The Association Between Nurse Shift Patterns and Nurse-Nurse and Nurse-Physician Collaboration in Acute Care Hospital Units

Nurse-to-Nurse Collaboration: A Scoping Review

OBJECTIVE

To map predictors and outcome of collaboration between nurses, outcomes of a good collaboration, and the tools developed to evaluate nurse-nurse collaboration.

BACKGROUND

Collaboration between nurses is an intraprofessional relationship between coworkers that is expressed through shared objectives, authority, and a decisional process. Studies on collaboration between nurses are very limited.

METHODS

A scoping review was conducted through 4 databases.

RESULTS

Eighteen studies were included. Nurses with higher levels of collaboration are more satisfied with their work and report less of an intention to leave their job. Greater collaboration among nurses resulted in a decrease of patient falling, hospital-acquired pressure ulcers, and a better care. Three tools have been developed to evaluate nurse-nurse collaboration: the Nurse-Nurse Collaboration Scale, the Nurse-Nurse Collaboration Behavior Scale, and the Nurse-Nurse Collaboration Between Sector.

CONCLUSIONS

Further studies should be conducted to fully understand the issue of collaboration between nurses and the factors connected to it.

The insomnia, fatigue, and psychological well-being of hospital nurses 18 months after the COVID-19 pandemic began: A cross-sectional study

BACKGROUND

Research has shown sleep problems, elevated fatigue, and high cases of burnout, as well as signs of post-traumatic stress and psychological distress among nurses during the COVID-19 pandemic. Many US hospitals attempted to minimise its impact on staff by providing basic resources, mental health services, and wellness programs. Therefore, it is critical to re-evaluate these well-being indices and guide future administrative efforts.

PURPOSE

To determine the long-term impact of the COVID-19 pandemic after 18 months on hospital nurses' insomnia, fatigue, burnout, post-traumatic stress, and psychological distress.

DESIGN

Cross-sectional.

METHODS

Data were collected online mainly through state board and nursing association listservs between July-September 2021 (N = 2488). The survey had psychometrically tested instruments (Insomnia Severity Index, Occupational Fatigue Exhaustion Recovery Scale, Maslach Burnout Inventory, Short Post-Traumatic Stress Disorder, and Patient Health Questionnaire-4) and sections on demographics, health, and work. The STrengthening the Reporting of Observational studies in Epidemiology checklist was followed for reporting.

RESULTS

Nurses had subthreshold insomnia, moderate-to-high chronic fatigue, high acute fatigue, and low-to-moderate intershift recovery. Regarding burnout, they experienced increased emotional exhaustion and personal accomplishment, and some depersonalisation. Nurses had mild psychological distress but scored high on post-traumatic stress. Nurses who frequently cared for patients with COVID-19 in the past months scored significantly worse in all measures than their co-workers. Factors such as nursing experience, shift length, and frequency of rest breaks were significantly related to all well-being indices.

CONCLUSION

Nurses' experiences were similar to findings from the early pandemic but with minor improvements in psychological distress. Nurses who frequently provided COVID-19 patient care, worked ≥12 h per shift, and skipped rest breaks scored worse on almost all well-being indices.

RELEVANCE TO CLINICAL PRACTICE

Administration can help nurses' recovery by providing psychological support, mental health services, and treatment options for insomnia, as well as re-structure current work schedules and ensure that rest breaks are taken.

Hospital staff nurse perceptions of resources and resource needs during the COVID-19 pandemic

BACKGROUND

There is a knowledge gap related to the resource needs of hospital nurses working during the Coronavirus disease 2019 (COVID-19) pandemic.

PURPOSE

To investigate nurses' perceptions of organizational resources and support needs approximately 18 months after the COVID-19 pandemic began.

METHOD

Cross-sectional survey of a convenience sample of 2,124 U.S. hospital nurses from July to September 2021 FINDINGS: There were some misalignments between what resources were provided to nurses and what was perceived as helpful to them. Nurses reported increased staffing, compensation, and management and leadership support most frequently as resources that could help them continue to provide safe and quality care during and after the pandemic. These were also the resources nurses most frequently reported that they wanted to be provided by their hospitals during the pandemic but were not.

DISCUSSION

The findings offer valuable insights into how organizations can prepare to ensure workforce resilience during future crises.

Physician-Nurse and Nurse-Nurse Collaboration From the Perspective of Nurses: A Cross-Sectional Study

The study aims to determine the physician-nurse and nurse-nurse collaboration levels of nurses and effective factors. A cross-sectional study was conducted with a sample of 477 nurses from five hospitals using a questionnaire. It was determined that the characteristics of working life explained 10% of the Nurse-Nurse Collaboration Scale and the regression model between variables and the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration was not statistically significant. Physician-nurse and nurse-nurse collaboration are affected by a variety of factors.

The newly-licensed registered nurse workforce: Looking back to move forward

BACKGROUND

Newly licensed registered nurses (NLRNs) are a vital health human resource necessary for the sustainability of the nursing workforce. There are challenges associated with the transition of NLRNs into practice; yet, new nurses continue to leave their positions within the first year. To compound the situation, a global pandemic hit in 2020. To leverage a sustainable future for our nursing workforce we must examine workforce data of NLRNs.

PURPOSE

The purpose of this descriptive study was to review the most recent national source of workforce data to determine if the data reveals insight to help renew the focus on the NLRN workforce.

METHODS

This descriptive study was a secondary analysis of demographic, education, employment, and work environment variables from the 2018 National Sample Survey of Registered Nurses.

FINDINGS

The NLRN workforce is slightly more diverse, seeking a BSN as the first degree, and funding their initial education with federal loans. NLRNs cite inadequate staffing, stressful work environments, burnout, and salary as the reasons for leaving the first job. NLRNs cite a balanced schedule, experience in the job, and a sense of community with peers as reasons why they stay.

DISCUSSION

This study joins the decades of literature that points to a small group of problems that account for the overwhelming majority or nursing turnover and attrition. After analyzing the data, the authors pose several questions to readers for consideration about the NLRN workforce. The authors' hope is to garner renewed attention to the issues facing NLRNs.

The relationship between nurse-nurse collaboration and work readiness among new graduate nurses

BACKGROUND

Communication and collaboration with colleagues are crucial for new graduate nurses (NGNs) because of the adaptation to both the healthcare system and professional role. Therefore, working units with effective collaboration among nurses may increase new graduates' work readiness.

AIM

This study aimed to determine the relationship between the perceptions of nurse-nurse collaboration and the work readiness level among NGNs.

METHODOLOGY

This descriptive, cross-sectional study was carried out with 198 NGNs in four private hospitals affiliated with a university. A self-administered questionnaire, including a personal information form, the Nurse-Nurse Collaboration Scale, and Work Readiness Scale, was used to collect data. Data analysis was performed using descriptive tests, and Spearman's rank correlation coefficients.

RESULTS

NGNs had moderate perceptions of nurse-nurse collaboration, with a median score of 2.46 (2.23-2.88) out of 4. Work readiness among NGNs was moderate, with a median score of 304 (270-332) out of 460. There was a statistically significant correlation between nurse-nurse collaboration and work readiness (r_s  = 0.26; p < .001).

CONCLUSION

The results of this study demonstrated that improving nurse-nurse collaboration is an effective way to increase work readiness among NGNs.

Drowsy Driving Among Nurses: Potential Impetus to Support Napping

BACKGROUND

As shift workers, nurses are at an increased risk of drowsy driving because of long hours at work and/or short sleep periods between shifts.

METHODS

In this study, a descriptive cross-sectional cohort design was used to examine the prevalence of drowsy driving among nurses.

FINDINGS

An electronic survey was sent to 7,217 nurses of which 2,205 (30.5%) completed the survey. Thirty percent (672 nurses) reported having dozed off while driving during their commute to work. In addition, 44.6% (976) of nurses disclosed feeling unsafe or uncomfortable during their commute due to drowsiness or fatigue.

CONCLUSION/APPLICATION TO PRACTICE

As shift workers, nurses are subject to drowsy driving and its untoward effects. Healthcare leaders and nurse executives are in a position to evaluate and explore fatigue mitigation strategies such as napping, as this may prove to be beneficial in supporting nurse well-being and public safety.

Insomnia, fatigue and psychosocial well-being during COVID-19 pandemic: A cross-sectional survey of hospital nursing staff in the United States

AIMS AND OBJECTIVES

To describe the levels of insomnia, fatigue and intershift recovery, and psychological well-being (burnout, post-traumatic stress and psychological distress), and to examine differences in these measures based on work-related characteristics among nursing staff during COVID-19 pandemic in the United States.

BACKGROUND

The COVID-19 pandemic has created a major physical and psychological burden on nursing staff in the United States and worldwide. A better understanding of these conditions will lead to tailored support and resources for nursing staff during and after the pandemic.

DESIGN

Cross-sectional study.

METHODS

Hospital nurses and nursing assistants (N = 587) were recruited online between May-June 2020. The survey included measures on insomnia (Insomnia Severity Index) fatigue and intershift recovery (Occupational Fatigue and Exhaustion Recovery-15), burnout (Maslach Burnout Inventory-Human Services Survey), post-traumatic stress (Short Post-Traumatic Stress Disorder Rating Interview) and psychological distress (Patient Health Questionnaire-4), and questions on work and demographics. The STROBE checklist was followed for reporting.

RESULTS

The sample had subthreshold insomnia, moderate-to-high chronic fatigue, high acute fatigue and low-to-moderate intershift recovery. The sample experienced increased emotional exhaustion and depersonalisation, increased personal accomplishment, moderate psychological distress and high post-traumatic stress. Nurses who cared for COVID-19 patients had significantly scored worse on almost all measures than their co-workers. Certain factors such as working hours per week and the frequency of 30-min breaks were significant.

CONCLUSION

Nursing staff experienced poor sleep, fatigue and multiple psychological problems during the COVID-19 pandemic. Moreover, staff who were involved in the care of COVID-19 patients, worked more than 40 h per week and skipped 30-min breaks showed generally worse self-reported outcomes.

RELEVANCE TO CLINICAL PRACTICE

Nursing administration is recommended to monitor for fatigue and distress on nursing units, re-visit current scheduling practices, reinforce rest breaks and provide access to mental health and sleep wellness resources with additional support for their front-line nursing groups.

Inter-professional physician-nurse collaboration in Lebanon

Purpose

A physician–nurse relationship is a complex, professional and shared-decision-making process, which is an important predictor of high-quality patient care. The purpose of this paper is to explore the attitude of the physician–nurse relationship in Southern Lebanon hospitals.

Design/methodology/approach

A descriptive institutional cross-sectional study was conducted among different departments of three hospitals in Southern Lebanon using a validated Jefferson Scale of Attitude.

Findings

In sum, 89 physicians and 245 nurses accepted to participate. The nurses’ mean age was 32 and the physicians’ was 44. The mean score was found to be 46 for all participants, with significantly higher scores noted among nurses compared to physicians (48 vs 43, respectively) and higher scores among females compared to males (48 vs 46, respectively). However, the study scored no significant difference in relation to the degrees attained by nurses and the participants’ years of experience. The majority had agreed that the shortage in the nurses’ staff affects proper patient care delivery. One fourth of the physicians disagreed that nurses should be considered as a collaborator and colleague. Therefore, more work is required to improve this collaboration.

Research limitations/implications

There is a complex relationship normally displayed by physicians and nurses, which cannot be easily interpreted and analyzed. Physicians and nurses may have given socially desirable responses while filling the questionnaire. Even more, this study was conducted in Hospitals in Southern Lebanon, and it would be nice to extend this study to include further hospitals in other regions in Lebanon as well.

Practical implications

Nurses had higher scores toward collaboration, with females scoring higher than males. However, overall scores are considered to be lower compared to other countries. Thus, more efforts should be done on improving this communication among nurses and physicians, through promoting inter-professional undergraduate and postgraduate education training toward more effective communication.

Social implications

Quality of patient care would be improved if more work is done on improving the collaboration between physicians and nurses, and this was shown to be required as per study results.

Originality/value

There is a gap in literature assessing this important topic which is the collaboration and attitude of nurses and physicians toward their relationship in Lebanon. It is extremely important that efforts should be taken in order to determine the type of nurse–physician relationship in every local context as this relationship affects quality of patients’ care.

Organization of Work Factors Associated with Work Ability among Aging Nurses

The United States (U.S.) workforce is aging. There is a paucity of literature exploring aging nurses' work ability. This study explored the work-related barriers and facilitators influencing work ability in older nurses. We conducted a qualitative descriptive study of aging nurses working in direct patient care (N = 17). Participants completed phone or in-person semi-structured interviews. We used a content analysis approach to analyzing the data. The overarching theme influencing the work ability of aging nurses was intrinsically motivated. This was tied to the desire to remain connected with patients at bedside. We identified factors at the individual, unit-based work level and the organizational level associated with work ability. Individual factors that were protective included teamwork, and feeling healthy and capable of doing their job. Unit-based level work factors included having a schedule that accommodated work-life balance, and one's chronotype promoted work ability. Organizational factors included management that valued worker's voice supported work ability.

Overtime Negatively Affects Nurses' Collaboration with Coworkers

According to this study.