A preliminary analysis of psychophysiological variables and nursing performance in situations of increasing criticality.
OBJECTIVE
To examine the relationship between psychological, physiological, and performance variables in intensive care unit (ICU) nurses in situations of increasing criticality.


METHODS
Psychophysiological variables and endotracheal suctioning performance were examined in a classroom, a skills laboratory, and an ICU. Situation-specific anxiety (state anxiety) and the predisposition to view situations as threatening (trait anxiety), cognitive appraisal, and heart rate were measured and compared with self-appraisal and a nurse instructor's ratings of suctioning performance. Baseline data were obtained during class on 45 novice ICU nurses.


RESULTS
Twenty-six nurses provided complete data, which included being videotaped and monitored in the classroom, in the skills laboratory performing endotracheal suctioning, and in the ICU during suctioning. High state anxiety significantly predicted poor ICU suctioning performance (P<.04). Nurses high in state and trait anxiety, worry, and heart rate performed poorly compared with less anxious nurses. Nurses in this study who performed best had a mean heart rate of 94 beats/min.


CONCLUSIONS
Those nurses who are high state anxious, high trait anxious, and worried and who had a faster heart rate performed less well than their more relaxed peers. Nurses with high state anxiety may be at risk for attrition, burnout, medical errors, and poor performance in other ICU nursing tasks.
Sports Medicine Center, Mayo Clinic, Rochester, Minn 55905, USA. smith.aynsley@mayo.edu
A M
AM
Smith
S A
SA
Ortiguera
E R
ER
Laskowski
A D
AD
Hartman
D M
DM
Mullenbach
K A
KA
Gaines
D R
DR
Larson
W
W
Fisher
D001007:Anxiety; D002983:Clinical Competence; D003422:Critical Care; D006801:Humans; D007362:Intensive Care Units; D019300:Medical Errors; D009732:Nursing Care / Q000592:standards; D015399:Nursing Research; D009741:Nursing Staff, Hospital / Q000523:psychology*; D012307:Risk Factors; D013315:Stress, Psychological / Q000523:psychology*; D013396:Suction; D000078329:Workforce