The Emotional Well-Being of Nurses and Nurse Leaders in Crisis

Work engagement among nurses in the context of the COVID-19 pandemic: A systematic review

BACKGROUND

Despite nurses receiving education on how to respond during crises, the stress and demands arising from unprecedented situations, such as the COVID-19 pandemic, may affect their work engagement.

AIM

To appraise and synthesize studies examining work engagement among nurses in the context of the COVID-19 pandemic.

METHODS

It is a systematic review in which three databases were searched. Critical appraisal tools and PRISMA guidelines were used. Content analysis was performed.

ETHICAL CONSIDERATIONS

Ethical approval was not required for this systematic review.

FINDINGS

A total of 21 studies were included. The results were classified into three categories: (1) levels and meanings of work engagement, (2) the relationship of work engagement with various factors, and (3) measures to enhance work engagement.

CONCLUSION

The review revealed that nurses' work engagement varied from moderate to high. Factors such as education level and work schedule flexibility influenced their engagement. Positive associations were found between work engagement and job satisfaction, intention to stay, and organizational support, while stress and workload showed negative relationships. The crucial role of health policymakers, hospital administrators, and nurse managers in acting ethically, creating favorable working conditions and fostering nurses' work engagement was emphasized.

Experiences of Frontline Managers during the COVID-19 Pandemic: Recommendations for Organizational Resilience

The COVID-19 pandemic caused a global health crisis directly impacting the healthcare system. Healthcare leaders influence and shape the ability of an organization to cope with and recover from a crisis such as the COVID-19 pandemic. Their actions serve to guide and support nurses' actions through unpredictable health service demands. The purpose of this paper was to examine frontline managers' experiences and organizational leadership responses that activated organizational resilience during the COVID-19 pandemic, and to learn for ongoing and future responses to healthcare crises. Fourteen managers participated in semi-structured interviews. We found that: (1) leadership challenges (physical resources and emotional burden), (2) the influence of senior leader decision-making on managers (constant change, shortage of human resources, adapting care delivery, and cooperation and collaboration), and (3) lessons learned (managerial caring behaviours and role modelling, adaptive leadership, education and training, culture of care for self, and others) were evidence of managers' responses to the crisis. Overall, the study provides evidence of managers experiences during the early waves of the pandemic in supporting nurses and fostering organizational resilience. Knowing manager's experiences can facilitate planning, preparing, and strengthening their leadership strategies to improve work conditions is a high priority to manage and sustain nurses' mental health and wellbeing.

Learning Lessons for Future Preparedness: Exploring Work Well-Being-Related Leadership Challenges among Paramedics during the Early Stage of the COVID-19 Pandemic-A Qualitative Study

The beginning of the COVID-19 pandemic majorly impacted the population and public services. In Finland, a state of emergency was declared to ensure the security of healthcare resources, and prehospital emergency medical service (EMS) organizations faced emergency conditions for the first time. This study explores the leadership challenges related to well-being experienced during the early phase of the pandemic. This qualitative study utilized reflective essay material written between August and November 2020 by experienced advanced-level paramedics (n = 30) who participated actively in EMS fieldwork at the beginning of the pandemic. The material (32,621 words) was analyzed with inductive content analysis. The work well-being-related leadership challenges experienced by paramedics during the early phase of the pandemic were divided into four upper categories: inadequate guidance, workplace reorganization, atmosphere mismanagement, and insufficient resources to cope. These upper categories were comprised of 17 subcategories. Several actions can be taken to enhance personnel well-being and prepare for similar challenges. Guidance and support should be clear and timely. Visible leadership should be emphasized and enhanced with modern communication. Efforts should be made to strengthen the work atmosphere to support those on the front lines of healthcare. This study was not registered on a publicly accessible registry.

Challenges faced by nurse managers during the COVID-19 pandemic: an integrative review

Background

Nurses have crucial roles in caring for patients and preventing the spread of COVID-19. Therefore, nurse managers have a prominent role during the pandemic, being responsible for the support and training of the nursing team to ensure quality care. While performing their duties in this time of fear and uncertainty, nurse managers face several challenges.

Aim

To identify the challenges faced by nurse managers during the COVID-19 pandemic.

Methods

It is an integrative literature review whose search for articles was carried out in Medline, PubMed and Scopus. Qualitative content analysis was used.

Results

Twelve primary research studies were included. Four themes emerged: (1) Workplace demands, (2) Impacts on physical and psychological health, (3) Coping measures and resilience and (4) Recommendations to better support nurse managers in times of crisis. Nurse managers had their roles expanded or completely changed, and they experienced many pressures and stressors in the workplace. Nurse managers also faced physical and psychological health problems. Nurse managers drew on experience; management skills; social media applications; support from family, colleagues and hospital administrators; training, and continuing education to solve the problems that emerged due to the COVID-19 pandemic. Organisations should use collaborative, inclusive and participatory practices for better crisis management.

Conclusions

Knowing the experiences of nurse managers during the pandemic period may help health institutions and policymakers better prepare for emergencies.

Nurse managers' challenges and opportunities in the COVID-19 pandemic crisis: A qualitative descriptive study

AIM

The study was conducted to understand the experiences of nurse managers with regard to the difficulties and opportunities they encountered during the pandemic.

BACKGROUND

Although many studies have been carried out to understand how nurses were affected in the COVID-19 pandemic, there are few studies that treat the experiences of nurse managers.

METHODS

In this qualitative descriptive study with 19 nurse managers working in pandemic management at a university hospital in Turkey during the first three waves of the pandemic, data were collected between April and July 2021 using the semi-structured interview method. Content analysis was performed to analyse the data.

RESULTS

Six themes were identified with respect to the experiences of nurse managers during the pandemic. These themes were initial reactions to the crisis, ineffective crisis management, excessive workload, the moral burden in decision-making, support of colleagues and other multidisciplinary team and nurse manager empowerment.

CONCLUSIONS

The nurse managers had difficulties in their managerial roles during the pandemic. However, they also viewed the crisis as an opportunity because they were able to note the deficiencies in management at all levels of the hospital and their leadership and decision-making roles took on more importance.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers may use the results of this study to be prepared for the continuing COVID-19 pandemic and any other emergency circumstances that they may have to face in the future.

Critical Clinical Events and Resilience Among Emergency Nurses in 3 Trauma Hospital-Based Emergency Departments: A Cross-Sectional Study

INTRODUCTION

Emergency nurses experience occupational stressors resulting from exposures to critical clinical events. The purpose of this study was to identify the critical clinical events for emergency nurses serving 3 patient populations (general, adult, pediatric) and whether the resilience of these nurses differed by the patient population served.

METHODS

This study used a cross-sectional survey design. A total of 48 emergency nurses were recruited from 3 trauma hospital-based emergency departments (general, adult, pediatric). Clinical Events Questionnaire, Connor-Davidson Resilience scale, and an investigator-developed demographic questionnaire were used to collect data from respondents.

RESULTS

All respondents were female (n = 48, 100%), and most were White (n = 46, 96%). The average age of participants was 39.6 years, the average number of years as a registered nurse was 12.7 years, and the average number of years as an emergency nurse was 8.8 years. Clinical events considered most critical were providing care to a sexually abused child, experiencing the death of a coworker, and lack of responsiveness by a colleague during a serious situation. The least stress-provoking event was incidents with excessive media coverage. Nurses were less affected by the critical events they experienced more frequently at work. Nurses in the 3 trauma settings had high level of resilience, with no statistically significant differences between groups.

DISCUSSION

The occupational stress from exposure to significant clinical events varied with the patient population served by emergency nurses. It is important that interventions be adopted to alleviate the effect of work-related stressors and promote the psychological health of emergency nurses.

Clinical Nurse Specialist Expands to Crisis Management Role During COVID-19 Pandemic

PURPOSE

Emergence of the COVID-19 crisis into the healthcare system challenged existing roles and shifted organizational priorities and staff responsibilities. Operating within the spheres of impact, clinical nurse specialists (CNSs) adapted to the needs of the organization and expanded their responsibilities to provide crisis leadership.

DESCRIPTION OF PROJECT

The CNSs used advanced practice nursing skills and leadership to implement hospital rounds, identify issues, make decisions, collaborate with stakeholders, disseminate new and emerging information, and evaluate processes in an ongoing pandemic. Using the health crisis management framework, the CNSs demonstrated authentic leadership throughout the prevention, preparedness, response, recovery, and rehabilitation phases.

OUTCOME

Data analysis of CNS handoff and meeting communications generated these areas of focus involving the CNSs: (1) clinical practice, (2) supplies, (3) workflows, and (4) people.

CONCLUSION

The CNS played a vital role in the planning, training, and evaluation of crisis preparation. New and emerging infectious diseases may continue to confront the healthcare system. Thus, healthcare systems need to remain prepared for public health threats. In the crisis leadership role, the CNS helped the transition to learn and relearn practices. As authentic leaders, CNSs instilled calmness, confidence, trust, and resiliency to the staff during the COVID-19 pandemic.

Calling nurses to care for burn victims after color-dust explosion

BACKGROUND

Healthcare professionals follow codes of ethics, making them responsible for providing holistic care to all disaster victims. However, this often results in ethical dilemmas due to the need to provide rapid critical care while simultaneously attending to a complex spectrum of patient needs. These dilemmas can cause negative emotions to accumulate over time and impact physiological and psychological health, which can also threaten nurse-patient relationships.

AIM

This study aimed to understand the experience of nurses who cared for burn victims of the color-dust explosion and the meaning of ethical relationships between nurse and patient.

RESEARCH DESIGN

A qualitative descriptive study using a phenomenological approach.

PARTICIPANTS AND RESEARCH CONTEXT

Clinical nurses who provided care to the patients of the Formosa color-dust explosion of 2015 were selected by purposive sampling (N = 12) from a medical center in Taiwan. Data were collected using individual in-depth semi-structured interviews. Audiotaped interviews were transcribed and analyzed using Colaizzi's method.

ETHICAL CONSIDERATIONS

This study was approved by the institutional review board of the study hospital. All participants provided written informed consent.

FINDINGS

Three main themes described the essence of the ethical dilemmas experienced by nurses who cared for the burn-injured patients: (1) the calling must be answered, (2) the calling provoked my feelings, and (3) the calling called out my strengths.

CONCLUSIONS

Healthcare providers should recognize that nurses believed they had an ethical responsibility to care for color-dust explosion burn victims. Understanding the feelings of nurses during the care of patients and encouraging them to differentiate between the self and the other by fostering patient-nurse relationships based on intersubjectivity could help nurses increase self-care and improve patient caregiving.

Nurse Leaders' Experiences and Learnings Navigating Through the Chaos of a Pandemic

This article explores the experiences and learnings of 2 ambulatory care nurse leaders on the front lines of the Covid-19 pandemic using the theory "navigating through chaos" as a framework.

Nursing recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes

OBJECTIVE

to develop a protocol of recommendations for facing dissemination of COVID-19 in Brazilian Nursing Homes.

METHOD

a study of experts' recommendations using a structured form applied through the Delphi Technique, obtaining 100% agreement among professionals after four rounds of analysis. The population comprised six nurses members of the Scientific Department of Gerontological Nursing of the Brazilian Association of Nursing (Associação Brasileira de Enfermagem).

RESULTS

the protocol was structured in a nucleus of nursing interventions to face the spread of COVID-19 in Nursing Homes, consisting of 8 actions.

FINAL CONSIDERATIONS

the protocol can help nurse managers to organize assistance to face the pandemic, which can be adaptable to each reality, making training nurses and health teams easier.

Risk Perception and Depression in Public Health Crises: Evidence from the COVID-19 Crisis in China

Background: Scant attention has been paid to how risk perceptions of public health crises may affect people’s mental health. Aims: The aims of this study are to (1) construct a conceptual framework for risk perception and depression of people in public health crises, (2) examine how the mental health of people in the crisis of Coronavirus Disease 2019 (COVID-19) is affected by risk perception and its associated factors, including distance perception of the crisis and support of prevention and control policies, and (3) propose policy recommendations on how to deal with psychological problems in the current COVID-19 crisis. Methods: Online questionnaire survey was implemented. A total of 6373 people visited the questionnaire online, 1115 people completed the questionnaire, and the number of valid questionnaires was 1081. Structural equation modeling was employed for data analysis. Results: Risk perception and its associated factors significantly affect the mental health of people in public health crises. Specifically, (1) distance perception of public health crises is negatively associated with depression among people, (2) affective risk perception is positively associated with depression of people in public health crises, (3) cognitive risk perception is negatively associated with depression of people in public health crises, and (4) support of prevention and control policies is negatively associated with depression of people in public health crises. Conclusion: The findings of this study suggest that risk perception plays an important role in affecting the mental health of people in a public health crisis. Therefore, health policies aiming to improve the psychological wellbeing of the people in a public health crisis should take risk perception into consideration.