Resilience among nurses in long term care and rehabilitation settings

Work Disparities and the Health of Nurses in Long-Term Care: A Scoping Review

Work disparities, such as unfairness in pay or unequal distribution of work experienced by nurses in long-term care (LTC), can impact the retention and health of this workforce. Background: Despite the significant impact of disparities on nurses' health in LTC, a literature review on work disparities of nurses in LTC has not been conducted. Method: This scoping review aimed to explore the nature and extent of research on meso-level work disparities experienced by nurses in LTC and its links with nurse health and well-being. Five databases were searched: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), SCOPUS, and CINAHL (EBSCO host). Results: Of the 5652 articles retrieved, 16 studies (14 quantitative and 2 qualitative) published between 1997 and 2024 met the inclusion criteria. A total of 53 work disparities were identified. Only four articles investigated the association of a work disparity with a variable of health (e.g., physical, mental, or poor general health). Conclusions: The results suggest that more attention to how disparities impact nurses' health and lived experiences is warranted. Meso-level disparities from this review provide an initial basis to consider possibilities in the workplace, especially in supporting equity and opportunities for health and well-being at work (e.g., through fair access to professional growth opportunities and a more equitable balance of work expectations and demands of nursing staff). Future studies of the intersection of macro- and meso-level factors are needed to inform better workplace practices and social and economic policies to support the well-being, health, and safety of nurses at work in LTC.

Bridging the generational gap between nurses and nurse managers: a qualitative study from Qatar

BACKGROUND

The nursing workforce comprises multiple generations, each with unique values, beliefs, and expectations that can influence communication, work ethic, and professional relationships. In Qatar, the generational gap between nurses and nurse managers poses challenges to effective communication and teamwork, impacting job satisfaction and patient outcomes.

AIM

This study investigates the generational gap between nurses and nurse managers in Qatar, aiming to identify strategies to enhance collaboration and create a positive work environment.

METHODS

A qualitative research design was used, involving semi-structured interviews with 20 participants, including frontline nurses and senior nurse managers. Participants were purposively sampled to represent different generations. Data were collected through face-to-face and virtual interviews, then transcribed and thematically analyzed.

FINDINGS

Four key themes emerged: Optimizing the Work Environment: Older generations preferred transformational and situational leadership, while younger nurses valued respect, teamwork, accountability, and professionalism. Strengthening Work Atmosphere through Communication and values: Older nurses favored face-to-face communication, while younger nurses preferred digital tools. Cultivating Respect and Empathy: Younger nurses emphasized fairness in assignments and promotions, while older nurses focused on empathy and understanding. Dynamic Enhancement of Healthcare Systems: Younger nurses were more adaptable to technology and professional development, while older nurses prioritized clinical care and patient outcomes.

CONCLUSION

The study reveals significant generational differences in leadership preferences, communication styles, and adaptability to technology. Addressing these gaps through effective leadership, ongoing education, and open communication can improve job satisfaction and patient care.

Relationships of individual and workplace characteristics With nurses' moral resilience

BACKGROUND

Moral resilience is the integrity and emotional strength to remain buoyant and achieve moral growth amid distressing situations. Evidence is still emerging on how to best cultivate moral resilience. Few studies have examined the predictive relationship of workplace well-being and of organizational factors with moral resilience.

RESEARCH AIMS

The aims are to examine associations of workplace well-being (i.e., compassion satisfaction, burnout, and secondary traumatic stress) and moral resilience, and to examine associations of workplace factors (i.e., authentic leadership and perceived congruence of organizational mission and behaviors) and moral resilience.

RESEARCH DESIGN

This study uses a cross-sectional design.

PARTICIPANTS AND RESEARCH CONTEXT

Nurses practicing in a hospital in the United States were surveyed using validated instruments (N = 147). Individual factors were measured using demographics and the Professional Quality of Life Scale. Organizational factors were measured using the Authentic Leadership Questionnaire and a single item measuring organizational mission/behavior congruence. Moral resilience was measured using the Rushton Moral Resilience Scale.

ETHICAL CONSIDERATIONS

The study was approved by an institutional review board.

FINDINGS

Resilience was noted to have significant small correlations with burnout, secondary traumatic stress, compassion satisfaction, and organizational mission/behavior congruence. Burnout and secondary traumatic stress predicted less resilience, whereas compassion satisfaction and perceived congruence between organizational mission and behaviors predicted higher resilience.

DISCUSSION

Burnout and secondary traumatic stress, increasingly experienced by nurses and other health professionals, have negative effects on moral resilience. Compassion satisfaction can increase resilience, which is especially important in nursing. Organizational practices promoting integrity and confidence can have positive effects on resilience.

CONCLUSIONS

Continued work to confront workplace well-being issues, especially burnout, is needed as a way of increasing moral resilience. Studies of organizational and work environment factors to bolster resilience are likewise needed to assist organizational leaders in devising the best strategies.

Bridging Educational Grant in Nursing (BEGIN) students' intentions for retention in long-term, home and community care: A survey protocol

INTRODUCTION

Retention of nurses in long-term care (LTC) and home and community care (HCC) settings is a growing concern. Previous evidence underscores factors which contribute to nurses' intentions for retention in these sectors. However, perspectives of nursing students preparing to enter the workforce, and their intentions for short-term and long-term retention, remain unknown. This study aims to explore relationships between short-term and long-term intentions for retention with psychological empowerment, work engagement, career commitment, burnout, prosocial motivation, self-care and personal resilience among students enrolled in nursing educational bridging programs supported by the Bridging Educational Grant in Nursing (BEGIN) program in Ontario, Canada.

METHODS AND ANALYSIS

This cross-sectional design study will use an open online survey to investigate perspectives of current nursing students enrolled in educational bridging programs on factors relating to psychological empowerment, work engagement, career commitment, resilience, burnout, prosocial motivation, self-care and intentions for retention. Additionally, the survey will collect demographic information, including age, gender, ethnicity, citizenship, income, family status, nursing role, and years of employment and/or education. Open-ended questions will elicit participants' perspectives on financial considerations for career planning and other factors impacting intentions for retention. Descriptive data will be presented for contextualisation of participants' demographic characteristics to enhance generalisability of the cohort. Descriptive statistics will be used to summarise participants' scores on various assessment measures, as well as their short-term and long-term intentions for retention in LTC and HCC after completion of BEGIN. A Pearson's product moment r correlation will determine relationships between intentions for retention and other measures, and linear regression will determine whether any potential correlations can be explained by regression.

ETHICS AND DISSEMINATION

This research protocol received ethical approval from a research-intensive university research ethics board (#123211). Findings will be disseminated to nursing knowledge users in LTC and HCC through publications, conferences, social media and newsletters.

Nurses' Job Burnout and Resilience in Neonatal Intensive Care Units

PURPOSE

To assess the relationship between job burnout and resilience among nurses working in neonatal intensive care units (NICUs) in Oman.

BACKGROUND

NICUs induce a significant amount of stress that predisposes nurses to a substantial degree of burnout. Resilience can play a role in reducing the effects of job burnout. A limited number of studies have examined job burnout and resilience among NICU nurses.

METHODS

A cross-sectional survey design was utilized. The Maslach Burnout Inventory was used to assess burnout, and the Brief Resilience Scale was used to assess perceptions of resilience. Pearson correlation was used to assess the relationship between job burnout and resilience.

RESULTS

A total of 173 staff nurses participated. Participants reported low levels of emotional exhaustion and depersonalization but moderate levels on the personal accomplishment subscale. Nurses reported moderate levels of resilience. Emotional exhaustion and depersonalization were negatively correlated with resilience, while personal accomplishment was positively correlated with resilience.

CONCLUSION

This study demonstrated that enhancing resilience can reduce the effect of burnout among NICU nurses.

IMPLICATIONS FOR PRACTICE AND RESEARCH

Enhancing levels of resilience among NICU nurses, in addition to providing adequate managerial support and good collegial relations, is essential to reduce their perceived job burnout.

Relation and effect of resilience on burnout in nurses: A literature review and meta-analysis

AIM

To study the relation between burnout and resilience and to identify the profile of nurses presenting this quality.

BACKGROUND AND INTRODUCTION

Healthcare professionals are subject to high rates of burnout. Resilience could be an important factor in preventing or alleviating this condition.

METHODS

The PubMed, ProQuest, Scopus and ScienceDirect databases were consulted in February 2022 using the equation 'burnout AND resilience AND nurs*'. The inclusion criteria applied were that the texts should describe quantitative studies, be published in English or Spanish, in any year, and be directly related to the question considered. The meta-analysis was performed using StatsDirect statistical software.

RESULTS

Analysis of the 29 studies shows that among the dimensions of burnout, nurses are especially prone to emotional exhaustion, and are less affected by depersonalisation and low personal accomplishment. Those who score highly for resilience tend to have longer service experience, acceptable salaries and less work overload. Meta-analysis reveals an inverse correlation between resilience and burnout (r = -0.41; n = 2750), exhaustion (r = -0.27; n = 6966) and depersonalisation (r = -0.23; n = 6115).

CONCLUSION

Many nurses present low levels of resilience and suffer from burnout syndrome. The application of programmes to enhance their resilience would help prevent burnout and optimise the potential to provide quality health care.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Resilience is inversely correlated with burnout, depersonalisation and emotional exhaustion. Accordingly, healthcare organisations should develop and implement evidence-based programmes to foster nurses' resilience and thus reduce their susceptibility to burnout.

Intention to quit and its correlates among dieticians residing in the United Arab Emirates during the COVID-19 pandemic: A cross-sectional survey

BACKGROUND

The COVID-19 pandemic precipitated increased workload, stress, and burnout on healthcare providers on the frontlines of the pandemic, dieticians were no exception. Such unprecedented occupational risks and stressors contributed to a higher intention to quit, potentially leading to workforce shortages, and hindering the delivery of quality care, especially for patients with chronic conditions. The aim of this study was to examine the prevalence factors associated with the intention to quit among dieticians in the United Arab Emirates during a public health emergency.

METHODS

The study utilized a cross-sectional design with an online survey sent to dieticians between January and May 2021. The final version of the questionnaire included four sections: A sociodemographic section, intention to quit, work-related practices and challenges, as well as the resilience scale using the 25 items- Connor-Davidson Resilience Scale© (CD-RISC). Descriptive statistics as well as simple and multiple logistic regression analyses were carried out to explore factors associated with the intention to quit among dieticians.

RESULTS

Study results revealed that a quarter of dieticians intend to quit their jobs. Higher odds of intention to quit among dieticians were significantly associated with male gender, younger age, having a chronic condition, being non-resilient, feeling unappreciated, using online platforms for dietary counseling, reporting increased workload, and working from home or in a blended format during the pandemic.

CONCLUSION

This study revealed a high intention to quit among dieticians during the COVID-19 pandemic and identified a few correlates for the intention to quit that could support the development of evidence-based interventions. Such interventions should address through targeted programs the challenges faced by male dieticians, younger dieticians, as well as dieticians with Chronic health conditions. Furthermore, the findings of this study showed that promoting resilience among dieticians is crucial in reducing their intention to quit.

Resilience, job satisfaction, intentions to leave nursing and quality of care among nurses during the COVID-19 pandemic - a questionnaire study

BACKGROUND

The COVID-19 pandemic has challenged nurses and healthcare systems globally and raised major concerns for nurses' wellbeing and working conditions. This cross-sectional and correlational study design aims to describe nurses' resilience, job satisfaction, intentions to leave and quality of care, and explain their relationships during the COVID-19 pandemic.

METHODS

Data were collected from Registered Nurses (N = 437) in Finland through an electronic survey between February 2021 and June 2021. The questionnaire covered background characteristics (seven questions), resilience (four questions), job satisfaction (one question), intention to leave nursing (two questions), quality of care (one question), and requiring factors of the work (eight questions). The background variables and dependent variables were analyzed and presented using descriptive statistics. Structural equation modeling was used to explain dependent variables relationships. The study followed procedures recommended in the STROBE Statement for cross-sectional studies in efforts to maximize the quality of reporting results.

RESULTS

The surveyed nurses evaluated their resilience by mean score 3.92, more nurses had considered leaving nursing during the pandemic (16%) than before (2%). Nurses´ mean score of requiring factors of the work was 2.56 and overall job satisfaction 5.8. Structural equation modeling revealed that resilience affected their job satisfaction, which also influenced the quality of care, that was rated moderate (7.46 out of 10). Structural equation modeling indices of goodness of fit were NFI = 0.988, RFI = 0.954, IFI = 0.992, TLI = 0.97, CFI = 0.992, and RMSEA = 0.064. No direct relationship was found between resilience and intention to leave nursing.

CONCLUSIONS

Good resilience promoted delivery of high-quality care by nurses during the pandemic and enhanced their job satisfaction, which reduced their intention to leave nursing. The results indicate that it is important to develop interventions that support nurses' resilience.

IMPACT

The study highlights the importance of nurses' resilience during the pandemic, while job satisfaction may decrease and requiring factors of the work increase. Given the number of nurses who consider leaving nursing, there are clear needs to develop effective strategies to maintain quality healthcare with resilient, committed nursing staff.

Report on fraying resilience among the Ontario Registered Practical Nurse Workforce in long-term care homes during COVID-19

AIM

Registered Practical Nurses (RPNs) are frontline healthcare providers in Ontario long-term care (LTC) homes. Throughout COVID-19, RPNs working in LTC homes experienced prolonged lockdowns, challenging working conditions, and inadequate resource allocation. This study aimed to describe the personal and professional resilience of RPNs working in LTC during the COVID-19 pandemic.

DESIGN

An open cross-sectional online survey containing the Connor-Davidson Resilience Scale, Resilience at Work Scale®, and Resilience at Work Team Scale®.

METHODS

The survey was distributed by the RPN Association of Ontario (WeRPN) to approximately 5000 registered members working in Ontario LTC homes.

RESULTS

A total of 434 respondents participated in the survey (completion rate = 88.0%). Study respondents scored low on measures of resilience and reported extreme levels of job (54.5%) and personal (37.8%) stress. Resources to support self-care and work-life balance, build capacity for team-based care practice(s) are needed.

Factors related to the appearance and development of burnout in nursing students: a systematic review and meta-analysis

Introduction

Burnout may be suffered not only by experienced nurses, but also by those in training. The university environment can be highly stressful for student nurses, who are exposed to various stress-producing situations.

Aim

The aim of this study is to identify and analyse the main risk factors for burnout among nursing students.

Methods

A systematic review with meta-analysis was performed. The search equation used was "Burnout AND Nursing students". Quantitative primary studies on burnout in nursing students, and related risk factors published in English or Spanish and with no restriction by year of publication were included.

Results

A sample of n = 33 studies were included. Three variables are identified can influence burnout in nursing students: academic, interpersonal, environmental and/or social factors. The meta-analyses, with the higher sample of n = 418 nursing students, show that some personality factors, empathy, and resilience are correlated with emotional exhaustion, depersonalization and personal accomplishment.

Conclusion

The personality factors that can influence the development of burnout in nursing students, such as resilience and empathy, among others, must be taken into account when preventing the appearance and treating burnout. Professors should teach nursing students to prevent and recognize the most frequent symptoms of burnout syndrome.

Coping strategies that motivated frontline nurses while caring for the COVID-19 patients during the pandemic: A scoping review

BACKGROUND

The world faced a great health crisis during the COVID-19 pandemic. Consequently, the health care providers struggled and faced tremendous difficulties in treating high-load critical patients. This was particularly true in low- and middle-income countries where the work and patient loads are always higher and nurses at the forefront must deal with emergencies while being at high risk of exposure. However, little is known about the survival strategies of frontline nurses as dealt with the pandemic.

OBJECTIVES

This study catalogued the coping strategies of frontline nurses to deal with caring for the COVID-19 patients during the pandemic.

METHODS

The Arksey O'Malley framework was followed to conduct a scoping review. A systematic literature search was conducted using three databases: Google Scholar, Scopus and PubMed; and out of the 192 studies, 12 met the inclusion criteria set for this review study.

RESULTS

A total of 44 strategies were identified that motivated nurses to deal with the COVID-19 situation, and these strategies could be categorized into five main themes: nurses' self-strategies, nurses' strategies at the ethical level, employers' strategies, nursing leaders' strategies and supplementary strategies.

CONCLUSIONS

The findings of this study will provide guidance for health care workers, employers, policymakers, regulators and other stakeholders to adopt and promote different strategies in managing difficult emergency situations in future.

IMPLICATIONS FOR NURSING MANAGEMENT

This study emphasizes the importance of learning how to deal with adversity by health care workers and organizations in an emergency.