Feasibility and efficacy of integrating resiliency training into a pilot nurse residency program

Interventions that support novice nurses' transition into practice: A realist review

BACKGROUND

Many transition-to-practice programs have been developed to support novice nurses during their first years into practice. These programs report improvements in retention, wellbeing and clinical competence, but the driving mechanisms of these interventions remain largely unclear.

OBJECTIVE

To identify how transition-to-practice programs for novice nurses work and in what contexts they work successfully.

METHODS

A realist review was conducted. Eligibility criteria included intervention studies aimed at novice nurses in their first two years of practice that reported outcomes on organizational or individual nurse level. The underlying theory of included transition-to-practice programs was extracted, and relevant contextual factors, mechanisms and outcomes were explored and synthesized into context-mechanism-outcome (CMO) configurations. The search was limited to studies between 2000 and 2023.

RESULTS

A total of 32 studies were included, evaluating 30 different transition-to-practice programs with a wide range of intervention components including stress management, clinical education, professional and peer support, and ward rotations. Transition-to-practice programs were often designed without a theoretical foundation. Driving mechanisms behind the programs pertained to psychological, professional, and social development. Contextual factors that activated the mechanisms were enabling conditions for mentors and novice nurses, selection and motivation of novice nurses and organizational culture.

CONCLUSIONS

Current transition-to-practice programs primarily focus on the individual and professional development of nurses. However, transition to practice can benefit from a systemic approach that includes development initiatives on the organizational level.

REGISTRATION

PROSPERO ID CRD42021268080, August 15, 2021.

TWEETABLE ABSTRACT

Context and mechanisms determine successful implementation of transition to practice programs for novice nurses. @transitiontopractice @nurseworkforce.

Effects of interventions to promote resilience in nurses: A systematic review

BACKGROUND

Various trials are investigating the effect of digital and face-to-face interventions on nurse resilience; however, it remains unclear whether these interventions have immediate, short-term or long-term effects.

OBJECTIVE

The objective of the systematic review is to identify the types of interventions and assess the immediate (<3 months), short-term (3-6 months), and long-term (>6 months) effects of these interventions on nurse resilience.

DESIGN

This systematic review was registered in the International Prospective Register of Systematic Reviews (Registered Number: CRD 42023434924), and results are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol.

METHODS

Data were collated from the databases of CINAHL, Cochrane Library, Embase (OVID), Medline, and Scopus between March and May 2023. The research protocol was determined following the framework of population, exposure, outcomes, and type of study. The articles with full text published between 2000 and 2023 were included. Studies were included if they (1) involved the nurses who provided patient care directly, (2) utilised digital or face-to-face interventions, (3) reported resilience outcomes, and (4) were randomised controlled trials or clinical trials. The JBI critical appraisal tool was utilised to assess the risk of bias for the studies collected.

RESULTS

A total of 18 studies met the criteria and were analysed. Pooled results demonstrated that digital interventions had a statistically significant positive effect on nurse resilience at 4-5-month follow-ups (standardised mean difference [SMD] = 0.71; 95 % CI = 0.13, 1.29; P = 0.02) compared to no interventions. Additionally, pooled data showed no effect on nurse resilience at all the follow-ups, compared to no interventions. No significant results were observed in comparisons of digital or face-to-face interventions between the intervention and control groups.

CONCLUSIONS

The review assessed digital and face-to-face resilience interventions in nurses across 18 trials. Digital methods showed a short-term impact within 4-5 months, whilst face-to-face interventions had no effect during follow-ups. Realistic expectations, ongoing support, and tailored interventions are crucial for nurse resilience enhancement.

TWEETABLE ABSTRACT

It was identified digital interventions had a short-term impact on nurse resilience, whilst face-to-face interventions had no effect during follow-ups @fionayyu.

Promoting Nursing Student Mental Health Wellness: The Impact of Resilience-Building and Faculty Support

BACKGROUND

Being aware of elevated levels of student psychological distress by nursing faculty, and subsequently responding to it, may diminish nursing students' experience of negative mental health well-being.

PURPOSE

Relationships between perceived faculty support, resiliency, and the prevalence of depression, anxiety, and stress among undergraduate nursing students were explored.

METHODS

An exploratory mixed-methods design was used for this descriptive, cross-sectional study. The Depression, Anxiety, and Stress Scale-21, Brief Resilience Scale, Perceived Faculty Support Scale, a demographic questionnaire, and open-ended questions were used to collect data. A convenience sample of 989 undergraduate baccalaureate nursing students from across the United States completed the surveys.

RESULTS

Study results revealed resilience strategies and psychological and functional supportive faculty behaviors and actions are substantial predictors of lower depression, anxiety, and stress in undergraduate baccalaureate nursing students.

CONCLUSIONS

Investments in faculty development to support nursing student resilience may reduce the degree of negative mental health well-being that students exhibit related to nursing education and promote their successful transition to nursing practice.

Improving Resiliency in U.S. Air Force Healthcare Personnel: A Randomized Preventive Trial

INTRODUCTION

The effectiveness of the Stress Management and Resilience Training (SMART) with U.S. military personnel has not been reported in the literature. The purpose of this study was to examine the effectiveness of SMART in increasing resilience in Air Force healthcare personnel.

MATERIALS AND METHODS

We conducted a pilot, randomized preventive trial with active component Air Force healthcare personnel. SMART was offered via an in-person, 2-h training session delivered through face-to-face or synchronous video teleconference training, or via a self-paced, computer-based training. A baseline survey included demographics questions and the Connor-Davidson-10 Resilience Scale (CD-10), Perceived Stress Scale (PSS), Generalized Anxiety Disorder Scale (GAD-7), and overall quality of life (QOL) measure. Follow-up surveys with the CD-10, PSS, GAD-7, and quality of life were sent to participants at 12, 18, and 24 weeks after completing SMART.

RESULTS

Fifty-six service members completed the baseline assessment and were randomized to either the in-person modality (comprised of video teleconference or face-to-face training) or the computer-based training modality, and 49 participants completed SMART. Significant increases in median CD-10 scores were observed among all participants, showing a 4-point (14%), 6-point (21%), and 5-point (17%) increase at week-12, -18, and -24, respectively, from the baseline. A significant overall decrease in median PSS scores from baseline were observed, with 5.5-points (22%), 7.81-points (32%), and 8.5-points (35%) decrease at 12, 18, and 24 weeks post-SMART, respectively.

CONCLUSIONS

In this pilot study, SMART demonstrated significant and meaningful improvements in self-reported CD-10 and PSS-14 scores at 12, 18, and 24 weeks post-training completion. A future replication of the study is necessary to evaluate the effectiveness of SMART on a larger scale.

A rapid review of evaluated interventions to inform the development of a resource to support the resilience of care home nurses

BACKGOUND

Nurses working in care homes face significant challenges that are unique to that context. The importance of effective resilience building interventions as a strategy to enable recovery and growth in these times of uncertainty have been advocated. The aim of this rapid review was to inform the development of a resource to support the resilience of care home nurses. We explored existing empirical evidence as to the efficacy of resilience building interventions. undertaken with nurses.

METHODS

We undertook a rapid review using quantitative studies published in peer reviewed journals that reported resilience scores using a valid and reliable scale before and after an intervention aimed at supporting nurse resilience. The databases; Cumulative Index to Nursing and Allied Health Literature, Medline and PsychInfo. and the Cochrane Library were searched. The searches were restricted to studies published between January 2011 and October 2021 in the English language. Only studies that reported using a validated tool to measure resilience before and after the interventions were included.

RESULTS

Fifteen studies were included in this rapid review with over half of the studies taking place in the USA. No studies reported on an intervention to support resilience with care home nurses. The interventions focused primarily on hospital-based nurses in general and specialist contexts. The interventions varied in duration content and mode of delivery, with interventions incorporating mindfulness techniques, cognitive reframing and holistic approaches to building and sustaining resilience. Thirteen of the fifteen studies selected demonstrated an increase in resilience scores as measured by validated and reliable scales. Those studies incorporating 'on the job,' easily accessible practices that promote self-awareness and increase sense of control reported significant differences in pre and post intervention resilience scores.

CONCLUSION

Nurses continue to face significant challenges, their capacity to face these challenges can be nurtured through interventions focused on strengthening individual resources. The content, duration, and mode of delivery of interventions to support resilience should be tailored through co-design processes to ensure they are both meaningful and responsive to differing contexts and populations.

Legacy Letters Written by Oncology Nurse Residents: Post Hoc Poetic Inquiry

BACKGROUND

A qualitative analysis of Legacy Letters written by oncology nurse residents to future nurse residents on what they wish they knew and what they learned at the end of their 1-year residency program showed four themes. This article presents a poetic inquiry of select themes/subthemes, providing a new perspective on the findings.

METHOD

Post hoc poetic inquiry of select subthemes/themes from a previously conducted qualitative nursing research study on nurse residents' Legacy Letters was conducted using a collective participant voice approach.

RESULTS

Three poems were created. A sample quote by an oncology nurse resident and an explanation of the relationship of the poem to the Legacy Letters are provided.

CONCLUSION

These poems represent a larger theme of resilience. Learning from mistakes, dealing with emotions, and providing self-care embody the experience and adaptation of the oncology nurse residents to this year of transition from graduation to professional practice. [J Contin Educ Nurs. 2023;54(3):117-120.].

Steps toward a resilient future nurse workforce

INTRODUCTION

The psychosocial needs of nursing students are a pressing matter as mental health disorders may affect nursing students' journeys as professional nurses.

LITERATURE REVIEW

Psychological distress and burnout in nurses are threats to worldwide health care, as the stress associated with the COVID-19 pandemic could lead to an unstable future global nurse workforce.

DISCUSSION

Resiliency training can positively impact nurse stress, mindfulness, and resilience, as resilient nurses are better able to manage their response to stress and adversity which will contribute to positive patient outcomes.

IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE

Educating faculty on resilience will aid nurse educators to create new student instructional approaches to improve mental health wellness.

CONCLUSIONS

Supportive faculty behaviors, self-care techniques, and resilience-building infused throughout the nursing curriculum may promote the effective transitioning of students into practice, providing the necessary foundation for improving workplace stress management and increasing longevity and satisfaction in the profession.

Analysis of Factors Affecting Psychological Resilience of Emergency Room Nurses Under Public Health Emergencies

Resilience is essential for frontline health workers to cope with the unfavorable situations, especially under public health emergencies. Emergency room (ER) nurses are a special cohort of health professionals that may present moderate level of resilience. This study aimed to identify factors that are correlated with resilience in this special cohort to provide directions for intervention and management. ER nurses that have encountered a public health emergency within 3 months were recruited using purposive sampling and snowball technique for the study. Questionnaires, including Connor-Davidson Resilience Scale (CD-RISC), Zung Self-Rating Depression Scale (SDS), and Maslach Burnout Inventory-Human Services Survey (MBI-HSS) were established, followed by an in-depth interview to identify different clusters of themes. Thirteen ER nurses were recruited, and the average CD-RISC score was 66 ± 21. Resilience was negatively correlated with SDS index, and positively correlated with personal accomplishment. Five clusters of themes were identified from in-depth interviews, including physical tolerability, psychological tolerability, tenacity of internal drive, institutional implementation, and external adjustment. This study identified factors associated with resilience in ER nurses under public health emergencies, providing useful information for future directions for intervention.

Curricular and Clinical Innovation Engaging Undergraduate Nursing Students to Build a Resilient Primary Care Workforce

BACKGROUND

Primary care health settings provide access to services for underserved populations, yet baccalaureate (BSN)-prepared nurses are currently underutilized on the primary care health care team.

PROBLEM

BSN curricula often focus on acute care settings for clinical experiences, and students may not be aware of the scope and impact the RN has in a primary care setting. This gap in experiences may lead to overlooking primary care employment opportunities.

PURPOSE

The purpose of this article is to describe the development, implementation, and evaluation of an innovative course that builds the primary care nurse workforce capacity.

APPROACH

An undergraduate elective course focusing on primary care didactic and clinical experiences was created.

OUTCOMES

Qualitative student feedback regarding the course was positive, while quantitative data revealed an above-average course outcome rating.

CONCLUSIONS

An effective intervention to increase workforce capacity in primary care settings is to immerse students in primary care concepts and experiences in a formal, combined didactic and clinical course.

2021: The Year in Review

This year was a challenge in so many ways! Yet, it offered nursing professional development practitioners opportunities to think creatively and collaboratively while implementing new and better ways of delivering education and professional development. This column looks at some of the more notable events of 2021 and how they impacted education and professional development. [J Contin Educ Nurs. 2021;52(12):545-548.].