Management of work stress and burnout among community nurses arising from the COVID-19 pandemic

How did student district nurses feel during the COVID-19 pandemic? A qualitative study

BACKGROUND

The COVID-19 pandemic placed a huge strain on healthcare services around the world, including community services. Students also faced substantial disturbance to educational programmes. Student district nurses are usually employed members of staff and can be recalled to the workforce, whereas pre-registration students cannot.

AIMS

This paper explores the feelings and experiences of student district nurses during the first UK national lockdown of the COVID-19 pandemic. An interpretative phenomenological approach was taken.

METHOD

A semi structured 1:1 interview and focus group was held via zoom in July 2020. A total of eight student district nurses, who were all registered adult nurses, took part. Data was analysed using the Braun and Clarke model to identify themes.

RESULTS

The findings related to their experience of being a community adult registered nurse on the frontline, while also being a student district nurse. Three themes were identified from the analysis: anxiety and uncertainty, management of risk and teamwork.

CONCLUSION

This study highlights the contribution that community nurses made in the clinical response to the COVID-19 pandemic. It adds to a paucity of literature available from this clinical setting and specifically from the viewpoint of a student district nurse. There is much written on the strains on hospital care, but it should be remembered that district nursing is the service that never shuts its doors because it has reached capacity. This study found that a lack of communication and uncertainty about their future as students contributed to heightened stress and anxiety. Teamwork and camaraderie are a vital aspect of any team and one that can support resilience in times of heightened stress. A lack of face-to-face interaction can lead to team members feeling isolated. Digital technology can be used to reduce this feeling when possible.

Cardiovascular nurses and organizational well-being: a systematic review

AIMS

This systematic review assesses the organizational well-being of nurses working in cardiovascular settings and identifies environmental variables influencing it.

METHODS AND RESULTS

The Joanna Briggs Institute's methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines have been followed. The search was conducted, from the database inception up to and including 1 December 2022, on Medline (via PubMed), Cumulative Index of Nursing and Allied Health, Cochrane Library, and Scopus. Critical appraisal and data extraction were conducted using standardized tools. Six articles of high quality were included. These mostly concerned cross-sectional studies, conducted in heterogeneous contexts, which highlight the peculiarity of the cardiovascular nursing setting. Three thematic areas were identified: stressors of cardiovascular settings; outcomes of stressors on nurses; and coping strategies used by cardiovascular nurses to deal with such stress factors. Identified stress factors included a lack of autonomy, conflicts between professional and family roles, high workloads, and stressful relationships with patients and caregivers. These organizational variables could generate nurses' burnout, depression, irritability, and/or sleep disorders. In trying to cope with such stressors, cardiovascular nurses used different strategies for compensating, avoiding, escaping, or ignoring the problem, or, in other cases, became somewhat aggressive.

CONCLUSION

Considering the limited data, cardiovascular nursing coping strategies should be further investigated, so that effective pathways for preventing or limiting stress factors can be identified and applied by the organizations. Monitoring and intervening on stress factors in this care setting could improve cardiovascular nurses' organizational well-being and accordingly patients' outcomes.

REGISTRATION

PROSPERO: CRD42022355669.

Loneliness and the COVID-19 pandemic: implications for practice

Loneliness is a complex universal human experience. A variety of evidence indicates that prolonged loneliness can have a negative effect on an individual's long-term physical and psychological outcomes. Empirical evidence and systematic reviews show strong links between loneliness and ill health, particularly cardiovascular disease and mental health. Loneliness is increasing in frequency and severity. The issue of loneliness has been part of UK Government mandates since 2018; however, evidence suggests that, due to the pandemic, the need to focus on the issue may be even more significant. Assessing for loneliness can be challenging and many people do not want to report their feelings of loneliness. Interventions should aim to be preventive and help people create meaningful interactions. Useful interventions include person-centred interventions, cognitive therapy and group intervention therapy. There is a need for more evidence-based loneliness interventions. A knowledge of local and voluntary sectors is vital so health professionals can effectively support their patients.

The Development and Implementation of a Model to Facilitate Self-Awareness of Professionalism for Enrolled Nurses

Within the South African context, the nursing profession comprises different nursing cadres. The enrolled nurse is considered a sub-category of nursing and therefore does not carry the title of 'professional' as in a professional nurse. The purpose of the study was to develop, describe, implement, and evaluate a model for the facilitation of self-awareness for the professionalism of enrolled nurses at a specific nursing agency in Gauteng. A theory generating, qualitative, exploratory, descriptive and contextual design was used and was conducted following Chinn and Kramer's four stages of model development. The model can benefit nursing education because it relates to an essential aspect of growth and maturity in one's career. Ultimately, the facilitation of self-awareness for professionalism can advance one's career, or the lack of self-awareness may impede one's career. Developing, describing, implementing and evaluating this model to facilitate self-awareness for the professionalism of enrolled nurses at a specific nursing agency in Gauteng provides an original contribution to the theory in nursing professionalism and ethos. This model can be utilised as a tool to facilitate self-awareness for the professionalism of enrolled nurses at a nursing agency.

Compassion fatigue in the community nursing workforce: a scoping review

BACKGROUND

compassion fatigue is a phenomenon in areas of nursing practice such as oncology, ICU, palliative care, hospice, and dementia care, but less so among community nurses (Joinson, 1992). A gap in enquiry exists around CN and compassion fatigue around end-of-life patient care.

METHODS

a scoping review with narrative analysis of selected literature on compassion fatigue in nursing using CINHAL, ProQuest, Science Direct, and the Cochrane Library.

FINDINGS

whilst no specific studies were located on compassion fatigue and UK community nurses. Australian, Spanish, and Taiwanese studies report of environment, care relationship duration, resources and poor organisational support being linked to a likelihood of developing compassion fatigue.

CONCLUSION

compassion fatigue is under-researched in community nursing and merits further enquiry to understand the challenges posed by providing end-of-life care.

Working as a nurse in community health services during Covid-19: a qualitative study

BACKGROUND

During the Covid-19 pandemic, new roles, increased workload, lack of staffing and infection control equipment, unclear infection control guidelines and conflicting information have led to uncertainty and unpredictability for health workers. Although community home-care nurses have been exposed to a range of personal and professional stressors during the pandemic, few studies have focused on their experiences. The aim of this study was to explore how Norwegian home-care nurses experienced the first wave of the Covid-19 pandemic. This knowledge may contribute to preparations for meetings with patients in future pandemics, how management can support its employees and how to structure a successful organization.

METHODS

This study was a qualitative descriptive design comprising 12 semi-structured individual interviews with home-care nurses. A thematic analysis was carried out.

RESULTS

Four main themes and 11 subthemes were constructed. The results revealed challenges related both to the organization and to management, experiences of unclear information, lack of available equipment, redeployment of staff and increased workload. Furthermore, it was challenging to provide high qualitative care. The nurses missed collegial togetherness and had feelings of uncertainty with a great fear of infecting others. Positive consequences were feelings of being valued and a greater awareness of infection control.

CONCLUSION

This study highlighted the importance of unambiguous information and clear delegation of responsibility, and that enough infection control equipment will likely minimize the fear of infecting each other. Being visible and admired for their work was important for the nurses' psychological well-being. Nurses, nursing managers and policymakers in community health care can use these results to develop strategies for future pandemic planning.

A study on the correlation between work stressors and the coping styles of outpatients and emergency nurses in 29 pediatric specialty hospitals across China

OBJECTIVE

This study aimed to better understand the current situation involving work stressors and the coping styles of outpatient and emergency nurses in 29 pediatric specialty hospitals across China. The study analyzed this correlation to provide a reference for the occupational stress management of pediatric nurses.

METHODS

From June to September 2020, 1,457 outpatient and emergency nurses in 29 pediatric specialty hospitals across China were selected as study participants, and a questionnaire survey was conducted using the Basic Information Questionnaire, the Chinese version of the Work Stressor Scale for Nurses, and the Simple Coping Style Scale.

RESULTS

The assessed stress level of outpatient and emergency nurses in 29 tertiary pediatric specialty hospitals nationwide is lower than the results of the survey of the 2007 domestic norm, p < 0.05. The stressors related to nurses' expectations, family conflicts, the nature of nursing work, patient factors, and workload were lower compared with the national norm (p < 0.05). The positive coping style score on the Simple Coping Style Scale for pediatric outpatient nurses was (36.66 ± 6.16), and work stressors were positively associated with negative coping styles (p < 0.01). Multiple regression analysis showed that the influencing factors of work stressors among pediatric outpatient and emergency nurses correlated with the authorized size, age, working years of nurses, work department, and negative coping styles.

CONCLUSION

Negative coping styles were present among pediatric outpatient and emergency nurses and were associated with work stressors. The influencing factors of stressors mainly correlated with the clinical establishment, age, years of employment as a nurse, work department, and negative coping styles.

Baccalaureate nursing students' experiences of how the COVID-19 pandemic influenced learning - a mixed method study

BACKGROUND

The COVID-19 pandemic mandated the reconstruction of educational programs globally. For nursing students in need of practical learning and training as a part of their curriculum, the pandemic also caused restrictions and alterations in practical placements and limited access to simulation training at campuses. The aim of this study is therefore, to describe and explore how the COVID- 19 pandemic influenced baccalaureate nursing students' experiences of learning and their social life as a student.

METHOD

We used a mixed method study design including quantitative data from one of the universities (University of Agder) from a national Norwegian survey of baccalaureate nursing students and qualitative data from focus-group interviews from the same university. The quantitative survey included 396 baccalaureate nursing students (response rate, 46%). We arranged five focus groups with a total of 23 students (15 females and 8 males). The students took part in one of the focus-group interviews. The quantitative data were analyzed using chi-square test for categorical data and ANOVA tests for continuous data, while the qualitative data were analyzed using Systematic Text Condensation and an editing analysis style.

RESULTS

Most students (70%) were concerned about the quality of the education program. In clinical placement, 83% of students had cared for patients with confirmed COVID-19 or unclear COVID-19 status. The qualitative data revealed three main themes: missing the social dimension of learning; worries and challenges in clinical placement; and experiencing normal instructive days in clinical placement. The general picture emerging from our analysis is the importance of social interactions for learning.

CONCLUSION

As the COVID-19 pandemic continues, our findings of students' worries about the quality of the education program and not reaching learning outcomes must be taken into consideration. Social interaction is considered crucial and fundamental for student learning. A follow-up study following baccalaureate completion is necessary to explore the consequences over time of disrupted education.