Leadership, support and acknowledgement of registered nurses work in acute mental health units

Taking appreciation to heart: appreciation at work and cardiovascular risk in male employees

Introduction

While perceived appreciation at work has been associated with self-reported health and wellbeing, studies considering biological health markers are lacking. In this study, we investigated whether appreciation at work would relate to coronary heart disease (CHD) risk as well as the specificity of this proposed association.

Methods

Our study comprised a total of 103 male participants, including apparently healthy, medication-free, non-smoking men in the normotensive to hypertensive range (n = 70) as well as medicated hypertensive and CHD patients (n = 33). CHD risk was assessed by blood pressure [mean arterial pressure (MAP)], the diabetes marker glycated hemoglobin A1c (HbA1c), blood lipids [total cholesterol (TC)/high-density lipoprotein-cholesterol (HDL-C) ratio], coagulation activity (D-dimer and fibrinogen), and inflammation [interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP)]. Perceived appreciation at work, as well as potentially confounding psychological factors (social support, self-esteem, and work strain due to a lack of appreciation), were measured by self-report questionnaires.

Results

We found higher appreciation at work to relate to lower overall composite CHD risk (p's ≤ 0.011) and, in particular, to lower MAP (p's ≤ 0.007) and lower blood lipids (p's ≤ 0.031) in medication-free participants as well as all participants. This overall association was independent of confounding factors, including related psychological factors (p's ≤ 0.049).

Discussion

Our findings indicate that appreciation at work might be an independent health-promoting resource in terms of CHD risk. Implications include that encouraging appreciation at work may help reduce the development and progression of CHD.

The Impact of Work Environment on Job Satisfaction: Pre-COVID Research to Inform the Future

Nursing is challenging work. Burnout, dissatisfaction, disengagement, as well as exodus from the profession are rampant, and COVID-19 has amplified these issues. Although nurse leaders cannot change the work, they can create work environments that support nurse satisfaction, enjoyment, and meaning at work. A literature review on work environment and job satisfaction conducted pre-COVID for a dissertation project revealed several factors that support healthy work environments. This article defines and describes the qualities of both unhealthy and healthy work environments, discusses the impact they have on employees, and offers suggestions for nurse leaders to improve the work environment in their organization.

How does appreciation lead to higher job satisfaction?

Purpose

Building on the “Stress-as-Offense-to-Self” theory, this study investigates appreciation as a predictor of job satisfaction over time, mediated by subjective success and feelings of resentment towards one's organization.

Design/methodology/approach

Analyses are based on a three-wave study with two-month time intervals, with a sample of 193 employees from six Swiss organizations.

Findings

Double mediation by subjective success and feelings of resentment was confirmed; no mediation was found in a reversed mediation model. Results highlight the importance of appreciation for employees' feelings of success and job satisfaction, but also for affect related to the organization as a whole.

Practical implications

Organizations should recognize the role of appreciation in satisfaction, affective reactions toward the organization, and information about one's standing. Appreciation can be expressed in multiple ways; it not only increases job satisfaction but also helps employees to validate their judgments about their own performance.

Originality/value

Appreciation is a promising resource for employee well-being. The present study is one of few focusing on appreciation as a resource in its own right, rather than as part of broader constructs, such as social support. Our results not only confirm the importance of appreciation but also shed light on mechanisms through which it may exert its influence. They complement a multilevel analysis based on the same data showing an association of appreciation with different indicators of well-being on the interpersonal as well as the intrapersonal level.

The Leadership Gap: Supporting New Front line Leaders in Cancer Care

INTRODUCTION

Although an individual may have gained considerable competence and skill in their specific discipline, it is unclear what resources are required for an experienced clinician to develop to a clinical leader. As a first step for many, front line leadership positions are often the only practical way to develop behaviors suited to more advanced leadership roles in health care. A new role requires impactful change in perspective that creates intensive learning opportunities for staff and an organization. Conversely, this transition may also represent risk to those failing to adjust to new behaviors and environment. A paucity of scholarly literature on this subject makes recommendations for best practice challenging, particularly in cancer care. The goals of this project were to understand the current state of leadership orientation in a single cancer center, while encouraging collaborative dialog to connect and engage stakeholders.

METHODS

Qualitative data were collected using a focus group with novice leaders and individual interviews with experienced leaders at a single cancer center. Novice leadership was defined as less than 2 years in a management role and experienced leadership as greater than 2 years of experience. The collective narrative was coded to identify repeating indigenous ideas and phrases. Broader review explored the relationships between concepts and categories to reveal important themes.

RESULTS

The narrative indicated that contributors understand the importance of support and guidance early in leadership development pathways. Additional findings revealed unmet expectations of novice leadership upon moving from individual clinical expert to front line leader and possible gaps in development support. Further examination of the data shows novice leaders are vulnerable and suggests that alongside didactic programming, peer support, mentorship, coaching with feedback, and project work underpin leadership development.

CONCLUSIONS

This project revealed positive behaviors enhancing new leader assimilation and performance while presenting possible solutions for apparent gaps in organizational support. Recommendations include creation of harmonized programming to address competency development and self-directed learning, enhanced peer support networks with job shadowing opportunities, and heightened organizational awareness of leadership transition supports.

Nurses experiences of delivering care in acute inpatient mental health settings: A narrative synthesis of the literature

Inpatient psychiatric care requires a balance between working with consumers' priorities and goals, managing expectations of the community, legal, professional and service responsibilities. In order to improve service delivery within acute mental health units, it is important to understand the constraints and facilitating factors for good care. We conducted a systematic narrative synthesis, where findings of qualitative studies are synthesised to generate new insights. 21 articles were identified. Our results show that personal qualities, professional skills as well as environmental factors all influence the ability to provide recovery focused care. Three overarching themes which either facilitated or hindered were identified. These included: (i) Complexity of the nursing role (clinical care; practical and emotional support: advocacy and education; enforcing aspects of the Mental Health Act. and, maintaining ward safety); (ii) Constraining factors (operational barriers; change in patient characteristic; and competing understandings of care); and (iii) Facilitating factors (ward factors; nursing tools; nurse characteristics; approach to people; approach to work and ability to self-care). We suggest that the therapeutic use of self is central to the provision of recovery oriented care. However person-centred practice can be fragile and fluid and a compassionate system of support is needed to enable an understanding of context and self. It is critical to have a work environment which fosters hope and optimism and is supportive of autonomy, ensures workload balance, and is safe.

Authenticity, creativity and a love of the job: experiences of grassroots leaders of mental health nursing in queensland

The strength of mental health nursing and its potential contribution to improved consumer outcomes depends upon strong and clearly articulated leadership. However, studies of leadership have tended to focus on nurses holding senior positions rather than exploring the leadership embedded in clinical work. A qualitative exploratory study was undertaken with identified mental health nurse leaders in one Australian state, in order to explore their experiences and what they found to be most meaningful in their work. This article reports the findings from this study. The data was analysed thematically to yield insights significant to mental health nursing and identity. The findings suggest these leaders find intrinsic rewards in the role; aspire to making authentic connections with consumers; appreciate the position of trust that they hold in bearing witness to individuals' distress; and use creative means to solve problems and achieve therapeutic outcomes. Sharing these themes builds knowledge on values that are embedded in mental health nursing practice and offers scope for integrating leadership attributes into the education, supervision and development of all mental health nurses. These findings also reveal the complexity of mental health nursing as a profession and the difficulties that might be encountered in attempts to define it in terms of its component tasks and functions.

Recent graduate nurse views of nursing, work and leadership

AIMS AND OBJECTIVES

To assess recent nurse graduates of a large university and seeks their views of university preparation, requisite nursing skills and qualities, workplace transition, supports received, nurse leadership and role models, and career development and retention.

BACKGROUND

Concern about attracting and retaining registered nurses is a continuing workforce issue in parts of Asia and throughout the world.

DESIGN

Qualitative interviews with recent nursing graduates.

METHODS

Seventeen face-to-face interviews took place using a structured schedule of 23 questions. Data were coded and analysed by hand to determine clusters of interest and develop themes.

RESULTS

Four broad topics emerged: (1) skills and qualities graduates consider central to nursing; (2) the support they received during the transition from graduate to novice practitioner and that which continues; (3) elements they value in nursing role models and leaders; and (4) the ward characteristics that will encourage them to remain in nursing and develop a career. Interviewees expressed concerns about retention-related issues, making suggestions for improvements. Unique findings focus on the blaming culture that many respondents consider they are working in, and the system whereby they are not free to access postgraduate studies until a specific time frame has elapsed, and when they do pursue further studies, they are bonded to the auspicing hospital/health service.

CONCLUSIONS

Responses unique to this research are the explicit concerns about a blaming culture, and complaints about rigid rules (bonding system) that virtually prevent an individual from accessing postgraduate studies independent of the hospital system. Interviewees strongly resent the bonding system that indentures them to that place of work.

RELEVANCE TO CLINICAL PRACTICE

Quality health care is dependent on a well-educated, sustainable and skilled nursing workforce. Recognition of the concerns of newly graduated nurses in relation to nursing skill acquisition, workplace support issues and career concerns can assist in ensuring these issues are adequately addressed and in turn contribute to a stronger, more stable and competent nursing workforce.

Mental health nurses' perceptions of good work in an acute setting

Frequently, research and conference papers explore difficult or problematic areas of practice that can inadvertently render daily nursing accomplishments invisible and create the perception of a discipline in crisis. In this qualitative study, we explore the views of registered nurses about achievements in the workplace and good nursing work in an acute inpatient mental health setting in Sydney, Australia. Mental health nurses were asked a series of questions about their experiences and understanding of what constitutes good nursing work as well as their sense of optimism about their work. A total of 40 structured face-to-face interviews were completed. Among the responses to questions about achievements and good nursing practice, five broad themes were identified: i) teamwork; (ii) interpersonal interactions with patients; (iii) providing practical and holistic support to patients; (iv) patients' mental health improvements; and (v) optimism-pessimism continuum. Findings contribute to a discussion of good nursing work in acute mental health settings, as well as self-perceptions of optimism and hopefulness, which are important contributors to positive, supportive health-care settings and patient recovery.