Nurse Leader Mindfulness Pilot Impact on Perceived Stress: A Quality Improvement Project

The recent COVID-19 pandemic exacerbated pre-existing stressful conditions in health care, further elevating the risk of negative health outcomes for nurses and particularly nurse leaders. The aim of this pilot project was to assess the efficacy of mindfulness practices in attenuating nurse leaders' perceived stress levels. There is a lack of evidence regarding the outcomes of stress reduction programs aimed at health care staff, especially for nurse leaders within the clinical setting. Mindfulness has been shown to have a significant positive effect on attenuating stress in a wide variety of populations. This study used a prospective longitudinal design with a volunteer nurse leader group comparing self-reported perceived stress levels before and after a brief mindfulness intervention. Results indicated a significant reduction in perceived stress among volunteer nurse leader participants postintervention. Further investigation is needed in a variety of settings to more fully understand and evaluate the potential impact of introducing mindfulness practices to support nurse leaders in hospital or clinical settings.

Effect of a Compassion Fatigue Resiliency Program on Nurse Managers' Professional Quality of Life, Stress, and Resilience: A Mixed-Methods Study

BACKGROUND

Compassion fatigue, stress, and burnout have an adverse impact on nurse managers.

PURPOSE

To evaluate the impact of a compassion fatigue resiliency program on nurse managers and to obtain their views of the program.

METHODS

This mixed-methods study was conducted with 16 nurse managers. The compassion fatigue resiliency program was implemented; compassion fatigue, compassion satisfaction, burnout, perceived stress, and resilience were assessed before and after implementation of the program.

RESULTS

The mean compassion fatigue and perceived stress scores of nurses decreased significantly after the intervention. Four themes were identified from qualitative analysis, including awareness, coping with stress, effective communication skills in team management, and recommendations.

CONCLUSIONS

The current study shows the training program reduced nurse managers' compassion fatigue and stress and enabled nurse managers to improve their coping skills and awareness.

Stress overload, influencing factors, and psychological experiences of nurse managers during early stages of the COVID-19 pandemic: a sequential explanatory mixed method study

Background

Healthcare systems had an exceptionally difficult time during the early COVID-19 pandemic. Nurse managers in particular made enormous contributions to ensuring the safety of patients and front-line nurses while being under excessive psychological stress. However, little is known about their experiences during this time.

Objective

The aim of this study was thus to assess the level of stress overload and psychological feelings of nurse managers during the early COVID-19 pandemic.

Methods

A mixed methods sequential explanatory design study with non-random convenience sampling was performed, following the STROBE and COREQ checklists. The study was conducted at the Affiliated Dongyang Hospital, Wenzhou Medical University, with data collected from six provinces in southern China (Zhejiang, Hubei, Shanghai, Jiangsu, Hunan and Jiangxi) during March 2020 and June 2020. A total of 966 nurse managers completed the Stress Overload Scale and Work-Family Support Scale. In addition, a nested sample of nurse managers participated in semi-structured face-to-face interviews. The data were then analyzed using qualitative content analysis, Pearson correlation, and multiple linear regression.

Results

The quantitative results showed that nurse managers experienced a moderate level of stress load. There was a significant negative correlation between work-family support and stress load (r = -0.551, p < 0.01). Concerns about protecting front-line nurses and work-family support were the main factors affecting the stress load, which accounted for 34.0% of the total variation. Qualitative analysis identified four main thematic analyses that explained stress load: (1) great responsibility and great stress, (2) unprecedented stress-induced stress response, (3) invisible stress: the unknown was even more frightening, and (4) stress relief from love and support. Taken together these findings indicate that concern about protecting front-line nurses and negative work-family support of nurse managers were the main factors causing stress overload.

Conclusion

Implementing measures focused on individual psychological adjustment combined with community and family support and belongingness is one potential strategy to reduce psychological stress among nurse managers.

Caring Knowledge as a Strategy to Mitigate Violence against Nurses: A Discussion Paper

Violence against nurses is a disturbing trend in healthcare that has reached epidemic proportions globally. These violent incidents can result in physical and psychological injury, exacerbating already elevated levels of stress and burnout among nurses, further contributing to absenteeism, turnover, and intent to leave the profession. To ensure the physical and mental well-being of nurses and patients, attention to the development of strategies to reduce violence against nurses must be a priority. Caring knowledge-rooted in the philosophy of care-is a potential strategy for mitigating violence against nurses in healthcare settings. We present what caring knowledge is, analyze its barriers to implementation at the health system and education levels and explore potential solutions to navigate those barriers. We conclude how the application of models of caring knowledge to the nurse-patient relationship has the potential to generate improved patient safety and increased satisfaction for both nurses and patients.

A mixed-methods pilot study of a psychoeducational group programme for nurse managers during the COVID-19 pandemic

AIM

This mixed-methods pilot study aimed to measure the feasibility and acceptability of a psychoeducational group programme and determine its impact on mental well-being.

BACKGROUND

The programme was developed to promote self-care, growth and adaptive coping for nurse managers. The programme themes were resilience, insight, self-compassion and empowerment.

METHODS

The sample included 19 hospital-based nurse managers. Outcomes included post-traumatic growth, resilience, insight, self-compassion, empowerment, perceived stress, burnout and job satisfaction. Paired samples t tests were conducted to compare outcomes at baseline to follow-up. Qualitative interviews were conducted. Thematic analysis was used to code the qualitative responses by keyword, which were then aggregated into themes.

RESULTS

Participants reported higher post-traumatic growth and psychological empowerment after the intervention. The following six themes emerged most consistently from the qualitative interviews: feasibility of the programme, benefits of peer support, sources of stress, barriers to self-care, sources of strength and sustainability of effects.

CONCLUSIONS

The results support the acceptability and feasibility of the psychoeducational group programme.

IMPLICATIONS FOR NURSING MANAGEMENT

Health care organizations can support and promote the implementation of programmes to alleviate burnout and improve mental well-being amid the complex demands of nursing management (ClinicalTrials.gov: NCT04987697).

Diversifying Nursing Leadership Through Commitment, Connection, and Collaboration

By 2043, it is projected that more than half of the nation's population will belong to a minority ethnic group. Health care organizations are challenged to create teams that mirror the communities they serve. Diversity in health care leadership can improve community relations, enhance quality of care, and reduce disparities in care. While the profession of nursing has made positive strides toward increased diversity, this is not reflected in nursing leadership. This article discusses how organizations can support the leadership development of underrepresented minority nurses through connection, collaboration, and commitment. Also highlighted are strategies that underrepresented minority nurses can employ, as they pursue leadership roles.

Effectiveness of Lifestyle Health Promotion Interventions for Nurses: A Systematic Review

BACKGROUND

Prior research has investigated various strategies to improve health, wellbeing and the job-related outcomes of nurses. However, the scope of this evidence is not clear and the types of intervention most likely to have positive outcomes are unknown.

OBJECTIVE

To provide an overview and synthesis of the effectiveness of interventions conducted with the goal of improving health, wellbeing and the job-related outcomes of nurses.

METHODS

A systematic database search was conducted from January 2000 to December 2018, with pre-defined criteria (Cochrane Central Register of Controlled Trials; MEDLINE and PubMed; EMBASE; CINAHL; PsycINFO; and BioMed Central). In total, 136 intervention studies with a total sample of 16,129 participants (range 9-3381) were included and evaluated. Data extraction, quality assessment and risk of bias analyses were performed.

RESULTS

Studies included randomised controlled trials (RCTs; n = 52, 38%), randomised crossover design studies (n = 2, 1.5%) and non-randomised pre-post studies with a control group (n = 31, 23%) and without a control group (n = 51, 37.5%). The majority of interventions focused on education, physical activity, mindfulness, or relaxation. Thirty-seven (27%) studies had a multimodal intervention approach. On average, studies had relatively small samples (median = 61; mode = 30) and were conducted predominantly in North America (USA/Canada, n = 53). The findings were mixed overall, with some studies reporting benefits and others finding no effects. Dietary habits was the most successfully improved outcome (8/9), followed by indices of body composition (20/24), physical activity (PA) (11/14), and stress (49/66), with >70% of relevant studies in each of these categories reporting improvements. The lowest success rate was for work-related outcomes (16/32). Separate analysis of RCTs indicated that interventions that focus solely on education might be less likely to result in positive outcomes than interventions targeting behavioural change.

CONCLUSIONS

Interventions targeting diet, body composition, PA, or stress are most likely to have positive outcomes for nurses' health and/or wellbeing. The methodologically strongest evidence (RCTs) is available for body composition and stress. Interventions relying solely on educational approaches are least likely to be effective. Organisational outcomes appear to be more challenging to change with lifestyle intervention, likely requiring more complex solutions including changes to the work environment. There is a need for more high-quality evidence since many studies had moderate or high risk of bias and low reporting quality.

The Impact of a Mindfulness Intervention for Nurse Managers

Purpose: To examine the impact of a mindfulness intervention on nurse managers in an acute care hospital. Design: A pre/post intervention design with three data collection points: prior to, at the conclusion of, and at 3 months following the intervention. Method: A survey to measure the impact of a mindfulness workshops on nurse managers’ perception of professional quality of life, burnout, and perceived wellness. Findings: There were significant changes in the scores on the compassion satisfaction (T-1 mean 3.9, T-2 mean 4.5, p = .002) and burnout subscales (T-1 mean 3.4, T-2 mean 2.8, p = .016) of the Professional Quality of Life scale, and on personal burnout (T-1 mean 4.2, T-2 mean 3.8, p = .023) and work-related burnout (T-1 mean 4.0, T-2 mean 3.5, p = .029) on the Copenhagen Burnout Inventory scale, following the mindfulness intervention. The 3-month follow-up scores on compassion satisfaction were higher but not statistically significant ( p = .810). Scores on the burnout scales, while lower than the preintervention levels, were higher at the 3-month follow-up than immediately following the intervention. Conclusions: These findings suggest that mindfulness practices need to be reinforced. Without continuous reinforcement, it may become a self-care practice moved to the bottom of the list of things to be done among the activities of a busy day.