Unpredictable and challenging circumstances make the nursing profession extremely demanding and stressful [1], [2]. A survey conducted just before the COVID-19 pandemic showed that job pressure, leading to stress and poor mental health, is the main reason nurses leave the profession [3]. The pandemic exacerbates the nurse retention problem in the global healthcare system, as higher psychological pressure is placed on nurses [4], [5]. The concept of stress in nursing may refer to the physiological state resulting from the lack of proper experience and knowledge in uncertain situations [6]. Such stress is harmful to nurses and patients [7]. Nurses' emotional and psychological state is a critical factor affecting their performance, risk of errors, healthcare delivery quality, patient care, recovery, and death [8], Roussillon-Soyer et al., 2021; [9]. Hospitals worldwide allocate funds to address stress-related issues among nurses to identify and adopt stress-alleviating measures [10].

In hospitals, emergency departments (ED) serve as a crucial entry point for patients with acute illnesses and injuries that require immediate attention and life-saving measures. ED nurses should act differently from how they operate in other wards or departments [11],Shamir & Howell, 2018). Working in ED requires precision and swift and prompt responses to various situations [12], [13]. Highly complex, unpredictable, traumatic, severe, and fast-changing clinical emergencies require nurses to possess enough knowledge, comprehension, and experience to understand the standard of care needed [14]. It is a high-pressure job because trauma patients require immediate attention, necessitating the need for quick action. There is very little time for reflection, but ED nurses cannot afford to act recklessly. The risk is very high, and it may result in loss of human life.

More precisely, ED nurses have to cope with many job stressors [14], namely, overcrowding [11], frequent workflow interruptions, poor teamwork [15], encountering multiple requests for immediate response simultaneously or time pressure, mainly at the triage phase [9], unavailability of doctors, high workloads, high short-term absenteeism, unsupportive management, and many interpersonal challenges [16] such as dealing with violent patients and handling their relatives' anger [17], [18]. In such context, nurses who lack the necessary knowledge and experience find emergencies more challenging and experience high job stress levels, resulting in lower job satisfaction and performance and increased burnout, absenteeism, and turnover intentions [19], [20]. Burnout has been reported by 26% of ED nurses [21], and it is always a current issue in research in ED [22].

However, in ED, cases abound where nurses are confronted with a lack of knowledge or experience [6], [23], [24]). They also often face work situations where they perceive there is no ready solution to pursue [11]. They then need to formulate interpretations and choose what to do while being held accountable for their actions (Santana, 2019; Weigl, 2016). Consequently, it is critical to understand the variance in nurses' approaches. We need to know more about how they cope in these uncertain situations and seek informal or formal support.

This study innovates in using the concept of “individual action propensity,” defined as “an individual orientation towards taking immediate action and using trial-and-error in situations where [people] lack knowledge or experience, as opposed to having a propensity to think and then act” [25]. ED nurses who approach a problem by first thinking have low individual action propensity, and nurses who prefer acting before thinking show high action propensity. According to Santos Alves et al. [26], nurses with high assessment orientation always try first to analyze and understand an uncertain situation before executing their action plan. Those with high locomotor exposure are more likely to make spontaneous judgments. In doing so, this study answers the need to investigate the relationship between individual action propensity and job stress in a hospital environment [27]. Its purpose is to understand better how ED nurses' help-seeking behaviors moderate the relationship between their action propensity and stress (see Fig. 1).

Vera et al. [25] argue that it is crucial to increase awareness among individuals about developing both modes of action propensity. If habits and routines are in place, the tendency of acting before thinking is likely to be efficient. However, when individuals recognize they do not have the necessary knowledge or experience, a higher propensity for thinking might alleviate their stress. Hence, ED nurses with higher “acting before thinking” tendencies are more likely to feel higher job stress levels when faced with these situations. In contrast, those showing a higher “thinking before acting” inclination should experience lower stress levels.

Moreover, in uncertain situations in which individuals lack knowledge or experience, they tend to use proactive help-seeking behaviors and turn to other people for input, assistance, and advice to solve specific problems [28]; Salvato & Rerup, 2011). Hofmann et al. [29] confirm that when nurses feel a lack of experience, they are likely to require social support and assistance to handle stressful situations. The nursing staff should be inclined to think and seek help to assist patients [30], [31]. Support from colleagues, supervisors, and organizations reduces stress among nursing staff [31], [32]. Vera et al. [25] state that help-seeking behaviors are negatively related to high action propensity (or locomotion) when individuals lack knowledge or experience. However, their help-seeking behaviors are expected to be beneficial regardless of their action propensity (action-oriented or reflective-oriented).