Perceived Physical Settings, Crowding Pressure and Stress Among Emergency Department Nurses in Northern Jordan

Emergency departments (EDs) are demanding workplaces, but evidence linking their physical settings to staff stress outside high-income countries is scarce. This cross-sectional survey included 284 nurses from the EDs of six public and private hospitals in northern Jordan. Nurses rated their physical service setting with Steinke’s six-domain instrument and reported crowding and workload pressure, security climate, organisational support, resilience (CD-RISC-10) and perceived stress (PSS-10). Categorical confirmatory factor analysis supported the six-domain structure (WLSMV: CFI = 0.994, RMSEA = 0.017, SRMR = 0.047). In multiply imputed regression models (R2 = 0.40), nurses who rated their setting more favourably reported lower stress. This association was independent of the other factors but small (β = −0.13, 95% CI −0.22 to −0.03), and it reflected the overall appraisal rather than any single domain. Crowding and workload pressure showed a stronger association (β = 0.33, 95% CI 0.21 to 0.45), which remained when only three crowding-oriented items were used. This pressure also statistically linked longer working hours and more patients per shift to higher stress. As the findings concern perceived environments in six hospitals, design responses on capacity, circulation and companion management remain hypotheses for testing with objective spatial measures and longitudinal or intervention studies.