The Seniority Swoop: Young Nurse Burnout, Violence, and Turnover Intention in an 11-Hospital Sample

Burnout and psychological distress among Hispanic nurses across Illinois and New York hospitals: Implications for structural and person-centered solutions

BACKGROUND

Despite high levels of burnout and psychological distress among nurses, few studies have evaluated these outcomes among Hispanic nurses.

PURPOSE

To evaluate the differences in job-related and psychological well-being outcomes for Hispanic and non-Hispanic White nurses and the association of nurse work environments.

METHODS

Cross-sectional analysis of the 2021 RN4CAST-New York-Illinois nurse survey. Multilevel logistic regression models examined the association between nurse ethnicity and job-related outcomes and psychological well-being.

DISCUSSION

Our sample included 798 (10.7%) Hispanic and 6,642 (89.3%) non-Hispanic White nurses in 249 hospitals. In unadjusted models, Hispanic ethnicity was associated with higher odds of burnout (odds ratio (OR) 1.21, 95% confidence interval (CI): 1.03-1.42), which diminished when considering the work environment (OR 1.16, 95% CI: 1.01-1.35) and nurse characteristics (i.e., age) (OR 1.01, 95% CI: 0.83-1.21).

CONCLUSION

Equity-driven solutions to support the well-being of Hispanic nurses should consider a focus on the needs of young Hispanic nurses and include increased support in work environments.

Do inexperienced nurses in the lactation period experience workplace violence? A qualitative study

Introduction

Among clinical healthcare personnel, nurses face the highest proportion of workplace violence, which has a significant impact on their physical and mental well-being as well as their personal and professional lives. However, little is known about the effects of workplace violence on inexperienced breastfeeding nurses and their experiences during and after breastfeeding when they return to work. This study aimed to explore the experiences of inexperienced breastfeeding nurses who encountered workplace violence and its resulting impacts.

Methods

This study employed a descriptive qualitative design. Semi-structured in-depth interviews were conducted with 20 nurses working in various positions and departments at three tertiary hospitals. Purposive and maximum variation sampling techniques were employed. The interview data were analyzed using Colaizzi's method, and the research findings were reported according to Consolidated Criteria for Reporting Qualitative Studies (COREQ)standards.

Results

Inferences regarding workplace violence and risks for inexperienced breastfeeding nurses included physical labor (such as lifting heavy objects and performing cardiopulmonary resuscitation), conflicts, inadequate job skills, role confusion, occupational exposure risks, patient violence, and pressure from older adults. An inductive thematic investigation revealed the "Challenges faced during breastfeeding," "Conflicting professional and family roles," "Out of balance," and "Coping strategies."

Conclusion

Inexperienced breastfeeding nurses experience several negative consequences due to workplace violence. Therefore, it is essential to plan and implement preventive strategies and management programs that specifically target workplace violence among inexperienced breastfeeding nurses.

The relationships between precarious employment, having a calling, and occupational well-being among young nurses: a cross-sectional study

BACKGROUND

Working in the healthcare sector seems less interesting than other sectors: the salary is low relative to the demands of the labour involved, and working conditions as well as management are perceived as poor. These factors may have an impact on the well-being of nurses in the healthcare sector. This study aims to explore the relationship between precarious employment and occupational well-being, in addition to the moderating effect of having a calling in this relationship among younger and older nurses.

METHODS

Cross-sectional survey data were collected among Finnish nurses (n = 5867) between October and November 2020. Data were collected on demographics, occupational well-being, precarious employment, and having a calling in the field. Multiple linear regression analyses were used to explore the associations.

RESULTS

Younger nurses perceived lower levels of occupational well-being and calling, and higher levels of precarious employment compared to older nurses. Precarious employment had a negative relationship with occupational well-being, and having a calling showed a positive relationship with regard to occupational well-being. No interaction effect of precarious employment and having a calling with occupational well-being was found.

CONCLUSIONS

Young nurses' occupational well-being, precarious employment, and calling should be studied further because they are in a weaker position in working life. Using a qualitative approach should be considered in order to obtain more in-depth information.

Sense of failure in end of life care: Perspectives from physicians and nurses

Limited knowledge exists regarding sensed failure resulting provision of end-of-life (EOL) care. Among medical health professionals (MHP), a sense of failure is associated with impaired patientcare and reduced worker wellbeing, including higher rates of burnout and secondary traumatic stress. As part of a larger mixed-methods study on the effects of EOL-care provision on MHP in general hospitals, semi-structured in-depth interviews were conducted with 22 physicians and nurses at three tertiary Israeli hospitals, representing a wide range of medical specialties, training, experience, and cultural backgrounds. Qualitative thematic analysis of the interviews led to the identification of the theme 'sense of failure' with the sub-themes 'sources' and 'lived meanings' of the sensed failure. Apart from the source 'losing a patient' all other identified sources were recognized as work-related risk factors, including 'unsupportive environments' and 'shortcomings of the medical practice.' Two of the lived meaning 'sense of personal responsibility' and 'moral injury' were also recognized as work-related risk factors. Surprisingly, albeit the adverse context of EOL-care, the two remaining lived meanings 'learning from failure' and 'sense of purpose' were recognized as protective resilience factors. Changes in workplace norms by focusing on leadership and mentoring programs and implementation of evidence based interventions aimed at reducing the sense of failure and enhancing feelings of purpose are recommended. Finally, the findings described in the study would benefit from continued studies on larger scales.

The Role of Negative Age Stereotypes and Sociodemographic Factors in the Intention to Leave Among German University Hospital Nursing Staff

Staff shortages are a global problem in the nursing profession. Negative beliefs about older workers may have detrimental effects on the development and performance capacity of an aging workforce. To date, little is known about the impact of age stereotypes and potential factors on nurses' intent to leave (ITL). Therefore, the aim of our study was to assess intention to leave and potential predictors (eg, sociodemographic characteristics and age stereotypes) in a large representative sample of nurses in a German university hospital setting. A total of 423 nurses at the University Hospital of Heidelberg participated in a cross-sectional questionnaire study assessing sociodemographic data, age stereotypes using the "Beliefs About Older Workers" questionnaire, and participants' intentions to leave and give up their profession. Questionnaires were returned by 423 nurses (13.7% response rate). The results revealed that negative age stereotypes were highly prevalent. Significant correlations between age and negative age stereotypes were found, indicating that the younger the nurses were, the more negative their age stereotypes were. Most nurses with negative age stereotypes had no intention to leave their profession; however, the majority of nurses could not imagine working in the profession until they retired. Despite the low response rate, the results of the current study suggest that organizational and societal measures to reduce age stereotypes should be directed at newcomers and young nurses to retain them in the profession in the long term.

The effects of precarious employment and calling on the psychosocial health and work well-being of young and older workers in the care sector: a longitudinal study

OBJECTIVE

Employment conditions in the care sector are changing, and precarious employment (PE) is becoming more widespread, manifesting as undervaluation, adverse leadership, work overload, and inadequate control over work. This study aimed to examine changes in psychosocial health, work well-being, PE, and calling over time and explore the effects of PE and calling on psychosocial health and work well-being.

METHODS

The longitudinal study collected follow-up panel data in the three time points (2020, 2022, and 2023) from care workers (n = 1502), linear mixed effects models.

RESULTS

PE decreased (β =  - 0.02), and perceived work well-being increased (β = 0.04), but there were no change in psychosocial health (β =  - 0.01) and calling (β = 0.01) during the three-year period. Younger (< 39) care workers perceived higher levels of PE and had poorer psychological health. Moreover, PE had a negative effect on psychosocial health (β =  - 0.63) and work well-being (β =  - 0.68) and calling had a positive effect on psychosocial health (β = 0.41) and work well-being (β = 0.49) in multivariate models.

CONCLUSION

PE conditions affect work performance and employee well-being and may threaten patient care; therefore, it should be further investigated in the care sector. It is noteworthy that calling still seems to be central in care work. The results deepen the understanding of the current shortage crisis in health and social care workplaces but can also provide keys to resolving the crisis.

Associations among the workplace violence, burnout, depressive symptoms, suicidality, and turnover intention in training physicians: a network analysis of nationwide survey

Depression and anxiety are the most common mental disorders among physicians, who have a greater risk of suicide than those in other professional occupations. Relationships among a demanding workload, workplace violence, burnout, and intention to turnover have also been reported. The current study examined the principal components and propagating patterns of mental health and working environment interactions in training physicians. A total of 1981 training physicians completed online self-report questionnaires during September-October (midpoint of the training year) 2020. Regularized partial correlations in a mixed graphical model (MGM) and joint probability distributions (directed acyclic graph; DAG) were estimated for four subtypes of workplace violence (verbal abuse/physical violence perpetrated by clients/hospital staff), three burnout subdomains (Maslach Burnout Inventory), thoughts about quitting, and nine depressive symptoms, including suicidality, comprising the DSM-5 diagnostic criteria for major depressive disorder (assessed using the Patient Health Questionnaire-9). Thoughts of death/self-harm showed directional dependencies on the joint probability distributions of psychomotor agitation/retardation, concentration difficulty, self-reproach, and sadness in the DAG. In the MGM, a partial correlation with psychomotor agitation/retardation (r = 0.196) accounted for 56.5% of the variance in thoughts of death/self-harm. Partial correlations with concentration difficulties (r = 0.294), self-reproach (r = 0.257), changes in appetite (r = 0.184), and worker-on-worker physical violence (r = 0.240) in the MGM accounted for 54.4% of the variance in psychomotor agitation/retardation. Thoughts about quitting were partially correlated with and dependent upon the joint probability distributions of emotional exhaustion (r = 0.222), fatigue (r = 0.142), anhedonia (r = 0.178), and sadness (r = 0.237). In contrast, worker-on-worker (r = 0.417) and client-on-physician (r = 0.167) verbal abuse had regularized partial correlations with directional dependencies on thoughts about quitting. Organization-level interventions aiming to reduce the worker-on-worker violence and individual-level approaches of clinical screening program and psychiatric counseling clinic are required. Follow-up studies to verify the effectiveness of these interventions for training physicians are needed.

The effect of organizational justice on young nurses' turnover intention: The mediating roles of organizational climate and emotional labour

AIM

This study aims to explore the effect of organizational justice on young nurses' turnover intention and the roles of organizational climate and emotional labour in this relationship.

BACKGROUND

The shortage of nursing resources has become a growing problem in countries worldwide. As the main representatives of the nursing force, young nurses have high turnover intentions, which aggravates the possibility of nursing shortages. As an important variable affecting the turnover intention of young nurses, the mechanism underlying the impact of organizational justice should be studied in depth.

DESIGN

A descriptive cross-sectional design was employed.

METHODS

From November to December 2022, an online questionnaire survey was conducted among 1160 young clinical nurses from 5 hospitals in Henan Province, China. The scales used in this study include the organizational justice scale, the turnover intention scale, the organizational climate scale and the emotional labour scale. AMOS 26.0 was used for model drawing and mediation path testing, and SPSS 25.0 was used for data analysis. This study complies with the STROBE Statement of Observational Studies.

RESULTS

In general, the young nurses surveyed had high turnover intentions (14.82+/-4.44). Organizational justice has a negative predictive effect on young nurses' turnover intention (r = -0.465, P＜0.01). Organizational climate and emotional labour play a chain mediating role in the relationship between organizational justice and young nurses' turnover intention (β = -0.051).

CONCLUSIONS

Organizational justice is significantly related to the turnover intention of young nurses, and organizational climate and emotional labour play a chain mediating role in the relationship between organizational justice and turnover intention. Therefore, nursing managers should pay attention not only to organizational justice but also to the influence of organizational climate and emotional labour on the turnover intention of young nurses.

Burnout and network centrality as proxies for assessing the human cost of resilient performance

The extra effort of healthcare professionals to provide care is a manifestation of resilient performance (RP), usually going unnoticed due to successful outcomes. However, it is not clear how the human cost of RP can be assessed. This study addresses this gap by investigating the relationships between proxies of RP and its human cost. The proposed approach was tested in a 29-bed intensive care unit (ICU). The centrality of each professional in the advice-seeking social network was considered as the proxy of their contribution to system resilience. A resilience score was calculated for each professional as the product of three network centrality metrics (in-degree, closeness, and betweenness) and two non-network attributes, namely their availability and reliability. Professionals' burnout was the proxy of the human cost of RP, assessed through the Maslach Burnout Inventory, composed of 22 items divided into a triad of emotional exhaustion, depersonalization, and personal accomplishment. Both questionnaires, for social network analysis and burnout, included socio-demographic questions and were answered by 99.0% of the professionals. Results indicated a weak correlation between emotional exhaustion and the resilience score (p = 0.008). This score was also weakly correlated with working overtime (p = 0.005). Overall, findings provided initial evidence that RP as measured in our study matters to burnout, and that the two proxies are exemplars of applying a more general reasoning that might be valid for other proxies.

Analysis of some Demographic and Psy-chosocial Factors that Influence in the Perception of the Workplace Violence

Objective

The objective of this study is to evaluate the impact of psychosocial risks based on the demographic variables of sex, age, and seniority, on the perception of workplace violence in a group of workers from Spanish companies.

Methods

a total of 22 Spanish companies were analysed between 2016 and 2018 with a total sample of 26741 people using the FPSICO 3.1 psychosocial assessment method and divided into demographic groups of sex, age, and seniority for subsequent comparison of means and regression analysis.

Results

The results confirm the relationship between psychosocial risks and the perception of workplace violence. The analyses by demographic variables position the group of men as the group with the highest perception of workplace violence, except for discrimination, where it was higher in the group of women. The results confirm that the perception of workplace violence increases significantly with age and seniority in the company.

Conclusions

workplace violence is one of the most worrying risk factors today and it is necessary to better understand what risk factors can favour its appearance or its differentiated behaviour according to sex, age, or seniority. This can allow us to develop planned strategies to control this risk and focus on specific demographic groups.

Effects of Emergency Nurses' Experiences of Violence, Resilience, and Nursing Work Environment on Turnover Intention: A Cross-Sectional Survey

INTRODUCTION

Emergency nurses are vulnerable to violence, because they closely face patients or caregivers in emergency situations, where tension and conflicts are heightened. This is known to increase their turnover intentions. This study aimed to analyze the effects of emergency nurses' experiences of violence, resilience, and nursing work environment on turnover intentions.

METHODS

This descriptive study analyzed a questionnaire administered to emergency nurses from March 2020 to April 2020. Its participants included 100 emergency nurses from 4 emergency medical centers. The collected data were analyzed using the SPSS/WIN 25.0 program (IBM SPSS Statistics) by frequency, percentage, mean, SD, t test, analysis of variance, and multiple regression RESULTS: The main factors affecting the turnover intentions of emergency nurses were resilience (β = -0.32, P = .003), frequency of violence by patients (β = 0.27, P = .003), and nursing managers' leadership and support for nurses (β = -0.25, P = .021). The explanatory power of these 3 variables was 29.3%.

DISCUSSION

To reduce emergency nurses' turnover intentions, it may be necessary to conduct resilience programs for them. In addition, safety measures to prevent violence at the organizational level and improve nursing managers' abilities, leadership, and support for nurses can reduce nurses' intention to leave.

Development of a nurse-manager dualistic intervention program to alleviate burnout among nurses based on the appreciative inquiry

Aims

To develop a feasible and effective nurse-manager dualistic intervention program to support nurses coping with burnout symptoms.

Background

Person-organization combined interventions were recommended as the most effective approach for reducing burnout symptoms. However, few interventions have been developed in the nursing field.

Methods

The Medical Research Council, United Kingdom (MRC UK), Framework for Development and Evaluation of Complex Interventions, was employed for nurse-manager dualistic intervention program development. The following three steps were followed for developing the dualistic intervention program: (1) identifying the evidence base by conducting extensive reviews of the relevant literature and a mixed study; (2) identifying/developing a theory by selecting the job demands-resources model and proposing the theoretical framework for intervention development; and (3) modifying the process and outcomes of the nurse-manager dualistic intervention program.

Results

The intervention program consists of six group sessions over 9 weeks. Researchers/managers are supposed to deliver the program. The main contents of the intervention are (1) inception (session 1); (2) discovery (session 2); (3) dream (session 3); (4) design (session 4); (5) destiny (session 5); and (6) keep (session 6). The emphasis of the intervention is on helping nurses dealing with burnout symptoms.

Conclusion

Following the guidance of the MRC framework, a feasible and potentially effective nurse-manager dualistic intervention program was developed for nurses coping with burnout. Future studies are needed to model the intervention and assess the effects and replicability of the intervention.

Workplace Violence against Hospital Workers during the COVID-19 Pandemic in Israel: Implications for Public Health

Workplace violence (WPV) against healthcare workers, a serious public health problem with profound implications, has worsened during the COVID-19 pandemic. This study examined the incidence of different types of WPV in a public hospital in Israel during the pandemic and analyzes the factors associated with its occurrence. A cross-sectional study was performed via an online questionnaire with 486 workers at a government hospital in Israel. Data were collected about sociodemographic and occupational characteristics, exposure to different forms of WPV over the preceding six months, and the responsibility and reasons for WPV from the workers' perspective. Approximately 71% of respondents were exposed to WPV and 64% perceived that WPV escalated during the pandemic. The prevalence of verbal/psychological and physical WPV were 69 and 11%, respectively. The main reason for WPV was frustration over long wait times (70%). The escalation during the pandemic can be attributed to patients' or relatives' anxiety and mental states following the onset of the COVID-19 pandemic (72%), an increase in waiting time since the pandemic began (54%), lack of hospital resources to care for everyone (45%), and the inability to visit critically ill relatives with COVID-19 (44%). Increased exposure to WPV was attributed to lower seniority, working in emergency or internal departments, and being a nurse or a doctor. The findings raise an urgent need to develop strategies to reduce WPV in hospitals at all levels: national, organizational, and individual. Further research could focus on the effectiveness of innovative strategies and interventions to prevent violence against healthcare workers.