The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction

Factors Associated with Intent to Leave and Burnout among Canadian Nurses Amidst the COVID-19 Pandemic: A Quantitative Analysis of the Survey on Health Care Workers' Experiences During the Pandemic

BackgroundThe increased demands and stressors from the COVID-19 pandemic led to widespread burnout and job stress, prompting concerns about retention rates. This study identifies demographic and occupational predictors of Canadian nurses' intent to leave their jobs due to burnout and job stress during the COVID-19 pandemic.MethodsData was utilized from the Survey on Health Care Workers' Experiences During the Pandemic conducted by Statistics Canada. Multivariate logistic regression models were generated to analyze the associations between demographic and occupational factors and nurses' intent to leave.ResultsA total of 12,246 eligible participants responded to the survey (54.9% response); however, the analysis was restricted to 1138 nurses after excluding participants of other healthcare occupations. Younger nurses were significantly more likely to consider leaving their jobs [OR = 9.95, 95% CI: (5.92-16.73)], as well as nurses living in Alberta [OR = 3.16, 95% CI: (1.58-6.32)] and British Columbia [OR = 3.16, 95% CI: (1.66-6.03)]. Moreover, nurses with less work experience [OR = 3.91, 95 CI = (2.53-6.05)], work in acute care [(OR = 3.31, 95 CI = (1.69-6.51)], experienced changes in workload [OR = 2.69, 95% CI: (1.58-4.57)], had increased work hours [OR = 1.92, 95% CI: (1.27-2.92)], and lacked emotional support [OR = 3.43, 95 CI = (2.31-5.09)] had greater odds of intending to leave.ConclusionThe findings underscore the need for strategies to mitigate stress and burnout among nurses, particularly during public health crises. Implementing measures to address these factors could help improve retention rates and ensure a stable nursing workforce during future pandemics.

"Scheduling Is Everything": A Qualitative Descriptive Study of Job and Schedule Satisfaction of Staff Nurses and Nurse Managers

BACKGROUND

Shift work and scheduling are major contributors to occupational stress for nurses, leading to job dissatisfaction and risk of turnover. Nurse scheduling processes are complex, as they are dynamically linked to nurse staffing and patient demand.

OBJECTIVE

This study sought to describe barriers and facilitators influencing job and scheduling satisfaction among staff nurses and nurse managers.

METHODS

We used a qualitative descriptive design. The sampling frame included staff nurses and nurse managers employed at an urban academic medical center. Participants (N = 16) completed individual semi-structured Zoom interviews from August 2023 to February 2024, which were audio recorded and transcribed. Data were analyzed using content analysis.

RESULTS

The overarching theme identified was "Scheduling is everything," reflecting the importance of scheduling for nurses' satisfaction in and outside of work. Both staff nurses and managers identified tensions between scheduling for patient care needs (e.g., adequate staffing) and scheduling to optimize staff needs (e.g., health, sleep). They also identified staffing shortfalls as a contributor to these scheduling tensions. Staff nurses reported that scheduling challenges compromised their health and well-being, caused work-family conflict, and influenced turnover intentions. Facilitators of scheduling satisfaction included scheduling flexibility, autonomy, and equity. Participants also provided pragmatic ideas for improving scheduling processes.

CONCLUSIONS

Our study explored perspectives on job and scheduling satisfaction through the lens of both staff and managers. Scheduling challenges contribute to nurses' job dissatisfaction and turnover intentions. By increasing scheduling flexibility, equity, and integrating nurse-led innovations into the scheduling process, healthcare organizations can potentially increase nurse retention.

The impact of night shifts on the physical and mental health of psychiatric medical staff: the influence of occupational burnout

BACKGROUND

The mental health of mental health care professionals has become a key area of research due to the increasing demands and stressors inherent in the work environment. This study explored the relationship between night shift work stress, burnout, social support, and physical and mental health among psychiatric medical staff.

METHODS

A cross-sectional survey was conducted among 244 psychiatric medical staff at a psychiatric specialty hospital in eastern Taiwan. The study utilized validated instruments, including the Effort-Reward Imbalance Questionnaire, the Maslach Burnout Inventory, the Social Support Scale, and the SF-12 Health Survey, to measure work stress, burnout, social support, and health outcomes. Descriptive statistics, Pearson correlation, and hierarchical regression analyses were employed to assess the relationships among these variables and the moderating effects of social support.

RESULTS

The findings revealed significant positive correlations between work stress and occupational burnout (r = 0.42, p < 0.001) and negative correlations with physical and mental health (r = - 0.23, p < 0.001). Occupational burnout is a negative significant predictor of physical and mental health (β = -0.533, p < 0.001). Additionally, higher levels of social support were associated with better health outcomes (r = 0.18, p < 0.01), although its moderating effect on the relationship between stress and health was not significant.

CONCLUSION

This study highlights the significant impact of night shifts on the physical and mental health of psychiatric medical staff. The findings suggest that interventions to reduce the negative impacts of night shifts are crucial, such as improving shift systems, increasing organizational support, and providing targeted mental health programs. These measures will help enhance night shift workers' health and job satisfaction, improving the overall quality of health care services.

Analysis of nursing staff job satisfaction and its influencing factors: a cross-sectional study of 38 hospitals/nursing homes in China

Background

Nurses' job satisfaction directly impacts their attitudes and efficiency at work. This study aimed to identify the factors influencing job satisfaction among nursing professionals in China.

Methods

This cross-sectional study utilized an online questionnaire to assess the job satisfaction, work conditions, and sociodemographic characteristics of nursing professionals in China. Data were analyzed using descriptive statistics, chi-square tests, Spearman correlation analysis, and linear regression analysis.

Results

The study collected 605 questionnaires from 38 hospitals and nursing homes in Nantong. Among them, 599 were valid responses, resulting in a validity rate of 99%. The majority of participants were aged 51-60 (43.14%) and were female (91.65%). The multivariate model results indicated that age, work location, and policy understanding significantly influenced overall job satisfaction. Specifically, the 51-60 age group and those aged ≥61 had a positive impact on overall satisfaction compared to the ≤30 age group (β = 0.95, 95% CI = 0.43 to 1.47; β = 1.53, 95% CI = 0.82 to 2.25). Compared to working in a hospital, working in a nursing home had a negative impact (β = -1.13, 95%CI = -2.10 to -0.17). Additionally, lower policy understanding negatively affected overall job satisfaction.

Conclusion

This study found that age, workplace, and policy understanding are factors influencing the job satisfaction of nursing staff. Therefore, corresponding measures should be taken for young nurses and those working in nursing homes, such as improving welfare benefits and reducing work pressure, to enhance their job satisfaction. In addition, training for all nursing staff should be strengthened to improve their understanding of relevant policies, thereby increasing job satisfaction and retention rates. This will help better meet the growing demand for nursing services.

Recommendations on supporting neonatology healthcare givers from the French National Society

AIM

Healthcare givers are exposed to stress and therefore are at risk of the development of pathologies. We aimed to provide recommendations regarding psychosocial risks such as stress, moral distress, burnout syndrome or secondary stress syndrome in neonatal care units to best support neonatal healthcare givers.

METHODS

We searched PubMed for articles published from 1 January 2017 to 1 December 2023 by using the keywords burnout OR (moral and distress) AND neonatal unit. Recommendations were developed after internal and external review by a multidisciplinary group including 15 professionals and parent representatives.

RESULTS

We identified 207 studies and developed 15 recommendations based on 118 eligible studies. Recommendations to support neonatology healthcare givers were developed for the individual level, the collective or department level to organise the environment, the training of the team with communication sessions and team cohesion; and the institutional level to respect and organise working time.

CONCLUSION

Psychosocial risks have consequences for the neonatal healthcare givers themselves and possibly those being cared for. To date, prevention, screening and treatment have been insufficiently developed and explored. In this context, an overall institutional review of the chosen care model is needed.

Nursing graduates' perceived future career pathway and career shift tendency in Egypt: a cross sectional study

PURPOSE

Addressing the dynamics shaping nurses' career trajectories and strategies to support workforce stability and retention in the healthcare sector. The aim of this study was to explore nursing graduates' perceptions of their future Career pathways, and their tendency toward career shifts. Additionally, the study examined the factors influencing career shift tendencies and the relation between career pathway perceptions and career shift tendencies.

METHODS

A descriptive cross-sectional study was used, with an online distributed questionnaire for study participants from different nursing graduates' categories. That included demographic characteristics, a section that measured nursing graduates' future career pathway perception, and career shift tendency.

RESULTS

Nursing graduates in Egypt were having a positive perception regarding their future career pathway. However, more than one quarter of them were considering career shift represents potential workforce instability and dissatisfaction within the nursing profession and financial factors was one of the main provoking drivers for career shift tendency. In addition, nursing graduates' perception of career pathway had a significant effect on their career shift tendency in future.

CONCLUSION

Based on the findings of this study, further efforts should be made to confront nursing shortage in Egypt, implementing targeted interventions to support nursing graduates in navigating their career pathways. Additionally, proactive measures should be taken to address the identified factors driving intentions to leave the profession, such as improving workplace conditions, fostering intergenerational collaboration, and offering mentorship programs. These strategies are essential for fostering a resilient and satisfied nursing workforce and ensuring the delivery of high-quality patient care in the healthcare sector.

Job Satisfaction Among Blood Center Nurses Based on the Job Crafting Model: A Mixed Methods Study

PURPOSE

Job satisfaction among blood center nurses is suboptimal due to challenging working conditions, characterized by unexpected tasks resulting from sudden schedule changes and frequent weekend shifts. This study aimed to quantitatively examine the relationships among job stress, psychological capital, person-job fit, job crafting, and job satisfaction, based on the job crafting model. Additionally, qualitative data were collected through mixed methods to gain a better understanding of the experiences related to job satisfaction among blood center nurses.

METHODS

A convergent mixed methods research design was employed to simultaneously collect quantitative and qualitative data and to integrate the findings from both analyses. A total of 127 full-time nurses who had completed at least a three-month probationary period at blood centers participated in the study. Participants were recruited from three blood centers operated by the Korean Red Cross in three metropolitan cities. The survey included open-ended qualitative questions and five quantitative measures covering job satisfaction, job stress, psychological capital, person-job fit, and job crafting. The data collection occurred from September to October 2022.

RESULTS

Regression analysis identified key factors influencing job satisfaction as person-job fit, job stress, psychological capital, and marital status, explaining 80% of the variance. Qualitative analysis of the open-ended responses showed five main themes: "deriving fulfillment from work," "challenges encountered at work," "driving forces behind positive outcomes," "congruence between individual's traits and job requirements," and "efforts to perform meaningful work."

CONCLUSIONS

The findings suggest the need for developing an employee assistance program and educational initiatives aimed at enhancing job satisfaction among blood center nurses. These should focus on improving person-job fit, managing stress, aiding with emotional labor, and bolstering psychological capital.

Burnout status of Japanese healthcare workers and the association with medical errors: A 1-year follow-up

BackgroundBurnout and medical errors are the most prevalent issues affecting health and life outcomes among healthcare professionals.ObjectiveThis study aimed to investigate the longitudinal association between burnout and medical errors in healthcare workers in Japan.MethodsWe conducted a prospective cohort study involving 539 healthcare workers from January 2017 to January 2018. Burnout was evaluated using the Maslach Burnout Inventory-General Survey (MBI-GS), which included exhaustion, cynicism, and professional efficacy dimensions. Medical errors during the previous year were measured by self-assessment at follow-up. Multivariate modified Poisson regressions estimated the association between baseline burnout and follow-up medical errors.ResultsIn the age and sex-adjusted model, overall burnout was significantly associated with medical errors (p = 0.008). Participants with high burnout levels exhibited a greater risk of medical errors than those with low or moderate levels (RR = 1.19, 95% CI: 1.05-1.35). Exhaustion and cynicism correlated significantly with medical errors (p < 0.05). High or moderate levels of exhaustion and cynicism were associated with elevated risks of medical errors (RR = 1.31 [95% CI: 1.10-1.55]; 1.25 [1.02-1.53]), (RR = 1.31 [95% CI: 1.13-1.53]; 1.20 [1.03-1.41]), compared to low-level counterparts, respectively.ConclusionHealthcare workers who experience burnout may be at an increased risk for medical errors.

Identifying and managing fatigue in nurses completing on-call work

Specialist nurses working in Therapeutic Apheresis Services (TAS) at NHS Blood and Transplant participate in an on-call rota. This means working above and beyond their rostered hours and can lead to them working 24 hours in one period. There is a noted risk of fatigue for people who work more than 13 hours in one stretch, and therefore it is important to understand how to recognise and manage the signs of fatigue. A literature review was performed to understand fatigue in various industries and how this was managed. This was then coupled with TAS internal data collection, exit interview data and sickness data to inform the design of a Fatigue Identification Questionnaire filled out by nurses during on-call working. Due to the strong link between fatigue and the hours worked, it is recommended that further work is undertaken to implement fatigue-management processes.

A qualitative study on burnout and coping in palliative nurses

BACKGROUND

With burnout rates highly prevalent in palliative care nurses, it is important to have a holistic understanding of the causes of burnout and strategies both to prevent burnout and to cope with burnout.

AIM

To understand the causes of burnout and strategies used to prevent and cope with burnout in palliative care nurses. This would allow the implementation of strategies on a personal level and organisational level to mitigate the effects of burnout.

METHODS

A thematic analysis to explore palliative care nurses' experiences and their interpretations. In total, 11 in-depth interviews and one focus group discussion with 19 nurses were conducted. The study participants were recruited from three palliative care units within a health cluster in Singapore and had at least 1 year of experience working in palliative care.

RESULTS

Five themes were identified: (a) description of burnout and its attributes; (b) factors that contribute to burnout; (c) triggers that initiate burnout; (d) coping with burnout; and (e) resilience to burnout. The nurses were competent in recognising signs of burnout and understood the use of coping strategies to manage burnout. They were also able to develop resilience to burnout through meaning-making and personal experiences.

SIGNIFICANCE OF RESULTS

Helping palliative nurses find a deep purpose in their work builds resilience. Managers, organisation leaders, researchers and peers should look into ways to increase resilience in this group of nurses.

Addressing burnout among nurses of color: Key priorities and calls for action

Nursing burnout remains a public health crisis. However, few stakeholders have considered the disproportionate toll of burnout among nurses of color, including nurses identifying as Black, Hispanic/Latino, or Native American. We convened a one-day conference, titled Solutions to Health Inequities and Nurses' Emotional Exhaustion (SHINE), to begin identifying contributing factors and solutions to burnout amongst nurses of color. SHINE included plenaries, small group discussions, and breakout sessions with nearly 40 expert stakeholders from around the country. We employed a deliberative dialogue (DD) methodology to identify key takeaways and implications for research, practice, and policy. High-priority solutions included: improving the work environment and nurse staffing, reducing stigma against nurses seeking mental healthcare, addressing workplace racism as a root cause of nurse burnout, and increasing support for nurses experiencing racism at work. Key priorities identified through SHINE offer a roadmap for nurse leaders to address burnout through an equity-centered lens.

Best Practices in Telecritical Care: Expert Consensus Recommendations From the Telecritical Care Collaborative Network

OBJECTIVES

Telecritical care (TCC) refers to the delivery of critical care using telehealth technologies. Despite increasing utilization, significant practice variation exists and literature regarding efficacy remains sparse. The Telecritical Care Collaborative Network sought to provide expert, consensus-based best practice recommendations for the design and delivery of TCC.

DESIGN

We used a modified Delphi methodology. Following literature review, an oversight panel identified core domains and developed declarative statements for review by an expert voting panel. During three voting rounds, voters agreed or disagreed with statements and provided open-ended feedback, which the oversight panel used to revise statements. Statements met criteria for consensus when accepted by greater than or equal to 85% of voters.

SETTING/SUBJECTS

The oversight panel included 18 multidisciplinary members of the TCC Collaborative Network, and the voting panel included 32 invited experts in TCC, emphasizing diversity of discipline, care delivery models, and geography.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

We identified ten core domains: definitions/terminology; care delivery models; staffing and coverage models; technological considerations; ergonomics and workplace safety; licensing, credentialing, and certification; trust and relationship building; quality, safety, and efficiency, research agenda; and advocacy, leading to 79 practice statements. Of 79 original statements, 67 were accepted in round 1. After revision, nine were accepted in round 2 and two in round 3 (two statements were merged). In total, 78 practice statements achieved expert consensus.

CONCLUSIONS

These expert consensus recommendations cover a broad range of topics relevant to delivery of TCC. Experts agreed that TCC is most effective when delivered by care teams with specific expertise and by programs with explicit protocols focusing on effective communication, technical reliability, and real-time availability. Interventions should be tailored to local conditions. Although further research is needed to guide future best practice statements, these results provide valuable and actionable recommendations for the delivery of high-quality TCC.

Patient satisfaction and associated factors in Addis Ababa's public referral hospitals: insights from 2023

Background

Currently, patient satisfaction is a major concern in the healthcare system of Ethiopia. Patient satisfaction with nursing care is considered an important factor in explaining patients' service quality. Satisfied patients are more likely to have a good relationship with nurses, which suggests improved quality of care.

Objective

To assess the prevalence of patient satisfaction and its associated factors among admitted patients in Addis Ababa city public referral hospitals, Ethiopia 2023.

Methods and materials

An institutional-based cross-sectional study design was employed among 471 randomly selected patients from June 1 to July 30, 2023. Interviewer-administered a structured questionnaire was used to collect data. Patient satisfaction was measured by using the Newcastle Nursing Care Satisfaction Scale. Bivariable and multivariable logistic regressions were used to identify the factors associated with patient satisfaction.

Result

471 participants responded among 506 selected patients yielding a response rate of 93%. The satisfaction of patients was 47.8% (95% CI = 42.9, 52.2%) Multiple logistic regression showed that participants aged 26-35 were less likely to be satisfied with nursing care [AOR = 0.25, 95% CI: 0.11, 0.56]. In contrast, those in the surgical ward [AOR = 3.85, 95% CI: 1.98, 7.45] and ophthalmology ward [AOR = 4.27, 95% CI: 1.81, 10.05] were more satisfied. No previous admission [AOR = 0.13, 95% CI: 0.07, 0.26], having no comorbidities [AOR = 13.4, 95% CI: 7.06, 25.4], and shorter admission duration [AOR = 9.14, 95% CI: 3.46, 24.11] were found to be factors with a significant association with patient nursing satisfaction.

Conclusion

Overall, just under one in every two admitted patients were satisfied, indicating areas for potential improvement in nursing care. Specific factors such as patients in the age range of 26 to 35 reported significantly lower levels of satisfaction, whereas patients in the surgical and ophthalmology wards, as well as those without comorbidities and with shorter hospital stays, reported significantly higher levels of satisfaction. These findings emphasize the importance of targeted strategies to enhance nursing care.

Safe limits on work hours for the nursing profession: a rapid evidence review

Persistent staffing shortages in health care driven by years of inadequate funding and deficiencies in human resources planning, which overlooked the impacts of population aging, have converged into a crisis in health care settings. An essential consequence of the widespread and growing staffing shortfalls in health care has been increased pressure on nurses to work longer hours. The present rapid review has two major objectives: (1) to systematically review and synthesize evidence considering the health and human consequences of excessive work hours, work-related fatigue and associated occupational health and safety hazards; and, (2) to identify policies and practices that demonstrate efficacy in managing or mitigating the adverse effects of occupational fatigue. Findings show that shifts lasting longer than 12 h elevate the risk of occupational fatigue, leading to several fatigue-based hazards. Despite governmental restrictions on long work hours and occupational fatigue in safety-critical industries such as transport, aviation, and nuclear sectors, health care remains largely unregulated in this regard. Ensuring safe and high-quality care over the long term requires implementing adequate regulatory supports for work hour limits for nurses. These measures not only improve workplace satisfaction but also enhance patient outcomes, ultimately fostering a healthier and more resilient health care system.

Understanding the Experiences of Nurses' Work: Development and Psychometric Evaluation of an End of Shift Survey

AIM

To explore and validate an end of shift survey with a low response burden, practical application and generated evidence of related associations between workload, quality of work and patient care, missed care and job satisfaction.

DESIGN

A retrospective cross-sectional survey of the experiences of nursing staff.

METHODS

Data were collected from 265 nurses who responded to a questionnaire at the end of their shift in 2022. Exploratory factor analysis was undertaken using IBM SPSS v.27 and confirmatory factor analysis was undertaken using IBM AMOS v27. Hypotheses testing was undertaken using IBM SPSS v.27 using multiple regression analyses.

RESULTS

All of the hypotheses were supported. There was a negative association between workload and quality of work and job satisfaction. Quality of work was negatively associated with workload and missed care and positively associated with job satisfaction. The association between missed care and job satisfaction was negative.

CONCLUSION

The EOSS is a valid and reliable tool with a low response burden. The tool supports previous research which demonstrated there is a negative relationship between level of workload and shift type with satisfaction, quality of work and potentially nurse retention.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

In the context of a global nursing shortage nursing leaders must ensure that care we provide is of the highest quality. We must take every action to address high workload to reduce the risk that fundamental care is not sacrificed, job satisfaction is improved and nurses remain in the profession. The EOSS gives nurse leaders a reliable, practical, consistent, applied tool that will better enable associations to be observed between resource configuration, workload and critical impacts on nursing and patient care.

REPORTING METHOD

We have adhered to the relevant EQUATOR guidelines using the STROBE reporting method.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Comprehensive Risk Analysis of Emergency Medical Response Systems in Serbian Healthcare: Assessing Systemic Vulnerabilities in Disaster Preparedness and Response

BACKGROUND/OBJECTIVES

Emergency Medical Response Systems (EMRSs) play a vital role in delivering medical aid during natural and man-made disasters. This quantitative research delves into the analysis of risk and effectiveness within Serbia's Emergency Medical Services (EMS), with a special emphasis on how work organization, resource distribution, and preparedness for mass casualty events contribute to overall disaster preparedness.

METHODS

The study was conducted using a questionnaire consisting of 7 sections and a total of 88 variables, distributed to and collected from 172 healthcare institutions (Public Health Centers and Hospitals). Statistical methods, including Pearson's correlation, multivariate regression analysis, and chi-square tests, were rigorously applied to analyze and interpret the data.

RESULTS

The results from the multivariate regression analysis revealed that the organization of working hours (β = 0.035) and shift work (β = 0.042) were significant predictors of EMS organization, explaining 1.9% of the variance (R2 = 0.019). Furthermore, shift work (β = -0.045) and working hours (β = -0.037) accounted for 2.0% of the variance in the number of EMS points performed (R2 = 0.020). Also, the availability of ambulance vehicles (β = 0.075) and financial resources (β = 0.033) explained 4.1% of the variance in mass casualty preparedness (R2 = 0.041). When it comes to service area coverage, the regression results suggest that none of the predictors were statistically significant. Based on Pearson's correlation results, there is a statistically significant correlation between the EMS organization and several key variables such as the number of EMS doctors (p = 0.000), emergency medicine specialists (p = 0.000), etc. Moreover, the Chi-square test results reveal statistically significant correlations between EMS organization and how EMS activities are conducted (p = 0.001), the number of activity locations (p = 0.005), and the structure of working hours (p = 0.001).

CONCLUSIONS

Additionally, the results underscore the necessity for increased financial support, standardized protocols, and enhanced intersectoral collaboration to strengthen Serbia's EMRS and improve overall disaster response effectiveness. Based on these findings, a clear roadmap is provided for policymakers, healthcare administrators, and EMS personnel to prioritize strategic interventions and build a robust emergency medical response system.

More Than Just a Pain in the Back: Pain Among American Nurses and Its Relationship to Modifiable Work Factors and Work Performance

Nursing is a profession with high rates of workplace injuries, hazards, and turnover. Improving the health and safety of nurses at work is vital to retain and grow the workforce to meet future demands. The purpose of this study was to describe the breadth of pain among American nurses and explore the relationships between this pain and modifiable work factors and perceived work performance. We used a cross-sectional descriptive design of 2312 nurses from across the United States. Nurses completed a survey containing questions about demographics, the presence of pain in the past week, the number of pain sites, pain locations, severity, and the impact on work performance. The median number of pain locations reported was 2, back pain was the most reported pain site, and average pain severity ranged from 4 to 5. Significant modifiable work factors associated with pain were average patient load and shift length. Many participants indicated that their pain impacted work performance, while a smaller proportion acknowledged that their pain impacted patient care. Pain among nurses spans multiple locations, is moderately severe, and impacts work performance. Addressing related modifiable work factors may decrease pain and the impact on the health, safety, and work performance of the nursing workforce.

The influence of effort-reward imbalance and perceived organizational support on perceived stress in Chinese nurses: a cross-sectional study

BACKGROUND

The nursing profession is characterized by high intensity and significant stress. Nurses must not only manage heavy workloads but also address diverse patient needs, engage in emotional labor, and cope with occupational exposure risks. These factors collectively contribute to substantial work-related stress for nurses. Currently, there is limited research on identifying distinct categories of nurse stress profiles and their influencing factors.

OBJECTIVES

This study aimed to explore the potential categories of perceived stress among nurses using Latent profile analysis (LPA) and to analyze the influence of sociodemographic factors, effort-reward imbalance, and perceived organizational support on perceived stress categories.

DESIGN

Cross-sectional study METHODS: Data were collected via electronic surveys from 696 nurses in Shanxi Province, China, from February 18 to 28, 2023. The survey parameters included sociodemographic characteristics, nurse job stressors scale, effort-reward imbalance scale, and perceived organizational support scale. Latent profile analysis (LPA) was used to classify the perceived stress levels of nurses, and disordered multi-classification logistic regression was used to identify the influencing factors.

RESULTS

The most suitable model was a three-profile model, comprising the "low perceived stress" group (10.5%), "moderate perceived stress" group (66.7%), and "high perceived stress" group (22.8%). Multi-classification logistic regression analysis showed that average working hours per day (OR = 3.022, p = 0.026), extrinsic effort (C2 vs. C1, OR = 1.589, p < 0.001; C3 vs. C1, OR = 2.515, p < 0.001), and perceived organizational support (C2 vs. C1, OR = 0.853, p < 0.001; C3 vs. C1, OR = 0.753, p < 0.001) were the factors influencing the classification of nurses' perceived stress.

CONCLUSIONS

Latent profile analysis revealed that nurses' perceived stress exhibits distinct characteristics. It is recommended that clinical administrators should identify these characteristics and the influencing factors of different nurse categories, and adopt targeted intervention strategies to reduce the levels of perceived stress.

Psychometric Evaluation of the Insomnia Severity Index in Nurses

OBJECTIVES

Examine psychometric properties of the Insomnia Severity Index (ISI) in a sample of nurses.

METHOD

In a sample of day shift nurses (N = 289), a confirmatory factor analysis (CFA), convergent and discriminant validity analyses, and a test-retest reliability analysis were performed.

RESULTS

CFA showed that a two-factor model provided the best fit. The ISI had moderate to poor convergent validity with sleep diary parameters, and moderate convergent validity with the Sleep Condition Indicator (r = -.66), Pittsburgh Sleep Quality Index (r = .66), and PROMIS Sleep-Related Impairment measure (r = .67). The ISI demonstrated good discriminant validity with the measures Composite Scale of Morningness (r = -.27), Nightmares Disorder Index (r = .25), PTSD Checklist for DSM-5 (sleep items removed; r = .32), and Perceived Stress Scale (r = .43). The ISI had weaker discriminant validity with the PHQ-9 (r = .69) and Generalized Anxiety Disorder Screener (r = .51). The ISI demonstrated a good test-retest reliability (ICCs = .74-.88).

CONCLUSIONS

The ISI is a psychometrically strong measure for the assessment of insomnia severity in day shift nurses. Overlap with psychological symptoms, primarily anxiety and depression, suggests caution while interpreting these constructs.

Variability and relative contribution of surgeon- and anesthesia-specific time components to total procedural time in cardiac surgery

BACKGROUND

Decreasing variability in time-intensive tasks during cardiac surgery may reduce total procedural time, lower costs, reduce clinician burnout, and improve patient access. The relative contribution and variability of surgeon control time (SCT) and anesthesia control time (ACT) to total procedural time is unknown.

METHODS

A total of 669 patients undergoing coronary artery bypass graft (CABG) surgery were enrolled. Using linear regression, we estimated adjusted SCTs and ACTs, controlling for patient and procedural covariates. The primary endpoint compared overall SCTs and ACTs. The secondary endpoint compared the variability in adjusted SCTs and ACTs. Sensitivity analyses quantified the relative importance of the specific surgeon and anesthesiologist in the adjusted linear models.

RESULTS

The median SCT was 4.1 hours (interquartile range [IQR], 3.4-4.9 hours) compared to a median ACT of 1.0 hours (IQR, 0.8-1.2 hours; P < .001). Using linear regression, the variability in adjusted SCT among surgeons (range, 1.8 hours) was 3.5-fold greater than the variability in adjusted ACT among anesthesiologists (range, 0.5 hour; P < .001). The specific surgeon and anesthesiologist accounted for 50% of the explanatory power of the predictive model (P < .001).

CONCLUSIONS

SCT variability is significantly greater than ACT variability and is strongly associated with the surgeon performing the procedure. Although these results suggest that SCT variability is an attractive operational target, further studies are needed to determine practitioner specific and modifiable attributes to reduce variability and improve efficiency.

Factors influencing patient experience in hospital wards: a systematic review

BACKGROUND

Patient experience plays an essential role in improving clinical effectiveness and patient safety. It's important to identify factors influencing patient experience and to improve quality of healthcare.

OBJECTIVE

To identify factors that influence patient experience in hospital wards.

METHODS

We conducted a systematic review including six databases; they were PubMed, CINAHL, Embase, PsycInfo, ProQuest, and Cochrane. Studies were included if they met the inclusion criteria. The JBI checklist was used to perform quality appraisal. We used 5 domains of the ecological model to organize and synthesize our findings to comprehensively understand the multi-level factors influencing the issue.

RESULT

A total of 138 studies were included, and 164 factors were identified. These factors were integrated into 6 domains. All domains but one (survey-related factors) could be mapped onto the attributes of the ecological framework: intrapersonal, interpersonal, institutional, community, and public policy level factors. All factors had mixed effect on patient experience. The intrapersonal level refers to individual characteristics of patients. The interpersonal level refers to interactions between patients and healthcare providers, such as the caring time spent by a nurse. The institutional level refers to organizational characteristics, rules and regulations for operations, such as hospital size and accreditation. The community level refers to relationships among organizations, institutions, and informational networks within defined boundaries, such as a hospital located in a larger population area. Public policy level refers to local, state, national, and global laws and policies, including health insurance policies. The sixth domain, survey-related factors, was added to the framework and included factors such as survey response rate and survey response time.

CONCLUSION

The factors influencing patient experience are comprehensive, ranging from intrapersonal to public policy. Providers should adopt a holistic and integrated perspective to assess patient experience and develop context-specific interventions to improve the quality of care. PROSPERO REGISTRATION NUMBER CRD42023401066.

[It] Does Harden a Person Working in Such a Stressful Environment: U.S. Correctional Nurses Share Spillover Effects of Their Work

BACKGROUND

The United States makes up 4.4% of the world's population but nearly a quarter of the world's incarcerated population. Despite caring for nearly 2 million incarcerated persons and managing their unique needs, little is known about how this work spills over and affects the nurses who work in correctional settings.

STUDY OBJECTIVE

This descriptive study aimed to (a) examine write-in answers regarding correctional nurse perceptions of how their work impacts their health and their home lives and (b) explore correctional nurse responses for how to improve the work environment to better support their well-being.

METHOD

The researchers compiled and analyzed qualitative data from a cross-sectional study where U.S. correctional nurses ( N = 270) completed an online survey. Manifest content analysis was used to analyze optional write-in data.

RESULTS

Approximately 41% ( n = 111) of participants answered qualitative questions. Participants were primarily White (77.3%) and non-Hispanic or Latino (88.7%), working in prisons (65.8%), and employed by the state (63.8%) as registered nurses (70%). Three major themes emerged: (a) "personal impact": increased stress and burnout, overwhelming work hours, and emotional and physical effects; (b) "social relationships and family impacts": withdrawn, strained homelife, and uncertainty; and (c) "need for change": improved staffing, reduced mandatory overtime, and better support from management.

CONCLUSIONS

Correctional organizations may consider ways to support the well-being of their nurses through adequate staffing, flexible scheduling, decreased mandatory overtime, and hiring effective nurse managers as key members of the correctional team.

Assessment of Nursing Faculty Members' Knowledge Toward Research: A Cross-Sectional Study

Background and aim In the context of contributing to healthcare and the well-being of a nation and its communities, nursing research plays a vital role in advancing the discipline of nursing science. Nursing research is essential for improving the quality of nursing care. This study aims to examine the research knowledge level of faculty members at the College of Nursing, University of Raparin, Kurdistan Region, Iraq. Methods We conducted a cross-sectional study involving 43 nursing faculty members at the University of Raparin. The survey was distributed using convenience sampling in April 2024. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (released 2019, IBM Corp., Armonk, NY). Continuous variables were analyzed using mean and standard deviation, while categorical variables were analyzed using frequency and percentage distributions. The association between knowledge scores and demographics was tested using Mann-Whitney, Kruskal-Wallis, Chi-square, and post-hoc tests. Stepwise multiple regression analysis was used to determine the variables that influence the knowledge score. Significance was set at p < 0.05. Results A total of 43 participants were enrolled in this study. The mean age was 32.56 ± 4.75, with 69.8% of participants being male. In terms of educational attainment, 48.8% held master's degrees, 39.5% held bachelor's degrees, and only 11% possessed PhDs. The mean work experience was 5.40 ± 4.04 years, and the mean knowledge score toward research was 3.09 ± 1.97 out of 7. Demographic variables, such as age, marital status, and gender, showed no significant associations with knowledge levels (p > 0.05). However, significant associations were found for education level (p = 0.004) and years of experience (p = 0.011). In the stepwise regression analysis, we observed a significant positive correlation between the level of education and knowledge score (F =10.787, p = 0.002). However, variables, such as age, gender, marital status, years of experience, and participation in research courses, did not demonstrate statistical significance (p-values > 0.05). Conclusion This study highlights a significant lack of research expertise among nursing faculty members, emphasizing the urgent need for targeted interventions and instructional activities in nursing education programs. It is crucial to address this knowledge gap in order to support the professional growth of faculty members and promote the advancement of nursing research and evidence-based practice. Policymakers should also consider implementing mentorship programs that strategically pair less experienced faculty members with seasoned researchers. This initiative aims to cultivate a collaborative learning environment and enhance research skills.

Predicting the work ability of security guards at a university in Nakhon Si Thammarat province, Thailand

Objectives. The number of security guards in universities has increased significantly. This study aimed to predict work ability of university security guards. Methods. A cross-sectional study of 97 university security guards in Thailand was performed. Data were collected through interviews using a questionnaire covering social demographics, behavioral health and work ability. The data were analyzed using χ2 tests and logistic regression models. Results. The average work ability index (WAI) score was 38.1 ± 3.8, with 65.0% of participants scoring 'good'. Social support significantly influenced the WAI (p = 0.004). Those with insufficient support were 4.3 times more likely to show poor work ability. Mental health also impacted the WAI (p = 0.006); those with poor mental health were 4.7 times at risk. Additionally, work experience affected the WAI (p = 0.039). Those with ≥5 years of experience showed reduced work ability compared to their less-experienced counterparts (adjusted odds ratio 0.4; 95% confidence interval [0.20, 0.96]). Conclusions. Supervisors should provide social support and offer rewards and commendations to enhance employees' abilities, health behaviors and management of underlying diseases. Additionally, organizations should prioritize health and safety in the workplace to ensure their employees are healthier and perform their tasks more effectively.

The effect of commuting time on burnout: the mediation effect of musculoskeletal pain

OBJECTIVES

This study explores the relationship among commuting, musculoskeletal (MS) pain, and burnout.

METHODS

An observational and cross-sectional study was conducted at a medical university-affiliated hospital in Taichung, Taiwan in 2021. The two questionnaire was used and they included the Copenhagen Burnout Inventory (CBI) and the Nordic Musculoskeletal Questionnaire (NMQ). All participants were invited to complete the cross-sectional survey. A multiple linear regression was assessed correlations between commuting, MS pain, and burnout.

RESULTS

After excluding those with missing data, 1,615 healthcare workers were deemed valid as research participants. In multiple linear regression, commuting time longer than 50 min was associated with personal burnout (PB) in the presence of adjusted confounders; however, long commuting time was not associated with work-related burnout (WB). Furthermore, the choice of commuting method did not affect PB or WB. Notably, both neck and shoulder pain (NBSP) and ankle pain (BAP) increase the risk of PB and WB. The mediation analysis demonstrated that NBSP is a mediating factor, increasing the level of PB and WB for commuting times longer than 50 min.

CONCLUSIONS

Healthcare workers who commute for more than 50 min should be considered part of a high-risk group for burnout and musculoskeletal pain. They should also be provided with resources and programs focused on burnout prevention and MS pain relief.

The Partial Mediator Role of Satisficing Decision-Making Style Between Trait Emotional Intelligence and Compassion Fatigue in Healthcare Professionals

Background: Compassion fatigue (CF) represents a relevant issue for healthcare professionals. Currently, it is still unclear which psychological mechanism might lead to CF and which might protect workers from that. Decision-making styles, as well as emotional intelligence, might partially account for the presence of CF. Specifically, we hypothesized that a satisficing decision-making style would mediate the relationship between emotional intelligence and CF.Methods: A cross-sectional online survey was conducted on physicians and nurses from Italian Medical Departments. Three self-reported questionnaires were administered to collect data in accordance with our aims. A mediation model with Structural Equation Modeling on the relationship between trait emotional intelligence (TEI) and CF through the maximizing decision-making style was performed.Results: We found a significant relationship between TEI and CF (β = -0.28, SE = 0.04, p < .001). The maximizing style partially mediated this relationship (β = -0.04, SE = 0.01, p < .001). Moreover, negative relationships were found between sex (male), working hours, sleep quality, and CF. Conversely, a positive relationship between age and CF was demonstrated.Conclusions: Being emotionally intelligent resulted as a protective factor for developing CF, while the decision-making styles shaped the risk of developing CF.

Top Factors in Nurses Ending Health Care Employment Between 2018 and 2021

Importance

The increase in new registered nurses is expected to outpace retirements, yet health care systems continue to struggle with recruiting and retaining nurses.

Objective

To examine the top contributing factors to nurses ending health care employment between 2018 and 2021 in New York and Illinois.

Design, Setting, and Participants

This cross-sectional study analyzed survey data (RN4CAST-NY/IL) from registered nurses in New York and Illinois from April 13 to June 22, 2021. Differences in contributing factors to ending health care employment are described by nurses' age, employment status, and prior setting of employment and through exemplar nurse quotes.

Main Outcomes and Measures

Nurses were asked to select all that apply from a list of contributing factors for ending health care employment, and the percentage of nurse respondents per contributing factor were reported.

Results

A total of 7887 nurses (mean [SD] age, 60.1 [12.9] years; 7372 [93%] female) who recently ended health care employment after a mean (SD) of 30.8 (15.1) years of experience were included in the study. Although planned retirement was the leading factor (3047 [39%]), nurses also cited burnout or emotional exhaustion (2039 [26%]), insufficient staffing (1687 [21%]), and family obligations (1456 [18%]) as other top contributing factors. Among retired nurses, 2022 (41%) ended health care employment for reasons other than planned retirement, including burnout or emotional exhaustion (1099 [22%]) and insufficient staffing (888 [18%]). The age distribution of nurses not employed in health care was similar to that of nurses currently employed in health care, suggesting that a demographically similar, already existing supply of nurses could be attracted back into health care employment.

Conclusions and Relevance

In this cross-sectional study, nurses primarily ended health care employment due to systemic features of their employer. Reducing and preventing burnout, improving nurse staffing levels, and supporting nurses' work-life balance (eg, childcare needs, weekday schedules, and shorter shift lengths) are within the scope of employers and may improve nurse retention.

Healthcare Workers' Perceptions of Work-Related Stress and Burnout: Strategies and Barriers for Self-Care

Background: There is little research providing critical understanding of how healthcare professionals perceive and manage work-related stress. This study aims to understand healthcare workers' perspectives regarding work-related stress and burnout, strategies and barriers for self-care, and organizational support for self-care and resiliency. Methods: A qualitative descriptive approach was used. Individual, semi-structured interviews were conducted with healthcare workers from 5 organizations in New York State. Data was analyzed using Braun and Clarke's Thematic Analysis. Results: Interviews were conducted with 27 healthcare workers from various disciplines. Findings indicated that healthcare workers experienced high levels of stress and burnout, which negatively impacts their mental health, quality of work, relationships with coworkers, and patient care. Many participants expressed an interest in self-care activities, and there were apparent differences among respondents regarding perceived organizational support. Five themes were identified, including: staff shortages, coworker conflict and interactions, strategies to mitigate stress, impacts of work-related stress, and managing stress and burnout in the workplace. Conclusion: Workplace stress affects patient care, but workers feel that there is limited support from leadership. It is critical that healthcare organizations and governments prioritize providing support along with other resources to healthcare workers to address burnout and assist with mental health concerns.

Sleep quality and fatigue among nurses working in high-acuity clinical settings in Saudi Arabia: a cross-sectional study

BACKGROUND

Poor sleep quality is prevalent among nurses worldwide. Around two-thirds of nurses doing shift work are known to experience sleep problems and fatigue. Fatigue and sleep problems are linked to poor performance, impaired alertness, injuries, chronic diseases, compromised healthcare quality, and medical errors, all of which detrimentally impact nurses and threaten patients' safety. This area of research has received insufficient attention in Saudi Arabia; therefore, the purpose of this study was to examine the levels of sleep quality and perceived fatigue and their association among nurses working in acute care settings in comprehensive hospitals in Saudi Arabia.

METHODS

A descriptive cross-sectional study using the Pittsburgh Sleep Quality Index and Chalder Fatigue Scale. Data was obtained via an online questionnaire that was distributed to nurses using the QuestionPro platform through hospital administrators, social media (WhatsApp), and personal contact.

RESULTS

A total of 173 nurses completed the online survey. Most participants reported poor sleep quality (n = 127, 73.4%) and severe perceived fatigue (n = 156, 90.2%). Furthermore, the study revealed a significant correlation between the overall sleep disturbance and fatigue global scores (r = 0.57, P < 0.001), indicating that poor sleep quality was significantly associated with higher fatigue levels among the study sample.

CONCLUSIONS

The current study found a significant association between sleep quality and severe fatigue in nurses working in high acute care settings in Saudi Arabia. It is very clear from the results that nurses are experiencing poor sleep and severe fatigue, which in turn, will negatively impact the nurse's quality of life and patient safety.

Post-Traumatic Stress Disorder Symptoms among Pediatric Healthcare Workers

Post-traumatic stress disorder symptoms related to work in pediatric departments aremajor public health problems, as they directly affect health organizations, healthcare workers, and, due to the poor quality of care, the patients as well. The post-traumatic symptoms that a healthcare worker may experience are related to intrusion, avoidance, negative changes in cognition and mood, and changes in arousal and reactivity. The aim of the present investigation was to identify risk factors that contribute to the development of PTSD in pediatric healthcare workers, in order to implement necessary workplace measures. A sample of four hundred and forty-five pediatric workers at seven Greek public hospitals consented to participate in the survey. Socio-demographic data and a post-traumatic checklist (5th edition) were used to diagnose post-traumatic stress disorder. According to the results, risk factors for the development of post-traumatic symptoms include medical or nursing errors, threats to a child's life, and incidents of workplace bullying. More specifically, 25.2% of the participants had a provisional PTSD diagnosis, 72.8%of the sample experienced an incident involving a medical or nursing error in their workplace related to the treatment or care of a child, 56% experienced an incident involving a child's death or a threat to a child's life due to a serious illness or injury, and 55.5% experienced an incident of workplace bullying. In addition, it was found that having a university-level education, master's, or PhD, working in a circular shift, being assigned to a department by management rather than the worker, and dissatisfaction with salary were associated with post-traumatic stress disorder. The high rates of PTSD symptoms among participants highlight the need for prevention and management measures to protect and support the mental health of workers in pediatric departments. We propose frequent evaluations of the mental health of employees, more time for rest, incentives for professional development, utilization of their specializations and specialties, support from mental health specialists when symptoms are diagnosed, and the option for employees to change departments if they wish or if they show symptoms of mental trauma.

Effect of Mandatory and Voluntary Overtime Hours on Stress Among 9-1-1 Telecommunicators

BACKGROUND

9-1-1 telecommunicators are frequently exposed to indirect traumatic events that impact their mental and physical health and are often required to work overtime with rotating shifts. Previous studies reported various harmful effects of overtime on the health and well-being of workers, such as musculoskeletal injuries, burnout, low job satisfaction, fatigue, and intent to leave. However, there is limited research on the impact of overtime hours on 9-1-1 telecommunicators' stress symptoms, especially mandatory overtime hours. This study aimed to examine the relationship between overtime hours-mandatory and voluntary-and the level of stress symptoms among 9-1-1 telecommunicators.

METHODS

We used secondary data from the surveys of the "Multi-tasking to hyper-tasking: Investigating the impact of Next Generation 9-1-1" study for analysis. Linear mixed-effects regression was applied to examine the association of overtime hours with the stress level.

RESULTS

Of the 403 participants, 47.6% reported that they were required to work mandatory overtime, and the mean mandatory overtime was 7.51 (SD = 12.78) hours in the past month. 58.3% reported working voluntary overtime, and the mean voluntary overtime was 11.63 (SD = 17.48) hours. This study found that mandatory overtime hours were associated with an increase in self-reported stress symptoms (β = 0.30, p = .002), whereas no significant association was found between voluntary overtime and the level of stress symptoms (β = -0.01, p = .885).

CONCLUSION/APPLICATION TO PRACTICE

Study results highlight the importance of reducing mandatory overtime in call centers as one possible strategy for reducing stress levels among this critical workforce.

Work-Related Health Conditions Among American Nurses: A Scoping Review

Background

Working in the nursing profession is hazardous, and nurses report poor health. Risk factors associated with poor health outcomes have been documented. However, the extent of literature exploring the prevalence of health conditions among American nurses that may be attributable to their work has not been examined.

Method

A scoping review following the Joanna Briggs Institute recommendations was conducted of peer-reviewed quantitative studies to answer the question: What are health conditions experienced by American nurses that may be attributable to their work as nurses?

Results

Thirty articles met the inclusion criteria. Due to the methods used in many articles, studies of the prevalence of health conditions among the nursing population were lacking. Health conditions studied broke into six categories: (a) work-related injuries and hazards; (b) unhealthy lifestyles; (c) mental health conditions; (d) burnout; (e) fatigue, sleep, and migraines; and (f) reproductive health. The role of work in the health conditions studied varied from an immediate impact on health (e.g., a needlestick or injury) to a cumulative impact (e.g., scheduling or workplace demands). Within the work demands, the physical environment; physical, emotional, and cognitive demands of work; and shiftwork were all frequently identified as antecedents that could be further explored and addressed to improve nurse health.

Conclusions

Healthcare systems should seek to address the hazards and exposures that may be linked to health conditions in the nursing workforce. Understanding and mitigating the impact of the pandemic and nursing work on the workforce's health is crucial to the solvency of the workforce. Occupational health practitioners should assess for workplace hazards and exposures.

What makes nurses flourish at work? How the perceived clinical work environment relates to nurse motivation and well-being: A cross-sectional study

BACKGROUND

Literature shows that the work environment is a main determinant of nurses' well-being and psychological strain; yet, the (psychological) mechanisms underlying this relationship remain understudied.

OBJECTIVE

This study explored the underlying (psychological) mechanisms (why) and boundary conditions (when) by which characteristics present in the clinical work environment influence nurses' well-being. We investigated the mediating role of intrinsic motivation in the relationship of job demands and job resources with burnout vs. work engagement. In addition, we examined if job resources strengthen the relationship of job demands with intrinsic motivation and burnout.

DESIGN

A cross-sectional survey study.

SETTING(S)

General acute care hospitals in Belgium (n = 14).

PARTICIPANTS

Direct care nurses (n = 1729).

METHODS

Data were collected by means of online questionnaires between October 2020 and July 2021. Study variables included burnout, work engagement, intrinsic motivation and a set of different job demands (workload, role conflicts, emotional demands, red tape) and job resources (performance feedback, autonomy, skill use, opportunity for growth, and value congruence). All variables were obtained using self-report measures. The central hypotheses were tested using structural equation modeling.

RESULTS

Job resources appeared to be a crucial factor for nurses' health showing positive associations with work motivation (β = 0.513) and work engagement (β = 0.462) and negative associations with burnout (β = -0.216). Job demands remained an essential factor that harms psychological health and is associated with increased burnout (β = 0.489). Our results confirmed that intrinsic motivation mediated the relationship of job resources with work engagement (β = 0.170) and burnout (β = -0.135). In addition, job resources moderated the relationship of job demands with burnout (β = -0.039). Against our expectations, we found no associations between job demands and intrinsic motivation or a moderation effect of job resources on the respective relationship.

CONCLUSIONS

A highly demanding work environment can be a source of significant stress which may put nurses' health at severe risk. Nurses who perceive sufficient job resources such as feedback, autonomy and opportunities for growth and development, are likely to feel intrinsically motivated at work. In addition, it will foster their work engagement and prevent them from burning out, particularly when job demands are high.

REGISTRATION

The study described herein is funded under the European Union's Horizon 2020 Research and Innovation program from 2020 to 2023 (Grant Agreement 848031). The protocol of Magnet4Europe is registered in the ISRCTN registry (ISRCTN10196901).

TWEETABLE ABSTRACT

Providing nurses with sufficient resources will not only increase their motivation and engagement at work but also reduce their feelings of burnout.

Burnout syndrome among medical nurse-technicians in intensive care units in cardiovascular surgery

Background

Healthcare workers in intensive care units work under specifically hard conditions compared to healthcare workers who work under regular clinical conditions. In this sense, the research aims at assessing the level of burnout symptomatology among nurse technicians working in intensive care units for cardiovascular surgery and to compare those burnout levels with those recorded for medical technicians working under regular clinical conditions.

Method

The research was designed as a cross-sectional study. The sample consisted of nurse technicians working in intensive care units specializing in cardiovascular surgery (70 participants) and nurse technicians working under regular clinical conditions (70 participants) at the Institute for Cardiovascular Diseases "Dedinje," Belgrade, Serbia. To evaluate the manifestation of burnout syndrome at work, the analysis uses the Serbian version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS).

Results

To examine the variances in the average sub-scores for burnout within two groups of medical technicians, the study used Two Independent Samples T-test. The statistically noteworthy differentiation was ascertained for emotional exhaustion and personal accomplishment, but this does not hold true for depersonalization. However, the mean score values across the different burnout levels (low, moderate, high) are similar in two cohorts of respondents (p > 0.05).

Conclusion

This study will serve as an impetus for a policy reform focused on ameliorating working conditions and improving healthcare workers' satisfaction and overall healthcare quality.

Barriers to conducting and publishing research among nursing faculty members at Shaqra University, Saudi Arabia: A qualitative study

AIM

To identify barriers to conducting and publishing research among nursing faculty members at Shaqra University, Saudi Arabia.

DESIGN

A qualitative descriptive design was used.

METHODS

This qualitative descriptive study was conducted on 12 nursing faculty members from two nursing colleges at Shaqra University, a public university located in Riyadh region, SA, under the supervision of the Ministry of Education. Data were collected between September and October 2021 using semi-structured interviews and analysed thematically using content analysis.

RESULTS

Three themes emerged in the study, namely (I) individual/personal barrier, (II) institutional barrier and (III) external factors. Barriers to conducting and publishing research included lack of time due to a high teaching load and lack of administrative and financial support. The present findings suggest that nursing faculty members in SA are facing many barriers hindering them from carrying out and publishing research activities. Such barriers need to be urgently addressed through different strategies, including allocating facilities and funds for research, motivating faculty members towards research, and ongoing education and training on research.

Missed nursing care in pediatric emergency departments in Turkey: A cross-sectional study

OBJECTIVE

A pediatric emergency department deals with a vast number of patients and a high load of emergent/high-priority healthcare practices. Therefore, at times, it is possible to experience missed nursing care in this department. This study aims to ascertain the types of and reasons for missed nursing care cases in pediatric emergency departments in Turkey.

METHOD

This is a cross-sectional survey study. Survey data were collected from 155 nurses using the "Introductory Information Form" and the "MISSCARE-Pediatric Emergency Department Survey."

RESULTS

Gastrostomy care, colostomy care, tracheotomy care, and teaching about hospital discharge were the care practices most often missed. The volume of patients, urgent patient situations, an inadequate number of nurses in charge, too many inexperienced nurses in the department, and assignment of work outside the scope of the job are the main reasons for missed care.

CONCLUSION

Pediatric emergency department patients experience missed nursing care and nurses should be supported more in order for them to provide efficient care to children.

A narrative review of occupational scheduling that impacts fatigue and recovery relevant to veterinarian well-being

Background

Sleep insufficiency is a worldwide affliction with serious implications for mental and physical health. Occupational factors play a large role in determining sleep habits. Healthcare workers are particularly susceptible to job-mediated sleep insufficiency and inadequate rest in general. Little is published on sleep practices among veterinarians, and overall recognition of the impacts of inadequate rest within the veterinary profession is poor.

Objectives and procedures

This review describes occupational factors affecting sufficiency of rest and recovery, reviews veterinary-specific and relevant adjacent literature pertaining to sleep patterns, and discusses potential solutions for addressing occupational schedules contributing to sleep insufficiency and inadequate rest. Online databases were searched to extract contemporary literature pertaining to sleep, insufficient rest, and occupational factors, with a focus on veterinary medicine and other healthcare sectors.

Results

Occupational factors leading to inadequate rest among healthcare workers include excessive workloads, extended workdays, cumulative days of heavy work hours, and after-hours on-call duty. These factors are prevalent within the veterinary profession and may contribute to widespread insufficient rest and the resulting negative impacts on health and well-being among veterinarians.

Conclusion and clinical relevance

Sufficient sleep quantity and quality are critical to physical and mental health and are negatively affected by many aspects of the veterinary profession. Critical review of current strategies employed in clinical practice is essential to promote professional fulfillment, health, and well-being among veterinarians.

The Impact of Union Membership on Nursing Turnover and Job Satisfaction

OBJECTIVE

The present study examines the scope of nursing unions and the relationship with turnover and job satisfaction among RNs.

BACKGROUND

There is no recent empirical literature documenting evidence on workplace performance measures (turnover and job satisfaction) among unionized nurses at the national level.

METHODS

This cross-sectional study analyzed secondary data (n = 43 960), the 2018 National Sample Survey of Registered Nurses.

RESULTS

Approximately 16% of the sample reported being represented by labor unions. The overall nursing turnover rate for the sample was 12.8%. Unionized nurses were less likely than their counterparts to report turnover (mean, 10.9% vs 13.16%; P = 0.02) and less job satisfaction (mean, 3.20 vs 3.28). Union nurses were more likely than nonunion nurses to be male (12.72% vs 9.46%; P = 0.0004), minorities (37.65% vs 25.67%, P < 0.001), be employed in hospital settings (70.1% vs 57.9%, P = 0.001), but report fewer hours of work per week (mean, 36.73 vs 37.66; P = 0.003). Regression results revealed a positive association between union status and nursing turnover (odds ratio, 0.83; P < 0.05), whereas union status was inversely associated with job satisfaction (B = -0.13, P < 0.001) after adjusting for age, gender, race/ethnicity, care coordination time per week, weekly hours of work, and employment settings.

CONCLUSION

Overall, job satisfaction was high among all nurses, regardless of union membership. However, when comparing specifically union and nonunion members, unionized nurses were less likely to report turnover, but were more likely to experience job dissatisfaction.

Shift work characteristics and burnout among nurses: cross-sectional survey

BACKGROUND

Nurses working long shifts (≥12 h) experience higher levels of burnout. Yet other shift characteristics, including fixed versus rotating night work, weekly hours and breaks have not been considered. Choice over shift length may moderate the relationship; however, this has not been tested.

AIMS

To examine the association between shift work characteristics and burnout and exhaustion, and whether choice over shift length influences burnout and exhaustion.

METHODS

Cross-sectional online survey of nursing staff working in the UK and Ireland. We recruited two large National Health Service Trusts, through trade union membership, online/print nursing magazines and social media. We assessed associations using both univariable and multivariable generalized linear models.

RESULTS

We had 873 valid responses. Reports of inadequate staffing levels (odds ratio [OR] = 2.84; 95% confidence interval [CI] 2.08-3.90) and less choice over shift length (OR = 0.20; 95% CI 0.06-0.54) were associated with higher burnout in multivariable models. Similar associations were found for exhaustion, where rarely or never taking breaks was also a predictor (OR = 1.61; 95% CI 1.05-2.52). Nurses who worked long shifts had less choice than those working shifts of 8 h or less (66% of 12-h shift nurses versus 44% 8-h shift nurses reporting having no choice), but choice did not moderate the relationship between shift length and burnout and exhaustion.

CONCLUSIONS

The relationship between long shifts and increased burnout reported previously might have arisen from a lack of choice for those staff working long shifts. Whether limited choice for staff is intrinsically linked to long shifts is unclear.

Shift work disorder, mental health and burnout among nurses: A cross-sectional study

AIM

The aim of the study was to examine the relationships among nurses' shift work disorder, mental health and burnout to inform efforts to alleviate shift work disorder.

DESIGN

This cross-sectional study was conducted in China using a web-based platform for questionnaire.

METHODS

The study was comprised of a convenience sample of 1,268 Registered Nurses from 21 public hospitals in mainland China from June 2019-July 2019. Participants completed a web-based survey designed to collect demographic and other self-reported data. An independent sample t test and Pearson correlation were performed to analyse the relationship between shift work disorder, mental health and burnout.

RESULTS

The vast majority (98.2%) of the participants were women between the ages of 20-59 years. The participants exhibited a higher incidence of mental health problems (58.1%) and burnout (65.5%) and those with shift work disorder exhibited a higher risk of mental health problems and burnout than those who did not have shift work disorder. Our research demonstrated that shift work disorder, combined with other variables, accounted for 40.5% of the variance in mental health (R²  = .405, adjusted R²  = .401, F = 107.214, p < .001) and 36.5% in burnout (R²  = .365, adjusted R²  = .361, F = 90.323, p < .001). Moreover, burnout negatively regulated the relationship between shift work disorder and mental health.

CONCLUSION

High-risk nurses with shift work disorder were at a much higher risk of mental health problems and burnout.

Effects of nurses' schedule characteristics on fatigue: An integrative review

An integrative review of 21 studies found mixed results on the associations of work schedule and nurse fatigue. Suggestions for nurse leaders include monitoring fatigue in shift workers, ensuring supportive work design, promoting a healthy lifestyle, and implementing scheduling interventions.

Shift Length and Shift Length Preference Among Acute Care Surgeons

BACKGROUND

Work hour restrictions have been imposed by the Accreditation Council for Graduate Medical Education since 2003 for medical trainees. Many acute care surgeons currently work longer shifts but their preferred shift length is not known.

METHODS

The purpose of this study was to characterize the distribution of the current shift length among trauma and acute care surgeons and to identify the surgeons' preference for shift length. Data collection included a questionnaire with a national administration. Frequencies and percentages are reported for categorical variables and medians and means with SDs are reported for continuous variables. A chi-square test of independence was performed to examine the relation between call shift choice and trauma center level (level 1 and level II), age, and gender.

RESULTS

Data from 301 surgeons in 42 states included high-level trauma centers. Assuming the number of trauma surgeons in the United States is 4129, a sample of 301 gives the survey a 5% margin of error. The median age was 43 years (M = 46, SD = 9.44) and 33% were female. Currently, only 23.3% of acute care surgeons work a 12-hour shift, although 72% prefer the shorter shift. The preference for shorter shifts was statistically significant. There was no significant difference between call shift length preference and trauma center level, age, or gender.

CONCLUSION

Most surgeons currently work longer than 12-hour shifts. Yet, there was a preference for 12-hour shifts indicating there is a gap between current and preferred shift length. These findings have the potential to substantially impact staffing models.

The unintended detrimental effects of pursuing a professional vocation: The case of veterinarians

Pursuing one's life calling can be personally fulfilling and professionally rewarding, but it also requires sacrifice. We provide evidence of a strong vocational drive using veterinary students as a case study and find that they willingly contribute higher monetary donations for helping animals relative to students in other fields. We also find a significant reduction in the cognitive performance of veterinarian students when exposed to an animal-in-need manipulation. The performance of non-veterinary students in the cognitive task is unaffected by the manipulation. Our results highlight the need for programs to address the economic, financial, and mental health well-being of students and professionals to promote sustainable vocational career commitment. "You owe it to all of us to get on with what you're good at." W.H. Auden.

Association of Work Schedules With Nurse Turnover: A Cross-Sectional National Study

Objective: To examine the relationship of work schedules with nurse turnover across various work settings. Methods: A cross-sectional study design was used with data collected from 17,046 nurses who participated in the 2018 National Sample Survey of Registered Nurses in the U.S. Multivariate logistic regression was used to examine the effects of work hours and overtime on nurse turnover. Results: Longer weekly work hours increased nurse turnover (OR = 1.104, 95% confidence interval [CI] = 1.006-1.023). A non-linear relationship was observed between overtime and turnover. Compared with nurses with no overtime, the turnover for nurses working 1-11 h overtime per week decreased (OR = 0.893, 95% CI = 0.798-0.999). When nurses worked ≥12 h, turnover increased (OR = 1.260, 95% CI = 1.028-1.545). Earning from the primary nursing position decreased turnover among nurses working in hospitals, other inpatient settings, and clinics. Job satisfaction decreased turnover. Conclusion: To prevent nurse turnover, it is important to monitor and regulate nurses' working hours at institutional and government levels. Government support and policy implementations can help prevent turnover.

Mental health status of mental health nurses in China: Results from a national survey

INTRODUCTION

It has been acknowledged in China that actions should be taken immediately to ease the critical shortage of psychiatric nurses. However, with national data lacking, little is known about nurses' mental health status.

AIM

To evaluate psychiatric nurses' mental health status by measuring their burnout, depression, anxiety and stress.

METHODS

All psychiatric nurses in the 41 selected hospitals in China were invited to participate in the survey. The Maslach Burnout Inventory-Human Service Survey and Depression Anxiety Stress Scale were used to assess variables of interest.

RESULTS

38.6% of psychiatric nurses met the criteria for burnout. The rates of depression, anxiety and stress were 26.3%, 36.4% and 12.5%, respectively. It was found that workplace region, educational level, working years, longer working hours and night shifts were associated with risk of burnout and DASS.

CONCLUSIONS

More than a quarter of psychiatric nurses are suffering from burnout, depression or anxiety in China. Policymakers and hospital administrators should design a flexible schedule and restrict working hours for psychiatric nurses to achieve work-life balance.

IMPLICATIONS FOR PRACTICE

The study informs policymakers and administrators on addressing the nursing shortage by identifying nurses immersed in negative emotions and preventing mental health problems.

'Should I stay or should I go?': A mixed methods study on nurse retention during challenging times

BACKGROUND

The World Health Organization estimates that between 80,000 and 180,000 medical personnel perished as a result of COVID-19. Although studies about nurses' organizational commitment during the COVID-19 pandemic have been conducted, the sources of motivations and resilience strategies of nurses in providing a quality healthcare service amidst the COVID-19 pandemic have yet to be explored.

OBJECTIVE

This study aimed to investigate how motivation and resilience influence nurses to serve and cater to patients during the COVID-19 pandemic.

METHODS

A sequential exploratory mixed approach was used in this study between July and August 2022. The Connor-Davidson Resilience Scale (CD-RISC-10), Work Extrinsic and Intrinsic Motivations scale (WEIMS), and Garbee and Killacky's Intent to Stay Scale (GKISS) were used to measure resilience, motivation, and intention to stay, among 50 nurses within Metro Manila. Quantitative data were analyzed using quantile regression, while qualitative data from eight participants were analyzed using thematic analysis.

RESULTS

The majority of the nurses were working 12 hours and above (52%) and earning a bi-weekly income of PHP 15,001 to 20,000 (96%). The GKISS scores of most respondents indicated their likelihood of remaining in their current profession was moderately low (Mdn = 12.5; IQR = 12-14). It was also found that there was no sufficient statistical evidence to conclude that intention to stay was associated with resilience (p = 0.914) and work motivation (p = 0.560). The qualitative strand of this study explored the significant influences of motivation, resilience strategies, and sources of intention to stay among Filipino nurses while facing the COVID-19 pandemic. The primary motivations of nurses lie in family, passion for work, and career development, while the resilience strategies include adaptiveness, time management skills, and self-fulfillments. On the other hand, the intent to stay greatly lies in serving the people and the country.

CONCLUSION

This study concludes that positive and negative resilience and motivations from different facets of the social life of Filipino nurses, including passion, familial ties, patient care, and faith are the antecedents influencing the intention to serve in the healthcare service. In terms of staying for an extended period in a nursing career, the study found that institutionalized interventions, adequate compensation and benefits, and a good workplace are determinants of staying longer in the Philippines as Filipino nurses.

Analysis and mapping of global research publications on shift work (2012-2021)

BACKGROUND

The main objective of the study was to identify research trends, collaboration patterns, and the most impactful publications in the field of shift work.

METHODS

Documents published in scientific journals indexed in the Scopus database on shift work were retrieved and analyzed using the title/abstract search methodology. The study period was from January 1st, 2012, to December 31st, 2021.

RESULTS

Two thousand three hundred twenty-eight documents were retrieved with an h-index of 71 and an average number of 4.5 authors per document. The cumulative number of publications showed a linear growth pattern, while that of citations showed an exponential pattern. The most frequent author keywords, excluding keywords related to shift work, were sleep, fatigue, and nursing. The average annual growth rate was 4.3, and the average doubling time was 3.2. No significant correlation was found between the number of publications and national income among prolific countries. Cross-country research collaboration was weak while the degree of author-author collaboration was relatively high. The Chronobiology International journal was the most prolific, while Harvard University was the most active institution in the field of shift work.

CONCLUSIONS

Given the volume and the negative health impact of shift work, better human resource management is needed to create safer and healthier working schedules.

Case-Mix Moderation of the Relationship Between OR Performance Metrics and Utilization

We investigated the impact of the case-mix ratio of inpatients to outpatients on the relationships between OR utilization and late starts, turnover time, delays, cancellations, and idle time at an academic medical center in the southeastern United States. After extracting 55 months of data from the surgical repository, we used simple and multiple linear regression models to analyze the data and determine the strength and direction of the relationships among the variables. We compared models comprising proportionally more inpatients to models comprising proportionally more outpatients for each metric to ascertain the effects of case mix on OR utilization. Idle time had the greatest effect on OR utilization, followed by late starts and turnover time. Case mix moderated the relationship between OR utilization and the metrics of cancellations and turnover time. Perioperative leaders may enhance OR utilization by monitoring and addressing idle time and late starts and scheduling an appropriate mix of inpatients and outpatients.

Effect of Marriage on Burnout among Healthcare Workers during the COVID-19 Pandemic

Since the onset of the COVID-19 pandemic, burnout symptoms have been prevalent among healthcare workers. Living with spouses can be complex and was associated with an increased burnout risk during the COVID-19 pandemic. This study investigated the relationship between living with spouses and burnout among healthcare workers during the COVID-19 pandemic. We distributed questionnaires to participants working in a hospital affiliated with a medical university in Taiwan. The questionnaires were the Copenhagen Burnout Inventory, which comprises personal burnout (PB), work-related burnout (WB), and client burnout subscales; the Nordic Musculoskeletal Questionnaire; and information on basic demographic variables, family factors, living habits, work-related factors, and physical health factors. Multiple linear regression and mediation analysis were used. We obtained 1615 (63.81%) valid questionnaires. After analysis revealed that marriage was an independent risk factor for PB; however, the effect of marriage on WB was nonsignificant after controlling for risk factors. Parenthood, less alcohol use, reported sleep duration less than six hours, less overtime, less shift work, and participation in leisure activities with family and friends were found to be mediators between marriage and a lower WB level. In addition, chronic diseases, frequent neck pain, and shoulder pain were suppression factors. In summary, marriage was associated with an increased risk of PB. Married individuals sustain a high WB level because of changes in family roles, living conditions, and work conditions. Overall, helping healthcare workers to maintain well-being in marriage or family living may be effective in decreasing burnout during the COVID-19 pandemic.

Compassion fatigue and burnout in Turkish pediatric emergency nurses during the COVID-19 pandemic

PURPOSE

This study was conducted to determine compassion fatigue and burnout in nurses working in the pediatric emergency department (PED) during the COVID-19 pandemic in Turkey.

DESIGN AND METHODS

This descriptive and cross-sectional study was conducted with 164 nurses working in the PED and following the social media platforms of the Emergency Nurses Association between September 1, 2020, and January 1, 2021. Data were collected using the online survey method with the Descriptive Data Form, Maslach Burnout Inventory (MBI), and Compassion Fatigue-Short Scale (CF-SS).

RESULTS

Pediatric emergency nurses reported that they experienced high emotional exhaustion (28.25 ± 6.05) and depersonalization (11.89 ± 2.39), low personal accomplishment (17.98 ± 3.12), and moderate compassion fatigue (4.99 ± 1.43).

CONCLUSION

Pediatric emergency nurses had high levels of burnout and moderate levels of compassion fatigue during the pandemic in Turkey. To prevent any long-term negative effects of the pandemic, addressing the physiological, psychological, and psychosocial needs of nurses should be prioritized.

PRACTICAL IMPLICATIONS

Compassion fatigue and burnout can affect the quality of care provided by nurses, but also negatively affect their well-being and quality of life during the pandemic. Therefore, the development of interventions to reduce compassion fatigue and burnout can help manage these symptoms.