A hermeneutic literature review to conceptualise altruism as a value in nursing

Risk of burnout, psychological growth, longevity of career and making sense of Covid-19 in senior Australian radiation oncologists

INTRODUCTION

Senior radiation oncologists in hospital/organisational settings, are repetitively and vicariously exposed to others' traumatic distress-perpetuating risk of burnout. Little is known of the additional organisational burdens of the Covid-19 pandemic on their mental well-being for career longevity.

METHODS

Using Interpretative Phenomenological Analysis, semi-structured interviews provided positive and negative subjective interpreted data from five senior Australian radiation oncologists during Covid-19 lockdowns.

RESULTS

One superordinate theme, Vicarious risk, hierarchical invalidation, redefining altruistic authenticity, overarched four subordinate themes: (1) Vicarious contamination of caring, (2) The hierarchical squeeze, (3) The heavy burden of me and (4) Growth of authenticity. For these participants, juxtaposed challenges to career longevity and mental well-being were 'self' as empathic carer to vulnerable patients, and ever-increasing burdens of the organisation. Sensing invalidation, they experienced periods of exhaustion and disengagement. However, with experience and seniority, self-care was prioritised and nurtured through intrapersonal honesty, altruism and relational connectedness with patients and mentoring forward junior colleagues. Focusing on mutual well-being, a sense of life beyond radiation oncology became acceptable.

CONCLUSIONS

For these participants, self-care became a relational joining with their patients separate from the lack of systemic support which heralded an early termination to their career for psychological well-being and authenticity.

A Moderated Mediation Model of the Influence of Cynical Distrust, Medical Mistrust, and Anger on Vaccination Hesitancy in Nursing Staff

During the pandemic, nurses experienced anger that stemmed from a sense of threat, frustration, or even a sense of injustice. The purpose of this study was to examine the relationship between vaccination hesitancy, anger, cynicism, and medical mistrust among nurses, as there are no relevant studies in the literature. This study was conducted online by completing self-report questionnaires. The Dimensions of Anger Reactions-5, the 8-item "Cynical Distrust" scale, and the Medical Mistrust Multiformat Scale were used. For vaccination hesitancy, two questions with a 5-point scale were used: one question examining hesitancy to get vaccinated with the COVID-19 vaccine, and another question examining hesitancy to get vaccinated with the influenza vaccine. In total, 387 nurses (66 men and 321 women) participated in this study. Nurses showed statistically greater hesitancy toward the COVID-19 vaccine compared to hesitancy toward the influenza vaccine. The variation in vaccine hesitancy was explained by the scores in the Medical Mistrust Multiformat Scale, the Dimensions of Anger Reactions, and the Cynical Distrust Scale. The Medical Mistrust Multiformat Scale mediated the relationship between the Cynical Distrust Scale and total vaccine hesitancy. The Dimensions of Anger Reactions Scale significantly moderated the indirect effect of the Cynical Distrust Scale on total vaccine hesitancy through the Medical Mistrust Multiformat Scale. In conclusion, it is highly likely that anger is involved in reported vaccine hesitancy both by activating schemas of distrust in others and by adopting anti-systemic views of mistrust in the medical system.

Compassionate Nursing Care for COVID-19 Patients in the ICU in the Western Region of Saudi Arabia: A Lived Experience Study

INTRODUCTION

The rapid spread and the severity of symptoms of COVID-19 led to an increasing number of critical cases that need to be admitted to intensive care units (ICUs) worldwide. Compassion is a principle of nursing practice and indicates the meaning of providing high-quality care in all units, especially in the ICU. It means that nurses know what is important to patients and when they should be there for them when it is needed. There is a paucity of literature from Saudi Arabia that explores how critical care nurses perceive compassionate care during COVID-19.

OBJECTIVES

The aim of this study was to investigate the lived experiences of critical care nurses providing compassionate care to COVID-19 patients at King Abdulaziz Medical City, Jeddah, Saudi Arabia.

METHODS

A prospective, cross-sectional, descriptive phenomenological approach was utilized in this study. Data were collected from 13 ICU nurses through interviews. Collected data were transcribed and analyzed using Colaizzi's data analysis method.

RESULTS

 Eleven out of the 13 ICU nurses hold a Bachelor of Science in Nursing (BSN) and have more than five years of experience. Despite all the challenges surrounding the care for critically ill COVID-19 patients, nurses provide compassion in different ways to show personal interest to the patients. Data analysis revealed five themes: (1) contemporary meaning and competencies for compassionate nursing care, including communication and the inability to freely use touch; (2) physical symptoms, including discomfort, body aches and headaches, and sleep disturbances; (3) emotional turmoil, where three sub-themes emerged, including fear and anxiety, uncertainty, and isolation and loneliness; (4) role changing, including frequent guidelines change, additional roles and responsibilities, and altruism; (5) professionalism, including cultural facets of care, teamwork, and support.

DISCUSSION

The COVID-19 pandemic has caused major changes in nurses' working environment and so their experience. The results of this study indicated that nurses working in the ICU experienced remarkable and massive physical, psychological, and emotional symptoms during the COVID-19 pandemic. The nurses extended the relationships to the patients' families as they are at high risk of stress, anxiety, and depression. In addition, they were able to support them in dealing with the fear associated with the uncertainty of COVID-19. Also, results revealed that remote therapeutic relationships and psychotherapy can be credible and trustworthy alternatives to in-person care.

CONCLUSIONS

The results of this study indicated that ICU nurses provide compassionate care despite experiencing unprecedented and immense physical, psychological, and emotional symptoms during the COVID-19 pandemic.

RECOMMENDATIONS

Further study is recommended using other research methodologies. It is also recommended to conduct the same study in different cities for better generalization.

Investigating the intentions and reasons of senior high school students in registering for nursing education in China

BACKGROUND

A shortage of qualified nurses and their low level of educational qualifications hinders the development of global health services. Studies have proven the role of nursing education in addressing these problems. However, no related studies have focused on senior high school students in China. This study aimed to explore senior high school students' intentions to learn nursing and identify the factors influencing their decision-making processes.

METHODS

An anonymous questionnaire was distributed to 8050 senior high school students, which included questions regarding their demographic characteristics, obtaining nursing specialty information, cognition of the nursing occupation and the impact of the COVID-19 on the nursing profession. Descriptive calculation, the chi-square test and logistic regression were used for the analysis.

RESULTS

Only 0.73% of the participants had a clear intention to study nursing. Academic performance and family support were significant predictors of students' intentions to pursue nursing education. Students' interest in nursing specialties was associated with their choice. There was a positive correlation between cognition of nursing occupation and students' choice of nursing. Students' experience of the COVID-19 pandemic also had a positive impact on their nursing career choice.

CONCLUSION

This survey to some extent reflects the problem of nurses shortage in China. In addition, these findings may also provide a new perspective for predictors of nursing shortage and potential interventions.

Empathy, sympathy, and altruism-An evident triad based on compassion. A theoretical model for caring

BACKGROUND

Based on existing confusion and a suggested contradiction regarding empathy and compassion in relation to caring science as well as in clinical health care.

AIM

The aim of the study was to find a knowledge base for the development of clinical caring science for, empathy, sympathy altruism, and compassion and their mutual relationship.

DESIGN

A theoretical paper.

RESULTS

The text discusses the different concepts separately, considering their history, research, obstacles, and bias and then brings them together in a concept model. The conclusion shows that empathy, sympathy, and altruism have no contradictions. Instead, they together form an evident triad based on compassion. Compassion is a prerequisite and a basis for the others to work. In clinical application, empathy is metaphorically a quality coming from the head, sympathy from the heart and altruism from the hand, merged in an attitude of compassion as a motif to care. The paper also reflects on the possibilities to increase and develop a compassionate mood and capacity by education and training.

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.

The effect of drama-supported, patient role-play experience on empathy and altruism levels in nursing students: A randomized controlled study

AIM

This study aims to determine the effect of drama-supported, patient role-play experiences on the empathy and altruism levels of nursing students.

BACKGROUND

Empathy, one of the most important skills of the nursing profession, has an important place in the patient-nurse relationship. To be empathetic, which is acknowledged as the most basic motivation of altruistic behavior, requires recognizing emotional states and understanding the needs of others.

DESIGN

The format of this study was a pre-test-post-test, regular parallel-group, randomized, controlled experiment.

METHODS

The study data were collected between October 2021 and February 2022. The research was carried out with second-year students at Necmettin Erbakan University, Faculty of Nursing, who did not have any history of hospitalization or any chronic diseases. All subjects agreed to participate in the study (n = 52, intervention group=26, control group 26). Data were collected using a Descriptive Characteristics Form, the Altruism Scale and the Jefferson Scale of Empathy for Nursing Students (JSENS). After a three-hour drama workshop, participants in the intervention group acted out the role of a bed-bound patient in the laboratory environment and no intervention was applied to the control group. A series of Mixed ANOVAs were conducted for the analysis of the data.

RESULTS

The mean age of participants was 19.94 years (SD = ± 1.31) and 83.7 % of the participants were women. The intervention group showed a significant increase in altruism compared with the control group, as evidenced by higher scores in the Altruism Scale Total Score and a significant group*time interaction effect. However, in the JSENS Total Score, including the perspective taking and standing in patient's shoes sub-dimensions, no differences were observed based on group, time and group * time interactions.

CONCLUSION

The patient role-play experience increased the empathy and altruism levels of nursing students, but the effect was not evident at the three-month follow-up.

"We are really starving for respect and support," the struggle of Iranian nurses in adhering to professional values: A qualitative study

AIMS

To investigate nurses' experiences of adhering to professional values in clinical settings.

DESIGN

A qualitative study with a conventional content analysis approach.

METHODS

This study was conducted from January 2021 to March 2022. Semi-structured interviews were conducted with 12 nurses working in different wards of five public and private hospitals in West Azerbaijan of Iran. Data were analysed using the conventional content analysis approach proposed by Graneheim and Lundman (Nurse education today, 24, 2004, 105) RESULTS: "Barriers to nurses' professional values" emerged as the main category of Iranian nurses' experiences in adhering to professional values. Three subcategories of barriers were revealed: "nurses' challenges," "professional suppressors" and "poor working conditions."

CONCLUSION

Barriers in clinical settings can overshadow nurses' professional performance and disrupt their adherence to professional values. Nursing managers must pay attention to nurses' challenges, their professional suppressors and poor working condition to help them promote their professional performance in clinical settings. Thus, nursing managers should not neglect the continuous education of nurses to assist them in increasing their clinical skills by holding practical and theoretical workshops. Improving the working conditions and clinical atmosphere by recruiting a capable workforce and applying psychological and financial support for nurses are essential to increase the quality of nursing care.

Just world beliefs and altruistic behaviors of college students during the COVID-19 pandemic: The mediating role of empathy

Altruistic behavior is of great significance for individual happiness and social development. The study has focused on the influence of two factors at the individual level on college students' altruistic behavior. The self-report questionnaires of 2,272 college students on belief in a just world, empathy and altruistic behavior were investigated. The results of the study found that: 1) Just-world belief and empathy both positively predicted altruistic behavior; 2) Empathy influenced altruistic behavior through just-world belief. And from the perspective of motivation theory, it explains that individuals affirm that altruistic behavior will bring spiritual pleasure, so individuals will maintain the consistency of their own internal factors to promote altruistic behavior.This study enriches the research value of altruistic behavior at the individual level and provides an empirical basis for the cultivation of altruistic behavior at the individual level.

Practical advice for refugees aspiring to become registered nurses in Australia

AIMS

This paper describes practical advice for refugees aspiring to become Registered Nurses (RNs) in Australia.

DESIGN

Qualitative description using a naturalistic inquiry framework.

METHODS

Between February 2018 and September 2019, the lead author conducted semi-structured interviews with employed RNs that are former refugees that speak English. Interviews were 45-90 min in duration and digitally recorded. Participants provided voluntary informed consent and were sent questions beforehand. All transcription data were thematically analysed for key themes until no further themes were identified. This paper covers practical advice provided by the participants at the conclusion of their interviews.

RESULTS

Twelve participants provided practical advice. Six themes were identified: (1) Find your purpose and set goals; (2) Work hard and never give up; (3) Seek support; (4) Capitalize on opportunities; (5) Be optimistic; (6) Give back. The last theme, give back, was salient across all interviews and was an inherent motivator for some participants once their RN status was achieved.

CONCLUSION

Each participant set the goal of becoming a fully registered nurse and made it a life goal that provided meaning for them. Despite their experiences, the participants provided practical advice that could guide younger people aspiring to become successfully qualified RNs.

IMPACT

The findings in this study are unique as they are derived from people with experiences as refugees who, despite their adversity, became RNs. The practical advice provides a framework not only for younger people from refugee backgrounds seeking to achieve their professional goals, but others looking to succeed in other workforce sectors. The practical advice for success will be useful in informing nursing authorities, tertiary institutions and private and public health organizations to develop effective approaches to guide the next generation of would-be RNs set to contribute to nursing practice in Australia. There were no patient or public contributions as the focus was the personal and professional lives of nurses with refugee backgrounds.

Intensive care nurses' lived experience of altruism and sacrifices during the Covid-19 pandemic: A phenomenological study

AIM

The aim of this study was to understand the lived experience of altruism and sacrifices among Swedish nurses working in intensive care units (ICU) during the COVID-19 pandemic.

DESIGN

This was a descriptive phenomenological study.

METHODS

The study was conducted between June 2020 and March 2021 and included 20 nurses who were directly involved in the ICU care of COVID-19 patients in Sweden during the pandemic. The text transcripts were analysed using Malterud's Systematic Text Condensation.

FINDINGS

The analysis revealed four themes. The work situation changed from 1 day to another-the nurses were brutally confronted with a new and highly demanding situation. Adapting to the chaotic situation-despite fear, anguish and exhaustion, the nurses adapted to the new premises. They shouldered the moral responsibility and responded to the needs of the patients and the health care system since they had the competence. Being confronted with ethical and moral challenges-the nurses were overwhelmed by feelings of helplessness and inadequacy because despite how hard they worked, they were still unable to provide care with dignity and of acceptable quality. The importance of supporting each other-collegiality was fundamental to the nurses' ability to cope with the situation.

CONCLUSIONS

Taken together, being exposed to a constantly changing situation, facing the anguish and misery of patients, families, and colleagues, and being confronted with a conflict between the moral obligation to provide care of high quality and the possibility to fulfil this commitment resulted in suffering among the nurses. Collegial back-up and a supportive culture within the caring team were important for the nurses' endurance.

IMPACT

The study contributes an understanding of nurses' lived experience of working during the COVID-19 pandemic and highlights the importance of protecting and preparing nurses and nursing organisation for potential future crises.

Nurses' experience in stoma care for refugees and asylum seekers: Qualitative research

This study aimed to determine the experiences of ostomy and wound care nurses in providing care to refugees and asylum seekers with stomas. This study used a descriptive qualitative design. The study population comprised 14 female nurses working as ostomy and wound care nurses in Turkey. Purposive sampling was adopted. The interviews were conducted at times convenient for the participants and researchers and by interviewing each nurse once. Prior to the interviews, the questions of an individual characteristics identification form were read to the participants, and the form was filled out on the basis of their responses. The interviews were conducted using a semistructured approach. Thematic analysis was used to identify, analyze, and report themes within the data. The emerging themes following data analysis were communication problems, problems with stoma supplies, nurses' efforts to prevent inequalities in care, and emotional burden. To maintain appropriate nursing care, this study recommends the expansion of appropriate translation services and the reconsideration of problems related to patients' access to stoma care materials.

Altruism in Paramedicine: A Scoping Review

While altruism has been studied in healthcare professions such as nursing and medicine, the exploration of the characteristics of altruism, as related to paramedicine and emergency care in Australia, is limited. This scoping review explores altruism in paramedicine from the perspective of the paramedic as practitioner, learner, and educator as seen through the lens of the paramedic and the patient. Also discussed is the positive impact of altruism on the patient experience of care. A scoping review was used to assess the availability of data related to altruism in paramedicine. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was used to guide the process. Search categories were orientated around the subject (altruism) and discipline (paramedicine). A total of 27 articles are included in this scoping review. Initial searching identified 742 articles; after duplicate removal, 396 articles were screened with 346 excluded. Fifty articles were full-text reviewed and 23 excluded. The final 27 were extracted following full-text screening. None of the articles are specific to altruism in paramedicine. The data related to the practice of altruism in paramedicine are extremely limited. The preponderance of data arise from Europe and North America which, due to crewing and service differences, may impact the practice of altruism in different regions. Recent changes to the scope of paramedic practice, workload, education, and case acuity may influence behaviour regarding altruism, compassion, caring, and associated caring behaviours. The practice and education of paramedics including altruism, compassion, caring and caring behaviours in the Australasian setting warrants further research.

A qualitative systematic review on the lived experience of men in nursing

Aim

This qualitative systematic review was conducted to describe the lived experience of men in nursing.

Design

A systematic review of qualitative studies.

Methods

Five databases (Scopus, CINAHL, MEDLINE, PsycINFO and Embase) were systematically searched. The PRISMA guideline was used for reporting the literature search in different phases, and the Critical Appraisal Skills Program, a qualitative research checklist, was used to evaluate the studies that met the inclusion criteria. Thomas and Harden's thematic analysis approach for qualitative research was used for data synthesis.

Results

Six qualitative studies were included. Five analytical themes related to lived experiences of men in nursing emerged: value in nursing, the double‐edged sword of gender, being accepted in the nursing profession, attractions of nursing and coping strategies.

Wellbeing Conceptualizations in Family Medicine Trainees: A Hermeneutic Review

PHENOMENON

High levels of burnout have been widely reported among postgraduate medical trainees, however relatively little literature has examined what 'wellbeing' means for this group. Moreover, the literature that does exist has generally overlooked the potential role of specialty factors in influencing such conceptualizations. This is particularly true for family medicine and general practice trainees - a specialty considered to be unique due, in part, to its focus on community-based care. The present review sought to explore conceptualizations of wellbeing specifically within the context of family medicine and general practice training.

APPROACH

The Embase, Ovid Medline, and PsycINFO databases were searched from inception to November 2019 for literature examining wellbeing in family medicine and general practice trainees. Literature was iteratively thematically analyzed through the process of a hermeneutic cycle. In total, 36 articles were reviewed over seven rounds, at which point saturation was reached.

FINDINGS

The findings confirm the complex and multifaceted nature of wellbeing as experienced by family medicine and general practice trainees. An emphasis on psychological factors - including emotional intelligence, positive mental health, self-confidence and resilience - alongside positive interpersonal relationships, rewards, and balanced interactions between trainees' personal and professional demands were deemed critical elements.

INSIGHTS

A model of wellbeing that emphasizes rich connections between trainees' personal and professional life domains is proposed. Further qualitative research will help to extend current understanding of wellbeing among medical trainees, including the individuality of each specialty's experiences, with the potential to enhance interventional efforts.

Impact of COVID-19 on Intensive Care Unit Nurse Duty of Care and Professional Roles: A Qualitative Content Analysis

Background

Nurse duty of care, the balance between nursing occupational obligations to provide care, the personal costs for providing such care, and the reward for providing care, has been significantly altered by the COVID-19 pandemic. ICU nurses are increasingly burdened with higher personal costs to fulfill their jobs, but little additional reward for continuing to provide care.

Objectives

The purpose of this study was to examine the impact of the COVID-19 pandemic on the duty of care balance among ICU nurses who manage COVID-19 patients.

Design

This was a descriptive qualitative study using semi-structured interviews.

Methods

Nurses were recruited for a parent study on ICU nursing during COVID-19; this is a secondary analysis of the interviews that took place during the parent study. Content analysis was utilized to identify themes from interview transcripts.

Results

Thirteen nurses participated in interviews. Nurses reported betrayal at perceived breeches in their duty of care agreement by their employers, the general public, and national health authorities. They described alterations to previous standards of care such as significantly increased workloads, worsening understaffing, and changes to patient care expectations that were implemented for reasons other than betterment of patient care. Nurses reported they felt a moral obligation to provide care, however they experienced disempowerment and burnout that affected them both in and out of the workplace.

Conclusion

The COVID-19 pandemic has affected several aspects of the duty of care balance, resulting in a duty of care balance that is inequitable to nurses. Imbalance in the effort, risks, and rewards for nursing professionals may contribute to nurse burnout.

Relevance to Clinical Practice

This research highlights the need for healthcare administrators to consider resource allocation, nurse appreciation, and commensurate compensation for professional nurses.

Altruism in nursing from 2012 to 2022: A scoping review

BACKGROUND

Being a nurse with non-altruistic orientation exists and altruism decline is being challenged as never before, which would be a disaster for medicine if left unnoticed.

PURPOSE

To describe the meaning of altruism and altruistic behaviors in nursing, and to discuss dilemmas we face today.

METHOD

Cochrane, PROSPERO, PubMed, Web of Science, CINAHL, Scopus, Embase, ProQuest, and CNKI were searched for original research published in English or Chinese from 2012 to February 2022.

RESULTS

By screening 13 studies came from 12 different countries described altruism and altruistic behavior together were included in. Altruism has been described as value, vocation, or professionalism in nursing which can reflect nurses' compassion, level of expertise, and quality of care. Altruistic nursing care, body donation, financial endowment, volunteering, sharing, benefiting patients maximum, and helping colleagues represented most of the altruistic behaviors in nursing. There is a vacant that not any assessment tool designed for measuring altruism in nurse groups. Interventions from curriculums in class and support of organizations with psychological methods could be helpful to improve the nurses' level of altruism.

CONCLUSION

Altruism and altruistic behaviors in the past decades were described. A new concept of altruism in nursing was proposed based on the original meaning and the current changes, and interventions for promoting altruism and some of the dilemmas faced today were synthesized.

COVID-19 pandemic impact on experiences and perceptions of nurse graduates

BACKGROUND

Transitioning from education to practice is stressful for new nurses and those entering new roles and can lead to workforce attrition and burnout. This dynamic is likely complicated when graduates are transitioning to practice during a pandemic.

PURPOSE

The purpose of this study was to describe recent nurse graduates' perceptions of the impact of the COVID-19 pandemic on their transition from education to practice.

METHODS

We conducted an online survey of BSN, RN-BSN, and DNP students who graduated between December 2019 and April 2020 (n = 82), including demographics, employment information, and free-response questions about the impact of the pandemic on their transition experiences, post-graduation plans, and perceptions of nursing. We used a qualitative descriptive approach to content analysis to synthesize and summarize the data.

RESULTS

Participants expressed three overarching concerns: 1) altered plans such as difficulty finding employment; 2) logistical, system-related stressors including licensing delays and chaotic onboarding; and 3) feeling pride in profession despite perceiving ambivalence in public discourse.

CONCLUSION

COVID-19 exacerbated challenges often experienced by new graduates. Common stressors, intensified during the pandemic, could exert long-term effects on the workforce. Educators and healthcare organizations must work to ensure nursing graduates receive the necessary support for a successful transition.

Frontline nurses' experiences of working in a COVID-19 ward-A qualitative study

Aim

To explore how nurses experienced working in a newly organized COVID‐19 ward with high‐risk patients during a new and unknown pandemic.

Design

A qualitative explorative study using a phenomenological‐hermeneutic approach.

Methods

Semi‐structured individual telephone interviews were conducted in June–July 2020 with 23 nurses working in COVID‐19 wards from three regional hospitals in Denmark. The nurses had been transferred from other departments at their hospital to the newly organized COVID‐19 wards. Data analysis was influenced by Paul Ricoeur's theory of narrative and interpretation, including three analytical levels: naïve reading, structural analysis and critical interpretation and discussion.

Results

During the structural analysis four themes were generated: (a) Challenging and uncertain situation, but also a positive experience (b) Professional and personal development (c) Lack of nurses' rights during a pandemic (d) Reward in itself or a desire for financial reward.

Preserving nurses' professional dignity: Six evidence-based strategies

AIM

This study aimed to develop and refine strategies for preserving nurses' professional dignity.

BACKGROUND

Professional dignity is a non-negotiable nursing professional value. It should at all times be respected because of the worthiness of nurses as professional human beings. They are at the centre of healthcare societies. Their worth and contributions to the health of others should be acknowledged and preserved.

METHODS

Descriptive qualitative research was conducted during the development of the strategies while applying the principles of strategic navigation. The process was guided by the findings of the initial phase of the study and contextualised literature. Focus group discussions were held with healthcare professionals for the refinement of the strategies in two private hospitals in South Africa.

FINDINGS

The strategies unfolded multiple possibilities to value nurses' professional dignity. These were pathways for respecting, appreciating and supporting nurses; honouring nurses' desire to hold the well-being of patients in the highest regard; supporting nurses in fulfilling their professional roles; enabling nurses to take pride in themselves and the nursing profession; supporting nurses in demanding and complex circumstances and supporting nurses in coping with humiliating workplace experiences.

CONCLUSION

Strategies to ensure successful outcomes in preserving nurses' professional dignity were developed and refined. The professional dignity experiences that mattered most were presented.

IMPLICATIONS FOR NURSING/HEALTH POLICY

Valuing nurses' professional dignity promotes respect and support for nurses and their desire to prioritise patient-centred care, contributing to improved nursing practice and nurses' confidence to assert their professional dignity. Preserving nurses' professional dignity is a necessity in healthcare. It should be affirmed in equal standing in nursing codes of conduct, nursing curriculums and healthcare policies.

"I've had horrible things said about me": An inductive content analysis of nursing academic experiences of contra-power harassment from undergraduate nursing students

AIM

The aim of this study was to describe the experiences of nursing academics exposure to contra-power harassment by under-graduate nursing students.

BACKGROUND

Contra-power harassment by nursing students is a growing phenomenon which is defined as the harassment of those ni formal positions of power by those who are not. Harassing behaviours can include verbal, physical and sexual and digital harassment through mediums such as social media. Cited behaviours perpetrated by under-graduate nursing students are often experienced after the release of grades.

DESIGN

A self-administered online questionnaire was used to elicit responses to four open-ended questions regarding nursing academics experiences of contra-power harassment and nursing student incivility.

METHOD

Inductive content analysis was used to identify text patterns from the academic comments. Each of comments was read through to get a sense of the whole. Re-reading the comments allowed for open coding into broad headings which described a specified meaning. Categorising the broad headings into higher order sub-categories then made it permissible to record comments that belonged to a particular group. The development of the main category using abstraction was first undertaken by creating generic categories from the sub-categories using content-characteristic words. The development of the broad and sub-categories were assessed independently by two of the authors and after discussion, agreement was reached as to the structure of the generic categories.

RESULTS

A total of 159 comments received from 82 nursing academics each describing incidents of contra-power harassment. Nursing academics were faced with several differing behaviours that were seen as aggressive, anger, manipulation and threats. These were viewed as both verbal and isolation attacks In all, four generic categories were identified - Experiencing Harassment; You're Adding to My Stress; Being Set-up to Fail; Feeling Unsafe Professionally and Academically. Nursing academics describe experiencing the behaviours of contra-power harassment as being distressing, disturbing, frustrating, saddening and disappointing.

CONCLUSION

The behaviours expressed by nursing students tended to occur at the release of grades. Most academics were concerned for their own safety both emotionally and physically because of the unpredictability of student behaviour. Most academics understood the pressures nursing students faced, especially the international students. However, they were often challenged by the need to support student learning and maintaining professional standards of behaviour.

Pediatric Ward Nurses' Caring Self-Efficacy Scale: Development and Validation

BACKGROUND

No instrument specifically designed to investigate the caring self-efficacy of nurses in pediatric wards was found. The aim of the present study was therefore to develop a scale to evaluate pediatric wards nurse's caring self-efficacy.

MATERIALS AND METHODS

In this study, an exploratory, sequential, mixed method was used in 2015 in Iran. Data collected from 27 semi-structured interviews with nurses in pediatric wards were analyzed using conventional content analysis. The initial version of the scale was obtained with 65 items. Face validity was determined using impact score and content validity using the Content Validity Index (CVI) and Content Validity Ratio (CVR). The construct validity of the scale was investigated using exploratory factor analysis with 305 nurses in pediatric wards. The concurrent validity of the scale was acquired using the General Self-Efficacy Scale. Internal consistency and test-retest reliability were also examined.

RESULTS

The scale-CVI (S-CVI) (average) was 0.85. The 14 items with a CVR and CVI of less than 0.51 and 0.70, respectively, were deleted and the final 51-item scale was approved. All 51 items had good impact score (>1.50). In the final scale, four subscales were extracted using construct validity. The concurrent validity of the scale was also obtained (r = 0.77, p < 0.001). The total Cronbach's α correlation coefficient of the scale was 0.96 and test-retest reliability was 0.98.

CONCLUSIONS

The Pediatric Ward Nurses' Caring Self-Efficacy (PWNCSE) scale developed in this study is a practical, reliable, and valid scale to evaluate pediatric ward nurses' caring self-efficacy.