Exploring Resilience at Work Among First-Line Nurse Managers

Report on fraying resilience among the Ontario Registered Practical Nurse Workforce in long-term care homes during COVID-19

AIM

Registered Practical Nurses (RPNs) are frontline healthcare providers in Ontario long-term care (LTC) homes. Throughout COVID-19, RPNs working in LTC homes experienced prolonged lockdowns, challenging working conditions, and inadequate resource allocation. This study aimed to describe the personal and professional resilience of RPNs working in LTC during the COVID-19 pandemic.

DESIGN

An open cross-sectional online survey containing the Connor-Davidson Resilience Scale, Resilience at Work Scale®, and Resilience at Work Team Scale®.

METHODS

The survey was distributed by the RPN Association of Ontario (WeRPN) to approximately 5000 registered members working in Ontario LTC homes.

RESULTS

A total of 434 respondents participated in the survey (completion rate = 88.0%). Study respondents scored low on measures of resilience and reported extreme levels of job (54.5%) and personal (37.8%) stress. Resources to support self-care and work-life balance, build capacity for team-based care practice(s) are needed.

Nurse managers' burnout and organizational support: The serial mediating role of leadership and resilience

AIMS

To investigate the relationship between organizational support and nurse managers' burnout and the serial multiple mediating effects of leadership and resilience.

BACKGROUND

Nurse managers are at a high risk of burnout, especially during the COVID-19 pandemic. However, no research has been done to examine the associations between nurse managers' organizational support, leadership, resilience and burnout.

METHODS

This cross-sectional study recruited 458 nurse managers from 13 tertiary public hospitals in Jiangsu, China. They completed the Survey of Perceived Organizational Support, the Clinical Leadership Survey, the Resilience Scale and the Maslach Burnout Inventor-Human Service Survey. The serial mediating effect of individual leadership and resilience was estimated using the structural equation modelling method via Mplus 7.0.

RESULTS

There were direct and indirect effects of organizational support on burnout, controlling for work variables. Leadership and resilience serially mediate the association between organizational support and burnout (β = -.051, 95% confidence interval: -0.093 to -0.020).

CONCLUSIONS

Among nurse managers, organizational support may be sequentially associated with improved leadership first and then resilience, which in turn is related to decreased burnout.

IMPLICATIONS FOR NURSING MANAGEMENT

We recommend that hospital administrators incorporate leadership, resilience and burnout assessment in the routine psychological screening of nurse managers and creatively apply the organizational interventions to decrease nurse managers' burnout.

Resilience, Moral Distress, and Job Satisfaction Driving Engagement in Emergency Department Nurses: A Qualitative Analysis

AIM

The aim of this study was to explore how resilience, job satisfaction, and moral distress affect emergency department (ED) nurses' workplace engagement.

BACKGROUND

Stressful nursing workplace conditions increase moral distress. Lowering moral distress and improving resilience can increase workplace engagement.

METHOD

Semistructured qualitative interviews were conducted with 15 ED nurses.

RESULTS

Participants indicated that greater nursing experience, increased confidence in skills, ability to overcome emotional stressors, and more satisfaction with patient care all improved resilience and workplace engagement. Morally distressed, disengaged nurses reportedly lacked workplace autonomy and/or ability to make workplace changes or worked in hostile and/or unsafe workplaces. Engaged nurses invested more time in their job and were more willing to remain in their workplace.

CONCLUSION

Retaining older, more experienced nurses, valuing staff work, and creating a meaningful workplace foster workplace engagement.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers can support nurses' workplace engagement through interventions that build resilience, lower moral distress, and increase job satisfaction.

A Prescription for Resilience: Evaluating a Measure of Leader Resilience in Hospital Pharmacy Departments

OBJECTIVE

Globally, leaders require strategies to sustain the performance and well-being of themselves and their teams while managing and adapting to uncertainty, workplace turbulence, and high job demands. This study evaluates the Resilience at Work Leader 180 Scale assessing leader behaviors that either promote or detract from resilience in others.

METHOD

Study participants comprised Australian pharmacy employees (N = 80) in two groups made up of the senior leadership team (n = 10) and their direct report employees (n = 70). A mixed-methods design was employed using a directed content analysis.

RESULTS

Results indicate that the Resilience at Work Leader 180 Scale provides insight into leader behaviors that foster or detract from employee resilience.

CONCLUSION

This scale is of value to researchers and organizations interested in a measure of leader resilience.

From coping to building nurse manager resilience in rural workplaces in western Canada

AIM

To investigate the role stressors, and how coping strategies cultivated nurse managers' resilience in rural workplaces.

BACKGROUND

A stressful workplace can impair the mental and physical health of nurse managers leading to poor performance. Building and sustaining manager resilience in complex and stressful practice environments is necessary to attract and maintain competent and skilled managers.

METHOD

In this qualitative exploratory inquiry, a purposive sampling method was used to recruit 16 nurse managers in rural western Canada.

RESULTS

Coping strategies fostered manager's resilience that made their work meaningful, and included putting out fires, psychologically reframing a situation, serving others and receiving support.

CONCLUSIONS

Managers brought expertise, knowledge and skill to make their work meaningful and central to ongoing health service delivery in these rural communities. Nurse manager resilience can be strengthened by using evidence-based strategies in an increasingly complex health care environment.

IMPLICATIONS FOR NURSING MANAGEMENT

Managers need to be supported and encouraged to develop awareness of their own protective factors as they cope with challenging situations. Building resilience through formal education, social support and meaningful recognition is an important focus for nurse leaders in establishing a healthy work environment and maintaining a stable nursing workforce.

Work, resilience and sustainable futures

Purpose

This paper examines the relationship between work, resilience and sustainable futures for organisations and communities by considering the nature of work-related problems (WRPs) and the work-based research designed to investigate them. The authors explore the axis of work environment > work-related problem > resilience > sustainable futures as it might be impacted by work-based research.

Design/methodology/approach

The paper introduces two current real-world examples, one in Australia and one in Asia, of work-based research projects associated with higher education aimed at promoting resilience and sustainability, and discusses the research problems, questions, designs, methods, resilience markers and sustainability markers used by these projects.

Findings

Work-based research, when conducted rigorously using mixed methods, may contribute to increased resilience of organisations and communities and thereby seeks to promote more sustainable organisational and social futures.

Practical implications

Work-based research conducted in higher education seeks to investigate, address and solve WRP, even when such problems occur in unstable, changing, complex and messy environments.

Social implications

Resilience and sustainable futures are ambiguous and disputed terms, but if work-based research can be brought to bear on them, organisations and communities might better adapt and recover from challenging situations, thus reducing their susceptibility to shock and adversity.

Originality/value

While resilience and sustainability are commonly referred to in the research literature, their association to work, and specifically problems associated with work, have yet to be examined. This paper goes some of the way to addressing this need.

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