Burnout, Compassion Fatigue, and Secondary Trauma in Nurses: Recognizing the Occupational Phenomenon and Personal Consequences of Caregiving

Cultivating Self-Compassion to Protect Nurses From Burnout and Secondary Traumatic Stress

Nursing burnout, a result of prolonged occupational stress, has always been a challenge in health care, but recently the COVID-19 pandemic made this issue into a national priority. In fact, burnout among health care workers is one of the four priorities of the U.S. Surgeon General. Health care leaders and organizations are eager to implement strategies to improve nurses' well-being and, thus, enhance their mental health. Much of the literature has focused on the antecedents and consequences of nursing burnout, but there is limited information on strategies that protect perinatal nurses from burnout. Self-compassion is emerging as one strategy that has a positive correlation with nurse well-being and a negative association with burnout, depression, and anxiety. In this article, we identify and translate strategies to promote self-compassion in perinatal nurses.

Trauma Registry Professionals' Perspectives on the Secondary Traumatic Stress Component of Compassion Fatigue: A Qualitative Study

BACKGROUND

Secondary traumatic stress and compassion fatigue have been studied among trauma clinicians yet have not been explored in trauma registry professionals (TRPs).

OBJECTIVE

The purpose of this study is to describe the secondary traumatic stress component of compassion fatigue among TRPs.

METHODS

A qualitative, phenomenological study was conducted to examine TRPs' experiences with the secondary traumatic stress component of compassion fatigue. The primary investigator assembled a multidisciplinary team of researchers, including nursing leadership, registry educators, mental health experts, and qualitative researchers. Two focus groups were held virtually in January 2021, using an interview guide designed by the research team. Participants were recruited via an email sent to a list of colleagues known to the research team from training classes held nationally and selected for their diverse clinical experiences, years in the role, demographic background, and trauma center representation. The recorded sessions were independently transcribed and analyzed by a five-member subgroup of the research team; the analysis concluded in December 2022.

RESULTS

Nine TRPs participated in the focus groups. Participants came from Level I, II, and III adult and pediatric trauma centers and military centers. Four themes emerged from the data: disquieting and rewarding work, reactions and emotional responses, the influence of personal histories and background, and coping strategies.

CONCLUSION

A qualitative analysis of focus group discussions revealed the secondary traumatic stress component of compassion fatigue is present in the TRP.

Development and Psychometric Test of the Salutogenic Survey on Sustainable Working Life for Nurses: Identifying Resistance Resources against Stress

Extensive research shows nurses' work environment to be particularly stressful. This study develops, explores, and psychometrically tests a new profession-specific questionnaire identifying generalised and specific resistance resources, that make it possible to measure resources to manage work-related stress. An exploratory study design was employed. The questionnaire development was inspired by the MEASURE approach and the salutogenic theory of health. Building on the results from a literature review of nursing research and salutogenesis, supplemented by twelve interviews with hospital nurses, an item pool was generated. The first version was pilot-tested in a group of nurses who were studying to become specialist nurses. The second version of the questionnaire was psychometrically tested on a sample of registered nurses in close patient care (n = 475), analysed using confirmatory factor analysis to test seven predefined domains of the questionnaire. The analysis revealed a first order seven-domain model of 21 items: job satisfaction, professional role, work motivation, commitment, belonging in the workplace, factors and conditions for remaining in the profession, and workload. The structure of the questionnaire indicates its usefulness in clinical practice for measuring resistance resources.

Compassion Satisfaction, Burnout, and Secondary Traumatic Stress Among Nursing Staff at an Academic Medical Center: A Cross-Sectional Analysis

BACKGROUND

Although several studies have recently described compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in nurses, few to date have examined these issues across nursing specialties. Such examination is needed to inform future nursing-subspecialty tailored interventions.

AIMS

To examine (1) differences in CS, BO, and STS across nursing specialties and (2) differences associated with demographic, work-related, and behavioral factors among nurses.

METHOD

A secondary analysis of survey responses from nurses (N = 350) at an academic medical center. Demographic, behavioral, work-related, and professional quality of life variables were analyzed using hierarchical regression analyses.

RESULTS

CS, BO, and STS scores significantly varied across specialties with emergency nurses experiencing significantly elevated rates of BO and STS, and lowest rates of CS; scores were also differentially associated with demographic, work-related, behavioral, and workplace violence variables.

CONCLUSIONS

Key differences in CS, BO, and STS by nursing specialty suggests the importance of tailoring BO and STS mitigative interventions. BO and STS risk factors should be assessed in nurses (e.g., behavioral health problems and poor sleep quality) and specialty-specific interventions (e.g., reducing workplace violence exposure in emergency settings) may be considered to improve CS while reducing BO and STS among nurses.

Secondary traumatic stress among pediatric nurses: Relationship to peer-organizational support and emotional labor strategies

BACKGROUND

Even though the cost of caring is acknowledged in multiple helping professions, research into secondary traumatic stress in pediatric nursing remains limited. This study aimed to determine the prevalence of secondary traumatic stress among pediatric nurses and examine its correlation with demographics, perceived organizational support, peer support, and emotional labor strategies.

DESIGN AND METHODS

A total of 186 nurses working in a pediatric hospital completed questionnaires addressing secondary traumatic stress, perceived organizational support, peer support, and emotional labor strategies. Through correlational and mediation analyses, we explored the relationships between the study variables.

RESULTS

Approximately 77.8% of the pediatric nurses surveyed exhibited moderate to severe secondary traumatic stress. Notably, the level of secondary traumatic stress did not correlate with demographic variables. Increased peer support was significantly associated with a heightened use of all emotional labor strategies (surface acting, deep acting, and natural expression) and with elevated levels of secondary traumatic stress. However, surface acting was the sole mediator of this relationship. Conversely, greater perceived organizational support correlated with decreased levels of surface acting and secondary traumatic stress, with surface acting serving as the mediator.

CONCLUSIONS

Pediatric nurses are greatly impacted by secondary traumatic stress. Enhancing organizational support and carefully assessing peer support can reduce this, by decreasing nurses' need to suppress or feign genuine emotions.

PRACTICE IMPLICATIONS

To enhance nurses' psychological well-being, healthcare institutions should raise awareness of secondary traumatization and foster a supportive organizational environment that prioritizes effective team emotional support and evaluates collegial emotional labor.

Conceptual framework on barriers and facilitators to implementing perinatal mental health care and treatment for women: the MATRIx evidence synthesis

Background

Perinatal mental health difficulties can occur during pregnancy or after birth and mental illness is a leading cause of maternal death. It is therefore important to identify the barriers and facilitators to implementing and accessing perinatal mental health care.

Objectives

Our research objective was to develop a conceptual framework of barriers and facilitators to perinatal mental health care (defined as identification, assessment, care and treatment) to inform perinatal mental health services.

Methods

Two systematic reviews were conducted to synthesise the evidence on: Review 1 barriers and facilitators to implementing perinatal mental health care; and Review 2 barriers to women accessing perinatal mental health care. Results were used to develop a conceptual framework which was then refined through consultations with stakeholders.

Data sources

Pre-planned searches were conducted on MEDLINE, EMBASE, PsychInfo and CINAHL. Review 2 also included Scopus and the Cochrane Database of Systematic Reviews.

Review methods

In Review 1, studies were included if they examined barriers or facilitators to implementing perinatal mental health care. In Review 2, systematic reviews were included if they examined barriers and facilitators to women seeking help, accessing help and engaging in perinatal mental health care; and they used systematic search strategies. Only qualitative papers were identified from the searches. Results were analysed using thematic synthesis and themes were mapped on to a theoretically informed multi-level model then grouped to reflect different stages of the care pathway.

Results

Review 1 included 46 studies. Most were carried out in higher income countries and evaluated as good quality with low risk of bias. Review 2 included 32 systematic reviews. Most were carried out in higher income countries and evaluated as having low confidence in the results. Barriers and facilitators to perinatal mental health care were identified at seven levels: Individual (e.g. beliefs about mental illness); Health professional (e.g. confidence addressing perinatal mental illness); Interpersonal (e.g. relationship between women and health professionals); Organisational (e.g. continuity of carer); Commissioner (e.g. referral pathways); Political (e.g. women's economic status); and Societal (e.g. stigma). These factors impacted on perinatal mental health care at different stages of the care pathway. Results from reviews were synthesised to develop two MATRIx conceptual frameworks of the (1) barriers and (2) facilitators to perinatal mental health care. These provide pictorial representations of 66 barriers and 39 facilitators that intersect across the care pathway and at different levels.

Limitations

In Review 1 only 10% of abstracts were double screened and 10% of included papers methodologically appraised by two reviewers. The majority of reviews included in Review 2 were evaluated as having low (n = 14) or critically low (n = 5) confidence in their results. Both reviews only included papers published in academic journals and written in English.

Conclusions

The MATRIx frameworks highlight the complex interplay of individual and system level factors across different stages of the care pathway that influence women accessing perinatal mental health care and effective implementation of perinatal mental health services.

Recommendations for health policy and practice

These include using the conceptual frameworks to inform comprehensive, strategic and evidence-based approaches to perinatal mental health care; ensuring care is easy to access and flexible; providing culturally sensitive care; adequate funding of services; and quality training for health professionals with protected time to do it.

Future work

Further research is needed to examine access to perinatal mental health care for specific groups, such as fathers, immigrants or those in lower income countries.

Trial registration

This trial is registered as PROSPERO: (R1) CRD42019142854; (R2) CRD42020193107.

Funding

This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR 128068) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 2. See the NIHR Funding and Awards website for further award information.

The effect of exposure to intimate partner violence of female nurses on communication skills and burnout levels

PURPOSE

Although intimate partner violence is a type of violence that women are frequently exposed to, its victims are adversely affected by violence at various levels, bio-psycho-socially. This study was conducted to determine the relationship between exposure to spousal violence, communication skills and burnout levels in female nurses.

MATERIAL AND METHODS

The study was carried out in a descriptive and cross-sectional research design. The study was conducted in a university hospital in the Black Sea region of Turkey in September 2021. Sample selection was not made in the study, and female nurses who agreed to participate in the study were included in the study. The study's sample size is 165 female nurses. A personal Information Form, Intimate Partner Violence Scale, Communication Skills Scale, and Burnout Scale were used to collect data.

FINDINGS

It was concluded that the exposure of female nurses to spouse violence significantly affects their communication skills and there is a significant relationship between nurses' communication skills and burnout levels (P = 0.001).

PRACTICAL IMPLICATIONS

The attitudes and behaviors of nurses who are strong in the caregiving process are very important. Personal characteristics, communication styles and body language of nurses who are exposed to partner violence are reflected in nursing care practices and affect the caregiving process. In this context, prevention and intervention approaches for intimate partner violence of female nurses should be known.

Study of the Relationship between Sensory Processing Sensitivity and Burnout Syndrome among Speech and Language Therapists

BACKGROUND

Burnout syndrome can arise due to either situational factors such as working conditions, or dispositional factors such as certain temperaments, like a high sensory processing sensitivity. We aim to address the relative absence of studies on speech-language therapists and seek to determine the role of high sensitivity for these healthcare workers in relation to burnout syndrome.

METHOD

The sample consisted of 602 female speech-language pathologists who anonymously completed a questionnaire measuring burnout (ProQOL 5th edition) and sensory processing sensitivity (HSPS-FR).

RESULTS

The results revealed that 77.41% of the participants reported moderate or high burnout scores. Furthermore, the analyses revealed that highly sensitive participants are more vulnerable to burnout than others.

CONCLUSION

This study highlights the negative impact of high sensory processing sensitivity on burnout. However, according to the kind of sensitivity, we discuss the way in which highly sensitive caregivers can master this sensitivity in order to use it as a strength in their professions and to spare themselves from suffering deleterious effects, such as compassion fatigue and/or burnout.

Moral courage, burnout, professional competence, and compassion fatigue among nurses

BACKGROUND

Moral courage is the ability to defend and practice ethical and moral action when faced with a challenge, even if it means rejecting pressure to act otherwise. However, moral courage remains an unexplored concept among middle eastern nurses.

AIM

This study investigated the mediating role of moral courage in the relationship between burnout, professional competence, and compassion fatigue among Saudi Arabian nurses.

RESEARCH DESIGN

Correlational, cross-sectional design following the STROBE guidelines.

PARTICIPANTS AND RESEARCH CONTEXT

Convenience sampling was used to recruit nurses (n = 684) for four government hospitals in Saudi Arabia. Four validated self-report questionnaires (Nurses' Moral Courage Scale, Nurse Professional Competence Scale-Short Form, Maslach Burnout Inventory, and Nurses Compassion Fatigue Inventory) were used to collect data between May to September 2022. Spearman rho and structural equation modeling analyses were employed to analyze the data.

ETHICAL CONSIDERATIONS

The ethics review committee of a government university in Ha'il region, Saudi Arabia, approval this study (Protocol no.: H-2021-012; Approved: 08/022,021). Participants were fully explained the study aims, and consent was voluntarily secured.

RESULTS

The emerging model showed that burnout had a direct and positive influence on compassion fatigue, while professional competence had a direct, negative effect on compassion fatigue. Moral courage had a small and direct but negative influence on compassion fatigue. Mediation analyses also indicated that moral courage significantly mediated the indirect effects of burnout and professional competence on compassion fatigue.

CONCLUSION

Moral courage can be a crucial aspect in preserving the psychological and mental health of nurses, particularly under stressful conditions. Therefore, it is advantageous from an organizational and leadership standpoint to implement measures such as programs and interventions to foster moral courage among nurses.

Examining moral injury in clinical practice: A narrative literature review

Healthcare workers experience moral injury (MI), a violation of their moral code due to circumstances beyond their control. MI threatens the healthcare workforce in all settings and leads to medical errors, depression/anxiety, and personal and occupational dysfunction, significantly affecting job satisfaction and retention. This article aims to differentiate concepts and define causes surrounding MI in healthcare. A narrative literature review was performed using SCOPUS, CINAHL, and PubMed for peer-reviewed journal articles published in English between 2017 and 2023. Search terms included "moral injury" and "moral distress," identifying 249 records. While individual risk factors predispose healthcare workers to MI, root causes stem from healthcare systems. Accumulation of moral stressors and potentially morally injurious events (PMIEs) (from administrative burden, institutional betrayal, lack of autonomy, corporatization of healthcare, and inadequate resources) result in MI. Individuals with MI develop moral resilience or residue, leading to burnout, job abandonment, and post-traumatic stress. Healthcare institutions should focus on administrative and climate interventions to prevent and address MI. Management should ensure autonomy, provide tangible support, reduce administrative burden, advocate for diversity of clinical healthcare roles in positions of interdisciplinary leadership, and communicate effectively. Strategies also exist for individuals to increase moral resilience, reducing the impact of moral stressors and PMIEs.

The mediating role of empathy in the impact of compassion fatigue on burnout among nurses

Background

The burnout levels of nurses, who have an important place in the delivery of health services, are increasing day by day. As the burnout levels of nurses increase, there may be undesirable situations such as compassion fatigue specific to them, their patients and their institutions.

Purpose

The aim of this study is to determine the effect of compassion fatigue seen in nurses on burnout and the mediating role of empathy in this effect.

Methods

The research was conducted on nurses working in three public hospitals operating in Sakarya, Turkey, between 2 January and 16 April 2019. Since the research was conducted in more than one hospital, the minimum number of participants was determined for each hospital using the stratified sampling method in the first stage. In the second stage, the participants were selected by convenience sampling method. Descriptive statistics, linear regression and process macro regression analysis were used to analyse the data.

Results

The results showed the effect of nurses' compassion fatigue on burnout and empathy (β = 0.673). In addition, empathy has a mediating role in the effect of compassion fatigue on burnout (β = 0.251).

Conclusions/implications for practice

Reducing the burnout levels of nurses, who have a very important place in the delivery of health services, is important for both themselves and patients. It is recommended that the results of this study, which may contribute to the development of the awareness of nurse managers, should be made with the ability to understand the symptoms of compassion fatigue and burnout, teaching coping methods and providing support by experts when necessary.

The relationship between empowerment and compassion satisfaction, compassion fatigue, and burnout in nurses during COVID-19 outbreak

BACKGROUND

The quality of nurses' professional life is at stake in crises such as COVID-19. Empowerment helps employees perform better and advance the goals of the organization. This study aimed to investigate the relationship between empowerment and the quality of nurses' professional life during the outbreak of COVID-19.

MATERIALS AND METHODS

The current cross-sectional study was conducted in 2021 in the hospitals of Babol University of Medical Sciences with the participation of 200 nurses providing care for COVID-19 patients who were included in the study by convenience sampling method. Data collection tools included the Empowerment Questionnaire (Leader Empowerment Behaviors Scale, Structural Empowerment, and Psychological Empowerment) and the Professional Quality of Life Questionnaire. SPSS software version 23 was used to analyze the data. Multiple linear regressions were used to investigate the relationship between empowerment and quality of professional life.

RESULTS

In the majority of nurses, compassion satisfaction 140 (70%), burnout 172 (86%), and compassion fatigue 126 (63%) were at moderate level. A significant relationship was found between compassion satisfaction and Leader Empowerment (R = 0.54, P =. 001), Psychological Empowerment (R = 0.55, P =. 001), and Structural Empowerment (R = 0.42, P =. 001) and Compassion Fatigue and Leader Empowerment (R = 0.35, P =. 001), psychological empowerment (R = 0.42, P =. 001), and structural empowerment (R = 0.49, P =. 001).

CONCLUSION

Nursing managers' attention to empowerment strategies in crises such as COVID-19 can improve compassion satisfaction and reduce compassion fatigue in nurses. It is also necessary to implement policies and guidelines for the development of psychosocial support to health promotion of the workplace, education, informing, and empowering nurses.

Implementing Brief Mindfulness-Based Interventions to Reduce Compassion Fatigue

BACKGROUND

Nurses in surgical-trauma units are susceptible to compassion fatigue due to work-related stressors. Mitigating and preventing compassion fatigue are critical to supporting the health and well-being of surgical-trauma nurses.

LOCAL PROBLEM

During the COVID-19 pandemic, a surgical-trauma unit was converted to a designated COVID-19 unit. Nurses verbalized feelings of burnout and stress during the pandemic and did not have a mechanism to cope with work-related stress. This project evaluated the impact of brief mindfulness-based interventions on compassion fatigue.

METHODS

From February 2021 to March 2022, mindfulness champions led 5 minutes of mindfulness-based interventions, including meditation, deep breathing, and self-compassion exercises, during shift huddles. The Professional Quality of Life, version 5, questionnaire was used to evaluate preintervention and postintervention burnout, secondary traumatic stress, and compassion satisfaction. Paired-sample t tests were used to evaluate the results.

RESULTS

Twenty-nine of 34 nurses responded (85% response rate) with matched preintervention and postintervention questionnaires. All subscale scores showed significant improvement after intervention. The mean burnout subscale score decreased by 9.35% (P = .003), mean secondary traumatic stress subscale score decreased by 11.89% (P = .005), and mean compassion satisfaction subscale score increased by 6.44% (P = .03) after intervention.

DISCUSSION

After implementing brief mindfulness-based interventions in shift huddles, nurses reported reductions in elements of compassion fatigue (burnout and secondary traumatic stress). Nurses reported that adding brief mindfulness-based interventions to shift huddles helped them cope with work-related stress.

CONCLUSIONS

Brief mindfulness-based interventions can improve nurses' compassion satisfaction while reducing compassion fatigue measurements.

Compassion Fatigue and Ethical Attitudes in Nursing Care in Intensive Care Nurses During the COVID-19 Pandemic: A Cross-sectional Study

BACKGROUND

Intensive care unit (ICU) nurses faced an increased risk of compassion fatigue and ethical concerns during the COVID-19 pandemic.

PURPOSE

To evaluate compassion fatigue of ICU nurses and their ethical attitudes in care during the COVID-19 pandemic and analyze contributing factors.

METHODS

An exploratory cross-sectional research design was used.

RESULTS

A total of 103 ICU nurses participated. The nurses' compassion fatigue and ethical attitude scores were high. Compassion fatigue was explained by the following variables: considering resigning, receiving support for ethical decisions, willingness to work in the ICU, duration of providing activities of daily living in a shift, and number of patients per nurse.

CONCLUSIONS

Compassion fatigue was high in nurses working in the ICU during COVID-19. The high level of ethical attitudes shows commitment to professional ethics and reflects the development of the nurses' professional identity. Implementation of interventions that help improve compassion fatigue among nurses is needed.

Analysis of the Level of Stress and Methods of Coping with Stress among the Nursing Staff

In general, "stress" is the reaction of the body to mental and physical demands placed on it. Stress disrupts mental balance, and reduces the ability to work and function, which negatively affects the performance of duties. The aim of this study was to analyse the level of stress and ways of coping with it among nursing staff. The study covered 220 nurses employed at the Provincial Specialist Hospital in Włocławek. The research tool was the Perceived Stress Scale (PSS-10) and the Brief-COPE. The results of this survey showed the occurrence of average and high levels of experiencing stress in 36% and 40%of staff, respectively. Brief-COPE scale results show that substance use/gender (men) and use of emotional support/place of work (internal medicine department) are significant at p < 0.01. Considering the impact of the workplace on the use of psychoactive substances, it can be seenthat people working in the surgical ward are more likely to use psychoactive substances. Furthermore, nurses in the surgical ward find it easier to think and plan what to do when faced with a difficult life situation. Most often, the respondents with the highest work experience, i.e., the elderly, declared a return to religion. The results of the research indicate that the nursing community experiences stress to an average or significant degree. The strategies are mainly based on active coping and seeking emotional and instrumental support. Further research is needed in this field. This study was not pre-registered on a publicly accessibly registry.

The effect of spiritual well-being on compassion fatigue among intensive care nurses: A descriptive study

OBJECTIVES

This study aimed to determine the effect of spiritual well-being of intensive care nurses on compassion fatigue.

METHODS

It is a descriptive study. The sample of the study was composed of 167 nurses who were working in the intensive care units of the hospitals in Turkey. Data were collected by using "Personal Information Form", "The Spiritual Well-Being Scale" and "The Compassion Fatigue-Short Scale" between July and October 2022. Descriptive statistics, t-tests, correlation, and simple regression analysis were used to analyse data.

FINDINGS

35% (n = 59) of the participants were between 22 and 27 years old; 73% (n = 122) were females; 67% (n = 112) had an undergraduate degree; 57% (n = 96) had an experience of 1 to 5 years in the intensive care. It was determined that intensive care nurses had a moderate level of compassion fatigue and a high level of spiritual well-being. Although especially the educational levels of the nurses contributed to their level of spiritual well-being, a younger age and being single and less experienced in the nursing profession and intensive care were identified as significant factors in determining compassion fatigue. Nurses' Spiritual Well-Being Scale mean score was 113.89 ± 15.50. The mean score of the Compassion Fatigue Scale was 60.15 ± 29.24. A positive correlation was found between the Spiritual Well-Being and the Compassion Fatigue Scales (ß = 0.358, p = 0.000).

CONCLUSIONS

Although intensive care nurses have a high level of spiritual well-being in general, they experience a moderate level of compassion fatigue. Younger and less experienced nurses should get more attention in intensive care units against compassion fatigue.

IMPLICATIONS FOR CLINICAL PRACTICE

Management of feelings of compassion can be a protective factor for compassion fatigue and can be used as a prevention strategy in the context of improving mental well-being among intensive care nurses. Awareness and knowledge of nurses on spiritual needs should be enhanced.

Passionate healthcare workers in demanding intensive care units: its relationship with daily exhaustion, secondary traumatic stress, empathy, and self-compassion

This study focuses on Intensive Care Units (ICU) and aims to test whether daily job demands are related to daily emotional exhaustion and secondary traumatic stress (STS) after work through the experience of passion at work and whether personal resources in ICU, such as empathy and self-compassion, moderate these relationships. A diary study was designed to assess day-level job demands, passion, empathy, self-compassion at work; and day-level emotional exhaustion and STS after work. The sample was 97 healthcare workers from ICU from different Spanish hospitals being selected by the snowball technique. This sample was assessed 5 days x two moments per day through a diary questionnaire. The multilevel analysis showed a negative mediational effect of harmonious passion between daily job demands and both emotional exhaustion and STS. Also, in predicting emotional exhaustion, a moderator effect of empathy on harmonious passion was found, as well as a moderator effect of self-compassion on obsessive passion. In predicting STS, a direct positive effect was found in empathy. Our findings highlight the vocational work of these healthcare workers, considering job demands as challenging and enhancing their harmonious passion to overcome the drawbacks. Moreover, empathy revealed to have a negative effect whereas self-compassion the contrary. Thus, increase the awareness on these personal resources and how to train them could be considered as valuable preventative measures.

Characteristics of Occupational Burnout among Nurses of Various Specialties and in the Time of the COVID-19 Pandemic-Review

Occupational burnout is particularly common among nurses due to their work being associated with stress, showing understanding, compassion, and commitment, along with the simultaneous need to maintain the necessary emotional distance. The aim of this review was to assess the occurrence and characterization of burnout among nurses working within neurology, geriatric care, intensive care units and with patients infected with the novel COVID-19 virus. PRISMA guidelines were used to conduct the review. The search for literature was limited to articles meeting the inclusion criteria and published from 2017 to 2022 in PubMed, Scopus, Science Direct, Google Scholar, and Wiley. A total of 768 articles from this category have been found. Ultimately, after in-depth analysis, 20 articles were included in the study. The group of respondents ranged from 49 to 3100 participants. According to the data, the percentages of nurses suffering from burnout in the presented research ranged from 14.3% to 84.7%, with the highest value of burnout among nurses who worked in the ICU during the COVID-19 pandemic. There are certain factors among nurses that significantly affect the occurrence of burnout. These include, among others, working time, age, exposure to infection and contact with infected patients, lack of training on COVID-19 prevention, providing care to an increased number of COVID-19 patients per shift, lack of personal protective equipment, lack of support of administration, lack of pay satisfaction, intrinsic motivation and turnover intention.

Meaningful Recognition: The Tie to Purpose

Meaningful recognition is powerful and tied to purpose. As nurses, we are motivated by our ability to contribute and make a difference in our patients' lives. As leaders, we can buffer the negative effects of burnout, foster a positive work environment, and cultivate a culture of gratitude and trust by creating and sustaining a culture of recognition.

Fear of COVID-19 and secondary trauma: Moderating role of self-efficacy

COVID-19 has affected millions of people around the globe. People's mental health, especially those of nurses, has been primarily affected by the fear of this virus. More focus has been paid to vaccination and treatment of the virus, but less attestation has been given to addressing the mental health of people affected by the virus. Empirical studies show that different external factors are not easily manageable and controllable by the individual. This study preliminarily explores the connection between fear of COVID-19 and secondary traumatic stress in nurses. Further, it examines the moderating effects of occupational self-efficacy on the relationship between fear of COVID-19 and secondary traumatic stress. Data for the study was collected from the nurses of six large hospitals in Karachi, Pakistan. The final analysis was performed on 243 samples. Studies on COVID-19 suggest that increased occupational self-efficacy decreases fear and its impact. This study offers insights for managers to develop stress management programs and provide proper training and counseling sessions to the nurses to motivate them emotionally. Theoretically, this study broadens the understanding of the theory of emotions by using the pandemic as a stressor. Future studies may explore different roles of occupational self-efficacy and study its influential role in managing different kinds of emotions explained by the theory of emotions. Managers at the workplace could design different self-efficacy training for nurses to increase their self-motivation to fight different types of stress they face at the workplace.

Compassion satisfaction and compassion fatigue in frontline nurses during the COVID-19 pandemic in Wuhan, China

Aim

The aim of this study is to investigate the compassion satisfaction and compassion fatigue among Chinese frontline nurses during the COVID‐19 pandemic in Wuhan, China and to explore the related factors.

Background

Frontline nurses undertake a huge nursing workload with a risk of infection, causing great pressure on them and making them face a risk of compassion fatigue during the pandemic.

Methods

A cross‐sectional online survey was conducted from 9 March to 15 March 2020. A total of 1582 nurses caring for critical patients with COVID‐19 participated. Compassion satisfaction and compassion fatigue (comprising burnout and secondary traumatic stress) were assessed with the Professional Quality of Life Scale, and resilience was measured with the Chinese 10‐item Connor‐Davidson Resilience Scale.

Results

Moderate levels of compassion satisfaction (36.99 ± 6.71), burnout (24.14 ± 5.33) and secondary traumatic stress (24.53 ± 5.24) were experienced by frontline nurses. Resilience and perceived work pressure were the main predictors.

Conclusions

Frontline nurses demonstrated a moderate level of compassion satisfaction and compassion fatigue.

Implications for nursing management

The compassion fatigue of frontline nurses should be considered. Strategies aiming to reduce stress and enhance resilience, such as training about psychological adjustment, developing professional skills and creating a supportive workplace environment, are several options.

The trial is not registered. This study is a cross‐sectional study, and according to China's clinical trial registration standards, such studies are not required to be registered. So the trial is not registered. However, oral consent was obtained from the ethics committee of the hospital before this study was conducted.

Causal Model Analysis of Police Officers' COVID-19 Fear, Resistance to Organizational Change Effect on Emotional Exhaustion and Insomnia

Since the end of 2019, COVID-19 has continued to spread around the world. The police have performed various epidemic prevention and routine duties. This study explores how police officers' COVID-19 fear, resistance to organizational change, intolerance of uncertainty, and secondary trauma affect emotional exhaustion and insomnia in the context of COVID-19. A total of 205 valid police samples were collected in this study, and the established hypotheses were tested using confirmatory factor analysis and structural equation modeling. The results of the study confirmed that during the COVID-19 outbreak, secondary trauma of police officers positively affects emotional exhaustion and insomnia; intolerance of uncertainty positively affects emotional exhaustion; resistance to organizational change positively affects intolerance of uncertainty and emotional exhaustion; intolerance of uncertainty mediates the relationship between resistance to organizational change and emotional exhaustion; COVID-19 fear positively influences secondary trauma.

The Impact of US Nurses' Personal Religious and Spiritual Beliefs on Their Mental Well-Being and Burnout: A Path Analysis

This study addresses the gap in the literature regarding the impact of nurses' personal religious and spiritual beliefs on their mental well-being and burnout. A model of the association between these factors was tested based on surveys of 207 nurses located in southeastern USA and analyzed to determine the association between religion/spirituality, mental well-being, and burnout. A path analysis supported a model in which, through its positive impact on mental well-being, religion/spirituality was negatively associated with emotional exhaustion and depersonalization and positively associated with personal accomplishment.

Trauma, Compassion Fatigue, and Burnout in Nurses: The Nurse Leader's Response

Within health care, trauma-informed care has become an embedded approach in caring for patients; however, nurse leaders are not always prepared to lead nurses with a background of trauma. Nurses' past trauma, coupled with workplace stressors, may result in compassion fatigue, burnout, and secondary traumatic stress. Nurse leader engagement and trauma-informed leadership approaches are imperative to mitigate and mediate the effects of trauma in nurses as the COVID-19 pandemic recedes.

COVID-19 Pandemic Mental Health Challenges: Patients and Providers

Interviews with 15 Tennessee Advanced Practice Registered Nurses early in the COVID-19 pandemic revealed a major theme of mental health challenges unrelated to the primary study purpose. Without direct prompts, 13 out of 15 interviewees mentioned mental health issues among patients and 14 of the 15 interviewees discussed provider mental health problems. A secondary analysis of interview transcripts revealed three themes associated with mental health challenges: general barriers to mental health care, patient-specific concerns, and provider issues. Responding to the new and worsening mental health and substance use disorders revealed by informants and cited in the literature is an urgent priority.

Cross-sectional Analysis of Burnout, Secondary Traumatic Stress, and Compassion Satisfaction among Emergency Department Nurses in Southern California Working through the COVID-19 Pandemic

Objective

Methods

Results

Discussion

A little goes a long way: Strategies to support nursing staff amid COVID-19

ABSTRACT

This article discusses the impact of staffing shortage on nurses' mental health, and outlines ways, including a successful rounder initiative, for nurse leaders and facilities to address nurses' stress and burnout.

Health-related behaviors, self-rated health, and predictors of stress and well-being in nursing students

BACKGROUND

Nursing students are at increased risk for the consequences of stress on wellbeing. Little is known about nursing students' health promoting behaviors and how these relate to health, stress, and well-being.

PURPOSE

The purpose was to describe perceived stress and measures of well-being (self-compassion, happiness, and life satisfaction) along with self-reported health promoting behaviors and health status in order to identify factors that could affect stress and well-being in nursing students.

METHODS

A multi-site team employed cross-sectional research methods to explore well-being, stress, and potential physical and emotional health-relevant factors in undergraduate nursing students. Baccalaureate Nursing students from three nursing programs in North Texas participated in a web-based survey. Undergraduate students (n = 417) reported being junior or senior level in a traditional (74.1%) or an alternative nursing training program (on-line, fast-track, or weekend nursing program; 24.9%) in the fall of 2019. Recruitment fliers went to a total of 2264 potential participants via university e-mail. Consenting students completed online surveys collecting demographic and health related factors as well as measures of well-being and stress.

RESULTS

More than half (56.6%) of students reported worsening health since starting nursing school. Exercise and meditation were related to higher measures of well-being and lower stress, but this relationship diminished in the multivariate model when considering individual demographic and health related factors. Our multivariate model suggests that self-rated health status remains a main potential predictor of reduced stress and improved well-being.

CONCLUSIONS

Self-reported health factors are related to wellbeing in nursing students. Targeted interventions to improve well-being among nursing students may be necessary and would fit with national recommendations for nursing education programs. Resiliency skills training with mindfulness practices may help nursing students reduce stress, improve overall well-being, and equip students to avoid burnout and stress-related illness once in the workforce.

Preventing patient violence in hospitals: Applying critical decision method interviews to understand how skilled staff think and act differently

AIMS

Our aims were to understand how hospital staff who are skilled at managing aggressive patients recognize and respond to patient aggression and to compare the approaches of skilled staff to the experiences of staff who were recently involved in incidents of patient violence.

BACKGROUND

Violence from patients toward staff is prevalent and increasing. There is a need for greater understanding of effective approaches to managing patient aggression in a wide variety of hospital settings.

METHODS

We conducted grounded theory qualitative research applying Critical Decision Method interviews at two hospitals. Skilled staff and incident-involved staff were asked to describe experiences involving aggressive patients and the data were analyzed qualitatively.

RESULTS

Our interviews (N = 23) identified positive approaches and challenges to managing aggressive patients. Positive approaches included: maintaining empathy for the patient, allowing the patient time and space, exhibiting a calm demeanor, not taking things personally, and implementing strategies to build trust. Challenges included: inadequate psychiatric resources, balancing priorities between patients with urgent physical needs and those exhibiting difficult behaviors, and perceiving pressure to de-escalate situations quickly. Incident-involved staff were more likely to describe the challenges listed above and a limited tolerance for patients whose behavior they perceived as unjustified or detracting from other patients' care.

CONCLUSION

The Critical Decision Method proved valuable for highlighting nuanced understandings of skilled staff that sometimes contrasted with perceptions of incident-involved staff. Our findings support investigation of novel approaches to training such as peer coaching and improving empathy through increased understanding of mental illnesses and addiction.

Reflecting Before, During, and After the Heat of the Moment: A Review of Four Approaches for Supporting Health Staff to Manage Stressful Events

Being a healthcare professional in both paediatric and adult hospitals will mean being exposed to human tragedies and stressful events involving conflict, misunderstanding, and moral distress. There are a number of different structured approaches to reflection and discussion designed to support healthcare professionals process and make sense of their feelings and experiences and to mitigate against direct and vicarious trauma. In this paper, we draw from our experience in a large children's hospital and more broadly from the literature to identify and analyse four established approaches to facilitated reflective discussions. Each of the four approaches seeks to acknowledge the stressful nature of health professional work and to support clinicians from all healthcare professions to develop sustainable skills so they continue to grow and thrive as health professionals. Each approach also has the potential to open up feelings of uncertainty, frustration, sorrow, anguish, and moral distress for participants. We argue, therefore, that in order to avoid unintentionally causing harm, a facilitator should have specific skills required to safely lead the discussion and be able to explain the nature, scope, safe application, and limits of each approach. With reference to a hypothetical but realistic clinical case scenario, we discuss the application and key features of each approach, including the goals, underpinning theory, and methods of facilitation.

Spirituality and Vicarious Trauma Among Trauma Clinicians: A Qualitative Study

BACKGROUND

There has been a lack of research so far on spirituality and trauma. There has been some indication that religion and spirituality are resources in protection against burnout.

OBJECTIVE

The aim of this study was to understand the phenomenon of spirituality in the context of vicarious trauma among trauma clinicians.

METHODS

This was a qualitative study based on hermeneutic phenomenological methodology. Individual interviews were conducted with 36 physicians, nurse practitioners, and physician assistants on the relationship between their spirituality and trauma work.

RESULTS

Participants were recruited from a large Midwest metropolitan Level I trauma center and attendees at the 2018 Eastern Association for the Surgery of Trauma annual conference. Four patterns emerged from the interviews that transcended religious or spiritual affiliation and medical specialty. These included (1) the world of trauma; (2) religious or spiritual beliefs guiding their work; (3) the need for support systems; and (4) the importance of coping mechanisms.

CONCLUSION

Religion or spirituality plays a role in underlying meaning making and, in the moment, coping for trauma professionals.

Compassion fatigue, burnout and compassion satisfaction among emergency nurses: A path analysis

AIMS

To verify a hypothesized model of the relationships between compassion fatigue, burnout and compassion satisfaction, as well as their influencing factors and consequences, among emergency nurses.

DESIGN

A descriptive, cross-sectional design.

METHODS

A hypothesized model was proposed on the basis of the current literature. A convenience sample was conducted of nurses working in the emergency departments of six hospitals in Shanghai, China, from July to September 2020. A total of 445 valid data points were collected using various self-designed and well-validated instruments. Descriptive statistics and correlations were computed, and a path analysis was used to assess model fitness and to investigate direct and indirect effects.

RESULTS

The final model reported a desirable fit with significant paths. Compassion satisfaction and compassion fatigue directly and inversely affected burnout, and compassion satisfaction positively influenced compassion fatigue. Perceived social support directly improved compassion satisfaction and protected against compassion fatigue. Compassion satisfaction and compassion fatigue directly affected mental health, and burnout directly influenced physical health. Compassion fatigue, burnout and compassion satisfaction had complicated effects on turnover intention.

CONCLUSION

Emergency nurses' compassion satisfaction and compassion fatigue may be two coexisting constructs, and both affect burnout. Perceived social support acts as a protector of the three dimensions, and their effects on health status and turnover intention can be significant and complicated.

IMPACT

Emergency nurses may experience high levels of compassion satisfaction and compassion fatigue simultaneously, which can help to explain why compassion fatigue did not directly increase emergency nurses' turnover intention. The direct effects of compassion fatigue and burnout on emergency nurses' health status and working engagement were significantly different. Support from significant others, professional psychological intervention and emergency nursing system reforms are required to tackle emergency nurses' compassion fatigue and burnout and improve their compassion satisfaction.

Supporting Frontline Staff During the COVID-19 Pandemic

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic that emerged in early 2020 put unprecedented physical, mental, and emotional strain on the staff of health care organizations, who have been caring for a critically ill patient population for more than a year and a half. Amid the ongoing pandemic, health care workers have struggled to keep up with new information about the disease, while also coping with the anxiety associated with caring for affected patients. It has also been a continual challenge for nurse leaders to provide adequate support for staff members and keep them informed about frequently changing practices and protocols. In this article, nursing leaders at an academic medical center in Boston reflect on the initial COVID-19 patient surge, which occurred from March to June 2020, and identify key actions taken to provide clinical and emotional support to frontline staff who cared for these patients. Lessons learned in this period provide insight into the management of redeployed staff, use of emotional support and debriefing, and relationship between access to information and staff morale. The knowledge gained through these initial experiences has been a vital resource as health care workers continue to face challenges associated with the ongoing pandemic.

A National Survey of Secondary Traumatic Stress and Work Productivity of Emergency Nurses Following Trauma Patient Care

BACKGROUND

Secondary traumatic stress is common for emergency nurses working in trauma care, but it is unknown whether this secondary traumatic stress negatively correlates to work productivity.

OBJECTIVE

The purpose of this research was to examine the relationship between secondary traumatic stress and work productivity of emergency nurses who provide trauma patient care in the emergency department.

METHODS

This study used a cross-sectional survey design with a systematic random sample of emergency nurses. Respondents (N = 255) completed the Impact of Events Scale-Revised (IES-R) and the Healthcare Productivity Survey (HPS) on the basis of trauma patient care within the preceding 30 days. A 2-tailed Pearson correlation was calculated to explore the relationship between secondary traumatic stress and work productivity for emergency nurses providing trauma patient care.

RESULTS

Mean IES-R score was 19.1, and HPS score was 2.7. About 38% of respondents reported high secondary traumatic stress, and 29% reported decreased work productivity. Although overall correlation between IES-R and HPS was not significant, IES-R-Intrusion was significantly correlated with HPS-Cognitive Demands (p = .003) and HPS-Safety and Competency (p = .011), IES-R-Avoidance with HPS-Safety and Competency (p = .003), and IES-R-Hyperarousal with HPS-Cognitive Demands (p = .002) and HPS-Handle/Manage Workload (p = .015).

CONCLUSIONS

Secondary traumatic stress and decreased work productivity were significant problems for some emergency nurses. To address this problem, employers can provide stress reduction and management techniques to emergency nurses providing trauma patient care. In addition, emergency nurses need to be proactive in seeking social support and using stress mitigation and reduction programs.

The Job Demands and Resources Related to COVID-19 in Predicting Emotional Exhaustion and Secondary Traumatic Stress Among Health Professionals in Spain

The current COVID-19 crisis may have an impact on the mental health of professionals working on the frontline, especially healthcare workers due to the increase of occupational psychosocial risks, such as emotional exhaustion and secondary traumatic stress (STS). This study explored job demands and resources during the COVID-19 crisis in predicting emotional exhaustion and STS among health professionals. The present study is a descriptive and correlational cross-sectional design, conducted in different hospitals and health centers in Spain. The sample consisted of 221 health professionals with direct involvement in treating COVID-19. An online survey was created and distributed nationwide from March 20 to April 15 which assessed: sociodemographic and occupational data, fear of contagion, contact with death/suffering, lack of material and human protection resources (MHRP), challenge, emotional exhaustion, and STS. Descriptive findings show high levels of workload, contact with death/suffering, lack of MHPR and challenge, and are moderately high for fear of contagion, emotional exhaustion, and STS. We found an indirect significant effect of lack of MHPR on predicting (1) emotional exhaustion through the workload and (2) on STS through fear of contagion, contact with death/suffering, and workload. To conclude, this study examines the immediate consequences of the crisis on health professionals' well-being in Spain, emphasizing the job demands related to COVID-19 that health professionals are facing, and the resources available in these health contexts. These findings may boost follow-up of this crisis among health professionals to prevent them from long-term consequences.

Compassion fatigue of funeral directors during and after the first wave of COVID-19

BACKGROUND

Compassion fatigue has not been studied among funeral directors. Yet, funeral directors have been exposed to the same risks for compassion fatigue as other caregivers during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS

An online survey was spread two times to 287 employees of funeral home DELA, in Belgium. Once during the height of the first wave of COVID-19 in Belgium, and a second time at the end of the first wave. The professional quality of life-scale 5 (PROQOL-5) was used to measure compassion fatigue, which includes burnout, compassion satisfaction and secondary trauma. Non-parametric tests were performed.

RESULTS

In total, 104 participants answered the first survey, and 107 the second. Burnout increases from survey 1 to survey 2 (P < 0.001), while compassion satisfaction (P = 0.011) and secondary trauma decrease (P < 0.001). In survey 1, only age (P = 0.007) and gender (P = 0.040) were found to be significantly associated with secondary trauma. In survey 2, having more work experience is associated with having a higher burnout (P = 0.008) and secondary trauma (P = 0.001) score. Neither for burnout (P < 0.001), nor for secondary trauma (P < 0.001) are there any respondents in the highest category.

CONCLUSIONS

Although overall funeral directors do not have acute problems with compassion fatigue, burnout scores increase significantly after the first wave.

Being present: Examining the efficacy of an Internet Mantram Program on RN-delivered patient-centered care

Background

The COVID-19 pandemic highlighted nurses’ compassionate presence during stressful conditions. Strategies to reduce workplace stress are needed.

Purpose

The purpose of this study was to evaluate a stress reduction strategy, an Internet-based Mantram Repetition Program (MRP), for nurses caring for hospitalized Veterans.

Methods

A one group pre-/post-test design was used to assess change in nurses’ perceived outcomes after participating in the MRP. A post-test-only design was used to assess hospitalized Veterans’ perceptions of nursing presence and satisfaction with care. Qualitative interviews were used to supplement quantitative data.

Findings

Patients perceived high levels of presence and satisfaction with care. Post MRP, nurses perceived increased mindfulness, compassion satisfaction, spiritual well-being, and nursing presence. Increased mindfulness was associated with greater compassion satisfaction and less burnout.

Discussion

For nurses working on the front lines of patient care, the potential for experiencing stress and burnout is a reality. Participating in a MRP could lessen these effects and facilitate nursing presence.

Sensory Processing Sensitivity and Compassion Satisfaction as Risk/Protective Factors from Burnout and Compassion Fatigue in Healthcare and Education Professionals

The study analyzes sensory processing sensitivity and the compassion satisfaction as risk/protective factors against burnout and compassion fatigue, during the first period of the COVID-19 health emergency. A sample of 1566 Spanish adult healthcare (n = 694) and education (n = 872) professionals was evaluated. An ad hoc questionnaire for sociodemographic data, and the highly sensitive person scale (HSPS), Maslach burnout inventory (MBI) and professional quality of life scale (ProQOL-vIV) were administered. Burnout and compassion fatigue were observed in the healthcare and education professionals, where personal realization and depersonalization were higher in healthcare and compassion fatigue in education. The protective role of compassion satisfaction was confirmed, as was sensory processing sensitivity as a risk factor, except for its low sensory threshold dimension, which positively influenced personal realization. The findings of this study demonstrate the presence of burnout and compassion fatigue in healthcare and education professionals, displaying compassion fatigue as an emerging psychosocial risk in education, which was made more severe under the conditions of study, which is at the beginning of the COVID-19 pandemic. The importance of incorporating adequate management strategies for high sensitivity, empathy and compassion satisfaction in prevention programs is emphasized.

Does the Type of Exposure to Workplace Violence Matter to Nurses' Mental Health?

Workplace violence is a prevalent phenomenon in healthcare, particularly among nursing professionals. Exposure to workplace violence may be direct through firsthand involvement, indirect through secondhand witnessing, or both. Even though implications for victims of workplace violence have been well-studied, less is known about the various types of exposure and their effects on nurse mental health. The purpose of this study is to examine the impact of workplace-violence exposure types on the mental health of nurses, while accounting for the intensity of the incident/s. This study employs an exploratory correlational design with survey methods. Nurses from British Columbia (BC), Canada, were invited by the provincial nurses' union to complete an electronic survey in Fall 2019. A total of 2958 responses from direct-care nurses in acute-care settings were analyzed using logistic regression. The results showed that mental-health problems increased with cumulative exposure; even though nurses with solely indirect exposure to workplace violence did not report greater mental-health problems, those experiencing solely direct exposure, or both direct and indirect exposure, were two to four times more likely to report high levels of post-traumatic stress disorder (PTSD), anxiety, depression and burnout compared to their counterparts with no exposure. There is an urgent need for better mental-health support, prevention policies and practices that take into account the type of workplace-violence exposure.

Life balance and professional quality of life among baccalaureate nurse faculty

BACKGROUND

The nurse faculty shortage is a well-documented problem. The future workforce is dependent upon qualified faculty who desire to teach students.

PURPOSE

The purpose was to explore the relationship between nurse faculty life balance and quality of life.

METHODS

A cross-sectional study was conducted through surveying nurse faculty (N = 108). The Life Balance Inventory measured health, relationships, identity, challenge/interest, and activities of daily living with scores ranging from 1 (unbalanced) to 3 (very balanced). The Professional Quality of Life scale measured compassion satisfaction, burnout, and secondary traumatic stress with scores ranging from 22 or less (low), 23-41 (average), and 42 or more (high). Descriptive statistics and correlations were calculated.

RESULTS

Nurse faculty had moderate life balance (Mean = 2.23), average compassion satisfaction (Mean = 40.17), average burnout (Mean = 24.86), and low secondary traumatic stress (Mean = 20.14). The moderate and weak, negative correlations between total life balance and both burnout (r = -0.461, p < .001) and secondary traumatic stress (r = -0.267, p = .008) respectively were significant, but the correlation with compassion satisfaction (r = 0.174, p = .078) was not.

CONCLUSION

It is critical to create supportive work environments for nursing faculty that promote well-being and reduce burnout and stress.

Building Nurses' Resilience to Trauma Through Contemplative Practices

Nurses can benefit from strategies that build resilience to counterbalance trauma exposures. Adverse childhood experiences (ACEs) and adverse community environments are common; nurses frequently encounter trauma victims and hear trauma narratives in most care settings. Having skills to manage the triggers present in health-care environments is essential. Contemplative practices can help to meet these needs. Breathing exercises can be used as needed throughout the work day; gratitude practices are simple but powerful; and visual journaling can help nurses process experiences. These practices are easy to implement and can profoundly affect health outcomes for nurses.

Correlates of post-traumatic growth among nursing professionals: A cross-sectional analysis

AIMS

Among nursing professionals, our aims were to examine (a) self-reported traumatic experiences, (b) differences in post-traumatic growth (i.e. positive psychological growth after experiencing a traumatic event) by nursing professional level and (c) demographic, work-related, behavioural and traumatic experience covariates of post-traumatic growth.

BACKGROUND

Trauma experience among nursing professionals is higher than observed in the general population. Due to the nature of their work environment, workplace trauma rates are particularly alarming. Understanding post-traumatic growth among nursing professionals may guide interventions to enhance well-being.

METHOD

A secondary analysis of cross-sectional survey data from nursing professionals (N = 299). Demographic, work-related, behavioural, trauma experience categories and post-traumatic growth variables were examined.

RESULTS

Advanced practice nurses and clinical nurses reported higher rates of workplace trauma, as compared to nursing assistants. Higher post-traumatic growth scores were associated with having a postgraduate degree, serving the paediatric population and lower frequency of alcohol use. Lower post-traumatic growth scores were associated with being married/widowed, being an advanced practice provider or clinical nurse, working in the intensive care unit and reporting workplace, family/personal stress and undisclosed trauma.

CONCLUSIONS

Nursing professionals have several demographic, work-related, behavioural and traumatic experience-related variables associated with and that explain variances in post-traumatic growth.

IMPLICATION FOR NURSING MANAGEMENT

Targeted screening and individualized treatment based on nursing professional level should be considered to support trauma recovery and post-traumatic growth.

Detriments of a Self-Sacrificing Nursing Culture on Recruitment and Retention: A Qualitative Descriptive Study

AIM

To investigate the presence and impact of self-sacrifice within the nursing profession.

BACKGROUND

Evidence suggests the existence of a culture of self-sacrifice within nursing, but its potential detriments to the profession have not been explored.

DESIGN

A qualitative descriptive approach was used.

METHODS

Semistructured interviews were conducted with 10 practicing nurses to explore the existence and potential implications of a self-sacrificing culture within nursing.

RESULTS

All participants reported self-sacrifice within the nursing profession as the result of the prevailing stereotypical image of the "ideal nurse," leading to job dissatisfaction, presenteeism, and burnout. Younger nurses reported being less willing to self-sacrifice and consequently felt unsupported by management and senior staff, resulting in job dissatisfaction and intent to leave their job.

CONCLUSION

A culture of self-sacrifice within the nursing profession may lead to job dissatisfaction, presenteeism, burnout, and retention problems, especially for younger nurses. A self-sacrificing image of nursing may also deter potential recruits from exploring a career in the profession.