Nurses' Intent to Leave their Position and the Profession During the COVID-19 Pandemic

Workplace violence, work-related exhaustion, and workplace cognitive failure among nurses: A cross-sectional study

AIM

To examine the relationships between nurses' exposure to workplace violence and self-reports of workplace cognitive failure.

DESIGN

A cross-sectional study.

METHODS

An online questionnaire was administered in April 2023 to nurses in Michigan, US. Structural equation modelling was used to examine effects of physical and non-physical workplace violence (occupational stressors) and work efficiency and competence development (occupational protective factors) on workplace cognitive failure.

RESULTS

Physical violence was a significant predictor of the action subscale of cognitive failure. There were no direct effects of non-physical violence, workplace efficiency, or competence development on any of the workplace cognitive failure dimensions. Both types of violence and efficiency had significant indirect effects on workplace cognitive failure via work-related exhaustion. Work-related exhaustion predicted significantly higher scores for workplace cognitive failure.

CONCLUSION

Workplace violence and work efficiency exhibited primarily indirect effects on workplace cognitive failure among nurses via work-related exhaustion.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

Nurses experiencing workplace violence may be at increased risk for workplace cognitive failure, especially if they are also experiencing work-related exhaustion. Workplaces that nurses perceive as more efficient can help to mitigate the effects of violence on nurses' cognitive failure.

IMPACT

This study addressed the possible effects of workplace violence as well as work efficiency and competence development on nurses' cognitive failure at work. Analyses revealed primarily indirect effects of workplace violence, and indirect protective effects of work efficiency, on nurses' cognitive failure via work-related exhaustion. This research has implications for healthcare organizations and suggests that efforts made by healthcare workplaces to prevent violence and work-related exhaustion, and to enhance work efficiency, may help to mitigate workplace cognitive failure among nurses.

REPORTING METHOD

We have followed the STROBE checklist in reporting this study.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or public contribution.

Addressing Nurse Burnout: Moving Beyond the Conversation

BACKGROUND

Nurse burnout is a widespread issue in the health care industry, jeopardizing the well-being of both health care professionals and the patients they serve, manifesting as an intense sense of exhaustion, depersonalization, and a diminished sense of personal achievement.

METHOD

In nursing, professionals are exposed to an extraordinary array of challenges and demands that increase their likelihood of experiencing burnout and resulting mental health issues. Although burnout has been aggressively discussed and studied in recent years, strategies for preventing and mitigating burnout have been underreported.

RESULTS

This article highlights leading causes of burnout, delves into its alarming prevalence, and underscores the critical need for comprehensive strategies to address and prevent it.

CONCLUSION

This article highlights several initiatives established by a resilience program at a college of nursing that can be implemented within health care systems to directly address both individual and organizational burnout. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

Determinants of intention to leave among nurses and physicians in a hospital setting during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

The global outbreak of COVID-19 has brought to light the profound impact that large-scale disease outbreaks can have on healthcare systems and the dedicated professionals who serve within them. It becomes increasingly important to explore strategies for retaining nurses and physicians within hospital settings during such challenging times. This paper aims to investigate the determinants of retention among nurses and physicians during the COVID-19 pandemic.

METHOD

A systematic review of other potential determinants impacting retention rates during the pandemic was carried out. Secondly, a meta-analysis on the prevalence of intention to leave for nurses and physicians during the COVID-19 pandemic.

FINDINGS

A comprehensive search was performed within four electronic databases on March 17 2023. Fifty-five papers were included in the systematic review, whereas thirty-three papers fulfilled the eligibility criteria for the meta-analysis. The systematic review resulted in six themes of determinants impacting intention to leave: personal characteristics, job demands, employment services, working conditions, work relationships, and organisational culture. The main determinants impacting the intention to leave are the fear of COVID-19, age, experience, burnout symptoms and support. Meta-analysis showed a prevalence of intent to leave the current job of 38% for nurses (95% CI: 26%-51%) and 29% for physicians (95% CI: 21%-39%), whereas intention to leave the profession for nurses 28% (95% CI: 21%-34%) and 24% for physicians (95% CI: 23%-25%).

CONCLUSION

The findings of this paper showed the critical need for hospital managers to address the concerning increase in nurses' and physicians' intentions to leave during the COVID-19 pandemic. This intention to leave is affected by a complex conjunction of multiple determinants, including the fear of COVID-19 and the confidence in and availability of personal protective equipment. Moreover, individual factors like age, experience, burnout symptoms, and support are maintained in this review. Understanding the influence of determinants on retention during the COVID-19 pandemic offers an opportunity to formulate prospective strategies for retaining nurses and physicians within hospital settings.

Measuring the work environment among healthcare professionals: Validation of the Dutch version of the Culture of Care Barometer

OBJECTIVES

A positive work environment (WE) is paramount for healthcare employees to provide good quality care. To stimulate a positive work environment, employees' perceptions of the work environment need to be assessed. This study aimed to assess the reliability and validity of the Dutch version of the Culture of Care Barometer (CoCB-NL) survey in hospitals.

METHODS

This longitudinal validation study explored content validity, structural validity, internal consistency, hypothesis testing for construct validity, and responsiveness. The study was conducted at seven departments in two Dutch university hospitals. The departments were included based on their managers' motivation to better understand their employees' perception of their WE. All employees of participating departments were invited to complete the survey (n = 1,730).

RESULTS

The response rate was 63.2%. The content of the CoCB-NL was considered relevant and accessible by the respondents. Two factor models were found. First, confirmative factor analysis of the original four-factor structure showed an acceptable fit (X2 2006.49; df 399; p = <0.001; comparative fit index [CFI] 0.82; Tucker-Lewis index [TLI] 0.80; root mean square error of approximation [RMSEA] 0.09). Second, explanatory factor analysis revealed a five-factor model including 'organizational support', 'leadership', 'collegiality and teamwork', 'relationship with manager', and 'employee influence and development'. This model was confirmed and showed a better fit (X2 1552.93; df 395; p = < 0.00; CFI 0.87; TLI 0.86; RMSEA 0.07). Twelve out of eighteen hypotheses were confirmed. Responsiveness was assumed between the measurements.

CONCLUSIONS

The CoCB-NL is a valid and reliable instrument for identifying areas needing improvement in the WE. Furthermore, the CoCB-NL appears to be responsive and therefore useful for longitudinal evaluations of healthcare employees' work environments.

Attitudes and experiences related to the deaths of COVID-19 patients among nursing staff: A qualitative evidence synthesis

AIM

To identify and synthesize the experiences and attitudes of nursing staff regarding the deaths of COVID-19 patients.

REVIEW METHODS

A qualitative evidence synthesis was carried out, using Noblit and Hare's meta-ethnographic approach. The review protocol was listed in PROSPERO (CRD42022330928). Studies published from January 2020 to January 2022 that met the criteria were searched in PubMed, Web of Science, Scopus, CINAHL, CUIDEN and PsycInfo. A total of 12 articles were included.

RESULTS

Thirty-three metaphors emerged, which were grouped into three main themes: Determining factors of care, Feelings about death and Strategies for coping with death. Nurses reported the high emotional toll, the absence of family and the lack of staff, protocol and training as determining factors. Furthermore, staff had doubts about the quality of care that COVID-19 patients received. As coping strategies, nurses developed avoidance behaviours towards COVID-19 patients, selective memories, resilience, and/or leaving the profession.

CONCLUSIONS

The difficulty in providing adequate nursing care and the high number of deaths has increased anxiety and stress among nurses. These factors, alongside their lived experiences of seeing patients suffering, many dying alone without family members, have had psychological repercussions on nursing staff.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

The results demonstrate a high emotional toll and doubts surrounding their caregiving role caused by the lack of professional training needed to face a pandemic. This research shows what has been learned for future pandemics and highlights basic components that could provide a foundation for coping interventions for healthcare professionals.

IMPACT

WHAT PROBLEM DID THE STUDY ADDRESS?: The challenges posed by COVID-19 patient deaths for nursing staff around the world and also by the pandemic circumstances in which those deaths occurred. WHAT WERE THE MAIN FINDINGS?: The high number of deceased patients who were isolated from family members, communication with family members and doubts surrounding care given during the pandemic have created feelings of fear, stress and anxiety, as well as obsessive thoughts that have changed nursing staff's perception of death due to COVID-19. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: Results will be useful for preparing for future pandemics, and for policymakers and health staff in supporting healthcare professionals by creating programmes to help them cope with the emotional toll they have felt after dealing with death in such unprecedented circumstances.

REPORTING METHOD

The authors have adhered to the PRISMA guidelines and the eMERGe Reporting Guidance.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Factors Associated With Intent to Leave the Profession for the Allied Health Workforce: A Rapid Review

Shortages of satisfied and well-trained health care professionals are an urgent threat for health systems worldwide. Although numerous studies have focused on retention issues for nurses and physicians, the situation for the allied health workforce remains understudied. We conducted a rapid review of the literature on allied health workers to investigate the main reasons for leaving their profession. 1,305 original research articles were retrieved from databases MEDLINE, CINAHL, PsycInfo, and Epistemonikos, of which 29 were eligible for data extraction. Reviewed studies featured mainly pharmacists, psychologists, dietitians, physical therapists, emergency medical professionals, and occupational therapists. We categorized 17 typical factors of the intent to leave as organizational, psychological, team and management, and job characteristics. The relative importance of each factor was assessed by measuring its prevalence in the selected literature. By revealing common themes across allied health professions, our work suggests actionable insights to improve retention in these vital services.

Moral Distress and Intention to Leave During COVID: A Cross-sectional Study on the Current Nursing Workforce to Guide Nurse Leaders for the Future

OBJECTIVE

The aim of this study was to investigate how the experience of caring for COVID-19 patients, nurses' moral distress, and the current practice environment impact nurses' intention to leave.

BACKGROUND

Caring for COVID-19 patients has been associated with an increase in nurses' moral distress and an increase in nurses' turnover. To date, research has focused on nurses' moral distress, the practice environment, and intentions to leave during the pandemic's peak. The current workplace climate, including those who stayed in their positions, has not been adequately assessed.

METHODS

This cross-sectional correlational study was conducted in a Magnet® hospital.

RESULTS

Moral distress related to team/system (B = 0.64, t = 3.86, P < 0.001), nurses' participation in hospital affairs (B = -2.21, t = -3.52, P < 0.001), and staffing (B = -1.91, t = -5.48, P < 0.001) are strongest predictors for nurses' intention to leave postpandemic.

CONCLUSIONS

Nurses in practice still report experiencing COVID-related moral distress; however; issues related to resources and staffing have the most substantial impact on intention to leave among the current nursing workforce.

Exploring US Nursing Leadership During the Initial COVID-19 Pandemic Response: A Qualitative Descriptive Study to Guide Leadership Development for Future Emergent Situations

OBJECTIVE

This study aimed to describe the experiences of nurse leaders during the 1st wave of the COVID-19 pandemic to enhance understanding in preparation for future disasters.

BACKGROUND

The COVID-19 pandemic has posed significant challenges to the healthcare system globally. Nurse leaders play an essential part and have a significant impact on the efficacy of disaster management in future emergent situations.

METHODS

The parent study conducted interviews with 100 nurses in the United States across specialty areas. This article presents a subgroup analysis of interview data from 13 self-identified nurse leaders. The research team used qualitative descriptive methodology and thematic analysis to identify patterns within the data.

RESULTS

Five themes were identified for effective nurse leadership during an emerging pandemic: 1) responsiveness; 2) anticipating needs; 3) care innovations; 4) collaboration; and 5) adaptability.

CONCLUSION

Supporting nurse leaders to exhibit effective leadership during periods of crisis is imperative to increase preparedness for future health events, protect population health, and create a pipeline of future nursing leadership. Involving nursing in developing and reforming policy is integral.

Clinical Nurse Well-being Improved Through Transcendental Meditation: A Multimethod Randomized Controlled Trial

OBJECTIVE

To evaluate the impact of Transcendental Meditation® (TM®) practice on the multidimensional well-being of nurse clinicians affected by the COVID-19 pandemic.

BACKGROUND

The health of clinical nurses has substantial impact on both the availability of a nursing workforce and the quality and safety of patient care. TM improved health and coping strategies across many populations.

METHODS

Clinical nurses were recruited from 3 Magnet®-designated hospitals during the COVID-19 pandemic. Well-being outcomes included flourishing, burnout, anxiety, and posttraumatic stress disorder. Participants were randomized following completion of baseline surveys into immediate (intervention) or delayed (control) TM instruction. Surveys were repeated at 1 and 3 months following baseline survey or TM instruction. Repeated-measures analysis of variance compared differences in groups over time.

RESULTS

Across the 3 sites, there were 104 clinical nurse participants. Repeated-measures analysis of variance showed significant medium to large effects in improvement over time in well-being measures for the intervention group.

CONCLUSIONS

TM improved multidimensional well-being of clinical nurses by reducing posttraumatic stress disorder, anxiety, and burnout and improving flourishing. TM is easy to practice anywhere. The benefits are immediate and cumulative. Organizations and individual nurses can use TM to support clinical nurses in the difficult and meaningful work of patient care, especially in challenging times. Future studies may consider the feasibility of integrating TM into clinical shifts and evaluating its impact on patient and organizational outcomes.

Barriers and Facilitators to Clinical Practice Development in Men and Women Surgeons

Importance

Many early-career surgeons struggle to develop their clinical practices, leading to high rates of burnout and attrition. Furthermore, women in surgery receive fewer, less complex, and less remunerative referrals compared with men. An enhanced understanding of the social and structural barriers to optimal growth and equity in clinical practice development is fundamental to guiding interventions to support academic surgeons.

Objective

To identify the barriers and facilitators to clinical practice development with attention to differences related to surgeon gender.

Design, Setting, and Participants

A multi-institutional qualitative descriptive study was performed using semistructured interviews analyzed with a grounded theory approach. Interviews were conducted at 5 academic medical centers in the US between July 12, 2022, and January 31, 2023. Surgeons with at least 1 year of independent practice experience were selected using purposeful sampling to obtain a representative sample by gender, specialty, academic rank, and years of experience.

Main Outcomes and Measures

Surgeon perspectives on external barriers and facilitators of clinical practice development and strategies to support practice development for new academic surgeons.

Results

A total of 45 surgeons were interviewed (23 women [51%], 18 with ≤5 years of experience [40%], and 20 with ≥10 years of experience [44%]). Surgeons reported barriers and facilitators related to their colleagues, department, institution, and environment. Dominant themes for both genders were related to competition, case distribution among partners, resource allocation, and geographic market saturation. Women surgeons reported additional challenges related to gender-based discrimination (exclusion, questioning of expertise, role misidentification, salary disparities, and unequal resource allocation) and additional demands (related to appearance, self-advocacy, and nonoperative patient care). Gender concordance with patients and referring physicians was a facilitator of practice development for women. Surgeons suggested several strategies for their colleagues, department, and institution to improve practice development by amplifying facilitators and promoting objectivity and transparency in resource allocation and referrals.

Conclusions and Relevance

The findings of this qualitative study suggest that a surgeon's external context has a substantial influence on their practice development. Academic institutions and departments of surgery may consider the influence of their structures and policies on early career surgeons to accelerate practice development and workplace equity.

Work Engagement, Burnout, and Well-being in Nursing Professional Development Practitioners

Work engagement, burnout, and well-being in nursing professional development practitioners during the second year of COVID-19 were explored. Increased levels of work engagement were associated with decreased burnout and higher levels of well-being. Significant differences were noted in work engagement and burnout among those with more than 1 year of nursing professional development experience. Examining the health of the specialty highlights current concerns and provides insight into developing interventions to address the consequences of the pandemic.

Effect of mode of healthcare delivery on job satisfaction and intention to quit among nurses in Canada during the COVID-19 pandemic

The COVID-19 pandemic resulted in a major shift in the delivery of healthcare services with the adoption of care modalities to address the diverse needs of patients. Besides, nurses, the largest profession in the healthcare sector, were imposed with challenges caused by the pandemic that influenced their intention to leave their profession. The aim of the study was to examine the influence of mode of healthcare delivery on nurses' intention to quit job due to lack of satisfaction during the pandemic in Canada. This cross-sectional study utilized data from the Health Care Workers' Experiences During the Pandemic (SHCWEP) survey, conducted by Statistics Canada, that targeted healthcare workers aged 18 and over who resided in the ten provinces of Canada during the COVID-19 pandemic. The main outcome of the study was nurses' intention to quit within two years due to lack of job satisfaction. The mode of healthcare delivery was categorized into; in-person, online, or blended. Multivariable logistic regression was performed to examine the association between mode of healthcare delivery and intention to quit job after adjusting for sociodemographic, job-, and health-related factors. Analysis for the present study was restricted to 3,430 nurses, weighted to represent 353,980 Canadian nurses. Intention to quit job, within the next two years, due to lack of satisfaction was reported by 16.4% of the nurses. Results showed that when compared to participants who provided in-person healthcare services, those who delivered online or blended healthcare services were at decreased odds of intention to quit their job due to lack of job satisfaction (OR = 0.47, 95% CI: 0.43-0.50 and OR = 0.64, 95% CI: 0.61-0.67, respectively). Findings from this study can inform interventions and policy reforms to address nurses' needs and provide organizational support to enhance their retention and improve patient care during times of crisis.

Recommendations From a Systematic Review of Leadership Development to Support a New Nursing Practice Model

OBJECTIVE

To develop a new nursing practice model for use within the US military, researchers aimed to create evidence-based recommendations for nursing leadership development based on current literature.

BACKGROUND

The role of nursing leadership has many implications, including better nurse and patient outcomes. Therefore, an actionable compilation of recommendations informing how to develop effective nurse leaders could be helpful for current and aspiring nurse leaders.

METHODS

Researchers conducted a systematic literature review of 5 databases searching for relevant articles published from 2001 to 2020.

RESULTS

Seventy-eight articles were synthesized to develop a list of 5 broad yet actionable recommendations for leadership development.

CONCLUSIONS

Leadership development is essential for current and future nurse leaders. The recommendations identified from this review can assist in developing leaders. Leaders can use these recommendations to guide leadership training initiatives, engage in self-development, or begin succession planning.

Nurses' Experiences and Perspectives of the Telehealth Working Environment and Educational Needs

BACKGROUND

The continuing evolution of health care and the nursing profession includes the exponential growth of telehealth platforms. The goal of this study was to describe nurses' experiences with and perspectives on their practice with and future need for telehealth.

METHOD

A cross-sectional descriptive mixed methods study was conducted with nursing graduates from a single university. Completed survey questions focused on demographics, current work status, plans for employment participation, and telehealth experience. Descriptive analysis was conducted with statistical software, with directed content analysis for narrative responses.

RESULTS

A total of 305 of 5,080 participants completed the survey (6% response rate). Nurses described perceived benefits and barriers to working in a telehealth environment. Nurses identified continuing education needs that could form the basis for a telehealth continuing education program to increase confidence in telehealth delivery.

CONCLUSION

The identified telehealth educational needs will positively influence the formation of continuing education opportunities for practicing nurses. [J Contin Educ Nurs. 2023;54(11):501-508.].

Work alienation and its relationship with job crafting and job embeddedness among a group of Iranian nurses during the coronavirus disease 2019 pandemic

Background

The difficult work conditions of nurses during the coronavirus disease 2019 (COVID-19) pandemic can cause them work alienation. Work alienation is in turn associated with negative consequences such as turnover intention. Therefore, identifying the contributing factors of work alienation is essential.

Aim

This study aimed to assess the relationship of work alienation with job crafting and job embeddedness among a group of Iranian nurses during the COVID-19 pandemic.

Methods

A total of 332 eligible nurses participated in this descriptive correlational study. The data were collected using a demographic questionnaire, the work alienation measure, the job crafting scale and the global measure of job embeddedness.

Results

The mean scores of work alienation, job embeddedness and job crafting were 22.67 ± 6.46 (possible range: 7-49), 21.05 ± 3.65 (possible range: 7-35) and 77.54 ± 11.93 (possible range: 21-105), respectively. Work alienation had a significant inverse correlation with job embeddedness and job crafting. Job crafting and job embeddedness significantly predicted 44% of the variance of work alienation.

Conclusions

Around half of the variance of work alienation is explained by job crafting and job embeddedness. Nursing managers can use strategies to improve nurses' job embeddedness and job crafting in order to reduce the probability of their work alienation.

The associations among nurse work engagement, job satisfaction, quality of care, and intent to leave: A national survey in the United States

Objectives

Employee work engagement, job satisfaction, quality of care, and intent to leave are critical indicators for healthcare organizational performance. This study aimed to analyze the current state of nurses' work engagement and its factors to examine the associations among nurses' work engagement, job satisfaction, quality of care, and intent to leave in the United States (US).

Methods

This is a quantitative descriptive cross-section design. Data were collected online from the US registered nurses from March to September 2022. Measures comprised the Utrecht Work Engagement Scale, the demographics, and questions regarding job satisfaction, perceived quality of care, and intent to leave.

Results

Nine hundred nurses participated in the online survey. Among the participants, 79.2% reported holding a specialty certification, 59.4% scored high/very high on job satisfaction, 82.2% expressed high/very high on the perceived quality of nursing care, and 28.4% conveyed likely/very likely to leave in the following year. Nurses' work engagement was positively associated with nurses' job satisfaction and their perceived quality of care but negatively associated with intent to leave. More certified nurses reported high or very high job satisfaction than non-certified nurses. As for demographics, the linear regression analysis showed that nurses who were older, identified as White, and held doctorate degrees reported higher levels of work engagement in comparison to their counterparts.

Conclusions

This study shows that nurses' work engagement is associated with their job satisfaction, perceived quality of care, and intent to leave. Nurses' work engagement in this study is lower than in other studies, especially before the COVID-19 pandemic, which may indicate a possible association with the COVID-19 impact. Because nurses' work engagement is significantly associated with job satisfaction, nurse leaders need to find ways to promote nurses' job satisfaction and retention.

Wake-up Call: Night Shifts Adversely Affect Nurse Health and Retention, Patient and Public Safety, and Costs

The purpose of this mini review is to (1) summarize the findings on the impact of night shift on nurses' health and wellness, patient and public safety, and implications on organizational costs and (2) provide strategies to promote night shift nurses' health and improve organizational costs. The night shift, compared with day shift, results in poorer physical and mental health through its adverse effects on sleep, circadian rhythms, and dietary and beverage consumption, along with impaired cognitive function that increases nurse errors. Nurse administrators and health care organizations have opportunities to improve nurse and patient safety on night shifts. Low-, moderate-, and higher-cost measures that promote night nurses' health and well-being can help mitigate these negative outcomes. The provided individual and organizational recommendations and innovations support night shift nurses' health, patient and public safety, and organizational success.

Professional Fulfillment, Burnout, and Turnover Intention Among US Dialysis Patient Care Technicians: A National Survey

RATIONALE & OBJECTIVE

High professional fulfillment and low burnout and staff turnover are necessary for a stable dialysis workforce. We explored professional fulfillment, burnout, and turnover intention among US dialysis patient care technicians (PCTs).

STUDY DESIGN

Cross-sectional national survey.

SETTING & PARTICIPANTS

National Association of Nephrology Technicians/Technologists (NANT) members in March-May 2022 (N=228; 42.6% aged 35-49 years, 83.9% female, 64.6% White, 85.3% non-Hispanic).

EXPOSURE

Likert-scale items (range, 0-4) related to professional fulfillment and 2 domains of burnout (work exhaustion and interpersonal disengagement) and dichotomous items related to turnover intention.

ANALYTICAL APPROACH

Summary statistics (percentages, means, medians) were calculated for individual items and average domain scores. Burnout was defined by combined work exhaustion and interpersonal disengagement scores of≥1.3 and professional fulfillment by a score≥3.0.

RESULTS

Most respondents (72.8%) worked ≥40 hours per week. Overall scores for work exhaustion, interpersonal disengagement, and professional fulfillment (median [IQR]) were 2.3 (1.3-3.0), 1.0 (0.3-1.8), and 2.6 (2.0-3.2), respectively; 57.5% reported burnout, and 37.3% reported professional fulfillment. Important contributors to burnout and professional fulfillment included salary (66.5%), supervisor support (64.0%), respect from other dialysis staff (57.8%), sense of purpose about work (54.5%), and hours worked per week (52.9%). Only 52.6% reported that they plan to be working as a dialysis PCT in 3 years. Free text responses reinforced perceived excessive work burden and lack of respect.

LIMITATIONS

Limited generalizability to all US dialysis PCTs.

CONCLUSIONS

More than half of dialysis PCTs reported burnout, driven by work exhaustion; only about one-third reported professional fulfillment. Even among this relatively engaged group of dialysis PCTs, only half intended to continue working as PCTs. Because of the critical, frontline role of dialysis PCTs in the care of patient receiving in-center hemodialysis, strategies to improve morale and reduce turnover are imperative.

The Impact of DNP Scholarly Projects on Healthcare Organizations: A Road Map for Success

Many DNP scholarly projects occur in healthcare organizations, often taking various forms based on specific academic requirements. Projects require site mentorship, project facilitation, and institutional review board resources. This article highlights the impact of DNP scholarly projects on healthcare organizations and provides a road map for success for healthcare leaders and site mentors.

Relationship between three aspects of resilience-adaptive characteristics, withstanding stress, and bouncing back-in hospital workers exposed to prolonged occupational stress during the COVID-19 pandemic: a longitudinal study

BACKGROUND

The term resilience is used to refer to multiple related phenomena, including: (i) characteristics that promote adaptation to stressful circumstances, (ii) withstanding stress, and (iii) bouncing back quickly. There is little evidence to understand how these components of resilience are related to one another. Skills-based adaptive characteristics that can respond to training (as opposed to personality traits) have been proposed to include living authentically, finding work that aligns with purpose and values, maintaining perspective in the face of adversity, managing stress, interacting cooperatively, staying healthy, and building supportive networks. While these characteristics can be measured at a single time-point, observing responses to stress (withstanding and bouncing back) require multiple, longitudinal observations. This study's aim is to determine the relationship between these three aspects of resilience in hospital workers during the prolonged, severe stress of the COVID-19 pandemic.

METHODS

We conducted a longitudinal survey of a cohort of 538 hospital workers at seven time-points between the fall of 2020 and the spring of 2022. The survey included a baseline measurement of skills-based adaptive characteristics and repeated measures of adverse outcomes (burnout, psychological distress, and posttraumatic symptoms). Mixed effects linear regression assessed the relationship between baseline adaptive characteristics and the subsequent course of adverse outcomes.

RESULTS

The results showed significant main effects of adaptive characteristics and of time on each adverse outcome (all p < .001). The size of the effect of adaptive characteristics on outcomes was clinically significant. There was no significant relationship between adaptive characteristics and the rate of change of adverse outcomes over time (i.e., no contribution of these characteristics to bouncing back).

CONCLUSIONS

We conclude that training aimed at improving adaptive skills may help individuals to withstand prolonged, extreme occupational stress. However, the speed of recovery from the effects of stress depends on other factors, which may be organizational or environmental.

Telenursing: A Concept Analysis

The national nursing shortage is affecting hospital leaders in their ability to employ nursing staff. Nursing staffing shortages contribute to extended nurse-to-patient ratios and increased workload for staff. Increased workload contributes to missed nursing care and correlates with increased patient length of stay, readmission rates, patient safety errors, and hospital-acquired infections. Telehealth services have shown initial improvements in care quality outcomes but have not addressed nursing workload or nursing shortages. Telenursing has potential to provide additional nursing support to offset the workloads of bedside nursing staff and break the associated cycle of adverse outcomes. Various definitions of telenursing are present in the literature, but a concept analysis of telenursing has not been published. Understanding the concept of telenursing is necessary to integrate this concept within the context of researching nursing shortages and patient and nurse outcomes in acute care hospitals. The author used Walker and Avant's eight-step procedure to define the concept of telenursing and present a model case, a related case, and a contrary case to describe the telenursing concept. This concept analysis helps to provide clarity around the concept of telenursing and directions for future research. Understanding the concept of telenursing is necessary to integrate this concept within the context of researching nursing shortages, nursing satisfaction, and patient and nurse outcomes in various healthcare settings.

Exploration of California School Nurse perspectives on the impact of COVID-19

OBJECTIVE

To explore in a sample of school nurses (SN) in California the impact of the COVID-19 pandemic on school nurse health services, how school nurses mitigated the impact of COVID-19, and moral distress levels among school nurses.

DESIGN AND METHODS

Nineteen (N = 19) school nurses who work in K-12 schools in California, USA participated in a mixed-methods approach involving qualitative descriptive design, inductive content analysis, and descriptive statistics. Interviews were conducted in August and September 2021.

RESULTS

Five themes emerged: (1) role of the SN during the COVID-19 pandemic, (2) coordination with school administration, (3) COVID-19 related challenges and disruptions to care, (4) moral distress, and (5) coping during the pandemic.

CONCLUSION

The pandemic had a profound impact on school nurses. This study provides school nurse perspectives of the impact of COVID-19 on services they delivered, the unique skills of school nurses essential to mitigation strategies, and moral distress school nurses encountered during the pandemic. Understanding the important role school nurses had during the pandemic is paramount to fully contextualize the contributions they made within public health nursing practice and inform preparedness for future pandemics.

Empathy and Occupational Health and Well-Being in Ecuadorian Physicians Working with COVID-19 Patients: A Mixed-Method Study

Approximately one out of ten COVID-19 cases in Ecuador was a physician. It has been reported that this situation has led to a serious detriment of physicians' health and well-being. This study aimed to (i) identify predictors of emotional exhaustion, somatization, and work alienation in Ecuadorian physicians working with COVID-19 patients and (ii) explore the pandemic impact on doctor-patient relationships and on empathy. In 79 Ecuadorian physicians (45 women) who worked with COVID-19 patients, two separate multiple regression models explained the following: 73% of the variability of emotional exhaustion was based on somatization, work alienation, working sector, and passing through a symptomatic infection (p < 0.001), and 56% of the variability of somatization was based on gender and emotional exhaustion (p < 0.001), respectively. Furthermore, intention to leave the profession was more frequent among physicians with greater work alienation (p = 0.003). On the contrary, more empathic physicians never considered leaving their profession during the COVID-19 pandemic (p = 0.03). In physicians' verbatim, cognitive empathy appeared associated to a positive change in doctor-patient relationships. On the contrary, having an overwhelming emotional empathy appeared associated to a negative change in doctor-patient relationships. These findings characterize differences in how physicians cope while working in the frontline of the pandemic.

The Experience of Frontline Nurses during the COVID-19 Pandemic: A Phenomenological Study

The purpose of this phenomenological study was to describe the experience of frontline nurses working during the COVID-19 pandemic. The first author conducted two individual audiotaped interviews with 23 qualified staff nurses. All the authors analyzed the professionally transcribed data according to hermeneutic principles. The researchers identified five major themes: (a) we are family; (b) heroes work here; (c) fear of contagion; (d) mental health and well-being; and (e) new reality. Given the uncertainties of working during the COVID-19 pandemic, findings revealed the value of supportive collegial relationships and the need to support the mental health and well-being needs of frontline nurses during the pandemic. Nurses need supportive environments to help ease the challenges associated with serving on the frontline during times of crisis. Findings have implications for future public health preparedness and response efforts.

Factors Influencing Perioperative Nurse Turnover: A Classic Grounded Theory Study

Perioperative nurse turnover rates range from 12% to 18.8%, and approximately 75% of perioperative managers reported at least one vacancy in 2021. Perioperative leaders are challenged to mitigate nurse turnover effectively because factors contributing to a nurse's decision to leave their job are not well defined. The purpose of this qualitative study using classic grounded theory was to explore perioperative nurses' turnover decision-making processes. We used social media to recruit participants and then conducted 26 interviews to collect data. We completed comparative analysis of the data and developed the Perioperative Nurse Turnover Decision-Making Theory, which describes the influence of the dimensions of perioperative nurse well-being (ie, physical and emotional well-being, career development, work-life balance, compensation, workplace culture) on their decision to leave an OR position. Perioperative leaders should consider the nurses' decision-making process when developing and implementing interventions aimed at reducing turnover.

The Long Tail of COVID-19: Implications for the Future of Emergency Nursing

INTRODUCTION

COVID-19 has led to exacerbated levels of traumatic stress and moral distress experienced by emergency nurses. This study contributes to understanding the perspectives of emergency nurses' perception of psychological trauma during COVID-19 and protective mechanisms used to build resilience.

METHOD

The primary method was qualitative analysis of semistructured interviews, with survey data on general resilience, moral resilience, and traumatic stress used to triangulate and understand qualitative findings. Analyses and theme development were guided by social identity theory and informed by the middle range theory of nurses' psychological trauma.

RESULTS

A total of 14 emergency nurses were interviewed, 11 from one site and 3 from the other. Almost all nurses described working in an emergency department throughout the pandemic as extraordinarily stressful, morally injurious, and exhausting at multiple levels. Although the source of stressors changed throughout the pandemic, the culmination of continued stress, moral injury, and emotional and physical exhaustion almost always exceeded their ability to adapt to the ever-changing landscape in health care created by the pandemic. Two primary themes were identified: losing identity as a nurse and hopelessness and self-preservation.

DISCUSSION

The consequences of the pandemic on nurses are likely to be long lasting. Nurses need to mend and rebuild their identity as a nurse. The solutions are not quick fixes but rather will require fundamental changes in the profession, health care organizations, and the society. These changes will require a strategic vision, sustained commitment, and leadership to accomplish.

Focusing on fundamentals of care in an ICU setting during a pandemic

AIMS

This manuscript aims to describe one acute care hospital's ICU journey during the COVID-19 pandemic and how fundamental care was central to the implementation of team-based models of care.

BACKGROUND

Over the course of the COVID-19 pandemic, team-based and alternative models of care are being employed to manage and address global shortages and surge capacity. Employing these alternate models of care required attention to ensure fundamental care needs of patients were being met.

DESIGN/METHOD

The following paper describes an ICU's journey of focusing on the delivery of the fundamentals of care through the implementation of team-based models of care to address the surge in patient care demands experienced in response to our global pandemic.

CONCLUSIONS

The implementation of an evidence-informed approach to optimizing models of care and staffing in the ICU amid the evolving COVID-19 waves in one acute-care hospital is provided. This local approach focused on meeting patients' fundamental care needs throughout the necessary introduction of team-based care models and staffing changes and drew from evolving evidence, the ILC Fundamentals of Care Framework, and regulatory guidance.

American Academy of Nursing consensus recommendations to advance system level change for nurse well-being

The COVID-19 pandemic has required close examination of workforce-related stressors that over decades have contributed to widespread burnout, negative health outcomes, including mental health outcomes, and the loss of the well-educated professionals who are the future of the nursing profession. In the United States and globally, evidence points to factors known to diminish well-being, including inequities, issues of minority status, persistent discrimination, and demanding work environments. The American Academy of Nursing (AAN), dedicated to organizational excellence, nursing leadership and evidence-based policy, develops statements reflecting its mission and those of its nursing affiliates and corporate member, The American Nurses Association. Within nursing, despite the efforts of its members toward advancement, professional fulfillment is often constrained by the systems in which nurses practice and workplace factors over which they have little control. Action by key organizations to initiate changes at systems levels in workplace safety, to increase professional mobility, and propel policies that increase access to health care resources could improve nurse well-being. This paper proposes recommendations from the AAN Expert Panels on Building Health Care System Excellence, Psychiatric Mental Health and Substance Use, and Global Health Expert Panels for the American Academy of Nursing to leverage related policy in the arenas of government and professional/healthcare organizations. Transforming health care work environments and advancing nurse well-being and equity can be accomplished through key, innovative policy changes. These will be achieved through collaboration among associations, organizations, nonprofit groups, and with the public and the media.

'No more heroes': The ILC Oxford Statement on fundamental care in times of crises

AIM

To outline the International Learning Collaborative (ILC) Oxford Statement, explicating our commitment to ensuring health and care systems are equipped to meet patients' fundamental care needs during times of unprecedented crisis.

DESIGN/METHOD

Discussion paper. The content was developed via a co-design process with participants during the ILC's international conference.

KEY ARGUMENTS

We, the ILC, outline what we do and do not want to see within our health and care systems when faced with the challenges of caring for patients during global pandemics and other crises. Specifically, we want fundamental care delivery to be seen as the minimum standard rather than the exception across our health and care systems. We want nursing leaders to call out and stand up for the importance of building fundamental care into systems, processes and funding priorities. We do not want to see the voices of nursing leaders quashed or minimized in favour of other agendas. In turn, what we want to see is greater recognition of fundamental care work and greater respect for the people who do it. We expect nurses to have a 'seat at the table' where the key health and care decisions that impact patients and staff are made.

CONCLUSION

To achieve our goals we must (1) ensure that fundamental care is embedded in all health and care systems, at all levels; (2) build on and strengthen the leadership skills of the nursing workforce by clearly advocating for person-centred fundamental care; (3) co-design systems that care for and support our staff's well-being and which foster collective resilience rather than overly rely on individual resilience; (4) improve the science and methodologies around reporting and measuring fundamental care to show the positive impact of this care delivery and (5) leverage the COVID pandemic crisis as an opportunity for transformational change in fundamental care delivery.

Relationship between Transition Shock, Professional Stressors, and Intent to Leave the Nursing Profession during the COVID-19 Pandemic

Background and Objectives: Moving nurses to a COVID-19 department may cause the phenomenon of transition shock, which occurs when already employed nurses change jobs. A set of confusing and uncertain feelings arise due to the unfamiliar work environment, which may lead to their intention to leave the nursing profession. The aim of this study was to examine transition shock and the contribution of both the respondents’ characteristics and the presence of stressors to the occurrence of transition shock in nurses assigned to work in COVID-19 departments. Materials and Methods: A cross-sectional study with 120 nurses employed in COVID-19 departments was conducted. Several linear regression models were used to assess the association between transition shock, personal and professional COVID-19 stressors, and the intention to leave the nursing profession. Results: Nurses who intended to leave the profession showed higher transition shock and higher personal and professional stressors (p < 0.001). Female nurses had lower transition shock (β = −0.16; p = 0.036) and higher personal COVID-19 stressors (β = 0.27; p < 0.001). University education contributes to the lowering of nurses’ transition shock (β = −0.16; p = 0.038). Nurses who did not intend to leave the nursing profession had lower personal COVID-19 stressors (β = −0.15; p = 0.044). Transition shock was associated with personal COVID-19 stressors (β = 0.39; p < 0.001) and professional COVID-19 stressors (β = 0.29; p < 0.001), and vice versa. Conclusions: The phenomenon of transition shock was present after nurses transitioned to working in COVID-19 departments. Transition shock may cause more nurses to leave the profession, which may have a strong impact on the health system in many countries that are already facing a shortage of nurses. Additional education on and preparation for adapting to new working conditions with psychological support could have an influence by lowering the level of nurses’ transition shock.

Factors contributing to nurse resignation during COVID-19: A qualitative descriptive study

AIMS

To explore and describe registered nurses' perceptions and experiences of work well-being extending from what inspired them to join the healthcare organization, what created a great day at work for them, through to what may have supported them to stay.

DESIGN

Qualitative descriptive study.

METHODS

Thirty-nine Australian nurses who resigned in 2021 from two metropolitan healthcare organizations in Victoria were interviewed in 2022, each for 30-60 min. The semi-structured interview transcripts were transcribed verbatim and analysed inductively and thematically.

RESULTS

Four themes were constructed for each of the key research questions. Inspiration to join the organizations transpired through organizational reputation, recruitment experiences, right position and right time, fit and feel. A great day at work was created through relationships with colleagues, experiences with managers, adequate resourcing and delivering quality care. Factors contributing to nurses resigning included COVID-19, uncertainty of role, workload and rostering, and finally, not feeling supported, respected and valued. Factors that may have supported the nurses to stay included flexible work patterns and opportunities, improved workplace relationships, workload management and support, and supportive systems and environments. Cutting across these themes were five threads: (1) relationships, (2) communication, (3) a desire to learn and develop, (4) work-life balance and (5) providing quality patient care.

CONCLUSIONS

Novel ways of working and supporting individuals, teams and organizations are needed to maintain and sustain nurses. The nurses' inspiration, what created a great day at work, and support needed to stay highlighted the importance of workplace initiatives to build nursing career pathways, provide equitable opportunities for professional development, workload and roster flexibility and implement professional relationship-enhancing actions to foster authentic civility.

IMPACT

This study contributes an in-depth exploration of the perceptions and experiences of nurses who resigned from two healthcare organizations and provides a description of (1) what inspired these nurses to initially join the organization, (2) what they perceived created a great day at work for them, (3) the factors contributing to their resignation and (4) what may have supported them to stay. The reasons nurses resign from an organization were identified as complex and multi-factorial, with opportunities for promoting nursing career pathways, addressing equity in opportunities and implementing professional relationship-enhancing actions. These contributions add both context and opportunity to strengthen organizational initiatives to attract, sustain and retain nurses.

Comparison of the Impact of COVID-19 on Veterans Affairs and Non-federal Hospitals: a Survey of Infection Prevention Specialists

BACKGROUND

As the COVID-19 pandemic evolves, it is critical to understand characteristics that have allowed US healthcare systems, including the Veterans Affairs (VA) and non-federal hospitals, to mount an effective response in the setting of limited resources and unpredictable clinical demands generated by this system shock.

OBJECTIVE

To compare the impact of and response to resource shortages to both VA and non-federal healthcare systems during the COVID-19 pandemic.

DESIGN

Cross-sectional national survey administered April 2021 through May 2022.

PARTICIPANTS

Lead infection preventionists from VA and non-federal hospitals across the US.

MAIN MEASURES

Surveys collected hospital demographic factors along with 11 questions aimed at assessing the effectiveness of the hospital's COVID response.

KEY RESULTS

The response rate was 56% (71/127) from VA and 47% (415/881) from non-federal hospitals. Compared to VA hospitals, non-federal hospitals had a larger average number of acute care (214 vs. 103 beds, p<.001) and intensive care unit (24 vs. 16, p<.001) beds. VA hospitals were more likely to report no shortages of personal protective equipment or medical supplies during the pandemic (17% vs. 9%, p=.03) and more frequently opened new units to care specifically for COVID patients (71% vs. 49%, p<.001) compared with non-federal hospitals. Non-federal hospitals more frequently experienced increased loss of staff due to resignations (76% vs. 53%, p=.001) and financial hardships stemming from the pandemic (58% vs. 7%, p<0.001).

CONCLUSIONS

In our survey-based national study, lead infection preventionists noted several distinct advantages in VA versus non-federal hospitals in their ability to expand bed capacity, retain staff, mitigate supply shortages, and avoid financial hardship. While these benefits appear to be inherent to the VA's structure, non-federal hospitals can adapt their infrastructure to better weather future system shocks.

A conflicted tribe under pressure: A qualitative study of negative workplace behaviour in nursing

AIM

This study explored workplace interactions of Australian nurses in regional acute care hospitals through an examination of nurses' experiences and perceptions of workplace behaviour.

DESIGN

This research is informed by Social Worlds Theory and is the qualitative component of an overarching mixed methods sequential explanatory study.

METHODS

Between January and March 2019, data were collected from 13 nursing informants from different occupational levels and roles, who engaged in semi-structured, in-depth, face-to-face interviews. Data analysis was guided by Straussian grounded theory to identify the core category and subcategories.

RESULTS

Theoretical saturation occurred after 13 interviews. The core category identified is A conflicted tribe under pressure, which is comprised of five interrelated subcategories: Belonging to the tribe; 'It's a living hell'; Zero tolerance-'it's a joke'; Conflicted priorities; Shifting the cultural norm.

CONCLUSION

This study provides valuable insight into the nursing social world and the organizational constraints in which nurses work. Although the inclination for an individual to exhibit negative behaviours cannot be dismissed, this behaviour can either be facilitated or impeded by organizational influences.

IMPACT

By considering the nurses' experiences of negative workplace behaviour and identifying the symptoms of a struggling system, nurse leaders can work to find and implement strategies to mitigate negative behaviour and create respectful workplace behaviours.

PATIENT OR PUBLIC CONTRIBUTION

This study involved registered nurse participants and there was no patient or public contribution.

CLINICAL TRIAL REGISTRATION

Study registration Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; December 14, 2018).

The Impact of the Working Hours Among Malaysian Nurses on Their Ill-Being, Intention to Leave, and the Perceived Quality of Care: A Cross-Sectional Study During the COVID-19 Pandemic

Purpose

This study explores the effect of working duration on nurses and their ill-being (ie, anxiety, depression, fatigue, and sleepiness), intention to leave, and the quality of nursing care.

Methods

A questionnaire survey was employed for a convenience sample of 400 nurses at Malacca General Hospital in Malaysia who voluntarily participated in this cross-sectional study. The Statistical Package for the Social Sciences (SPSS) was used to treat and analyze the data. Descriptive statistics were generated, and Post Hoc analyses and ANOVA tests were conducted.

Results

Findings indicated that working hours duration was significantly associated with nurses' anxiety (F (4, 394) = 10.362, p <0.001), depression (F (4, 395) = 23.041, p< 0.001), fatigue (F (4, 395) = 24.232, p< 0.001), sleepiness (F (4, 395) = 4.324, p < 0.002), quality of nursing care (F (4, 395) = 16.21, p <0.001) and intention leave their job, (F (4, 395) = 50.29, p <0.001). The results also revealed that working more than 14 hours was negatively associated with their perceived quality of nursing care and positively associated with their perceived ill-being and intention to leave.

Conclusion

Shift length is an important issue, and nursing managers must consider shift length as it can adversely correlate with the nurses' perceptions of work and life.

Public health nurses' perceptions and experiences of emergency preparedness, responsiveness, and burnout during the COVID-19 pandemic

OBJECTIVE(S)

To describe PHNs' perceptions and experiences of the COVID-19 pandemic, including training, response activities, and work-related challenges.

DESIGN

This was a qualitative study using interpretive description for analysis.

SAMPLE

PHN participants who worked in public health departments in Wisconsin were recruited using purposive sampling. A total of 15 PHNs participated in the study, including both general and supervisor-level PHNs.

MEASUREMENTS

Data were collected via semi-structured interviews from March to May 2021. Interview questions focused on PHNs' perceptions, experiences, response activities, and burnout in relation to the current pandemic as well as perceptions and experiences of emergency preparedness and response in general.

RESULTS

Five themes emerged in the study. These were: (1) experiences and observations of the COVID-19 pandemic, (2) organizational changes and their impacts, (3) public health emergency preparedness and response, (4) public health emergency response activities, and (5) role strain and burnout.

CONCLUSIONS

Findings presented here have important implications for PHN training and support in emergency preparedness and response. A wide array of strategies focused on developing and supporting the PHN workforce in response to the public health crisis this area need to be implemented at the organizational, community, and policy levels.

Effect of COVID-19 Frontline Nurses' Profession Perception on Their Intention to Stay: The Mediating Role of Job Satisfaction

Introduction

Understanding the factors affecting the intention of frontline nurses during the coronavirus disease (COVID-19) pandemic to stay in the nursing profession is essential for developing strategies to overcome the challenges associated with the pandemic.

Objectives

This study aimed to examine the mediating effect of nurses' job satisfaction on the relationship between their sense of calling, job-esteem, and the intention to stay in their profession.

Methods

The study used a previously collected dataset, sourced from a dedicated COVID-19 hospital in Seoul City, South Korea. Original data were collected from June to July 2021. The study sample consisted of 134 nurses who provided direct care to patients. The intention to stay was measured with the following question: "Are you willing to work during this COVID-19 pandemic?". The Job Satisfaction Scale from the Korean Labor and Income Panel Study, Korean version of a Multidimensional Calling Measure, and Job-Esteem Scale for Hospital Nurses were utilized. Associations between the study variables were estimated using bivariate correlation analyses and bootstrapping mediation analyses.

Results

In the bivariate correlation analysis, nurses' sense of calling (r = .36, p < .001), job-esteem (r = .32, p < .001), and job satisfaction (r = .39, p < .001) were significantly associated with the intention to stay. In the mediation analysis, job satisfaction partially mediated the relationship between the sense of calling and the intention to stay (total effect; B = 0.410, p < .001) and fully mediated the relationship between job-esteem and the intention to stay (total effect; B = 0.549, p < .001).

Conclusion

Enhancing nurses' job satisfaction is crucial for fostering the retention of the nursing workforce amid the pandemic. Consequently, it is imperative to closely examine the job satisfaction and work environment of frontline nurses to identify areas in need of improvement. Addressing the factors that impede nurses' job satisfaction is essential to unlock the positive effects of a sense of calling and job-esteem.

Sociodemographic Factors, Mental Health, and Emotional Eating Associated With Concern for COVID-19 Contagion in Nurses: A Cross-Sectional Study

OBJECTIVE

To determine the association between sociodemographic factors, stress, depression and anxiety, emotional eating, and concern about COVID-19 contagion in first and second-line Peruvian nurses.

METHODOLOGY

The study was cross-sectional and conducted with 500 Peruvian nurses of both sexes, over 18 years of age. Validated questionnaires were used to measure sociodemographic aspects, concern about COVID-19, generalized anxiety, depression, self-perceived stress, and emotional eating. Multiple linear regression analysis was performed to analyze the factors affecting concern about COVID-19 contagion.

RESULTS

The multiple linear regression analysis showed that stress, being between the ages of 18 and 29 years, being male, being from the coastal region or the jungle region, having a bachelor's degree, severe anxiety, and severe depression were associated with higher concern about COVID-19. On the other hand, having more than 5 to 10 years of experience and more than 10 years of experience, low emotional eating, and non-emotional eating were negatively associated with concern. This model explained 44.05% of the variability among the participating nurses.

CONCLUSION

These findings provide resources for future research on the comprehensive well-being of nursing staff by exploring various sociodemographic aspects and mental conditions associated with greater concern about COVID-19. Meanwhile, years of experience and emotional eating behavior were associated with lower concern about COVID-19. Future studies could incorporate this information to preserve the mental and physical health of nurses in the face of potential occupational threats.

Implementing a Resilience Bundle for Emergency Nurses: An Evidence-Based Practice Project

INTRODUCTION

Resilience bundles are designed to work within and enhance existing routines. In the wake of COVID-19, nurses are reporting high levels of burnout and are leaving the field at an alarming rate. Hospital system leaders across the country are working to develop wellness programs to improve nurse morale, decrease burnout, and enhance resilience. Resilience can help mitigate nurse burnout, and using a bundle of tools to help nurses develop resilience is more effective than a single strategy.

METHODS

Using the Connor-Davidson Resilience Scale-10 and the Perceived Stress Scale 4, emergency nurses were surveyed to measure resilience and stress before and after implementation of a 3-strategy resilience bundle. We surveyed at baseline, phase 1 (6 weeks after implementation), and phase 2 (15 weeks after implementation).

RESULTS

A statistically significant increase in the Connor-Davidson Resilience Scale-10 scores was identified between the baseline and phase 1 surveys. A measurable decrease in the Perceived Stress Scale 4 was found between the baseline survey and the phase 1 and phase 2 postintervention surveys.

DISCUSSION

Although evidence suggests a multifocal approach to improving resilience, use of resilience bundles is new. To enhance nurse resilience and mitigate burnout, nurse leaders may consider resilience bundles to prioritize the mental health and wellness of their staff.

The voices of online RN-BS students during the COVID-19 pandemic

The need for associate degree nurses to advance their education to replace the nursing workforce will be critical in the next decade. This qualitative descriptive study explored the experiences and challenges of nurses completing their educational journey in a RN-BS program during the COVID-19 pandemic. Four focus group interviews were conducted with a total of 20 RN-BS students. Data analysis revealed four themes; pulled in many directions, faculty understanding, resilience and opening doors. The COVID-19 pandemic and the current nursing shortage presented increased challenges not experienced before for these nurses pursuing a bachelor's degree. The importance of faculty support and a caring presence during this time was a significant factor for student success.

Psychological impact of COVID-19 on nurses caring for patients during COVID-19 pandemic in Gaborone

AIM

Nurses as front liners have direct contact with COVID-19 patients during the pandemic. Carrying the heavy burden during the pandemic has a mental health toll on healthcare professionals. The study explored nurses' experiences of psychological distress during the COVID-19 pandemic in Botswana's two COVID-19 special care centres.

DESIGN

The study used qualitative case study research to solicit nurses' experiences caring for patients with COVID-19 in selected COVID-19 centres in Gaborone.

METHOD

Researchers purposively recruited nurses from two COVID-19 centres in Botswana. Data were collected using semi-structured telephone interviews and analysed through inductive thematic analysis. Various institutional review boards ethically cleared the study.

RESULTS

Six themes emerged from the thematic analysis: feelings of fear and anxiety, hopelessness and helplessness, loneliness, physical distress, support mechanism and commitment to care.

PUBLIC CONTRIBUTION

The results offer important insights into the nurses' experiences during the COVI-19 pandemic.

The nursing profession circa 2030

ABSTRACT

The COVID-19 pandemic has forced immediate change and hopefully for the better. Navigating through this new world of care delivery warrants developing new maps to reach a new and acceptable normal. This article outlines urgent issues and necessary steps for measurable change, in nursing practice and work environments by 2030.

The effect of the COVID-19 pandemic on the professional perception and image of nursing among nurses working in surgical units: An online study

BACKGROUND

Understanding the effects of the COVID-19 pandemic on the perception and image of the profession are key factors in nurses' perceptions regarding their roles and their future.

OBJECTIVE

The purpose of this study was to determine the effect of the COVID-19 pandemic on the perception and image of the nursing profession among nurses working in surgical units.

METHODS

This cross-sectional, correlational study was conducted with 216 nurses using the random sampling method between 10 and 30 March, 2022. The study data were collected using an information form, the Perception of Nursing Professional Scale (PNPS), and the Scale for the Image of the Nursing Profession.

RESULTS

The nurses' mean age was 32.53±9.16 years (min 21, max 57) and their mean professional experience was 16.44±9.80 years (min 1, max 44). The mean PNPS score was 73.12±9.46, and the mean Scale for the Image of the Nursing Profession score was 171.11±11.16. Female nurses had significantly higher positive perceptions of nursing levels than male nurses. Gender, having a history of COVID-19, marginalization during the pandemic, and perception of the nursing profession significantly affected image perceptions of nursing at multiple linear regression analysis. These variables explained 43% of the total variance.

CONCLUSION

Nurses working in surgical units during the COVID-19 pandemic exhibited a good level of professionalism and image perception concerning nursing.