Professional Fulfillment and Burnout in Fourth-Year Pharmacy Students and Risk Factors for the Future: A Mixed Methods Study

OBJECTIVE

Many factors shape the professional identity of pharmacy students; however, little is known about the influence of well-being. Two aspects of well-being explored in this study include professional fulfillment and burnout. We describe the current levels of each among fourth-year pharmacy students, identify possible predictors, and uncover themes.

METHODS

The Stanford Professional Fulfillment Index was used to measure professional fulfillment and burnout among students in the prior 2 weeks. Multivariable linear regressions were conducted to identify individual characteristics and activities as predictors of professional fulfillment and burnout. Upon completion of activities to foster personal wellness, student self-reflections were analyzed using thematic analysis to describe student-perceived barriers and facilitators of professional fulfillment and burnout.

RESULTS

In total 54 students completed the Professional Fulfillment Index, wellness activities, and self-reflection. Having already completed the jurisprudence examination required for licensure and having a job upon graduation were statistically significantly associated with higher professional fulfillment scores. We identified that working in a non-pharmacy-related job, while completing practicums, was statistically significantly associated with higher work exhaustion scores. Themes uncovered from student self-reflections included a definition of wellness, how doing what you are supposed to be doing and working in a psychologically and physically safe environment contributes to professional fulfillment, and system-level factors leading to burnout.

CONCLUSION

This study provides evidence of the importance of supporting pharmacy students in the completion of the steps to licensure, the value of exposure to a variety of pharmacist-related activities through experiential education, and well-being as foundational to professional identity.

Joy at work and vocational identity during COVID-19: A structural equation model

OBJECTIVE

This study aims to explore the interrelations between joy at work, vocational identity, and COVID-19-related latent variables.

DESIGN

A cross-sectional design was adopted to survey 253 registered nurses through nursing organizations and social networking sites during the time of the COVID-19 pandemic.

METHODS

Structural Equation Modeling through Partial Least Squares (SEM-PLS) was employed to accurately analyze and estimate relationships among joy at work, vocational identity, and COVID-19-related constructs in compliance with published standards and guidelines.

RESULTS

Thirty-one items received convergent validity measures to represent the five study constructs related to joy at work, vocational identity, and Work life Impact of COVID-19 pandemic: Meaning, Engagement, and Growth (MEG), Compassion, Sensitivity, and Respect (CSR), Trust, Support, and Flexibility (TSF), Vocational Identity Questionnaire (VIQ), and Work life Impact of COVID-19 pandemic (CI). The generated model exhibited good model fit and consistent quality indices. The data fit statistically with the model: (Average Path Coefficient = 0.195, p < 0.000); Average R-Squared = 0.156, p < 0.003; Average Adjusted R-Squared = 0.151, p < 0.004; Average Variance Inflation Factor = 2.193 (within the ideal range); Average Full collinearity VIF = 2.388 (within the ideal range), and Tenenhaus Goodness of Fit (GoF) = 0.329. The perceived Work life Impact of COVID-19 pandemic (CI) was a significant predictor of joy at work constructs (MEG, CSR, and TSF) and VIQ with direct effects. It also exerted a negative influence over MEG and TSF, but positively on CSR and VIQ. Notably, joy at work constructs significantly mediated the effects of CI on VIQ.

CONCLUSION

A structural model was developed that offers insights and a parsimonious explanation for the interrelations of COVID-19, joy at work, and vocational identity variables. The pandemic unquestionably influences the nurses' perceived joy, sense of calling, and meaning in life's work, and joy at work enhances nurses' work-life worth during challenging times.

CLINICAL RELEVANCE

An increased understanding of nurses' joy at work during challenging times can potentially influence work culture, informs individual nurses, nurse leaders, and healthcare systems in all professional domains of practice and provides the foundational information to identify barriers to joy and strategies that enhance joy.

Resilience, job satisfaction, intentions to leave nursing and quality of care among nurses during the COVID-19 pandemic - a questionnaire study

BACKGROUND

The COVID-19 pandemic has challenged nurses and healthcare systems globally and raised major concerns for nurses' wellbeing and working conditions. This cross-sectional and correlational study design aims to describe nurses' resilience, job satisfaction, intentions to leave and quality of care, and explain their relationships during the COVID-19 pandemic.

METHODS

Data were collected from Registered Nurses (N = 437) in Finland through an electronic survey between February 2021 and June 2021. The questionnaire covered background characteristics (seven questions), resilience (four questions), job satisfaction (one question), intention to leave nursing (two questions), quality of care (one question), and requiring factors of the work (eight questions). The background variables and dependent variables were analyzed and presented using descriptive statistics. Structural equation modeling was used to explain dependent variables relationships. The study followed procedures recommended in the STROBE Statement for cross-sectional studies in efforts to maximize the quality of reporting results.

RESULTS

The surveyed nurses evaluated their resilience by mean score 3.92, more nurses had considered leaving nursing during the pandemic (16%) than before (2%). Nurses´ mean score of requiring factors of the work was 2.56 and overall job satisfaction 5.8. Structural equation modeling revealed that resilience affected their job satisfaction, which also influenced the quality of care, that was rated moderate (7.46 out of 10). Structural equation modeling indices of goodness of fit were NFI = 0.988, RFI = 0.954, IFI = 0.992, TLI = 0.97, CFI = 0.992, and RMSEA = 0.064. No direct relationship was found between resilience and intention to leave nursing.

CONCLUSIONS

Good resilience promoted delivery of high-quality care by nurses during the pandemic and enhanced their job satisfaction, which reduced their intention to leave nursing. The results indicate that it is important to develop interventions that support nurses' resilience.

IMPACT

The study highlights the importance of nurses' resilience during the pandemic, while job satisfaction may decrease and requiring factors of the work increase. Given the number of nurses who consider leaving nursing, there are clear needs to develop effective strategies to maintain quality healthcare with resilient, committed nursing staff.

The relationship between nurses' psychological resilience and job satisfaction during the COVID-19 pandemic: a descriptive-analytical cross-sectional study in Iran

BACKGROUND

Job satisfaction and factors affecting them are among the most important social issues. Resilience has a moderating role in the relationship between stress and diseases, so it can affect a person's job satisfaction because it enables a person to deal with adverse conditions. This study aimed to investigate the relationship between nurses' psychological resilience and job satisfaction during the COVID-19 outbreak.

METHODS

This descriptive-analytical cross-sectional study (2022) used convenience sampling to select 300 nurses. The Connor and Davidson Resilience Scale and Minnesota Satisfaction Questionnaire were used to collect data. The data were then analyzed with SPSS 22 and statistical methods (Independent t-test, Analysis of Variance, Pearson correlation coefficient, and Multiple linear regression).

RESULTS

The study results showed a positive and poor relationship between resilience, some of its dimensions (trust in individual instincts, tolerance of negative affect (p = 0.006), positive acceptance of change and secure relationships (p = 0.01), spiritual influences (p = 0.04)) and job satisfaction (p < 0.001). In other words, nurses' high level of resilience increased their job satisfaction and vice versa.

CONCLUSIONS

Enhancing the resilience of frontline nurses during the COVID-19 pandemic improved their job satisfaction and affected care provided by them. Nurse managers can control nurses' resilience and offer interventions that would strengthen it, especially at crises.

Community Resilience After Hurricanes: Can Neuman's Systems Theory Guide Public Health Nursing?

Objective: Examination of community resilience after Hurricane Harvey and -applicability of Neuman's systems model to the role of public health nurses in applying primary, secondary, and tertiary prevention strategies to communities susceptible to natural disasters. Design: Descriptive, exploratory study. Sample: A convenience sample (N = 1,470). Measurements: Hurricane Harvey Survey. Results: Respondents from seven counties in southeast Texas report previously experiencing a hurricane (80%) with no weather-related flooding (79%), adequate preparation (54%), failure to comprehend the potential severity of Hurricane Harvey (62%), damage to their homes (45%), and a 68% loss of personal belongings. Anxiety, frustration, disbelief, determination, and hopefulness were rated highest after the storm. Residents received updates from family and friends, social media, and online news reports regarding rising water, even though, in many cases, a mandatory evacuation was not officially announced. Only 35% of respondents reported being aware of resources available, possibly due to flooding or inaccessibility of typical resources (e.g., hospitals, shelters). Communicating through social networks (social media, family, and friends) provided avenues for arranging evacuations and assistance. Respondents report giving assistance to others and receiving assistance from family, friends, and their faith community. The majority of respondents reported that the community provided adequate services during the hurricane (59%), and they plan to stay in southeast Texas (70%). Conclusions: Southeast Texas residents demonstrated individual and community resilience which may be further supported with primary, secondary, and tertiary nursing interventions as illustrated by Neuman's systems model. The rise in positive emotional response traits demonstrates positive coping, which is consistent with resilience. Effective and timely communication through social networks provides an additional line of resistance to protect and promote the resilience of the community. The lack of medical resources indicates a break in the normal line of defense and an area for potential improvement with the utilization of mobile medical units to provide healthcare for areas not easily accessible during a disaster. Public health nurses are strategically positioned in the international community to lead prevention and recovery efforts by applying theory-based community interventions.

Mediating Role of Resilience on Nursing Faculty and Student QoL during COVID-19

COVID-19 greatly impacted nursing education and required nursing faculty and students to quickly adapt to changes caused by disease mitigation. The purpose of this study was to examine the mediating effects of resilience between the influence of demographics and school-related risk factors and nursing faculty and student quality of life (QoL) during the COVID-19 pandemic. A secondary data analysis was conducted using structural equation modeling to examine the mediating role of resilience on latent variables. Resilience had a positive, direct effect on nursing faculty and student QoL. Having a designated home workspace and being well-prepared for online learning had positive, indirect effects on QoL, mediated through resilience. Assisting children with schoolwork had a negative impact on the psychological and environmental QoL domains. Remarkably, having a caregiver role positively influenced the psychological QoL domain. Supporting and promoting faculty and nursing students' health and well-being is imperative during and after the pandemic.

The COVID-19 experience: A survey of RNs

PURPOSE

To explore the psychological factors that impacted RNs during the COVID-19 pandemic.

METHODS

Survey response data were collected from 151 respondents across 25 states and various healthcare system settings.

RESULTS

RNs in clinical settings had slightly more emotional stress than those in academia. Concerns ranged from personal health and family considerations to large-scale sociopolitical issues.

CONCLUSIONS

RNs in all settings experienced at least some emotional stress during the early stages of the pandemic. However, in a majority of respondents, none of the stressors individually or in combination were so great as to encourage departure from the profession.

Resilience of nurses at the epicenter of the COVID-19 pandemic in Lebanon

Objective

The study aimed to investigate the level and factors associated with the resilience of nurses practicing at the main COVID-19 referral center in Lebanon.

Methods

The study utilized a cross-sectional survey design. Data were collected electronically in the spring of 2020 from 265 nurses. The questionnaire included five sections: demographic characteristics, job satisfaction, turnover intentions, exposure to violence, and resilience levels. Multiple linear regression was used to determine factors associated with resilience.

Results

Results showed that the overall score of resilience among nurses was 66.91 ± 13.34. Most nurses were satisfied with their job (67.8%), and most nurses reported that it is unlikely for them to quit their present work in the coming year (76.2%). Over the last year, three-quarters of nurses (74.7%) reported being ever exposed to a form of occupational violence. The resilience of nurses was directly associated with job satisfaction and male gender and inversely associated with intention-to-quit and exposure to violence (P < 0.05).

Conclusions

Enhancing the resilience of nurses at the frontline of the COVID-19 pandemic improves their job satisfaction and retention and would help support the effectiveness and efficiency of care services. Nurse managers can regularly investigate the resilience of nurses and offer interventions that would strengthen it, especially at times of crisis.

Neuman Systems Model With Nurse-Led Interprofessional Collaborative Practice

The Neuman Systems Model was developed to create a structure to depict nursing clients as complex systems, in constant energy exchange with their environments, comprised of multiple interrelated parts. It has been widely used in practice, education, research, and administration. An analysis of the theory, based upon Meleis' methods, was conducted. The theory has high utility and a large circle of contagiousness despite its complexity, lack of teleology, and level of abstractness. Based upon this analysis, a new model entitled the Neuman Systems Model Perspective of Nurse-Led Interprofessional Collaborative Practice has been created to provide a framework for the care of community-dwelling older adults. As a first step in its development, this new model will be used to guide a mixed-methods study evaluating an interprofessional collaborative practice intervention for community-dwelling older adults.

A Descriptive Study of Resiliency and Health in Practicing Nurses

OBJECTIVES

The aim of this study was to identify the degree of resilience and self-perceived physical and mental health in practicing nurses.

BACKGROUND

Stressors and challenges of everyday demands influence resilience and well-being in acute care nurses.

METHODS

Nurses were surveyed using the Connor-Davidson Resilience Scale and PROMIS Global Health. One sample t test compared the study group to the general population mean of resiliency, physical and mental health scores. Linear regression analysis identified factors associated with resiliency.

RESULTS

Of the 859 practicing nurses in the sample, most were female and White, had a BSN or associate of science in nursing degree (55.2%, 30.0%) and more than 10 years of experience (57.1%), and worked in direct patient care (77.0%). Nurses had low resiliency (P < .0001) and physical health (P = .0037). Well-being factors included 2 or more missed days/shifts in 3 months (P < .001), thoughts of quitting (P = .003), and perceptions that workload was too much (P < .001).

CONCLUSIONS

Self-perceived physical and mental health was significantly associated with the degree of resilience.

Moral Resilience in Nursing Education: Exploring Undergraduate Nursing Students Perceptions of Resilience in Relation to Ethical Ideology

Introduction

Moral resilience has recently been proposed as one strategy to address moral distress in nurses and nursing students. Central to nursing students’ capacity for moral resilience is how they understood and enact resilience with an element of realism, suggesting an ethical, ideological influence. Resilience is shown to differ significantly across students, and possibly because of a disconnect between a students’ perceived resilience and their ethical ideology. Yet, resilience seldom has been explored in relation to ethical ideology.

Objective

This study aims to explore self-reported resilience in relation to ethical ideology in undergraduate nursing students, compare differences in scores, and explore relationships between study variables and selected demographic characteristics.

Methods

A descriptive cross-sectional research design was followed. An online encrypted survey was conducted among a convenient sample of nursing undergraduates who met the eligibility criteria and provided implied informed consent. This study complied with ethical principles outlined in the Canadian Tri-Council Policy Statement for research with human subjects. Ethical approval was secured from the University’s Research Ethics Board. Data were analyzed using mean scores, standard deviations, independent sample t-test, variance analysis with post hoc–testing, and Pearson correlation to explore differences in perceptions and associations between study and selected demographic variables.

Results

Undergraduate students have a high level of self-reported resilience. Statistically significant differences in self-reported resilience across selected demographic variables were observed. The association between resilience and ethical ideology was not significant. Ethical relativism was significantly correlated with age and year of study.

Conclusion

Findings suggest that faculty cultivating resilience in nursing students pays attention to gender’s influence discourses in students’ perceptions of resilience and ethical ideology and provides students with opportunities for ethical self-reflection and dialogue to critically examine their ethical ideological perspectives and the influence these may have on moral resilience development. Implications for future research are discussed.

Relationship of Quality of Life, Resilience, and Associated Factors Among Nursing Faculty During COVID-19

BACKGROUND

The COVID-19 pandemic and subsequent social distancing guidelines greatly impacted the quality of life (QoL) of nursing faculty.

PURPOSE

The purpose of this study was to examine the relationship of QoL, resilience, and associated factors among nursing faculty during the COVID-19 pandemic.

METHODS

In April 2020, a cross-sectional, anonymous survey was conducted with nursing faculty in a public university in rural Appalachia (n = 52). Instruments included QoL, resilience scales, work-related, and demographic variables. Descriptive, bivariate, and multiple linear regression analyses were used to analyze data. A content analysis was used to analyze an open-ended question.

RESULTS

Resilience was the strongest variable to predict each of the QoL domains. Nursing faculty who reported better QoL were those who were able to adapt to changes and challenges mandated during the COVID-19 pandemic.

CONCLUSIONS

Evidence-based programs to build resilience and improve nursing faculty working conditions and their QoL are needed.

Resilience as an Incomplete Strategy for Coping With Moral Distress in Critical Care Nurses

TOPIC

Moral distress is receiving increasing attention in health care. The theoretical value of resilience as a strategy for coping with moral distress is prominent in the literature.

CLINICAL RELEVANCE

The potential negative consequences of moral distress for nurses are indisputable, driving a push to identify interventions to help nurses deal with the experience. The evidence that resilience is an important quality and skill for maintaining wellness is equally clear.

PURPOSE

To review moral distress and resilience and examine the evidence for the new focus on resilience.

CONTENT COVERED

The complexity of both moral distress and resilience suggests that resilience by itself is an incomplete strategy for coping with and addressing moral distress.

Resilience-building module for undergraduate nursing students: A mixed-methods evaluation

In nursing students, resilience is recognised as a critical quality that will enable them to face and solve the challenges encountered in their studies and future careers. This mixed-methods study aimed to develop a resilience-building module for university nursing students and evaluate its effects on resilience, well-being and mindfulness. We recruited a convenience sample of 195 nursing students and delivered a resilience-building module comprising three 90-minute workshops on the following topics: resilience and emotion regulation, stress management and mindfulness, and burnout and depression. The participants' views and perceptions of the module were explored using pre-test and post-test questionnaires and focus group interviews. No significant changes in outcomes were observed from the pre-test to the post-test. However, a multivariable linear regression analysis indicated that mindfulness was significantly associated with resilience. A qualitative data analysis revealed that the resilience-building module evoked the participants' awareness of resilience and was considered an enjoyable learning experience. In conclusion, although the quantitative results demonstrated no significant changes in outcomes after the module, the qualitative results suggested that the resilience-building module could have beneficial effects if included in the undergraduate nursing curricula. Finally, better mindfulness was identified as important for enhancing resilience among undergraduate nursing students.

Nurse resilience: A concept analysis

Nurse resilience is attracting increasing attention in research and practice. Possession of a high level of resilience is cited as being crucial for nurses to succeed professionally and manage workplace stressors. There is no agreed definition of nurse resilience. A concept analysis was undertaken to examine nurse resilience using a priori selected analysis framework. This concept analysis aims to systematically analyse resilience as it relates to nurses and establish a working definition of nurse resilience. Sixty-nine papers met the search criteria for inclusion. Key attributes of nurse resilience were social support, self-efficacy, work-life balance/self-care, humour, optimism, and being realistic. Resilience enables nurses to positively adapt to stressors and adversity. It is a complex and dynamic process which varies over time and context and embodies both individual attributes and external resources. Sustaining nurse resilience requires action and engagement from both individuals and organizations.

A Transdisciplinary Conceptual Framework of Contextualized Resilience for Reducing Adverse Birth Outcomes

Research in preterm birth has focused on the disparate outcomes for Black, Hispanic, and Latina women as compared with White women. However, research studies have not focused on centering these women in frameworks that discuss how resilience is embodied. This article is a presentation of our transdisciplinary contextual framework of resilience, building on work that centers Black, Hispanic, and Latina women, as well as historical oppression and trauma resilience frameworks developed by transcultural psychiatry, psychology, public health, anthropology, medicine, nursing, sociology, and social work. To develop the model, we reviewed 115 articles and books (1977-2019), which were then evaluated and synthesized to develop a transdisciplinary framework of contextualized resilience to enable a better understanding of the complex interplay of medical and social conditions influencing preterm birth. The framework includes multiple ecological layers that cross the individual, familial and intimate, community, structural, policy and law, and hegemonic domains.

Nursing Challenges in Interactions With Patients Receiving Mechanical Circulatory and Respiratory Support

BACKGROUND

Mechanical circulatory and respiratory support (MCRS) systems provide short- to long-term life support for patients with severe cardiac or respiratory failure. Whereas the challenges of patients with these lifesaving systems are well understood, the challenges faced by nurses of patients receiving MCRS remain relatively unidentified.

OBJECTIVES

In this study, we investigated the challenges and experiences of MCRS nurses, with the aim of informing the design of future interventions.

DESIGN

A qualitative approach was taken to develop an in-depth understanding of the emotional issues nurses experience in their daily interactions with patients.

PARTICIPANTS AND SETTING

Nine MCRS nurses ranging in clinical experience were recruited from Australian hospitals.

METHODS

Participants were divided into 3 focus groups, with design prompts being used in the focus groups to facilitate discussion. Data from these focus groups were analyzed through a thematic analysis protocol.

RESULTS

The nurses' accounts were clustered around 2 themes, including (1) patient connection and (2) compassion vitality and fatigue. Each theme elicits a conflicting compromise that MCRS nurses face daily.

CONCLUSION

The challenges of nurses who support patients with MCRS are complex, multifaceted, emotionally stimulating, and exhausting. We therefore contributes a set of design criteria to support such nurses, setting a direction for future research.

A Mind-Body Skills Course Among Nursing and Medical Students: A Pathway for an Improved Perception of Self and the Surrounding World

Despite increased recognition of self-care and self-awareness as core competences for health care professionals, little attention is paid to these skills during their education. Evidence suggests that a Mind-Body (MB) skills course has the potential to enhance self-care and self-awareness among medical students. However, less is known about the meaning of this course for students and how it affects their personal and professional life. Therefore, we examined the lived experiences with an MB skills course among Dutch medical and Swedish nursing students. This course included various MB techniques, such as mindfulness meditation and guided imagery. Guided by a phenomenological hermeneutical method, three main themes were identified: "ability to be more present," "increased perception and awareness of self," and "connection on a deeper level with others." Overall, participation in the MB skills course served as a pathway to inner awareness and supported connecting with others as well as with the surrounding world.