The support needs of Australian primary health care nurses during the COVID‐19 pandemic

Listening to School Nurses' Voices: A Mixed Methods Study on the Continued Impact of COVID-19 on School Nursing Practice

School closures in March 2020 due to the COVID-19 pandemic precipitated losses of critical student resources as physical, mental, emotional, and social needs escalated. Identifying the challenges, strategies, and changes in school nurse (SN) practice in Massachusetts during this pandemic is fundamental to understanding how to manage future anticipated pandemics while protecting children, communities, and SNs. The purpose of this mixed-methods descriptive study in the second year of the global pandemic was to (a) listen to SN voices through a novel online survey including the prompts of challenges, strategies, and practice changes and (b) describe the SN experience of COVID-19 response in Massachusetts schools, including identification of intent to leave school nursing. Responses were analyzed using descriptive qualitative analysis (n  =  73). The prompts each elicited subthemes that coalesced to a cohesive theme: Finding one's way required the support of others to pave untraversed roads.

The well-being of nurses working in general practice during the COVID-19 pandemic: A qualitative study (The GenCo Study)

AIM

Exploration of experiences of nurses working in general practice during the COVID-19 pandemic to evaluate the impact on nurses' professional well-being.

DESIGN

An exploratory qualitative study comprised of case studies of three general practice sites in England and a nationwide interview study of nurses working in general practice and nurse leaders. The study was funded by The General Nursing Council for England and Wales Trust. University of York ethics approval (HSRGC/2021/458/I) and Health Research Authority approval was obtained (IRAS: 30353, Protocol number: R23982, Ref 21/HRA/5132, CPMS: 51834).

METHODS

Forty participants took part. Case site data consisted of interviews/focus groups and national data consisted of semi-structured interviews. Data collection took place between April and August 2022. Analysis was underpinned by West et al.'s The courage of compassion. Supporting nurses and midwives to deliver high-quality care, The King's fund, 2020 ABC framework of nurses' core work well-being needs.

FINDINGS

The majority of participants experienced challenges to their professional well-being contributed to by lack of recognition, feeling undervalued and lack of involvement in higher-level decision-making. Some participants displayed burnout and stress. Structural and cultural issues contributed to this and many experiences pre-dated, but were exacerbated by, the COVID-19 pandemic.

CONCLUSIONS

By mapping findings to the ABC framework, we highlight the impact of the COVID-19 pandemic on the well-being of nurses working in general practice and contributing workplace factors. The issues identified have implications for retention and for the future of nursing in general practice. The study highlights how this professional group can be supported in the future.

IMPACT

The study contributes to our understanding of the experiences of nurses working in general practice during the COVID-19 pandemic and beyond. Findings have implications for this skilled and experienced workforce, for retention of nurses in general practice, the sustainability of the profession more broadly and care quality and patient safety.

REPORTING METHOD

Standards for Reporting Qualitative Research (O'Brien et al. in Journal of the Association of American Medical Colleges, 89(9), 1245-1251, 2014).

PATIENT OR PUBLIC CONTRIBUTION

As this was a workforce study there was no patient or public contribution.

Prevalence of depression, anxiety, and stress and associated reasons among Iranian primary healthcare workers: a mixed method study

BACKGROUND

Different mental disorders may be associated with many work-related factors to which primary health care workers (PHCWs) are exposed. The current research aims to measure the rates of depression, anxiety, and stress among PHCWs, and their associated causes in primary health care (PHC) settings.

METHODS

An explanatory sequential mixed methods design was employed in this research from January 2021 to January 2022 in Tabriz, Iran's PHC centers. First, this study followed an online-based cross-sectional survey using a self-reported questionnaire. The Depression, Anxiety and Stress Scale-21 Items (DASS-21) and questions on demographic and work-related characteristics were completed by 303 frontline PHCWs during the quantitative phase. In the qualitative phase, a semi-structured interview was held with 12 PHCWs who had the highest level of depression, anxiety, and stress to identify the reasons and sources of mental health prevalence. Quantitative data were analyzed using descriptive statistics via SPSS-26. A content analysis was performed to analyze qualitative data.

RESULTS

The results showed that self-reported stress, anxiety, and depression had a prevalence of 40.3%, 42.9%, and 42.6%, respectively. Symptoms of at least one mental disorder were experienced by 54% of respondents, while 28% had all three. Major sources of stress, anxiety, and depression among PHCWs were working environment conditions, organizational policies, job-related reasons, and interpersonal relations.

CONCLUSIONS

The results of current study indicated that PHCWs experienced high levels of depression, anxiety, and stress. The main factors and reasons that contributed to these mental health issues among PHCWs were work environment conditions, organizational policies, job-related reasons and interpersonal relations. Therefore, interventions should be implemented to promote mental health of PHCWs. This can include measures such as psychological screening, supportive care, workload management, flexible scheduling, and access to mental health resources. Additionally, training programs can be implemented to enhance resilience and coping skills among healthcare professionals.

The experiences of public health nurses during the COVID-19 in Taiwan: A qualitative study

AIM

The coronavirus disease 2019 (COVID-19) pandemic has had a substantial effect on frontline health care workers and caused public health nurses (PHNs) to come under various forms of pressure. PHNs face high-risk challenges in their work environment, and their professional commitment and adaptability are key concerns. The aim of this qualitative study was to describe the experiences of PHNs during the COVID-19 outbreak.

METHODS/DESIGN

Twenty PHNs who worked during the COVID-19 outbreak were recruited from seven public health centres through posters. Data were collected through in-depth interviews that comprised semi-structured and open-ended questions; subsequently, the data were analysed through content analysis.

RESULTS

Three themes emerged from the study findings, namely (1) the disorderliness of COVID-19 pandemic prevention work, (2) managing stress and fear, and (3) the establishment of a new normal. Because of the severity of the pandemic, the workload and stress associated with epidemic prevention policies continue to increase. PHNs may infect their family members and experience a sense of alienation and distance. They must also deal with irrationality and reactions in the people within their community.

CONCLUSION

Health department directors and policymakers should provide the necessary support and assistance to frontline pandemic prevention workers to increase the efficiency of pandemic prevention efforts.

PATIENT OR PUBLIC CONTRIBUTION

The participants agreed to participate in the qualitative study during the study period.

The positioning of nursing in Turkish mass media: Before and after the COVID-19 outbreak

AIM

To explore the way the nursing profession was portrayed in online news coverage before and after the COVID-19 pandemic.

BACKGROUND

The power of the media can be used as a tool to introduce nursing services to society, make nursing visible, and influence the public perception of nursing.

INTRODUCTION

Analyzing the image of nursing as portrayed in the news can be a guide for more effective management of the media as a tool for positioning nursing in the future and presenting the right message.

METHODS

A qualitative design was applied. Three online newspapers published in the Turkish language-the most widely read newspapers in Turkey-were analyzed. The sample for this research consisted of 505 news articles containing the keywords "nurse" and "nursing" published before and after the COVID-19 outbreak. The MAXQDA2022 software was used for data management.

RESULTS

The articles selected were themed as news reflecting the nursing profession negatively, positively, and neutrally. When the negative and positive themes were compared, the two most repeated subthemes included (1) working conditions and being unprofessionalism; (2) impact on health, social recognition, and neutral included only subtheme that happens to you as a citizen/individual.

CONCLUSION

Compared with the pre-COVID-19 period, there was an increase in news coverage reflecting portrayed nursing positively on the nursing profession in the post-COVID-19 period. Mass media, which are indispensable in social communication, can be used as an effective tool to improve the image of nursing in society.

IMPLICATIONS FOR NURSING

From nursing students to policymakers, all professionals must act in a planned and purposeful manner to present nursing professionals positively as leaders in public healthcare.

A resilience perspective on healthcare personnels' experiences of managing the COVID-19 pandemic: a qualitative study in Norwegian nursing homes and come care services

BACKGROUND

The COVID-19 pandemic led to new and unfamiliar changes in healthcare services globally. Most COVID-19 patients were cared for in primary healthcare services, demanding major adjustments and adaptations in care delivery. Research addressing how rural primary healthcare services coped during the COVID-19 pandemic, and the possible learning potential originating from the pandemic is limited. The aim of this study was to assess how primary healthcare personnel (PHCP) working in rural areas experienced the work situation during the COVID-19 outbreak, and how adaptations to changes induced by the pandemic were handled in nursing homes and home care services.

METHOD

This study was conducted as an explorative qualitative study. Four municipalities with affiliated nursing homes and homecare services were included in the study. We conducted focus group interviews with primary healthcare personnel working in rural nursing homes and homecare services in western Norway. The included PHCP were 16 nurses, 7 assistant nurses and 2 assistants. Interviews were audio recorded, transcribed and analyzed using thematic analysis.

RESULTS

The analysis resulted in three main themes and 16 subthemes describing PHCP experience of the work situation during the COVID-19 pandemic, and how they adapted to the changes and challenges induced by the pandemic. The main themes were: "PHCP demonstrated high adaptive capacity while being put to the test", "Adapting to organizational measures, with varying degree of success" and "Safeguarding the patient's safety and quality of care, but at certain costs".

CONCLUSION

This study demonstrated PHCPs major adaptive capacity in response to the challenges and changes induced by the covid-19 pandemic, while working under varying organizational conditions. Many adaptations where long-term solutions improving healthcare delivery, others where short-term solutions forced by inadequate management, governance, or a lack of leadership. Overall, the findings demonstrated the need for all parts of the system to engage in building resilient healthcare services. More research investigating this learning potential, particularly in primary healthcare services, is needed.

Celebrating Nursing Week during the COVID-19 pandemic: The example of Twitter in Turkey for 2020-2021

AIM

To explore how the nursing profession reflected on Twitter in Turkey about the Nursing Week celebration during the COVID-19 pandemic.

BACKGROUND

The COVID-19 pandemic affected the whole world, made every aspect of life extremely difficult, and required excessive involvement by healthcare professionals-especially nurses. Nurses have played a key role in meeting the care needs of people during this time.

METHODS

A qualitative research design was used for this study. Turkish social media data were analysed via a data crawler on Twitter. Tweets regarding the COVID-19 pandemic during 12-18 May 2020 and 12-18 May 2021-dates celebrated as Nursing Week in Turkey-and tweets containing at least one of the following relevant hashtags: #nurse, #nursesday, #nursesweek, #nursingweek, #12May, or #12Maynursesday, were considered.

RESULTS

The hashtag #12May was used the most in both years, and the most tweets were posted with the hashtag #12May (n = 2996) in 2020. Three categories, 'Being a nurse in the pandemic', 'Nursing Week with celebrations', and 'Nursing Week with definitions', were identified through a thematic analysis. The categories included the importance of nursing, respectability, difficult working conditions, insufficiency in the number of nurses, difficulties in social life, etc. DISCUSSION: Turkish society posted tweets to celebrate Nursing Week. In addition to the celebration, there were many statements revealing the positive aspects of nurses and the nursing profession, as well as the difficulties nurses faced during the COVID-19 pandemic.

CONCLUSION

Our findings revealed that in the celebrations of Nursing Week in Turkey, the important role of nursing in the health system, difficulties experienced during the COVID-19 pandemic, and definitions describing the roles of nursing were reflected on Twitter.

IMPLICATION FOR NURSING AND HEALTH POLICIES

This presents a source for perspective on the opinions reflected on social media about nurses and the nursing profession via Nursing Week celebrations during the pandemic. The findings can guide the development of policies on the rights and social privileges of the nursing profession that need to be improved in exceptional situations like a pandemic.

Nursing practice and teleconsultations in a pandemic context: A mixed-methods study

AIM

To explore the use and implementation of teleconsultations by primary care nurses in the context of the COVID-19 pandemic.

BACKGROUND

Teleconsultation use increased rapidly during the COVID-19 pandemic. Its implementation has been documented for physicians and specialists, but knowledge is still limited in nursing practice.

DESIGN

A sequential mixed-methods study.

METHODS

Phase 1: A cross-sectional e-survey with 98 nurses (64 nurse clinicians [NCs] and 34 nurse practitioners [NPs]) was conducted in 2020 in 48 teaching primary care clinics in Quebec (Canada). Phase 2: Semi-structured interviews with four NCs and six NPs were conducted in 2021 in three primary care clinics. This study adheres to STROBE and COREQ guidelines.

RESULTS

During the pandemic, telephone was the principal teleconsultation modality used by NPs and NCs compared to other teleconsultation modalities (text messages, email and video). The only variable associated with a higher likelihood of using teleconsultations was type of professional (NCs). Video consultation was almost absent from the modalities used. The majority of participants reported several facilitators to using teleconsultations in their work (e.g. web platforms and work-family balance) and for patients (e.g. rapid access). Some barriers to utilisation were identified (e.g. lack of physical resources) for successful integration of teleconsultations at the organisational, technological and systemic levels. Participants also reported positive (e.g. assessment of cognitive deficiency) and negative (e.g. rural population) impacts of using teleconsultations during a pandemic that made the use of teleconsultations complex.

CONCLUSION

This study highlights the potential for nurses to use teleconsultations in primary care practice and suggests concrete solutions to encourage their implementation after the pandemic.

RELEVANCE TO CLINICAL PRACTICE

Findings emphasize the need for updated nursing education, easy-to-use technology and the strengthening of policies for the sustainable use of teleconsultations in primary health care.

IMPLICATIONS FOR THE PROFESSION

This study could promote the sustainable use of teleconsultations in nursing practice.

REPORTING METHOD

The study adhered to relevant EQUATOR guidelines; the STROBE checklist for cross-sectional studies and the COREQ guidelines for qualitative studies were used for reporting.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution, as the study focused on the use of teleconsultation among health professionals, specifically primary care nurses.

Iranian primary healthcare system's response to the COVID-19 pandemic using the healthcare incident command system

The present study aimed to evaluate the effects of the healthcare incident command system (HICS) on the district health networks (DHNs) covered by provincial Medical Universities (PMU) in terms of the management and commanding of the COVID-19 pandemic in Iran. This study was a cross-sectional survey. The study was performed in Iran in June 2020 in 60 DHNs, 41 of which had an active HICS. Data were collected on eight HCIS dimensions from all 60 DHNs by trained crisis management experts to evaluate the effects of HICS use on management of the COVID-19 pandemic. For all the 60 DHNs, the mean score of the COVID-19 incident command and management was 78.79 ± 11.90 (range 20-100); with mean scores highest for organizational support and coordination and lowest for logistic and planning. Significant differences were observed between the DHNs with active HICS and DHNs with inactive or no HICS in terms of the mean scores of incident management and command and their associated dimensions. According to the results, the HICS use had a positive impact on the improvement of incident management and command and all the related dimensions. Therefore, the HICS could be conducted and implemented in primary healthcare for the systematic and proper management of crises caused by infectious diseases and increasing primary healthcare system efficiency in response to these crises.

Experiences of Telenursing in Overcoming Challenges and Applaying Strategies by COVID-19 Patients in Home Isolation: Qualitative Study in Primary Care

During the first wave of the COVID-19 pandemic, there was a significant increase in the use of telenursing to provide care for patients at home. However, the quality of the patient experience when nurses rely on technology instead of personal contact has not been thoroughly investigated. This study aimed to understand the perspectives of COVID-19 patients in home isolation who received telenursing from primary care nurses during the initial phase of the pandemic. A qualitative study was conducted that employed purposive sampling and involved semi-structured interviews via videoconference with fourteen COVID-19 patients from two primary health centers in Catalonia (Spain). Thematic analysis was used, and the study adhered to the COREQ checklist. The findings revealed three themes related to the challenges faced by COVID-19 patients in home isolation: physical symptoms, emotional and social difficulties, and a lack of information. Three themes emerged regarding the strategies patients employed to overcome these challenges and the role of nurses: self-care, emotional support, and personal commitment. The patients reported having achieved strategies to improve their physical, psychological, and situational well-being despite the unprecedented situation. The study highlights that telenursing is a valuable resource for delivering patient-centered care, which could lead to changes in organisational policies and the development of best clinical practices.

Middle Eastern nurses' views/experiences of work and well-being with the support measures during past disease outbreaks and COVID-19: a qualitative systematic review

BACKGROUND

The potential psychological health impact of pandemics on nurses has been increasingly widely recognised, as have recommendations to establish support measures for nurses' well-being. Despite the availability of support measures significant number of nurses still experienced burnout and mental distress during Covid-19. Few efforts have been made in the wider literature to understand how nurses experience well-being support or how they perceive it affects their well-being during pandemics. In the Middle East, understanding and exploring well-being support measures during pandemics from nurses' perspectives has not received significant attention.

OBJECTIVE

To investigate nurses' perspectives and experiences of well-being support measures during prior pandemics and the Covid-19 pandemic in the Middle East.

METHODS

A systematic qualitative review was undertaken utilising the JBI model as a framework. Searches were carried out in databases comprised CINAHL, MEDLINE, NUsearch Library of Nottingham University and Google Scholar. Moreover, a manual search through reference lists for relevant studies were carried out.

DATA EXTRACTION AND SYNTHESIS

Eleven studies were included in the review. The findings from the included qualitative studies were extracted using the JBI-QARI data extraction tool for qualitative research. The results were synthesised using a meta-synthesis in line with the JBI approach.

RESULTS

The included studies yielded an aggregate of 111 findings and were categorised into 14 categories, followed by four synthesised findings. These were: [1] nurses experienced challenges during MERS, yet different strategies were implemented by leaders and nurses to manage these challenges; [2] some well-being support measures were unfulfilled during Covid-19; [3] additional aspects compounded negatively on nurses' well- being; and [4] nurses showed maturity during Covid-19.

CONCLUSION

In comparison to prior health emergencies, well-being support measures during Covid-19 were not sufficiently adopted. Nurse policymakers and managers should consider these support measures to correspond with nurses' needs and explore the contextual factors that affect their implementation.

TRIAL REGISTRATION

PROSPERO (CRD42022344005).

Challenges of being a maternity service leader during the COVID-19 pandemic: a descriptive analysis of the journey

BACKGROUND

In Australia, maternity care services provide care for pregnant and postpartum women and their newborns. The COVID-19 pandemic forced these services to quickly adapt and develop policies and procedures for dealing with transmission in health care facilities, as well as work under public health measures to counter its spread within the community. Despite well-documented responses and adaptations by healthcare systems, no studies have examined the experiences of maternity service leaders through the pandemic. This study aimed to explore the experiences of maternity service leaders, to understand their perspectives on what happened in health services and what was required of a leader during the COVID-19 pandemic in one Australian state.

METHODS

A longitudinal qualitative study collected data from 11 maternity care leaders during the pandemic in the state of Victoria. Leaders participated in a series of interviews over the 16-month study period, with a total of 57 interviews conducted. An inductive approach to developing codes allowed for semantic coding of the data, then a thematic analysis was conducted to explore patterned meaning across the dataset.

RESULTS

One overarching theme, 'challenges of being a maternity service leader during the pandemic', encompassed participant's experiences. Four sub-themes described the experiences of these leaders: (1) needing to be a rapid decision-maker, (2) needing to adapt and alter services, (3) needing to filter and translate information, and (4) the need to support people. At the beginning of the pandemic, the challenges were most acute with slow guideline development, rapid communications from the government and an urgent need to keep patients and staff safe. Over time, with knowledge and experience, leaders were able to quickly adjust and respond to policy change.

CONCLUSION

Maternity service leaders played an important role in preparing and adapting services in accordance with government directives and guidelines while also developing strategies tailored to their own health service requirements. These experiences will be invaluable in designing high quality and responsive systems for maternity care in future crises.

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.

Registered nurses' perceptions of their roles in medical-surgical units: A qualitative study

AIM

The aim of this study was to gain insight into the perception of nurses about their roles in medical-surgical units.

BACKGROUND

As a result of ever-changing work environments, medical-surgical nurses find it difficult to know and practice according to the full scope of their roles.

DESIGN

A qualitative descriptive study.

METHODS

Semi-structured individual interviews were conducted with 21 nurses on three campuses of a large tertiary care hospital located in Quebec, Canada. Thematic analysis was used to construe meaning from the interviews. This research adheres to the Standards for Reporting Qualitative Research guidelines and checklist.

RESULTS

The data analysis resulted in three main themes: (i) confusion in nurses' roles and scope of practice; (ii) challenges in the continuity of care and (iii) factors affecting the roles of nurses in medical-surgical units.

CONCLUSION

Attention must be paid to the care continuum as it represents a critical element for surgical patients' quality and safety of care.

RELEVANCE TO CLINICAL PRACTICE

Medical-surgical nurses should understand their roles and the factors that limit their full scope of practice in order to provide and manage complex care situations. Additionally, an interdisciplinary approach is a strategy that may better respond to patients' clinical needs across the surgical journey.

One-year follow-up of hospital nurses' work experiences during the COVID-19 pandemic: A qualitative study

AIM

To follow up on the experiences of Registered Nurses (RNs) working after 1 year of the COVID-19 pandemic in Canadian and American hospitals.

DESIGN

Semi-structured interviews were conducted, and transcripts were analysed through a reflexive thematic analysis (RTA).

METHODS

RNs (n = 19) first interviewed in the spring of 2020 were re-interviewed 1 year after their original interviews (May 25, 2021-June 25, 2021). Participants consisted of nurses residing in Canada and working in Ontario (n = 12) or American hospitals (n = 7), i.e., both local and cross-border nurses.

RESULTS

Five themes were identified: (1) "You call us heroes, but you forgot us": Nurses described experiences of disrespect and stigma from their communities, their government, and their workplaces. (2) "A whole new level of busy": Nurses reported stressors both at home and at work that had increased exponentially throughout the pandemic. (3) "Running on empty": Nurses described burnout and mental health struggles including depression, irritation, and suicidal ideation; they coped using both adaptive and maladaptive strategies. (4) "The job of nursing is painful": Ongoing pandemic issues led nurses to re-evaluate their commitments to their units, their hospitals and the profession itself. (5) "Surviving an un-survivable day": Nurses shared positive moments at work and home that helped give them the strength to carry on.

CONCLUSION

Significant investments will be required from hospital organizations and governments to ensure that healthcare systems continue to function safely for patients, their families and nurses.

IMPACT

The purpose of this study was to understand and describe nurses' experiences after 1 year of working during the COVID-19 pandemic. Nurses reported feeling disrespected, overwhelmed, and burned out; many were looking to leave the profession. These findings will be of interest to nurses working on the frontline of the pandemic as well as hospital managers and policy makers.

NO PATIENT OR PUBLIC CONTRIBUTION

In this investigation, nurses were the participants.

Australian nurses' and midwives' perceptions of their workplace environment during the COVID-19 pandemic

Background

Working as a front-line worker during a pandemic is a unique situation that requires a supportive work environment. An informed understanding of nurses' and midwives' workplace experiences during a pandemic, such as COVID-19, may enable better preparation and targeted support for future pandemics at an individual, organisational, and policy level.

Aim

The aim of this study was to explore nurses' and midwives' workplace experiences during the COVID-19 pandemic response.

Methods

A cross-sectional online survey consisting of open-ended questions was conducted with a convenience sample of nurses and midwives (n = 1003) working in New South Wales Health hospital settings, in Australia. Open-ended questions were analysed using content analysis.

Results

Five themes were identified; 'organisational communication', 'workplace support', 'availability of personal protective equipment', 'flexible working', and 'new ways of working'. Nurses' and midwives' workplace experiences during COVID-19 were influenced by leaders who were perceived to be adaptive, authentic, responsive, transparent, and visible. While many expressed a number of workplace challenges, including access to personal protective equipment, there was opportunity to explore, develop, and evaluate new and alternate models of care and working arrangements.

Conclusion

It is important that nurses and midwives are supported and well prepared to cope during pandemics in the workplace. Organisational leadership and timely dissemination of transparent pandemic plans may support nurses' adaptive workplace experiences.

Adaption of the Cancer Information Overload Scale for pandemics and assessment of infodemic levels among nurses and midwives

AIM

This study was conducted in three phases. Phase 1 aimed to adapt the Cancer Information Overload Scale and conduct content validity testing. Phase 2 aimed to conduct factorial validity testing of the scale. Phase 3 aimed to assess information overload and the sources of information used by nurses and midwives to keep up-to-date about COVID-19.

DESIGN

A cross-sectional survey of nurses and midwives working in a metropolitan Local Health District in Sydney, Australia, was conducted from May to June 2020.

METHODS

Adaptation of the Cancer Information Overload Scale and content validity of the modified scale (as the Pandemic Information Overload Scale) was undertaken by an expert panel comprising of senior nurses and researchers. Factorial validity and reliability of the Pandemic Information Overload Scale were evaluated using exploratory factor analyses using one subsample of the data. Using the second subsample of the data, information overload and sources of information used by nurses and midwives to keep up-to-date about COVID-19 were examined.

RESULTS

The Pandemic Information Overload Scale is a reliable and valid instrument for measuring information overload among nurses during a pandemic. Its internal consistency was high (α = 0.81, M = 3.84).

CONCLUSION

The 8-item PIO scale is a brief, reliable and psychometrically sound instrument for measuring nurses' and midwives' perceptions of information overload during COVID-19. Mean scores across this study indicated that participants were experiencing above average information overload. Implementing strategies to reduce this overload would optimize clinical decision making and promote patient safety.

Burnout in primary healthcare physicians and nurses in Turkey during COVID-19 pandemic

BACKGROUND

Due to additional responsibilities and uncertainties during the COVID-19 pandemic, primary healthcare (PHC) workers are at increased risk of burnout.

AIM

To determine and compare the burnout levels and related factors in PHC nurses and family physicians (FPs) during the COVID-19 pandemic.

METHODS

An online survey was delivered to PHC workers. Non-random sampling method was used. To evaluate burnout, the Maslach Burnout Inventory was used, which investigates burnout in three categories: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Multivariate linear regression was used to analyze factors associated with burnout for FPs and nurses separately.

FINDINGS

Among the participants, 55.7% were nurses, the mean age was 42.34. FPs and nurses experienced similar levels of burnout in terms of EE. Family physicians had higher levels of low PA and DP. Based on the results of the multivariate analysis, while higher EE levels were significantly associated with unequal distribution of workload and communication problems within the Family Health Center for physicians, the unequal distribution of PPE, lack of appreciation by patients or colleagues and restrictions on work-related rights were relevant factors for nurses. Lack of appreciation and restrictions of the rights were associated with increased DP scores in both groups. Unequal distribution of workload was also associated with reduced PA among FPs.

CONCLUSION

PHC physicians and nurses are affected by burnout in different ways under the conditions of the COVID-19 pandemic based on gender, socioeconomic status and working conditions. To protect the mental health of PHC workers in the next public health emergency, clarification in the organization of services, empowering PHC workers in emergency risk communication and provision of timely, adequate and free PPE is essential. It is also crucial to ensure the rights of health workers through macro policy changes especially during emergencies.

Motivating nurses' coworker-directed helping behaviour during the COVID-19 pandemic: Role of managerial humour and nurses' power distance orientation

AIMS

The aims of the research are to investigate (1) the influence of managerial humour on nurses' coworker-directed helping behaviour, (2) the mediating effect of nurses' feelings of energy between managerial humour and nurses' coworker-directed helping behaviour and (3) the moderating effect of nurses' power distance orientation.

DESIGN

This is a quantitative study. A three-wave survey design was conducted to collect data from direct managers to nurse dyads.

METHODS

The random sampling method was employed. Data were collected from the supervisor to subordinate dyad at three time points during the first half of 2021. A total of 235 paired data sets of nurses and their direct managers were collected from a large state-owned Chinese hospital. We used hierarchical regression analyses via SPSS 22.0 software to examine the hypotheses.

RESULTS

(1) Managerial humour can foster nurses' coworker-directed helping behaviour via accumulating their feelings of energy. (2) Power distance orientation moderates the effect of managerial humour on feelings of energy as well as the indirect effect of managerial humour on nurses' coworker-directed helping behaviour via feelings of energy, in a way that these effects are stronger when nurses have higher (vs. lower) level of power distance orientation.

CONCLUSION

Managerial humour can increase nurses' feelings of energy, which in turn, motivates them to help their coworkers. Nurses' power distance orientation is an important boundary condition that constrains managerial humour effectiveness.

IMPACT

Hospital managers could use more humour during their interactions with nurses because managerial humour can promote nurses' feelings of energy and coworker-directed helping behaviour. Hospitals can take humour into account during managers' selection and training to improve management effectiveness. Managers in eastern countries should use more humour during their interactions with followers.

PATIENT OR PUBLIC CONTRIBUTION

Nurses and their direct managers from a large state-owned Chinese hospital contributed to this study by completing the survey.

Exploring the impact of surface acting on nurse leaders during COVID

PURPOSE

Coronavirus (COVID) has had a massive impact on the health systems of many nations including Australia. Nurse leaders have, as part of their leadership and management roles, had to manage the emotional responses of the people around nurse leaders . The purpose of this study was to explore the experiences of nurse leaders who have held management roles during the health services crisis that has resulted from the COVID pandemic and to look at the emotional work nurse leaders have engaged in and the impact emotional work has had on nurse leaders' emotional well-being.

DESIGN/METHODOLOGY/APPROACH

The study adopted a social constructionist approach and employed unstructured interviews to generate data.

FINDINGS

The findings demonstrate that the nurse leaders were experiencing increased emotional exhaustion, which could be construed as a breach of psychological safety, as nurse leaders engaged in more surface acting. This has negatively impacted their lives outside of work. The study recommends that nurse leaders receive support through counselling and reflective practice activities. Consideration also should be given to renumerating nurse leaders appropriately for the emotional work nurse leaders perform.

RESEARCH LIMITATIONS/IMPLICATIONS

The structural issues endemic in the industry need to be addressed. Human resource management professionals, senior managers and hospital boards are charged with ensuring that the organisations are safe and healthy workplaces. This includes addressing issues that impact psychological health. If nurse leaders must undertake work that impacts negatively on nurse leaders' mental well-being and personal lives, then appropriate safeguards need to be put in place. The scope of the study was small, as the study is limited by the number of interviewees, the number of study sites and the sites' geographical location. Consequently, limited claims are made about the generalisability of the findings or the findings' transferability to other contexts.

PRACTICAL IMPLICATIONS

The findings overwhelmingly support the contention that we need to support nurse leaders in the vital role they play through engaging in surface acting in the workplace. The role needs to be recognised and valued as a critical part of the nurse leader role. The contribution the role makes to the welfare of others in the organisation needs to be acknowledged. Given the emotional and personal price that nurse leaders play for surface acting, organisations need to provide genuine support in the form of counselling and the introduction of opportunities for reflective practice.

SOCIAL IMPLICATIONS

The study suggests that nurse leaders need to be paid for emotional labour (EL) generally and surface acting in particular. The recognition of the value of caring work must go beyond symbols such as the Year of the Nurse and be rewarded financially.

ORIGINALITY/VALUE

The experience of nurse leaders using surface acting has received little attention and this is the first study to look at this particular phenomenon during COVID.

Promoting behavior-related low back health in nurses by in-person and social media interventions in the workplace

BACKGROUND

Nurses are put at high risk of work-related low back pain due to the nature of their work. The aim of this study was to develop and evaluate intervention based on the PRECEDE-PROCEED Model on promoting behaviors of low back health via two educational approaches.

METHODS

This study was a community randomized-controlled clinical trial. The educational content was developed with six modules: knowledge, attitude, self-efficacy, reinforcing factors, enabling factors, and behavior. Intervention was delivered by two modes: (1) in-person (n = 60) and (2) social media (n = 60). Data were evaluated by a self-designed questionnaire at baseline, 3, and 6 months. Baseline comparisons between groups were made with Mann-Whitney U Test and T-Test. Comparison of change scores between groups and two delivery types across the three time periods used the mixed between-within subject analysis of variance.

RESULTS

A total of 120 nurses received the allocated intervention. All educational component scores increased at 3-months in both groups. At the 6-month follow-up scores increased for enabling factors and behavior in the intervention group, while in the control group all scores increased except for attitude. Based on Bonferroni Post hoc analysis social media was more effective in knowledge, self-efficacy, reinforcing factors, and behavior than the in-person intervention.

CONCLUSION

An educational program for low back health based on the PRECEDE-PROCEED model proved effective at improving all components. However, social media was more successful than in-person in the maintenance of behavior over the long term.

TRIAL REGISTRATION

IRCT20170313033054N2: 25-02-2018. https://www.irct.ir/trial/25598.

Organizational responses to the COVID-19 pandemic in Victoria, Australia: A qualitative study across four healthcare settings

Objective

Organizational responses that support healthcare workers (HCWs) and mitigate health risks are necessary to offset the impact of the COVID-19 pandemic. We aimed to understand how HCWs and key personnel working in healthcare settings in Melbourne, Australia perceived their employing organizations' responses to the COVID-19 pandemic.

Method

In this qualitative study, conducted May-July 2021 as part of the longitudinal Coronavirus in Victorian Healthcare and Aged Care Workers (COVIC-HA) study, we purposively sampled and interviewed HCWs and key personnel from healthcare organizations across hospital, ambulance, aged care and primary care (general practice) settings. We also examined HCWs' free-text responses to a question about organizational resources and/or supports from the COVIC-HA Study's baseline survey. We thematically analyzed data using an iterative process.

Results

We analyzed data from interviews with 28 HCWs and 21 key personnel and free-text responses from 365 HCWs, yielding three major themes: navigating a changing and uncertain environment, maintaining service delivery during a pandemic, and meeting the safety and psychological needs of staff . HCWs valued organizational efforts to engage openly and honesty with staff, and proactive responses such as strategies to enhance workplace safety (e.g., personal protective equipment spotters). Suggestions for improvement identified in the themes included streamlined information processes, greater involvement of HCWs in decision-making, increased investment in staff wellbeing initiatives and sustainable approaches to strengthen the healthcare workforce.

Conclusions

This study provides in-depth insights into the challenges and successes of organizational responses across four healthcare settings in the uncertain environment of a pandemic. Future efforts to mitigate the impact of acute stressors on HCWs should include a strong focus on bidirectional communication, effective and realistic strategies to strengthen and sustain the healthcare workforce, and greater investment in flexible and meaningful psychological support and wellbeing initiatives for HCWs.

The impact of COVID-19 on the delivery of care by Australian primary health care nurses

This qualitative study describes the impact of the first wave of the COVID-19 pandemic on the provision of care by Australian primary health care (PHC) nurses. Participants were purposefully recruited following completion of a national survey about PHC nurses' experiences during the pandemic. Twenty-five semi-structured interviews were conducted by two experienced researchers and professionally transcribed. The mean duration of interviews was 38.5 min. Thematic analysis revealed three themes about the impact of COVID-19 on PHC nurses' provision of care. These were: workplace adjustments, changes in healthcare delivery and concerns about long-term health impacts of COVID-19. The sudden disruption and de-stabilisation of care delivery was reported as significantly impacting on initial service provision, although participants reported adapting quickly and finding new ways to deliver care. The impact of the pandemic on high risk communities and mental health support needs of clients created additional challenges, although some participants reported positive outcomes such as increased confidence of some clients to provide self-care. There were concerns about the potential long-term health impact on communities due to reduced levels of cancer screening, disrupted management of chronic conditions and reduced opportunistic health assessments. Findings from this study demonstrated how PHC nurses played an important role in the continued provision of PHC by adapting quickly to changed circumstances, adjusting and modifying clinical activities, and by monitoring for future potential negative outcomes from the pandemic. These findings are important for the future management of pandemics and inform the long-term planning of PHC services.

Primary care nurses during the coronavirus disaster and their struggle: Qualitative research

Background

Coronavirus disease 2019 (COVID‐19) has substantially affected the health and lives of medical professionals. However, the experiences of nurses engaged in primary care remain unclear. We explored how nurses working in primary care were psychologically and socially affected by the COVID‐19 disaster and how they overcame the difficulties experienced.

Methods

We conducted a qualitative study of seven Japanese nurses working in primary care. Data collection was performed before, during, and after a workshop based on the Tojisha‐Kenkyu (user‐led research) framework to explore how the COVID‐19 disaster affected the nurses and how they coped. Data were analyzed using inductive thematic analysis.

Results

Three themes emerged from the analysis: effects of the COVID‐19 disaster on nurses, nurses' newly found strength during the pandemic, and their changes and achievements through the Tojisha‐Kenkyu framework. The first theme comprised four subthemes: fear of the unknown; difficulty in adaptation; dysfunction in patient care; and defilement and oppression. The second theme involved feeling in control and professionalism. The third theme, which was based on participants' discovery of “same and different” fellowships, showed work reconstruction and self‐understanding, which alleviated their difficulties.

Conclusions

The effect of the pandemic on nurses working in primary care ranges from work‐related frustration to daily life issues. The Tojisha‐Kenkyu method can help nurses to alleviate difficulties. Further research should be conducted to elucidate the constant burden on primary care professionals and establish appropriate occupational and daily life support during pandemics.

Global Healthcare Needs Related to COVID-19: An Evidence Map of the First Year of the Pandemic

The COVID-19 pandemic has exposed gaps and areas of need in health systems worldwide. This work aims to map the evidence on COVID-19-related healthcare needs of adult patients, their family members, and the professionals involved in their care during the first year of the pandemic. We searched the databases MEDLINE, Embase, and Web of Science. Two reviewers independently screened titles and abstracts and assessed full texts for eligibility. Disagreements were resolved by consensus. Descriptive data were extracted and inductive qualitative content analysis was used to generate codes and derive overarching themes. Thirty-six studies met inclusion criteria, with the majority reporting needs from the perspective of professionals (35/36). Professionals' needs were grouped into three main clusters (basic, occupational, and psycho-socio-emotional needs); patients' needs into four (basic, healthcare, psycho-socio-emotional, and other support needs); and family members' needs into two (psycho-socio-emotional and communication needs). Transversal needs across subgroups were also identified and grouped into three main clusters (public safety, information and communication, and coordination and support needs). This evidence map provides valuable insight on COVID-19-related healthcare needs. More research is needed to assess first-person perspectives of patients and their families, examine whether needs differ by country or region, and evaluate how needs have evolved over time.

A Topic Modeling Analysis of the Crisis Response Stage during the COVID-19 Pandemic

The core of disaster management is the ability to respond spontaneously and rapidly to unexpected situations and also to apply planned and adaptable responses that follow manuals and guidelines. This study aimed to observe the changes in information during the COVID-19 pandemic period by collecting and analyzing information announced on a hospital intranet by an infection control team. This study performed text mining of large amounts of data to investigate notices about in-hospital strategies towards COVID-19 to identify changes in the coping strategies during the pandemic. Notices announced within the infection control rooms of 12 university hospitals in South Korea from 1 January to 31 August 2020 were searched. Four representative topics were identified based on the stepwise keywords shown in the topic modeling analysis: (1) “Understanding the new infectious disease”, (2) “Preparation of a patient care and management system”, (3) “Prevention of spread and securing employee safety” and (4) “Improvement of the management system according to the revision of guidelines”. Countries where an infectious disease emerges should provide accurate information on the disease and guidelines to determine how to respond. Medical institutions must revise and complement them while considering their specific circumstances. To efficiently respond to an infectious disease crisis, governments and medical institutions must cooperate closely, and implementing a systematic response is crucial.

A cross sectional study of nurses' perceptions of nurse leaders' internal crisis communication during the COVID-19 pandemic

Aim

The aim of this study is to describe nurse perceptions of nurse leaders' internal crisis communication during the COVID‐19 pandemic.

Background

Internal communication is a vital part of nurse leaders' work, even more so during crises such as the COVID‐19 pandemic.

Method

This is a cross‐sectional study design. The data were collected from 204 Finnish nurses in February 2021. A questionnaire developed in this study consisted of 29 items measuring internal crisis communication and seven demographic variables. The relationships between the variables were examined with cross‐tabulation, a chi‐squared test and non‐parametric tests. Factor structure was evaluated with exploratory factor analysis and reliability with Cronbach's alpha.

Results

Nurses perceived the timeliness of communication highest and interaction the lowest. Nurses from intensive care, acute care and operative rooms gave highest evaluations for the content of communication and timeliness. Nurses working with COVID‐19 patients daily or weekly evaluated the highest level of false communication.

Conclusion

Nurse leaders' internal crisis communication was timely, especially in the most critical units dealing with the pandemic. The study highlighted the importance of considering a unit's special needs for internal crisis communication. Interaction between nurse leaders and nursing staff during periods of crisis needs improvement.

Implications for Nursing Management

Nurse leaders' successful and emphatic communication is important in supporting nurses in managing a crisis.

The Communication Challenges and Strength of Nurses' Intensive Corona Care during the Two First Pandemic Waves: A Qualitative Descriptive Phenomenology Study

Intensive care nurses working with patients with severe COVID-19 illness are at the center and frontline of the dynamic pandemic, which poses communication challenges and demands of unusual strength on their part. The study aim was to capture the lived experience of intensive care COVID nurses' communication challenges and strengths as they cared for COVID-19 intensive care patients during the two first pandemic waves. The study used qualitative descriptive-phenomenology research designs. Twenty-two nurses were selected using snowball sampling, and online interviews were conducted with them. Data were recorded and transcribed, then reflexively double-coded for increased rigor. Four major themes emerged from the data. The first two expressed the communication challenges and difficulties communicating with patients due to the extreme protection needed and/or their medical condition. However, the other two themes expressed the nurses' strengths-sharing feelings with other caregivers and family. Accordingly, we recommend using simple language and ensuring patient comprehension, as well as creating an optimistic environment for fostering caregiver bonding.

Nurse experience during the COVID-19 pandemic: Implications for nurse leaders

Results of a two-question survey of nurses at one hospital identified 5 clear themes related to nurses' experiences during the pandemic and 7 areas for improvement, providing potential strategies for nurse leaders.

The effects of the COVID-19 pandemic on healthcare workers' psychological and mental health: The moderating role of felt obligation

BACKGROUND

The ravages of COVID-19 have created a worldwide emergency in healthcare units. Under these circumstances, the perception of an infection threat is primarily affecting the employees' performance in reducing contagion effects.

OBJECTIVE

The purpose of this study is to develop substantial measures of support for healthcare employees to maintain adequacy in job performance.

METHODS

Data were collected from state-owned hospitals in Pakistan to test the current study's proposed model. We applied structural equation modeling through a partial least square regression in addition to the blindfolding approach in Smart-PLS. Confirmatory factor analysis was also employed to measure the study's validity.

RESULTS

The current study's findings show that the perception of a threat from COVID-19 and the inadequate protective measures have influenced frontline healthcare workers' performance levels. The mediating path of depression symptoms indicated the threat of COVID-19 and the absence of protective measures as potential determinants of poor performance. However, an employee's ability to feel obligated toward their job duties reduces the effect of depression on employee performance.

CONCLUSION

The current model highlights an individual's feelings of obligation to maintain their performance level by minimizing the effect of depression and professional anxiety. The present study extensively described the psychological constraints healthcare workers are facing during the current pandemic. Current research addressing healthcare employees' mental health is vital for better prevention and control during pandemic circumstances. The current study's findings extend the emerging understanding of employee psychology in such circumstances.

Perceived corporate social responsibility and innovative work behaviour: the role of passion at work

Purpose

Perceived corporate social responsibility (CSR) reflects personal views towards CSR activities that impact emotion, attitude and behaviour. This paper aims to investigate how perceived CSR predicts innovative work behaviour (IWB).

Design/methodology/approach

This study used a survey questionnaire to collect data from Gen Y 508 nurses working in the United Arab Emirates health-care sector. This study used a structural equation model to examine the study’s hypotheses.

Findings

Perceived CSR was found positively and significantly related to employees’ passion at work (PAW). This study also found that PAW positively and significantly mediates the relationship between perceived CSR and IWB in the organisation.

Research limitations/implications

This study’s main limitation is that it used only quantitative methodology to examine the hypotheses. Thus, this study suggests mixed-method investigations in future research.

Practical implications

This study suggests that organisations should significantly engage in CSR-related activities, as it increases employees’ PAW and cause IWB to be in full swing. Passionate Gen Y nurses will improve the quality of patient care services with productive, IWB.

Originality/value

The study’s findings give an insight into how Gen Y nurses’ perceptions of CSR would affect their attitudinal and emotional variables. This study contributes to the knowledge domain of IWB in the organisation. Passionate Gen Y nurses will add value to the health-care system by implementing IWB.

Health care workers' experiences during the COVID-19 pandemic: a scoping review

BACKGROUND

COVID-19 has challenged health systems worldwide, especially the health workforce, a pillar crucial for health systems resilience. Therefore, strengthening health system resilience can be informed by analyzing health care workers' (HCWs) experiences and needs during pandemics. This review synthesizes qualitative studies published during the first year of the COVID-19 pandemic to identify factors affecting HCWs' experiences and their support needs during the pandemic. This review was conducted using the Joanna Briggs Institute methodology for scoping reviews. A systematic search on PubMed was applied using controlled vocabularies. Only original studies presenting primary qualitative data were included.

RESULTS

161 papers that were published from the beginning of COVID-19 pandemic up until 28th March 2021 were included in the review. Findings were presented using the socio-ecological model as an analytical framework. At the individual level, the impact of the pandemic manifested on HCWs' well-being, daily routine, professional and personal identity. At the interpersonal level, HCWs' personal and professional relationships were identified as crucial. At the institutional level, decision-making processes, organizational aspects and availability of support emerged as important factors affecting HCWs' experiences. At community level, community morale, norms, and public knowledge were of importance. Finally, at policy level, governmental support and response measures shaped HCWs' experiences. The review identified a lack of studies which investigate other HCWs than doctors and nurses, HCWs in non-hospital settings, and HCWs in low- and lower middle income countries.

DISCUSSION

This review shows that the COVID-19 pandemic has challenged HCWs, with multiple contextual factors impacting their experiences and needs. To better understand HCWs' experiences, comparative investigations are needed which analyze differences across as well as within countries, including differences at institutional, community, interpersonal and individual levels. Similarly, interventions aimed at supporting HCWs prior to, during and after pandemics need to consider HCWs' circumstances.

CONCLUSIONS

Following a context-sensitive approach to empowering HCWs that accounts for the multitude of aspects which influence their experiences could contribute to building a sustainable health workforce and strengthening health systems for future pandemics.

What can general practice learn from primary care nurses' and healthcare assistants' experiences of the COVID-19 pandemic? A qualitative study

OBJECTIVES

UK general practice has radically altered in response to COVID-19. The general practice nursing team has been central to these changes. To help learn from COVID-19 and maintain a sustainable nursing workforce, general practice should reflect on their support needs and perceptions of organisational strategies. This study aimed to explore primary care nurses' and healthcare assistants' experiences and perceptions of general practice, and the changes made to it, during the pandemic.

DESIGN

Exploratory qualitative study using semistructured interviews. Interview data were analysed using Braun and Clarke's 'codebook' thematic analysis.

SETTING

General practices in the Midlands, South East and South West England. Interviews were conducted in February and March 2021, as England began to unlock from its third national lockdown.

PARTICIPANTS

Practice nurses (n=12), healthcare assistants (n=7), advanced nurse practitioners (n=4) and nursing associates (n=1) recruited using convenience and snowball sampling.

RESULTS

Three themes were identified. Difficult changes describes dramatic changes made to general practice at the onset of the pandemic, creating confusion and anxiety. Dealing with change characterises how negative emotions were intensified by fear of infection, problematic government guidance, personal protective equipment (PPE) shortages and friction with doctors; but could be mitigated through effective practice communication, peer support and individual coping strategies. An opportunity for improvement highlights certain changes (eg, the increased use of telehealth) that participants believed could be adopted long term to improve efficiency.

CONCLUSION

General practice should learn from the COVID-19 pandemic to nurture the clinical role and resilience of nurses and healthcare assistants in the postpandemic 'new normal'. Robust PPE provision could enable them to undertake their patient-facing duties safely and confidently. Judicious implementation of telehealth could help preserve the practical and caring nature of nursing. Improving channels of communication and interprofessional collaboration could help realise their potential within the primary care team.

[Experience of Nurses in Charge of COVID-19 Screening at General Hospitals in Korea]

PURPOSE

The purpose of this study was to understand and describe the experiences of nurses in charge of COVID-19 screening at general hospitals in South Korea.

METHODS

Data were collected through individual in-depth interviews with 14 nurses who had been working for more than a month at a screening clinic operated by two general hospitals from May 11 to July 20, 2021. Verbatim transcripts were analyzed using Colaizzi's phenomenological analysis.

RESULTS

As a result of analysis, four theme clusters were extracted from nurses' experiences, as follow: the role of the hospital gatekeeper entrusted with managing the COVID-19 pandemic, struggling to maintain the protective barrier, boundlessness like a Mobius strip, and driving force to endure as a nurse in charge of COVID-19 screening.

CONCLUSION

The results of this study provide a deeper understanding of the lives of screening clinic nurses who are struggling with the COVID-19 situation. The results are expected to be useful in providing basic data for improving the infection control system and response strategies that can be applied to nursing practice in other pandemic situations.

Nurses' use of social media during the COVID-19 pandemic-A scoping review

BACKGROUND

During the COVID-19 pandemic, nurses stand in an unknown situation while facing continuous news feeds. Social media is a ubiquitous tool to gain and share reliable knowledge and experiences regarding COVID-19. The article aims to explore how nurses use social media in relation to the COVID-19 pandemic.

METHOD

A scoping review inspired by Arksey and O'Mally was conducted by searches in Medline, CINAHL, Academic Search Complete and Web of Sciences. Empirical research studies investigating nurses' use of social media in relation to COVID-19 were included. Exclusion criteria were: Literature reviews, articles in languages other than English, articles about E-health, and articles investigating healthcare professionals without specification of nurses included. Articles, published in January-November 2020, were included and analysed through a thematic analysis. The PRISMA-ScR checklist was used.

RESULTS

Most of the eleven included studies were cross-sectional surveys, conducted in developing countries, and had neither social media nor nurses as their main focus of interest. Three themes were identified: 'Social media as a knowledge node', 'Social media functioned as profession-promoting channels' and 'Social media as a disciplinary tool'. Nurses used social media as channels to gain and share information about COVID-19, and to support each other by highlighting the need for training and changes in delivery of care and redeployment. Further, social media functioned as profession-promoting channels partly sharing heroic self-representations and acknowledgment of frontline persons in the pandemic, partly by displaying critical working conditions. Finally, nurses used social media to educate people to perform the 'right 'COVID-19' behaviours in society.

CONCLUSION

This review provided snapshots of nurses' uses of social media from various regions in the world, but revealed a need for studies from further countries and continents. The study calls for further multi-methodological and in depth qualitative research, including theoretically framed studies, with a specific focus on the uses of social media among nurses during the pandemic.

The context, contribution and consequences of addressing the COVID-19 pandemic: A qualitative exploration of executive nurses' perspectives

AIMS

To explore (1) the context in which nursing executives were working, (2) nursing's contribution to the healthcare response and (3) the impact from delivering healthcare in response to the pandemic.

DESIGN

Retrospective, constructivist qualitative study.

METHODS

Individual interviews using a semi-structured interview guide were conducted between 12 February and 29 March 2021. Participants were purposively sampled from the Victorian Metropolitan Executive Directors of Nursing and Midwifery Group, based in Melbourne, Victoria the epi-centre of COVID-19 in Australia during 2020. All members were invited; 14/16 executive-level nurse leaders were participated. Individual interviews were recorded with participant consent, transcribed and analysed using thematic analysis.

RESULTS

Four inter-related themes (with sub-themes) were identified: (1) rapid, relentless action required (preparation insufficient, extensive information and communication flow, expanded working relationships, constant change, organizational barriers removed); (2) multi-faceted contribution (leadership activities, flexible work approach, knowledge development and dissemination, new models of care, workforce numbers); (3) unintended consequences (negative experiences, mix of emotions, difficult conditions, negative outcomes for executives and workforce) and (4) silver linings (expanded ways of working, new opportunities, strengthened clinical practice, deepened working relationships).

CONCLUSION

Responding to the COIVD-19 health crisis required substantial effort, but historical and industrial limits on nursing practice were removed. With minimal information and constantly changing circumstances, nursing executives spearheaded change with leadership skills including a flexible approach, courageous decision-making and taking calculated risks. Opportunities for innovative work practices were taken, with nursing leading policy development and delivery of care models in new and established healthcare settings, supporting patient and staff safety.

IMPACT

Nursing comprises the majority of the healthcare workforce, placing executive nurse leaders in a key role for healthcare responses to the COVID-19 pandemic. Nursing's contribution was multi-faceted, and advantages gained for nursing practice must be maintained and leveraged. Recommendations for how nursing can contribute to current and future widespread health emergencies are provided.

Repercussions of the COVID-19 pandemic on health professionals in the state of Rio de Janeiro / Brazil

Brazil has been severely affected by the COVID-19 pandemic. The high numbers of confirmed cases and deaths have continued unabated since the first reported case, with no flattening or downward turn in the curve. In this context, healthcare workers have been exposed uninterruptedly to stress factors throughout a year of the pandemic. The study´s aim was to identify and analyze healthcare workers´ perceptions of their feelings and concerns that have surfaced in responding to the pandemic. Method: This was a cross-sectional online qualitative survey study of 554 healthcare personnel working in the state of Rio de Janeiro during the COVID-19 pandemic. Recruitment occurred from July 20 to September 30, 2020, using an online survey, preceded byfree informed consent term. Data were analyzed with the Iramuteq software. Results: Through a dendrogram, the words with the highest chi-square were highlighted and grouped into four classes: healthcare workers´ fear of falling ill to COVID-19 and infecting their family members; work/labor issues; feelings of powerlessness and need for public policies for government action; and fatigue and burnout in the pandemic. Each word class was also illustrated by a similarity tree. Conclusion: The study revealed healthcare workers´ exacerbated fear of infection and transmission of COVID-19 to their family members, besides financial losses and feelings of powerlessness and abandonment.

Work-based concerns of Australian frontline healthcare workers during the first wave of the COVID-19 pandemic

OBJECTIVE

This research sought to gauge the extent to which doctors, nurses and paramedics in Australia were concerned about contracting SARS-CoV-2 during the country's first wave of the virus in April 2020.

METHODS

Australian registered doctors, nurses and paramedics (n=580) completed an online questionnaire during April 16-30, 2020 (period immediately following the highest four-week period (first wave) of SARS-CoV-2 confirmed cases in Australia).

RESULTS

During April 2020, two-thirds of participants felt it was likely they would contract SARS-CoV-2 at work. Half the participants suggested Personal Protective Equipment (PPE) supplies were inadequate for them to safely perform their job, with two-thirds suggesting management advised them to alter normal PPE use. One-third of participants suggested they were dissatisfied with their employer's communication of COVID-19 related information. Conclusions and implications for public health: After reports of PPE shortages during Australia's first SARS-CoV-2 wave, and suggestions access to PPE was still limited during Australia's second wave five months later, we must forecast for this and future pandemics ensuring adequate access to PPE for frontline healthcare workers. Further, ensuring consistent and standardised pathways for communication to staff (acknowledging the reality that information may rapidly change) will help alleviate frustration and anxiety.

Qualitative exploration of nurses' experiences of the COVID-19 pandemic using the Reconceptualized Uncertainty in Illness Theory: An interpretive descriptive study

AIMS

To explore nurses' personal, social and professional experiences in COVID-19 emergency departments and intensive care units based on the Reconceptualized Uncertainty in Illness Theory.

DESIGN

This study used an interpretive qualitative descriptive design.

METHODS

Open-ended interviews were conducted between August and November 2020 with 21 nurses using interview questions based on the Reconceptualized Uncertainty in Illness Theory. Data were analysed using steps informed by hermeneutic phenomenology and reported using Consolidated Criteria for Reporting Qualitative Research.

FINDINGS

Data were grouped under five categories with 10 themes based on the Reconceptualized Uncertainty in Illness Theory: 'antecedents of uncertainty', 'appraisal of uncertainty', 'coping with uncertainty', 'probabilistic thinking' and 'formation of a new life perspective'. Nurses reported that they experienced uncertainty about being infected and infecting others with COVID-19 as well as caring for COVID-19 patients. Despite the uncertainties related to COVID-19, nurses were determined to focus on caring for COVID-19 patients by prioritizing their professional identity and responsibilities. They described feeling motivated by patients' positive feedback, which also increased their professional satisfaction. They realized that caring was therapeutic not only for their patients, but also for them. They experienced empowerment in the care team through active reuse of their prior knowledge and experience and expanded decision-making roles. They also emphasized that they perceived the COVID-19 pandemic as a unique experience for their individual and professional growth.

CONCLUSION

Nurses experienced multiple sources of uncertainty during the COVID-19 pandemic. To manage uncertainty, they used strategies including focusing on patient care and satisfaction. Additionally, they made sense of their experience by acknowledging individual and professional growth.

IMPACT

This study has a potential impact to support healthcare policymakers to meet the needs of nurses in possible future pandemics.

Integrating Key Nursing Measures into a Comprehensive Healthcare Performance Management System: A Tuscan Experience

This paper addresses the evaluation of nursing quality and safety beyond nursing tasks in specific healthcare settings and sets it in a context that conveys the sense of complexity and multifaceted nature of the contribution that nursing makes to the whole system. The paper describes research conducted in Tuscany during 2019 involving regional managers and heads of nursing departments. This research has led to the development of an integrated evaluation framework through focus groups and consensus process with the latter, which includes Performance Organizational climate data, Patient-Reported Experience Measures (PREMs), and Patient-Reported Outcome Measures (PROMs). This integrated framework aims at both making sense of extant measures as key performance indicators shared among different professionals while recognizing the important role of nursing care by adding specific measures and can be seen as a tool that boosts the sense of “teamness” in healthcare.

[Collaborative Disaster Governance Recognized by Nurses during a Pandemic]

PURPOSE

We aimed to identify collaborative disaster governance through the demand and supply analysis of resources recognized by nurses during the COVID-19 pandemic.

METHODS

We used a descriptive study design with an online survey technique for data collection. The survey questions were developed based on focus group interviews with nurses responding to COVID-19 and expert validity testing. A 42-question online survey focusing on disaster governance was sent to nurses working in COVID-19 designated hospitals, public health offices, and schools. A total of 630 nurses participated in the survey. Demand and supply analysis was used to identify the specific components of disaster governance during a pandemic situation and analyze priority areas in disaster governance, as reported by nurses.

RESULTS

Demand and supply analysis showed that supplies procurement, cooperation, education, and environment factors clustered in the high demand and supply quadrant while labor condition, advocacy, emotional support, and workload adjustment factors clustered in the high demand but low supply quadrant, indicating a strong need in those areas of disaster governance among nurses. The nurses practicing at the public health offices and schools showed major components of disaster governance plotted in the second quadrant, indicating weak collaborative disaster governance.

CONCLUSION

These findings show that there is an unbalanced distribution among nurses, resulting in major challenges in collaborative disaster governance during COVID-19. In the future and current pandemic, collaborative disaster governance, through improved distribution, will be useful for helping nurses to access more required resources and achieve effective pandemic response.

Mental health, safety and support during COVID-19: A cross-sectional study of primary health care nurses

AIM

The aim of this study is to explore primary health care nurses' mental health, concerns and perceived safety and supports during COVID-19.

BACKGROUND

Respiratory pandemics have negative impacts on nurses' wellbeing. While literature is replete with hospital nurses' experiences, there is less exploration of COVID-19 impacts on primary health care nurses. Given the importance of primary health care nurses in the health system, understanding their experiences is vital.

METHODS

Three hundred and fifty nine primary health care nurses responded to an online cross-sectional survey. The Depression Anxiety Stress Scales (DASS-21) was used to measure emotional state. Data were analysed using descriptive and inferential statistics.

RESULTS

DASS-21 scores indicated that 39.6% of participants were experiencing symptoms of depression, anxiety or stress. Of those, 41.8% were experiencing symptoms on one scale, 26.9% were experiencing symptoms on two scales and 31.2% were experiencing symptoms across all three scales. Most participants identified that their feelings were related to COVID-19.

CONCLUSIONS

COVID-19 is having a significant impact on primary health care nurses' mental health. Nurse managers need to develop strategies to effectively address nurses' concerns and effectively support them to sustain the workforce during and after the pandemic.

IMPLICATIONS FOR NURSING MANAGEMENT

Findings from this study can inform the design of effective nurse support programmes to reduce mental health impacts and promote staff wellbeing during the pandemic.

[How are key resources and key demands associated with nurses' work engagement during the COVID-19 pandemic? A cross-sectional study]

INTRODUCTION

Nurses are assigned a key role in pandemic response, with work engagement considered to be pivotal. The job demands-resources theory assumes that work engagement depends on job resources and job demands. Key job resources and demands have already been proposed for nurses. However, there is no evidence on their importance under pandemic conditions. Hence, the aim of this study was to investigate their relevance to nurses' work engagement during the second wave of the COVID-19 pandemic.

METHODS

The study was carried out in a cross-sectional design and addressed nurses in direct health care settings in Germany. Data was collected administering a quantitative online survey using valid and reliable measures during the second wave of the pandemic. A convenience sample was obtained, including the use of social media, randomly selected health care facilities, and all universities with nursing-related programs in Germany. The dataset for analyses comprised a total of 1,027 cases. The sample included nurses of various educational levels and from different sectors. Multiple linear regression analysis after multiple imputation was used to examine the relevance of key resources and demands for work engagement.

RESULTS

Key resources and demands explained 36% of the variance in nurses' work engagement during the COVID-19 pandemic. Positive associations were found between the key resources of autonomy (β¯_SP=0.072, 95% CI [0.011; 0.133]), professional resources (β¯_SP=0.204, 95% CI [0.124; 0.285]), and interpersonal relationships (β¯_SP=0.178, 95% CI [0.117; 0.240]) and nurses' work engagement. On the demands side, lack of formal rewards negatively (β¯_SP=-0.312, 95% CI [-0.380; -0.245]) affected work engagement, whereas work overload (β¯_SP=0.063, 95% CI [0.001; 0.126]) was positively associated with work engagement.

DISCUSSION

The job demands-resources theory is suitable for explaining nurses' work engagement even in times of crisis. Taken together, key resources and demands have a significant influence on nurses' work engagement under pandemic conditions. However, not all so-called key resources and demands actually have a key status in a pandemic.

CONCLUSION

Any lack of formal rewards should be countered, professional resources should be sustainably secured, and the autonomy of nurses and their interpersonal relationships should be strengthened. Nursing management decisions should be made not only with the current pandemic but also the post-pandemic period in mind.

Insecure Employment Contracts during the COVID-19 Pandemic and the Need for Participation in Policy Making

Job security influences the ability of nurses to provide high-quality nursing care. The Iranian health system has always faced nursing shortages, and the COVID-19 pandemic has worsened this situation. Although nurses have been labelled 'heroes' across the globe, many of them have been hired using insecure employment contracts. This commentary aims to describe issues surrounding job contracts for Iranian nurses during the COVID-19 pandemic and discusses how the current situation can be improved. Iranian nurses are at the frontline of the fight against COVID-19 and need to receive better support in terms of job security and dignity. They should participate more in policymaking activities to improve their job condition and prevent the development and implementation of the short-term and insecure job contracts that lead to job insecurity.

Workplace Health Promotion and COVID-19 Support Measures in Outpatient Care Services in Germany: A Quantitative Study

Working conditions in the care sector, especially under the increased strain during COVID-19, make it difficult for outpatient caregivers to adhere to health-promoting behaviours. Research on workplace health promotion (WHP) and COVID-19 support measures in outpatient care services is limited. The aim of this pilot study was to characterise the current situation of WHP and COVID-19 support measures in outpatient care services and to explore how to offer WHP support measures targeted for a specific group. A web-based cross-sectional survey was conducted with outpatient caregivers (N = 171) in northern Germany. The results showed that 60.2% of the study participants were offered WHP support measures, with significantly higher work engagement when WHP support measures were available (Z = 4279.50, p < 0.01) and that 77.2% received specific support from their employer during the COVID-19 pandemic. Although spending a break in a break room was significantly associated with longer breaks as compared with being in a car (Z = 39.10, padj. = 0.01), a break room was neither available in all outpatient care services, nor did it appear to be feasible. Overall, WHP in outpatient care services is insufficiently covered. In order to be able to offer WHP support measures that are targeted to outpatient caregivers, cooperation among local care services, feasibility, and digital measures should be examined.

Psychosocial experiences of frontline nurses working in hospital-based settings during the COVID-19 pandemic - A qualitative systematic review

BACKGROUND

Frontline nurses have been directly exposed to the SARS-CoV-2 virus and come in close contact with patients during the COVID-19 pandemic. Nurses execute tasks related to disease control and face multiple psychosocial challenges in their frontline work, potentially affecting their mental well-being and ability to satisfyingly perform their tasks.

OBJECTIVES

To explore the psychosocial experiences of frontline nurses working in hospital-based settings during the COVID-19 pandemic.

DESIGN

The qualitative systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Registered in PROSPERO (CRD42021259111).

DATA SOURCES

Literature searches were performed through PubMed, CINAHL, and the WHO COVID-19 database. Inclusion criteria were: All types of nurses having direct contact with or taking care of patients; Primary, secondary, and tertiary health-care services admitting and treating COVID-19 patients; Experiences, perceptions, feelings, views in psychosocial aspects from the identified population group; Qualitative studies; Mixed methods studies; Language in English; Published date 2019-2021. Exclusion criteria were: Commentaries; Reviews; Discussion papers; Quantitative studies; Language other than English; Published in 2018 or earlier; Studies without an ethical approval and ethical statement.

REVIEW METHODS

The studies were screened and selected based on the inclusion and exclusion criteria. Quality appraisal was conducted according to the Critical Appraisal Skills Program qualitative study checklist. Data was extracted from included studies and a thematic synthesis was made.

RESULTS

A total of 28 studies were included in the review. The experiences of 1141 nurses from 12 countries were synthesised. Three themes were constructed: 'Nurses' emotional, mental and physical reactions to COVID-19', 'Internally and externally supported coping strategies', and 'A call for future help and support'.

CONCLUSION

Nurses working frontline during the COVID-19 pandemic have experienced psychological, social, and emotional distress in coping with work demands, social relationships, and their personal life. The results pointed to a need for increased psychological and social support for frontline nurses to cope with stress and maintain mental well-being, which may subsequently affect nursing care outcomes.

Experiences of Home Care Nurses During the COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic has provoked several changes in home care. Understanding home care nurses' experiences during the COVID-19 pandemic plays an essential role in home care management.

OBJECTIVE

This study aimed to explore and articulate the experience of home care nurses during the COVID-19 pandemic in Spain.

DESIGN

A qualitative study using hermeneutic phenomenology was carried out. Twenty home care nurses were interviewed by teleconference between January to March 2021. Interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative data analysis software.

RESULTS

Three main themes with five subthemes emerged from the data analysis: (a) "The effect of COVID-19 pandemic on home care," with the subtheme "the reorganization of home care nurses' competencies"; (b) "The role of telehealth in home care," which included the subthemes "home care nurses' satisfaction with telehealth" and "barriers to implement telehealth in home care"; and (c) "Effects of the pandemic on home care nurses' lives," including the subthemes "working in a pandemic is emotionally draining" and "the continuing fear of infecting others."

DISCUSSION

The findings from this study demonstrate the profound effect that home care has suffered from the COVID-19 pandemic. Home care nurses' competencies were modified to care for and diagnose COVID-19 patients. Face-to-face home care was replaced by telehealth. All home care nurses suffered physical and psychological symptoms and the fear of infecting others.

The impact of COVID-19 on primary health care delivery in Australia

AIMS

To validate the 'safe and effective staffing tool' and explore the impact of COVID-19 on the quality of Australian primary health care (PHC).

DESIGN

A national survey was conducted from October to December 2020.

METHODS

The online survey was distributed via social media and professional organisations to PHC nurses.

RESULTS

Three-hundred fifty-nine PHC nurses participated. A two-factor solution was found with factors named; 'Perception of quality of care provided' and 'Personal satisfaction with care delivered'. Cronbach's alpha demonstrated good internal consistency for the total scale (α = .915) and each subscale (α = .879/α = .864). Nearly three-quarters of participants (71.3%) were satisfied with the quality of care they delivered. Participants working in general practice, and those with more nursing experience had significantly higher scores in the factor 'perceptions of quality of care provided' and the total 'quality and satisfaction with care'. A lack of time, inadequate supervision and support, and performing non-nursing duties were reported to be impacting care quality. Most participants (80.5%) reported that COVID-19 had impacted negatively on the detection and management of non-COVID related health conditions.

CONCLUSION

The 'safe and effective staffing tool' is a valid and reliable measure of perceived quality of care and satisfaction with care delivered. Many PHC nurses perceive that there has been an overall reduction in the quality of care delivered due to COVID-19 and feel that there is a lack of adequate supervision and workplace support. Given the limited baseline data, further research is required to understand the extent that COVID-19 impacts these findings. However, this study demonstrates that strategies need to be implemented to support PHC nurses to provide high-quality care to optimise health outcomes and maintain nurse satisfaction.

IMPACT

This is the first attempt to evaluate care quality in Australian PHC. Policymaking requires this evidence to drive changes to better support PHC nurses.

Voices from the COVID-19 frontline: Nurses' trauma and coping

AIM

To describe the experiences of frontline nurses who are working in critical care areas during the COVID-19 pandemic with a focus on trauma and the use of substances as a coping mechanism.

DESIGN

A qualitative study based on content analysis.

METHODS

Data were collected from mid-June 2020 to early September 2020 via an online survey. Nurses were recruited through the research webpage of the American Association of Critical Care Nurses as well as an alumni list from a large, public Midwest university. Responses to two open-ended items were analysed: (1) personal or professional trauma the nurse had experienced; and (2) substance or alcohol use, or other mental health issues the nurse had experienced or witnessed in other nurses.

RESULTS

For the item related to psychological trauma five themes were identified from 70 nurses' comments: (1) Psychological distress in multiple forms; (2) Tsunami of death; (3) Torn between two masters; (4) Betrayal; and (5) Resiliency/posttraumatic growth through self and others. Sixty-five nurses responded to the second item related to substance use and other mental health issues. Data supported three themes: (1) Mental health crisis NOW!!: 'more stressed than ever and stretched thinner than ever'; (2) Nurses are turning to a variety of substances to cope; and (3) Weakened supports for coping and increased maladaptive coping due to ongoing pandemic.

CONCLUSIONS

This study brings novel findings to understand the experiences of nurses who care for patients with COVID-19, including trauma experienced during disasters, the use of substances to cope and the weakening of existing support systems. Findings also reveal nurses in crisis who are in need of mental health services.

IMPACT

Support for nurses' well-being and mental health should include current and ongoing services offered by the organization and include screening for substance use issues.