"Just pee in the diaper" - a constructivist grounded theory study of moral distress enabling neglect in nursing homes

BACKGROUND

A growing body of evidence shows that many nursing home residents' basic care needs are neglected, and residents do not receive qualitatively good care. This neglect challenges nursing staff´s professional and personal ideals and standards for care and may contribute to moral distress. The aim of this study was to investigate how nursing staff manage being a part of a neglectful work culture, based on the research question: "How do nursing home staff manage their moral distress related to neglectful care practices?"

METHODS

A qualitative design was chosen, guided by Charmaz´s constructivist grounded theory. The study was based on 10 individual interviews and five focus group discussions (30 participants in total) with nursing home staff working in 17 different nursing homes in Norway.

RESULTS

Nursing staff strive to manage their moral distress related to neglectful care practices in different ways: by favouring efficiency and tolerating neglect they adapt to and accept these care practices. By disengaging emotionally and retreating physically from care they avoid confronting morally distressing situations. These approaches may temporarily mitigate the moral distress of nursing staff, whilst also creating a staff-centred and self-protecting work culture enabling neglect in nursing homes.

CONCLUSIONS

Our findings represent a shift from a resident-centred to a staff-centred work culture, whereby the nursing staff use self-protecting strategies to make their workday manageable and liveable. This strongly indicates a compromise in the quality of care that enables the continuation of neglectful care practices in Norwegian nursing homes. Finding ways of breaking a downward spiralling quality of care are thus a major concern following our findings.

Work engagement, psychological empowerment and relational coordination in long-term care: A mixed-method examination of nurses' perceptions and experiences

Nurse engagement, empowerment and strong relationships among staff, residents and families, are essential to attract and retain a suitably qualified and skilled nursing workforce for safe, quality care. There is, however, limited research that explores engagement, empowerment and relational coordination in long-term care (LTC). Nurses from an older persons' mental health and dementia LTC unit in Australia participated in this study. Forty-one nurses completed a survey measuring psychological empowerment, work engagement and relational coordination. Twenty-nine nurses participated in individual interviews to further explore these concepts. Although nurses reported high psychological empowerment and work engagement, their relationships with key stakeholders varied. Our findings suggest that nurses in LTC require both supports and opportunities to contribute as active members of the multiprofessional care team that includes tailored education, professional development and positive interactions within the care team. Regular support is needed to enable nurses to feel empowered, foster relationships and communication, and facilitate work engagement. Based on these findings, we suggest that it is important to find ways to ensure that all who provide care perceive that they are part of the whole care team and able to contribute to the care and well-being of people in LTC.

Staff Perceptions on the Effectiveness of GRiP-S, a New Approach to Clinical Supervision Incorporating Safewards: An Interpretive Phenomenological Analysis

This study explored the impact of an innovative approach to clinical supervision for mental health nurses which integrates Safewards, named Group Reflective integrated Practice with Safewards - GRiP-S. Qualitative data was collected through 10 individual semi-structured interviews with nursing staff who had participated within the clinical supervision approach. Interviews provided insights into the nursing staff's perception and experience of the clinical supervision approach. Through interpretive phenomenological analysis six themes emerged (i) illuminating embodied practice of Safewards, (ii) building confidence through empowering connections, (iii) creating a culture of positive change, (iv) identifying internal motivation for and external barriers to supervision engagement, (v) navigating a global pandemic, and (vi) the transformative role of reflection. Findings demonstrated that the GRiP-S approach assisted mental health nurses' adoption of Safewards interventions in practice, while supporting the development of a cohesive staff team. The impact of COVID-19 within the study setting was addressed and nurses identified how the Safewards model assisted in navigating challenges during this time. Findings further supported prior research on the role of the supervisor and supervisee relationship. This study supports the integration of Safewards within reflective clinical supervision for mental health nursing staff to assist in Safewards fidelity and nursing staff personal and professional development.

Factors associated with satisfaction and depressed mood among nursing home workers during the covid-19 pandemic

AIMS AND OBJECTIVES

This paper aims to examine the satisfaction and depressed mood experienced by nursing home workers during the COVID-19 pandemic and associated variables. Specifically, to analyse the factors that may contribute to nursing home workers developing adaptive behaviours that promote satisfaction or, on the contrary, show characteristics associated with a negative mood.

BACKGROUND

Nursing homes have faced unprecedented pressures to provide appropriately skills to meet the demands of the coronavirus outbreak.

DESIGN

A cross-sectional survey design using the STROBE checklist.

METHODS

Professionals working in nursing homes (n = 165) completed an online survey measuring sociodemographic and professional characteristics, burnout, resilience, experiential avoidance, satisfaction with life and depression. Data were collected online from April to July 2021, the time in which Spain was experiencing its fifth wave of COVID-19. Two multiple linear regression models were performed to identify salient variables associated with depressive mood and satisfaction.

RESULTS

Resilience, personal accomplishment and satisfaction had a significant and negative relationship with depression and emotional exhaustion, depersonalisation and experiential avoidance had a positive relationship with depression. However, emotional exhaustion, depersonalisation and experiential avoidance had a negative and significant relationship with satisfaction and personal accomplishment, and resilience had a positive and significant relationship with satisfaction. In addition, it was found that accepting thoughts and emotions when they occur is beneficial for developing positive outcomes such as satisfaction.

CONCLUSIONS

Experiential avoidance was an important predictor of the effects that the COVID-19 pandemic can have on nursing home workers.

RELEVANCE TO CLINICAL PRACTICE

Interventions focusing on resources that represent personal strengths, such as acceptance, resilience and personal accomplishment, should be developed.

NO PATIENT OR PUBLIC CONTRIBUTION

The complex and unpredictable circumstances of COVID's strict confinement in the nursing home prohibited access to the centres for external personnel and family members. Contact with the professionals involved could not be made in person but exclusively through online systems. However, professionals related to the work environment have subsequently valued this research positively as it analyses 'How they felt during this complicated process'.

Caring for COVID-19 patients: Nurses' perceptions of the most critical issues and their impact on their well-being and performance

AIMS

(1) Exploring nurses' perceptions of issues that impacted the quality of patient care and their own performance on COVID-19 wards; (2) examining nurses' perceptions of how these issues impacted their psychological state and level of performance; and (3) presenting recommendations for improving healthcare policies.

BACKGROUND

Nurses played a critical role in caring for hospitalized COVID-19 patients and managing the disease.

METHODS

Semistructured interviews were conducted with 50 nurses (32 females), aged 31-58 years, 6-37 years' tenure, from eight hospitals across Israel. Prior to working in COVID-19 wards, they worked in internal medicine, emergency rooms, or intensive care units. Based on the COREQ checklist, these interviews were recorded and transcribed, and categorized into themes and subthemes.

FINDINGS

The findings indicate that the unpreparedness of healthcare systems for the pandemic outbreak rendered nurses paying a high price at the personal and professional levels, which in turn may have impacted the levels of care that they provided.

CONCLUSION

The rich, qualitative data source revealed important interactions between clinical, personal, social, and familial factors in determining distress levels and performance impairment. A nuanced understanding of the link between these stressors is key to developing and implementing policies that could mitigate deficiencies in the management of epidemics and pandemics in the future.

IMPLICATIONS FOR NURSING AND HEALTH POLICIES

Changes should be made to government directives and healthcare policies, with an emphasis on increasing the nursing workforce, providing emotional support, ensuring availability of equipment and beds, optimizing work practices, developing transparent means of communication within teams, and clearly defining the areas of responsibility of nurses-in times of routine and crises.

Physical and psychological repercussions on Nursing workers' health in COVID-19 units: A mixed-methods research study

OBJECTIVE

to analyze how Nursing workers in COVID-19 hospital units perceive the physical and psychological repercussions of work on their health, as well as to identify the factors associated with their perceptions.

METHOD

a parallel-convergent mixedmethods study conducted with 359 Nursing workers from COVID-19 units in seven hospitals. For the collection of quantitative data, a questionnaire containing sociodemographic and labor variables and related to perceptions of physical and psychological repercussions were used, and for qualitative data, semi-structured interviews were used. For the analysis, inferential statistics and thematic content analysis were used.

RESULTS

daytime workers, who had more than one employment contract and worked more than 41 hours/week perceived more moderate/intense physical repercussions, reporting overload and time off deficits. Nurses and CLT workers perceived psychological repercussions more moderately/intensely, mentioning managerial overload and job dissatisfaction. Women were 97% more likely to perceive physical repercussions and three times more likely to perceive psychological repercussions when compared to men, reporting household and family overloads.

CONCLUSION

work and family overloads, intensified by the pandemic context, were associated with the intensity with which Nursing workers perceived physical and psychological repercussions.

'Making the most of time during personal care': nursing home staff experiences of meaningful engagement with residents with advanced dementia

OBJECTIVES

Dementia progressively affects cognitive functioning, including the ability to communicate. Those who struggle to communicate are often considered unable to relate to other people. Frontline care workers are in a position to connect with residents. However, we know little about their perspectives. The aim of this study was to understand how and when nursing home staff meaningfully engaged with residents with advanced dementia.

METHODS

Semi-structured interviews, supplemented by informal conversations, were conducted with 21 staff from seven nursing homes. Inductive thematic analysis identified themes in the accounts.

RESULTS

Four themes related to how staff engaged with residents with advanced dementia (initiating meaningful engagement, recognising subtle reactions, practising caring behaviours, patience and perseverance). Two themes related to when meaningful engagement occurred (lacking time to connect, making the most of time during personal care).

CONCLUSION

A key barrier to implementing formal interventions to improve care is lack of staff time. Staff overcome this by using personal care time for meaningful engagement with residents. Their approach, developed through experience, is consonant with person-centred dementia care. Building on this, future research should use participatory approaches building on practice wisdom to further develop and evaluate meaningful engagement with residents with advanced dementia.

Comparative cross-sectional study of knowledge, attitudes and perceptions among mental health and ward nursing staff towards smoking

AIM

The aim of the study was twofold: to estimate smoking prevalence among nurses and to compare their knowledge, perceptions and attitudes towards smoking.

BACKGROUND

Given the critical role nurses have in the process of patients' smoking cessation both as counsellors and behavioural models, data are needed on their smoking rates and behaviour.

DESIGN

A cross sectional, comparative study was conducted.

METHODS

A convenience sample of 847 nurses working in various psychiatric and public hospitals in Northern Greece participated in the study. Data were collected between April and June 2020 using a battery of questionnaires.

RESULTS

Mental health nurses were less likely to consider quitting smoking within the next 6 months (P < 0.001), despite the fact that they reported higher levels of the importance of stop smoking compared to ward nurses (P < 0.05). However, ward nurses were more likely to quit smoking because of the cost of cigarettes (P = 0.024) and for personal reasons (P = 0.040).

CONCLUSION

Prevalence of smoking in nurses is high. Training and educational programmes are needed to develop the appropriate culture of health promotion among nurses, thus provide a more active support to patients who smoke.

Exploring the Factors Creating Happiness with Nursing Staff: The Mediating Effect of Life Satisfaction

Objectives: In this study, we investigate the relationships among personal well-being, self-esteem, supervisor support, life satisfaction, and happiness in a sample of nurses. In this study, we also investigate the mediating role of life satisfaction. Methods: Present research was quantitative in nature and the research design was cross-sectional. Data were collected from a convenience sample of nurses working in hospitals by using a self-administered survey. We used partial least square-structural equation modeling (PLS-SEM) for the assessment of statistical significance of the proposed model. Results: We found a statistically significant and positive relationship between personal well-being, life satisfaction, and happiness. Similarly, self-esteem and supervisor support positively affected life satisfaction. Conclusion: Our research adds to the present literature on the factors that affect happiness among nurses. The study also adds to the current literature on PLS-SEM in terms of the assessment of mediation and direct relationships. Our findings are helpful for decision-makers in the health sector in developing happiness and life satisfaction among nurses. These results are also valuable for academicians for their future studies.

How about an Educational Framework for Nursing Staff in Long-Term Care Facilities to Improve the Care of Behavioral and Psychological Symptoms of Dementia?

Behavioral and psychological symptoms of dementia (BPSD) are common in residents of long-term care facilities (LTCFs). In LTCFs, nursing staff, including nurses and care workers, play a crucial role in managing BPSD as those most in contact with the residents. However, it is ambiguous where their focus should be for effective BPSD care. Thus, this paper aims to reveal BPSD care competencies for nursing staff in LTCFs and to outline an initial frame of education. A multiphase mixed-methods approach, which was conducted through topic modeling, qualitative interviews, and a Delphi survey, was used. From the results, a preliminary educational framework for nursing staff with categories of BPSD care competence was outlined with the four categories of BPSD care competence: using knowledge for assessment and monitoring the status of residents, individualizing approaches on how to understand residents and address BPSD, building relationships for shared decision-making, and securing a safe environment for residents and staff in LTCFs. This preliminary framework illuminates specific domains that need to be developed for competent BPSD care in LTCFs that are centered on nursing staff who directly assess and monitor the changing and deteriorating state of residents in LTCFs.

Working Conditions and the Components of Burnout Among Nursing Staff in a Public Hospital in Mexico City

BACKGROUND

Working conditions in public hospitals in Mexico City are highly demanding. The need for healthcare is pressing, materials and instruments are scarce, and exposure to pain and suffering is constant. These adverse conditions have an adverse impact on the physical and mental health of healthcare professionals. The nursing staffs are among those who are most affected, and they frequently experience burnout syndrome or one of its several dimensions, including emotional exhaustion, depersonalization, and reduced personal accomplishment.

PURPOSE

The aim of this research was to analyze the relationship among working conditions, related stress, and the dimensions of burnout syndrome in a tertiary care public hospital in Mexico City.

METHODS

A cross-sectional design was applied on a random sample of 190 nurses in a public hospital in Mexico City. Working conditions and burnout syndrome were evaluated using standardized instruments. Adjusted prevalence ratios were calculated. Three clusters, one for each burnout dimension, were generated and then evaluated using a correspondence analysis with labor characteristics.

RESULTS

One quarter (25%) of the participants self-reported a sense of personal accomplishment, and 12% reported emotional exhaustion and depersonalization. The labor variables that were found to be associated with the dimensions of burnout were workload, performing potentially hazardous work, and conducting tedious tasks. Positive conditions were shown to decrease the prevalence of burnout in all three dimensions.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Working conditions for nursing staff impact the mental health of nurses and affect the quality of the healthcare they provide. The set of work demands and stressors to which they are exposed should be controlled and modified to ensure a healthy work environment.

Job Demands, Work Functioning and Mental Health in Dutch Nursing Home Staff during the COVID-19 Outbreak: A Cross-Sectional Multilevel Study

COVID-19 posed enormous challenges for nursing home staff, which may have caused stress and mental health problems. This study aimed to measure the prevalence of mental health problems among nursing home staff and investigate the differences in job demands, work functioning and mental health between staff with and without COVID contact or COVID infection and across different levels of COVID worries. In this cross-sectional study, 1669 employees from 10 nursing home organizations filled in an online questionnaire between June and September 2020. The questionnaire measured the participants’ characteristics, COVID contact, infection and worries, job demands, work functioning, depressive symptoms and burnout. Differences were investigated with multilevel models to account for clustering at the organization level. Of the participants, 19.1% had high levels of depressive symptoms and 22.2% burnout. Job demands, work functioning, depressive symptoms and burnout differed between participants who never worried and participants who often or always worried about the COVID crisis. Differences were smaller for participants with and without COVID contact or infection. Most models improved when clustering was accounted for. Nursing homes should be aware of the impact of COVID worries on job demands, work functioning and mental health, both at the individual and organizational level.

Resilience Will Not Erase Structural Racism

Acknowledging underlying inequities is crucial.

A 4-Part Strategy to Engage Frontline Nurses in Cultural Humility

Although many clinical leaders use the cultural competency model to help clinicians deliver equitable care, evidence on the model's effectiveness is mixed. In this article, the authors propose that nursing leaders adopt cultural humility as a framework that better positions nurses to build trust, engage patients in their care, and improve health outcomes. This article outlines 4 strategies that leaders can use to actively engage staff in cultural humility and support the cultural transformation required to mitigate the impact of clinician bias in care delivery.

Renaming COPD exacerbations: the UK respiratory nursing perspective

BACKGROUND

Patients with COPD experience acute worsenings, termed 'exacerbations'. While other terms to describe these events have been proposed there is no consensus on terminology which has led to multiple terms being used across the UK. Respiratory nurses are part of a multi-disciplinary team managing COPD patients, however, the nursing perspective on the term 'exacerbation' is unknown.

METHODS

An anonymised survey of 17 questions was sent to respiratory nurses through an email invitation link. The survey link was open for one month. The aim was to understand the nurse perspective on 'exacerbation'. Alternative terms used in the UK were compared versus the term 'exacerbation'.

RESULTS

Responses were received from 113 nurses. The majority (88%) were female. There was no consensus on preference or meaning for the term 'exacerbation' between nurses. Less than 5% of nurses thought that patients with COPD would understand the term 'exacerbation'. In ranked order, the nurses preferred the following terms: 'flare-up', 'lung attack', 'crisis', 'exacerbation' and 'chest infection'. The term 'crisis', although new, was considered to be the term that most resonated with clinical practice.

CONCLUSION

Respiratory nurses in the UK report that the term 'exacerbation' is not fit for purpose for patients, and alternatives should be sought.

An Interview With Judy Davidson: Nurse Suicide Risk Detection and Prevention

This month's column is an interview with Dr Judy Davidson, nurse scientist, University of California, San Diego Health Sciences Center. Dr Davidson has devoted a large part of her research to the reporting and prevention of nurse suicide.

Supporting the well-being of nurses working during COVID-19

On 11 March 2020, the World Health Organization declared that the coronavirus disease 2019 (COVID-19) was a pandemic. As the COVID-19 pandemic has developed there have been many parallels made with other pandemics and epidemics, such as the 1918 influenza A (H1N1) pandemic and the 2003 severe acute respiratory syndrome (SARS) epidemic. This article discusses the challenges experienced by healthcare staff working during COVID-19, and the lessons that can be learned, such as the enhanced support required for staff.

Development of the Perception of Opioid Use Survey Instrument

BACKGROUND AND PURPOSE

A new instrument was designed specifically to evaluate nurses' knowledge, attitude, and practice toward patients who use opioids. This study team developed and tested the psychometric properties of the Perception of Opioid Use Survey (POUS) instrument.

METHODS

The instrument was tested among 306 nurses at a 183 bed acute care community hospital, with psychometric evaluation for validity, reliability, and exploratory factor analysis.

RESULTS

Internal consistency results were Cronbach's alpha = .550 for the overall scale and each subscale: Self-Efficacy = .796, Attitudes = .744, Community Impact = .806, and Causative Factors = .763.

CONCLUSIONS

Psychometric testing results support that the POUS is valid, reliable, and significantly correlated with theoretically selected variables.

Another Look at Compassion Fatigue

ABSTRACT

Compassion fatigue has become a more significant concern as nurses have cared for patients during the COVID-19 pandemic. The results of compassion fatigue are detrimental for both nurses and their patients. Both administrative and individual actions can be taken to assess, prevent, and deal with compassion fatigue. Spiritual facets of recognizing the potential for and managing the problem are presented.

A Description of Staff-resident Interactions in Assisted Living

Positive social and care interactions are vital to understand and successfully accomplish the daily care needs of the residents in assisted living (AL) and optimize their quality of life. The purpose of this study was to explore and describe the staff-resident interactions in AL. This descriptive analysis utilized baseline data in a randomized trial that included 379 residents from 59 AL facilities. The majority of the interactions observed were positive; almost 25% were neutral or negative. Most interactions were care-related (31.9%) or one-on-one (27.4%), occurred with nursing (40.2%) or support staff (e.g., dining aide; 24.6%), and involved close interpersonal distance (64.6%). Future research should focus on the transition of neutral or negative interactions to positive and explore the factors that might influence neutral and negative interactions. Additionally, innovative approaches are needed to optimize interactions amid physical distancing in the context of the COVID-19 pandemic.

Depression and anxiety prevalence in nursing staff during the COVID-19 pandemic

This article reviews a study to determine the effects of COVID-19 on the rate of depression and anxiety in nurses and to identify potential strategies that nurse leaders can implement to reduce depression and anxiety in their staff.

Staff's Psychological Well-Being and Coping Mechanisms During COVID-19 Lockdown in Care Homes for Older Adults: A Structural Equation Modeling Analysis

The current study investigated the psychological well-being and coping mechanisms of care home staff during the coronavirus disease 2019 (COVID-19) lockdown. Among 147 staff members, 21.8%, 24.5%, and 12.9% reported depression, anxiety, and stress, respectively. The results of structural equation modeling showed that self-efficacy and coping strategies had direct effects on psychological well-being. In the paths from self-perceived caregiving to psychological well-being, self-efficacy and positive coping strategies played mediating roles independently and together, and social support played a mediating role together with coping strategies. Care home staff's psychological well-being was undermined during the COVID-19 lockdown. Interventions aimed at improving staff's self-efficacy, adoption of positive coping strategies, and avoidance of negative coping strategies or considerations of social support along with coping strategies are suggested to decrease exhibited symptoms of depression, anxiety, and stress. [Research in Gerontological Nursing, 14(4), 180-190.].

[Novel Coronavirus: Applying Transformational Leadership to the Combat of COVID-19 in Nursing Practice]

Cases in the current novel coronavirus (COVID-19) pandemic continue to increase, bringing tremendous psychological pressures to frontline caregivers and threating the ability of existing medical care systems in many countries to cope with related demands. In this situation, nursing leaders have a heightened responsibility to assist nursing staff to remain at their jobs and feel secure, to strengthen safety systems, to provide adequate equipment and personnel training, and to proactively lead nursing staff. In this article, leadership strategies implemented under the COVID-19 pandemic are presented from the perspective of transformational leadership in nursing practice. This article is divided into the following five themes: 1. Leadership makes the vision more vivid; 2. Demonstrating charismatic leadership; 3. Leaders who stimulate intellectual potential; 4. Paying attention to spiritual inspiration; 5. Providing individualized sincere care. Leaders should promote the professional role of nursing staff and provide a safe and secure practice environment.

How to bring residents' psychosocial well-being to the heart of the fight against Covid-19 in Belgian nursing homes-A qualitative study

BACKGROUND

Nursing homes (NH) for the elderly have been particularly affected by the Covid-19 pandemic mainly due to their hosted vulnerable populations and poor outbreak preparedness. In Belgium, the medical humanitarian organization Médecins Sans Frontières (MSF) implemented a support project for NH including training on infection prevention and control (IPC), (re)-organization of care, and psychosocial support for NH staff. As psychosocial and mental health needs of NH residents in times of Covid-19 are poorly understood and addressed, this study aimed to better understand these needs and how staff could respond accordingly.

METHODS

A qualitative study adopting thematic content analysis. Eight focus group discussions with direct caring staff and 56 in-depth interviews with residents were conducted in eight purposively and conveniently selected NHs in Brussels, Belgium, June 2020.

RESULTS

NH residents experienced losses of freedom, social life, autonomy, and recreational activities that deprived them of their basic psychological needs. This had a massive impact on their mental well-being expressed in feeling depressed, anxious, and frustrated as well as decreased meaning and quality of life. Staff felt unprepared for the challenges posed by the pandemic; lacking guidelines, personal protective equipment and clarity around organization of care. They were confronted with professional and ethical dilemmas, feeling 'trapped' between IPC and the residents' wellbeing. They witnessed the detrimental effects of the measures imposed on their residents.

CONCLUSION

This study revealed the insights of residents' and NH staff at the height of the early Covid-19 pandemic. Clearer outbreak plans, including psychosocial support, could have prevented the aggravated mental health conditions of both residents and staff. A holistic approach is needed in NHs in which tailor-made essential restrictive IPC measures are combined with psychosocial support measures to reduce the impact on residents' mental health impact and to enhance their quality of life.

Compassionate leadership: how to support your team when fixing the problem seems impossible

Stress, suboptimal mental health and an inadequate work-life balance are underlying and serious issues in the nursing profession, affecting staff recruitment and retention and potentially having a detrimental effect on patient care. While compassion towards patients is central to the nursing role, often 'compassion towards the compassionate' is lacking. The need for compassion is even more important now, and in the months ahead, due to the additional stressors experienced by nurses during the COVID-19 pandemic, whether they are on the front line, furloughed or shielding. This article includes reflections from nursing staff and uses their stories to encourage reflection on ethical and moral dilemmas experienced during the pandemic. The Compassion in the Workplace model is suggested as a tool that can be used by nurse managers to examine their compassion levels and to support the development of a compassionate workplace. In addition, this article offers some practical ideas on what compassionate leadership might look like in day-to-day practice.

Impact of Patient-Engaged Video Surveillance on Nursing Workforce Safety: Patient Aggression/Violence

BACKGROUND

Health care workers are 4 times more likely to suffer violence than workers in other industries.

PURPOSE

The aim was to examine types of patients' verbal/physical abuse against the nursing workforce observed through patient-engaged video surveillance (PEVS) and interventions initiated by monitor technicians.

METHODS

A descriptive study was conducted to analyze all types of patient-initiated abuse, physical and verbal, reported from 73 hospitals and patient response to PEVS.

RESULTS

Of 150 434 patients whom RNs enrolled into 24-hour PEVS, 5034 patients (3%) were identified by RNs as at risk for aggressive/violent behavior as their primary or secondary reason for PEVS enrollment, and 32 (0.60%) patients exhibited such behavior. A total of 221 patients demonstrated aggressive/violent behaviors, 32 (15%) were identified as at risk, and 189 (85%) were not. However, 5002 (99%; 5002/5034) of the patients identified as a risk for aggressive/violent behaviors did not exhibit these behaviors.

CONCLUSIONS

Patient-engaged video surveillance is an effective method to track and trend patient aggression toward nursing staff, increasing patient and nursing workforce safety. Because 99% of the patients who exhibited aggressive/violent behavior were not identified by RNs as at risk, organizations should consider adding violence risk tools as part of patients' admission assessment.

Prayer Moderating Job Stress Among Muslim Nursing Staff at the University of Malaya Medical Centre (UMMC)

This study examines how Salat (prayer) in Islam moderates the relationship between job stress and life satisfaction among Muslim nursing staff. The researchers sampled 335 nursing staff employed at the University of Malaya Medical Centre in Kuala Lumpur, Malaysia. Their ages ranged from 21 to 60 years. The findings indicate the job stress was associated negatively with life satisfaction; there is a strong positive and significant correlation, respectively, between Salat and life satisfaction and that Salat reduces stress and increases the life satisfaction of Muslim nurses. Thus, Salat has a moderating effect on job stress and life satisfaction of Muslim nurses.

Analyse des pratiques langagières des infirmiers dans le cadre de consultations avec des patientes atteintes d’un diabète gestationnel

Caregiver&#8211;patient communication is an essential parameter of quality of care, especially in the context of therapeutic patient education (TPE). In this study, I report on and analyze the language practices of nursing staff during appointments with patients suffering from gestational diabetes. To do so, I perform a semantic and pragmatic analysis of the study of speech coupled with text mining, using transcriptions of appointments. The results show that nursing staff use various language practices (including phatic expressions, softeners, metaphors, rhetorical questions, and examples). Among the results, I note that phatic expressions and softeners are ubiquitous language processes in caregivers&#8217; speech, that the words used by nursing staff are mostly related to control, permission, and obligation, and that patient participation in speech production is very limited. On a broader level, I show the continuing significant presence of the paternalistic model in medical appointments, which is surprising given the objectives of TPE. In conclusion, the article contributes to a more detailed understanding of the language practices used by nursing staff and paves the way for reflection on possible training opportunities for caregivers.

Spirituality and Caring for the Older Person: A Discussion Paper

Holistic healthcare to the older person is important. Spirituality is considered to be the very essence of being and for some is what motivates and guides us to live a meaningful existence. Nurses caring for the older person need support in responding to their spiritual needs in order to ensure that they are appropriately and successfully met. The aim of this paper is to explore these needs and highlight some evidence indicating how this care can be implemented and therefore ultimately influence nursing practice.

Omega-3 Eicosapentaenoic Acid Is Related to Happiness and a Sense of Fulfillment-A Study among Female Nursing Workers

Background: Omega (ω) 3 fatty acid (FA) is a polyunsaturated FA (PUFA) that can modulate some mental statuses. However, most studies have not considered the functional differences between eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). We investigated associations among happiness, a sense of fulfillment and serum ω3 PUFA levels. Methods: Participants were 133 female staff from a hospital and nursing homes. Happiness was measured using the Japanese version of the subjective happiness scale (SHS); a sense of fulfillment was assessed using a visual analogue scale. Serum FA concentrations were measured. A partial correlation test and a regression model were applied. Results: The SHS scores showed significantly positive correlations with a sense of fulfillment, DHA% and EPA% (p < 0.05, < 0.05 and < 0.005, respectively), after controlling for age, BMI, menopause, snacking habits and leisure-time physical activities. A sense of fulfillment was significantly negatively correlated with α-linoleic acid%, and positively correlated with DHA% and EPA% (p < 0.05, < 0.05 and < 0.005, respectively), after controlling for the confounders. A regression model showed that a sense of fulfillment, EPA, and not stopping menstruation explained happiness (standardised beta, B = 0.18, p < 0.05; B = 0.24, p < 0.01; and B = 0.32, and p < 0.05, respectively), whereas age, BMI and snacking habits could not. Simultaneously, a regression model could not explain the association between DHA and happiness. Conclusion: Happiness was related with serum EPA%, a sense of fulfillment, and premenopause.

Medical emergency kits in ambulatory care clinics

Implementation and staff perceptions of usability and feasibility.

Psychological effects of nurses and midwives due to COVID-19 outbreak: The case of Turkey

PURPOSE

The study was carried out to determine the psychological impact levels of nurses and midwives due to the COVID-19 outbreak.

METHODS

The research is planned in a descriptive type. Nurses and midwives working in any health institution in Turkey constituted the population of the research. The questionnaire form of the study was shared on social media tools between 01 and 14 April 2020 and a total of 758 nurses and midwives were included in the study sample. Personal Information Form, State-Trait Anxiety Inventory and Intolerance of Uncertainty Scale were used as data collection tools.

RESULTS

Participants who attended the study were 56.9% of nurses and 43.1% of midwives. Approximately half of the nurses and midwives (48.8%) participating in our study contacted the patient with suspected COVID-19, and 29.8% provided care to the patient diagnosed with COVID-19. Nurses and midwives were scored 52.75 ± 9.80 for State Anxiety, 44.87 ± 7.92 for Trait Anxiety Inventory and 35.16 ± 9.42 for Intolerance of Uncertainty Scale. It has been determined that 54.5% of nurses and midwives have been making their lives worse since the outbreak started, 62.4% had difficulties in dealing with the uncertain situation in the outbreak, 42.6% wanted psychological support and 11.8% had alienated from their profession. It was determined that there was a difference between scale scores and difficulties in work, family and private life due to COVID-19.

CONCLUSION

As a result, it is seen that the midwives and nurses in our country have high psychological effects due to the COVID-19 outbreak.

Emotional communication in home care: A comparison between Norway and Sweden

OBJECTIVE

Given the free movement of workers across countries, knowledge regarding communication differences between countries is imperative. In this study, we explored and compared the supportive responses of nursing staff to older persons' emotions in home care in Norway and Sweden.

METHODS

The study had an observational, cross-sectional, comparative design, which included 383 audio-recorded home-care visits. Communication was coded using Verona Coding Definitions of Emotional Sequences. Worries and responses were categorised with regard to reference, communicative function and level of person-centredness. Standard statistical tests were used to analyse the data.

RESULTS

The Swedish nursing staff provided space for further disclosure of worry more frequently than the Norwegian nursing staff (75.0 % versus 60.2 %, χ2 = 20.758, p < 0.01). In all, 65 % of the responses were supportive. Multiple logistic regression analyses showed that highly person-centred responses were independently associated with worries phrasing an emotion, OR (95 % CI) 3.282 (1.524-7.067).

CONCLUSION

The level of person-centredness was associated with the way in which older persons expressed their distress. The Swedish nursing staff provided opportunities for further disclosure of worries more frequently than the Norwegian nursing staff.

PRACTICE IMPLICATIONS

Findings of intercultural differences should be incorporated into the training of nursing staff.

Policy brief on climate change and mental health/well-being

Climate change has a significant global impact on individuals' mental health and well-being. However, global health systems are inadequately prepared to address this issue. Studies indicate that climate events such as floods, droughts, tornados, earthquakes, and fires not only exacerbate chronic mental illness, but also impact well-being causing anxiety, stress, and in the worst case, suicide. The World Health Organization estimates that 12.6 million preventable deaths per year can be attributed to environmental factors, all of which are exacerbated by climate change, and an additional 250,000 deaths per year are projected between 2030 and 2050. Nurses must advocate for research, education, and policies that support disaster-resilient infrastructure and human services that allow communities across the globe to effectively mitigate the impact of climate change on human health.