of life in palliative care nurses, International Journal of Palliative Nursing, 13(6), pp. 291-300, doi: 10.12968/ijpn.2007.13.6.23746.

Dwyer, T. & Williams, M. L. (2002) Nurses’ behaviour regarding CPR and the theories of reasoned action and planned behaviour, Resuscitation, 52(1), pp. 85-90, doi: 10.1016/s0300-9572(01)00445-2.

Enohumah, K. O. et al. (2006) Outcome of cardiopulmonary resuscitation in intensive care units in a university hospital, Resuscitation, 71(2), pp. 161-170, doi: 10.1016/j.resuscitation.2006.03.013.

Fitzpatrick, J. J., Campo, T. M., Graham, G. & Lavandero, R. (2010) Certification, empowerment, and intent to leave current position and the profession among critical care nurses, American Journal of Critical Care, 19(3), pp. 218-226, doi: 10.4037/ajcc2010442.

Firdousa, J. (2017) Level of Stress Among Staff Nurses Working in Emergency and General Wards of Skims Hospital, International Journal of Advanced Research, 5(4), pp. 1469 – 1476, doi: 10.21474/IJAR01/3969.

Ganz, F. D., Kaufman, N., Israel, S. & Einav, S. (2013) Resuscitation in general medical wards: who decides?, Journal of Clinical Nursing, 22(5/6), pp. 848-855, doi: 10.1111/j.1365-2702.2012.04240.x.

Gershengorn, H., Li, G., Kramer, A. & Wunsch, H. (2012) Survival and functional outcomes after cardiopulmonary resuscitation in the intensive care unit, Journal of Critical Care, 27(4), p. 421.e9-17, doi: 10.1016/j.jcrc.2011.11.001.

Goranski, S. (2011) Stres pri delu medicinskih sester v UKC Maribor; magistrsko delo. (Maribor: Univerza v Mariboru, Ekonomsko - poslovna fakulteta).

Happell, B., Reid-Searl, K., Dwyer, T., Caperchione, C. M., Gaskin, C. J., & Burke, K. J. (2013) How nurses cope with occupational stress outside their workplaces, Collegian, 20(3), pp. 195-199, doi: 10.1016/j.colegn.2012.08.003.

Hinderer, K. A. (2012) Reactions to patient death: the lived experience of critical care nurses, Dimensions of Critical Care Nursing, 31(4), pp. 252-259, doi: 10.1097/DCC.0b013e318256e0f1.

Hinkle, D. E., Wiersma, W. & Jurs, S. G. (2003) Applied Statistics for the Behavioral Sciences, 5th ed. (Boston: Houghton Mifflin).

Inwood, H. (1996) Knowledge of resuscitation, Intensive Crit Care Nursing, 12(1), pp. 33–39, doi: 10.1016/s0964-3397(96)81653-3.

Issak, C. & Paterson, B. (1996) Critical care nurses’ lived experience of unsuccessful resuscitation, Western Journal of Nursing Research, 18(6), pp. 688-702, doi: 10.1177/019394599601800606.

Jaracz, K., Gorna, K., & Konieczna, J. (2005) Burnout, stress and styles of coping among hospital nurses, Roczniki Akademii Medycznej v Bialymstoku, 50(S1), pp. 216-219.

Jus, A. (2017) Čustveno delo kot povzročitelj stresa pri delu zdravstvenega osebja v prehospitalnem okolju; magistrsko delo (Maribor: Univerza v Mariboru, Fakulteta za zdravstvene vede).

Kelly, J. (2008) Nurses’ and doctors’ perspectives on slow codes, Nursing Ethics, 15(1), pp. 110-120, doi: 10.1177/0969733007084164.

Kešpet, B. (2013) Pravna in etična vprašanja v nujni medicinski pomoči (Celje: Visoka zdravstvena šola Celje).

Kmetič, P. (2018) Stres in obremenjenost osebja zdravstvene nege v urgentni dejavnosti; diplomsko delo Maribor: Univerza v Mariboru, Fakulteta za zdravstvene vede).

Korošec, D. (2004) Medicinsko kazensko pravo (Ljubljana: Cankarjeva založba).

Kraljić, S. (2010) Nekateri vidiki pacientove avtonomije, In: Rijavec, V. & Flis, V. (eds.) Medicina in pravo - sodobne dileme II (Maribor: Pravna fakulteta Univerze v Mariboru), pp. 187-199.

Laws, T. (2001) Examining critical care nurses’ critical incident stress after in-hospital cardiopulmonary resuscitation (CPR), Australian Critical Care, 14(2). pp. 76-81, doi: 10.1016/s1036-7314(01)80010-2.

McGowan, J., Graham, C. & Gordon, M. (1999) Appointment of a resuscitation training officer is associated with improved survival from in-hospital ventricular fibrillation/ventricular tachycardia cardiac arrest, Resuscitation. 41, pp. 169–173, doi: 10.1016/s0300-9572(99)00046-5.

McMeekin, D. E., Hickman, R. L., Douglas, S. L. & Kelly, C. G. (2017) Stress and coping of critical care nurses after unsuccessful cardiopulmonary resuscitation, American Journal of Critical Care, 26(2), pp. 128-135, doi: 10.4037/ajcc2017916.

Mealer, M. L. et al. (2007) Increased prevalence of post-traumatic stress disorder symptoms in critical care nurses, American Journal of Respiratory and Critical Care Medicine, 175(7), pp. 693-697, doi: 10.1164/rccm.200606-735OC.

Mukaka, M. M. (2012) Statistics corner: a guide to appropriate use of correlation coefficient in medical research, Malawi Medical Journal, 24(3), pp. 69–71.

Myrianthefs, P. et al. (2003) Efficacy of CPR in a general adult ICU, Resuscitation, 57(1), pp. 43-48, doi: 10.1016/s0300-9572(02)00432-x.

Panesar, S. S., Ignatowicz, A. M., & Donaldson, L. J. (2014) Errors in the management of cardiac arrests: An observational study of patient safety incidents in England, Resuscitation, 85(12), pp. 1759–1763, doi: 10.1016/j.resuscitation.2014.09.027.

Pembeci, K. et al. (2006) Assessment of the success of cardiopulmonary resuscitation attempts performed in a Turkish university hospital, Resuscitation, 68(2), pp. 221-229, doi: 10.1016/j.resuscitation.2005.07.003.

Ryan, C. (1998) Matters of life and death: the challenge of CPR decision making. How can we improve patient involvement in this complex process? Medical Journal of Australia, 169(3), pp. 124–125.

Petrie, K.., Milligan-Saville, J., Gayed, A. et al. (2018) Prevalence of PTSD and common mental disorders amongst ambulance personnel: a systematic review and meta-analysis, Social Psychiatry and Psychiatric Epidemiology, 53(9), pp. 897–909, doi: 10.1007/s00127-018-1539-5.

Raosoft (2004) Sample size calculator, retrieved from: http://www.raosoft.com/samplesize.html (10. 1. 2020).

Resuscitation Council UK (2015), Resuscitation guidelines, retrieved from: https://www.resus.org.uk/resuscitation-guidelines/ (10 January 2020).

Schreuder, J. A. H. et al. (2012) Coping styles relate to health and work environment of Norwegian and Dutch hospital nurses: a comparative study, Nursing Outlook, 60(1), pp. 37-43, doi: 10.1016/j.outlook.2011.05.005.

Spencer, S. A., Nolan, J. P., Osborn, M., & Georgiou, A. (2019) The presence of psychological trauma symptoms in resuscitation providers and an exploration of debriefing practices, Resuscitation, 142, pp. 175-181, doi: 10.1016/j.resuscitation.2019.06.280.

Von Rueden, K. T., Hinderer, K. A., McQuillan, K. A., et al. (2010) Secondary traumatic stress in trauma nurses: prevalence and exposure, coping, and personal/environmental characteristics, Journal of Trauma Nursing, 17(4), pp. 191-200, doi: 10.1097/JTN.0b013e3181ff2607.

Wild, J., Smith, K. V., Thompson, E., et al. (2016) A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression, Psychological Medicine, 46(12), pp. 2571-2582, doi: 10.1017/S0033291716000532.

Zuzelo, P. R. (2007) Exploring the moral distress of registered nurses, Nurse Ethics, 14(3), pp. 344-359, doi: 10.1177/0969733007075870.

Legal sources:

Kazenski zakonik (KZ-1). Uradni list RS, št. 50/12-UPB, 6/16, 54/15, 38/16, 27/17, 23/20, 91/20.

Kodeks etike v zdravstveni negi in oskrbi Slovenije (2014). Uradni list RS, št. 71/14. Retrieved from: https://www.uradni-list.si/_pdf/2014/Ur/u2014071.pdf (20 January 2020).

Kodeks medicinske deontologije Slovenije (1997). Zdravniška zbornica Slovenije. Retrieved from: http://www.kme-nmec.si/files/2018/03/kodeks-medicinske-deontologije-Slovenije.pdf (8 June 2019).

Kodeks zdravniške etike. (2016). Slovensko zdravniško društvo in Zdravniška zbornica Slovenije. Retrieved from: https://www.zdravniskazbornica.si/docs/default-source/zbornicniakti/kodeks-2016.pdf?sfvrsn=2 (24 August 2020).

NIJZ, Nacionalni inštitut za javno zdravje. Podatkovni portal. Zaposleni po poklicnih skupinah in statističnih regijah. Retrieved from: https://podatki.nijz.si/Menu.aspx?px_tableid=BPI_TB05.px&px_path=NIJZ%20podatkovni%20portal__5%20Viri%20v%20zdravstvu__1%20Izvajalci%20zdravstvene%20dejavnosti&px_language=sl&px_db=NIJZ%20podatkovni%20portal&rxid=f5649956-e745-455c-94eb-5a0da91c875d (last update (16 December 2019).

Zakon o pacientovih pravicah (ZPacP). Uradni list RS, št. 15/08, 55/17.

Zakon o zdravniški službi (ZZDrS). Uradni list RS, št. 72/06 – UPB, 15/08 – ZPacP, 58/08, 107/10 – ZPPKZ, 40/12 – ZUJF, 88/16 – ZdZPZD, 40/17, 64/17 – ZZDej-K, 49/18, 66/19.

Zakon o zdravstveni dejavnosti (ZZDej). Uradni list RS, št. 23/05 – uradno prečiščeno besedilo, 15/08 – ZPacP, 23/08, 58/08 – ZZdrS-E, 77/08 – ZDZdr, 40/12 – ZUJF, 14/13, 88/16 – ZdZPZD, 64/17, 1/19 – odl. US, 73/19, 82/20.

How to Cite
Koželj A., Strauss M., & Strnad M. (2020). Experiencing Stress among Nurses during Resuscitation Procedure and Legal Obligations for Healthcare Workers in Slovenia. Medicine, Law & Society, 13(2), 237-262. https://doi.org/10.18690/mls.13.2.237-262.2020