Background: Postcode stress is a significant concern among nurses in high-stakes environments like emergencies and intensive care units. This stress arises from the emotional and psychological burden of performing cardiopulmonary resuscitation (CPR), especially when outcomes are unfavorable. Despite its recognized impact on nurses' mental health and patient care quality, empirical research does not quantify its prevalence and identify contributing factors. This study aims to conduct a systematic review and meta-analysis to determine the prevalence of postcode stress among nurses, providing a comprehensive understanding of this phenomenon to inform effective interventions and support mechanisms.

Methods: A thorough search was conducted across various online databases. Studies were deemed eligible for inclusion if they examined postcode stress within nursing practice utilizing validated instruments, irrespective of the academic status, gender, country, setting, ethnicity, race, or limitations of the studies. Two reviewers independently undertook data extraction and quality assessment, following the PRISMA guidelines.

Discussion:  Post-resuscitation stress, or "postcode stress," significantly impacts critical care nurses involved in failed CPR attempts. This emotional burden can lead to moderate to severe stress levels and symptoms like post-traumatic stress disorder, affecting mental health and job satisfaction. Key factors include high-stakes settings, emotional investment in patient care, and perceived responsibility. Like structured debriefing sessions, institutional support alleviates these adverse effects, highlighting the need for supportive work environments. Positive coping strategies and regular stress assessments can enhance nurses' well-being and improve patient care outcomes.

Systematic review registration: PROSPERO CRD42025646495. This protocol follows the PRISMA-P guidelines for reporting systematic reviews.