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McHugh A, Miller C, Stewart C. Maslow's Hierarchy of Needs: Achieving Outcomes, Improving Value, and Work Environment - Lessons Learned from the Pandemic. Crit Care Nurs Clin North Am 2024; 36:451-467. [PMID: 39069363 DOI: 10.1016/j.cnc.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Health care delivery science, according to Faerber, "focuses on ways to improve health and services to individuals and populations." The triple aim, described as improving population health, enhancing the care experience, and reducing costs; is a model for health care improvement. In 2014, the triple aim expanded to the quadruple aim to include the health and satisfaction of health care professionals.
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Shipp HG, Hall KC. Analyzing the concept of toxic positivity for nursing: A dimensional analysis approach. J Adv Nurs 2024; 80:3146-3157. [PMID: 38243659 DOI: 10.1111/jan.16057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/30/2023] [Accepted: 12/30/2023] [Indexed: 01/21/2024]
Abstract
AIM To analyze toxic positivity and its relevance to nursing. DESIGN Concept analysis using Schatzman's dimensional analysis approach. DATA SOURCES Two searches were conducted using Google Scholar, JSTOR, ProQuest and CINAHL (1990-2023). Keywords included "toxic positivity" (Phase 1) and "emotional suppression," "unrealistic optimism"; "disingenuous happiness," "forced gratitude" and "logical fallacy" (Phase 2). Retained sources (1) were in English (Phases 1 and 2); (2) used 'toxic positivity' as a construct reflecting the purpose of analysis (Phase 1); and (3) demonstrated relevance towards analytical findings (Phase 2). Total analytic sources were 35. METHODS The analytic phase, identification, elucidated conceptual dimensions and contexts. The analytic phase, logistics, examined relationships among dimensions and contexts through an iterative process resulting in a dimensional matrix/conceptual model. RESULTS Salient dimension is Emotional Suppression with two sub-dimensions, Logical Fallacy and Forced Gratitude. Other dimensions include Unrealistic Optimism and Disingenuous Happiness. Contexts include intra- and post-paradigmatic societal shifts and intra- and post-traumatic experiences. Analysis reveals toxic positivity as an exchange between a giver and receiver with the receiver experiencing negative outcomes. CONCLUSION The concept appears consistent in its application and use across contexts and is emerging in nursing literature. IMPLICATIONS FOR THE PROFESSION Acknowledging toxic positivity in nursing may inform theoretical and future research related to improving nursing burnout, bolstering retention, and enhancing well-being. Nurses across work environments may encounter toxic positivity. Leaders should consider policy adoption and inclusion of trauma-informed practices. IMPACT Nursing workforce issues require deeper examination of potential contributing factors. Findings suggest toxic positivity may be encountered in work environments impacting nursing at individual and system levels. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Hannah G Shipp
- College of Nursing, East Tennessee State University, Johnson City, Tennessee, USA
| | - Katherine C Hall
- College of Nursing, East Tennessee State University, Johnson City, Tennessee, USA
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Osei HV, Arthur J, Aseibu F, Osei-Kwame D, Fiakeye R, Abama C. The joint impact of burnout and neurotic personality on career satisfaction and intention to leave among health workers during the first 2 years of COVID-19. J Health Organ Manag 2024; ahead-of-print. [PMID: 38888569 DOI: 10.1108/jhom-03-2023-0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
PURPOSE The purpose of the study is to examine the psychological impact of COVID-19 on health workers' career satisfaction and intention to leave the health profession, with neurotic personality type as a moderator. DESIGN/METHODOLOGY/APPROACH A total of 277 health workers in two public hospitals in Ghana were included in this study. Purposive and convenience sampling techniques were adopted for the study, focusing on eight departments that were involved in the management of COVID-19 cases. Validated instruments were used to measure burnout, intention to leave, neurotic personality and career satisfaction. Using AMOS and partial least squares structural equation modeling (PLS-SEM), various techniques were employed to analyze mediating and moderating mechanisms. FINDINGS The departments had staff sizes ranging from 19 to 40, with 67% female and 33% male, with an average age of 31. Nurses accounted for the majority of responses (67.8%), followed by physicians (13.9%), sonographers (0.9%), lab technicians (0.9%) and other respondents (16.5%). The study found that health workers' level of burnout during COVID-19 had a positive effect on their intention to leave the health profession. Career satisfaction does not mediate this relationship; however, career satisfaction negatively influences the intention to leave the health profession. A neurotic personality does not moderate this relationship. ORIGINALITY/VALUE This study provides validation of burnout and intention to leave among health workers in Ghana during COVID-19 and supports the proposition that threats to resources (burnout) and having a resource (career satisfaction) have effects on the intention to leave one's profession.
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Affiliation(s)
- Hannah Vivian Osei
- Department of Human Resource and Organisational Development, KNUST School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Justice Arthur
- Department of Human Resource and Organisational Development, KNUST School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francis Aseibu
- Department of Human Resource and Organisational Development, KNUST School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Osei-Kwame
- Department of Emergency Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Rita Fiakeye
- Department of Human Resource and Organisational Development, KNUST School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charity Abama
- Department of Human Resource and Organisational Development, KNUST School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Bunch JL, Gedney-Lose A, Perkhounkova Y, Sharp B, Groves PS. Nurse Managers' Professional Quality of Life During the COVID-19 Pandemic. West J Nurs Res 2024; 46:183-191. [PMID: 38268463 DOI: 10.1177/01939459241227264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
BACKGROUND Health systems cannot effectively support nurse managers without understanding psychosocial effects of the COVID-19 pandemic. OBJECTIVE The objective of this study was to describe the professional quality of life of frontline nursing management during the COVID-19 pandemic. METHODS A cross-sectional online survey of 54 nurses in management positions at a large Midwest academic medical center during 2022 was conducted. Participants completed an electronic survey including demographics, Professional Quality of Life Measure Version 5, and items assessing past consideration of and future intent to leave their position, organization, or profession. RESULTS Most participants had previously considered changing roles (80%) or leaving the organization during the pandemic (76%). Fewer respondents reported that changing role (24%) or organization (20%) was likely during the upcoming 6-12 months. Most participants scored in moderate ranges of Compassion Satisfaction, Burnout, and Secondary Traumatic Stress scales (85%, 89%, and 74%, respectively). Higher Compassion Satisfaction was associated with extreme unlikelihood of leaving for an internal non-management role. Higher Burnout scores were associated with more time working and past consideration or future likelihood of leaving for an external non-nursing position. Secondary Traumatic Stress scores were higher for nurse managers and house operation managers than assistant nurse managers and associated with past consideration of moving to an internal non-management role or external non-nursing position and future likelihood of moving to an external non-nursing position. CONCLUSIONS Nurse management occupies a demanding position between frontline staff needs and administrative requirements, profoundly impacted by COVID-19. Health care researchers, administration, and policymakers must learn how to support, retain, and sustain nursing management in a post-pandemic world.
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Affiliation(s)
| | | | | | - Brittaney Sharp
- College of Nursing, University of Iowa, Iowa City, IA, USA
- University of Iowa Hospitals & Clinics, Iowa City, IA, USA
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5
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Miller GE, Holmes D. Self-Deception in Clinical Nursing Practice: A Concept Analysis. Clin Nurs Res 2024; 33:114-122. [PMID: 37872731 PMCID: PMC10731826 DOI: 10.1177/10547738231206610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
In this paper, we explore the phenomenon of "self-deception" within the context of nursing, focusing on how nurses employ this coping mechanism when faced with dissonance, distress, and conflicting situations in clinical settings. Our primary objective is to examine the phenomenon of self-deception using Rodgers' evolutionary method of concept analysis. Focusing on nurses' experiences in challenging situations, our analysis highlights how self-deception is often employed as a coping strategy. According to our conceptual analysis, self-deception in nursing clinical practice highlights tensions between different paradigms and expectations in healthcare settings. These tensions stem from the power dynamics and subservience that nurses often face, which can hinder their ability to advocate for themselves, their patients, and the nursing profession.
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Zuniga LM, Schuh A, Schwartz A, Seo-Mayer P, Cramton R, Sieplinga K, Kaushik R, Nassetta L, Homme JH, Babal J, Mahan JD, Batra M. Burnout During the COVID-19 Pandemic: A Report on Pediatric Residents. Acad Pediatr 2023; 23:1620-1627. [PMID: 37207966 PMCID: PMC10191699 DOI: 10.1016/j.acap.2023.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND AND OBJECTIVE The Pediatric Resident Burnout and Resilience Consortium (PRB-RSC) has described the epidemiology of burnout in pediatric residents since 2016. We hypothesized burnout rates during the pandemic would increase. We explored resident burnout during the COVID-19 pandemic and its relationship to resident perception of workload, training, personal life, and local COVID burden. METHODS Since 2016, PRB-RSC has sent an annual, confidential survey to over 30 pediatric and medicine-pediatrics residencies. In 2020 and 2021, seven questions were added to explore the relationship of COVID-19 and perceptions of workload, training, and personal life. RESULTS In 2019, 46 programs participated, 22 in 2020, and 45 in 2021. Response rates in 2020 (n = 1055, 68%) and 2021(n = 1702, 55%) were similar to those of previous years (P = .09). Burnout rates in 2020 were significantly lower than in 2019 (54% vs 66%, P < .001) but returned to pre-COVID levels in 2021 (65%, P = .90). In combined 2020-2021 data, higher rates of burnout were associated with reported increased workload (Adjusted Odds Ratio (AOR) 1.38, 95% CI 1.19-1.6) and concerns regarding the effect of COVID on training (AOR 1.35, 95% CI 1.2-1.53). Program-level county COVID burden in combined 2020-2021 data was not associated with burnout in this model (AOR=1.03, 95% CI 0.70-1.52). CONCLUSIONS Burnout rates within reporting programs decreased significantly in 2020 and returned to prepandemic levels in 2021. Increased burnout was associated with perceived increases in workload and concerns regarding effect of the pandemic on training. Given these findings, programs should consider further investigation into workload and training uncertainty on burnout.
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Affiliation(s)
- Linessa M Zuniga
- Baylor College of Medicine and Texas Children's Hospital (LM Zuniga), Houston, Tex.
| | - Abigail Schuh
- Medical College of Wisconsin and Children's Wisconsin (A Schuh), Milwaukee, Wis.
| | - Alan Schwartz
- University of Illinois College of Medicine (A Schwartz), Chicago, Ill.
| | | | - Rachel Cramton
- University of Arizona College of Medicine (R Cramton), Tucson, Ariz.
| | - Kira Sieplinga
- Spectrum Health/Michigan State University College of Human Medicine and Helen DeVos Children's Hospital (K Sieplinga), Grand Rapids, Mich.
| | - Ruchi Kaushik
- Baylor College of Medicine and The Children's Hospital of San Antonio (R Kaushik), San Antonio, Tex.
| | - Lauren Nassetta
- UAB Medicine and Children's of Alabama (L Nassetta), Birmingham, Ala.
| | - Jason H Homme
- Mayo Clinic Children's Center (JH Homme), Rochester, Minn.
| | - Jessica Babal
- University of Wisconsin School of Medicine (J Babal), Madison, Wis.
| | - John D Mahan
- The Ohio State University College of Medicine and Nationwide Children's Hospital (JD Mahan), Columbus, Ohio.
| | - Maneesh Batra
- University of Washington and Seattle Childrens, Neonatology (M Batra).
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Richard AL, Hornbogen A, Cooper A, Yohannan S, Hicks FD, Anen T, Ferket K. A Visionary Think Tank to Address the Nursing Workforce Crisis. J Nurs Adm 2023; 53:607-614. [PMID: 37874876 DOI: 10.1097/nna.0000000000001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
The COVID-19 pandemic exacerbated an existing problem plaguing hospital systems across the United States: a nursing workforce shortage. This article describes how one institution applied the American Organization for Nursing Leadership Nurse Executive Competencies to convene an immersive think tank to reimagine the nursing workforce.
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Affiliation(s)
- Angelique L Richard
- Author Affiliations: Chief Nursing Officer and Senior Vice President (Dr Richard), Hospital Operations, Rush University Medical Center; Vice President, Patient Care and Chief Nursing Officer (Hornbogen), Rush Copley Medical Center, Aurora; Chief Nursing Officer (Dr Cooper), Rush Oak Park Hospital, Oak Park; Associate Vice President (Dr Yohannan), Patient Care Services, Rush University Medical Center, Chicago; Associate Dean for Academic Programs and Affairs, Professor (Dr Hicks), Adult and Gerontological Nursing, Rush University College of Nursing, Chicago; Owner (Anen), Trish Anen Advisory Services LLC, Sugar Grove; Principal, Consultant and Executive Leadership Coach (Ferket), L3 Advisors Group, Park Ridge, Illinois
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Cottam C, Dillon A, Painter J. An Exploration of Student Nurses' Experiences of Burnout during the COVID-19 Pandemic Using the Copenhagen Burnout Inventory (CBI). Healthcare (Basel) 2023; 11:2576. [PMID: 37761773 PMCID: PMC10530923 DOI: 10.3390/healthcare11182576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
Burnout amongst healthcare professionals has been a long-considered condition associated with the workplace environment. Student nurses studying at Sheffield Hallam University continued to engage in their training during the COVID-19 pandemic; however, the stressors of this experience were anecdotally highlighted to their academic staff. Furthermore, burnout can be linked to the ongoing difficulties with recruitment and retention of nursing staff within the NHS workforce. This work aimed to determine the burnout among nursing students experience by obtaining quantitative data to understand their experiences. The Copenhagen Burnout Inventory was used to gauge levels of burnout across the different fields of nursing students. Results identified that: (1) mental health students reported feeling tired significantly less often than child and adult field students (mean rating of 69% versus 91.7% and 84.0%, respectively); (2) students aged 30-39 feel tired significantly less often than both younger student age groups (mean rating 59.4% versus 82.8% and 90.6%); (3) there was a significant difference in how often different age groups felt "tired of working with clients" (F(4) = 2.68, p = 0.04) and that "they couldn't take it anymore" (F(4) = 2.53, p = 0.05); (4) child-field students reported generally higher levels of global burnout (mean CBI total = 57.9%) whilst mental health students reported lower levels (mean CBI total = 54.1%). Considering these results, it is imperative for both higher education institutions and potential employers to consider the impact of COVID-19 and burnout, and the levels of support offered to student nurses during their training and transition to practice as newly qualified nurses.
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Affiliation(s)
- Charlie Cottam
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield S1 1WB, UK; (A.D.); (J.P.)
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Rizzo A, Yıldırım M, Öztekin GG, Carlo AD, Nucera G, Szarpak Ł, Zaffina S, Chirico F. Nurse burnout before and during the COVID-19 pandemic: a systematic comparative review. Front Public Health 2023; 11:1225431. [PMID: 37732086 PMCID: PMC10507882 DOI: 10.3389/fpubh.2023.1225431] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/27/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction This review aimed to compare available evidence examining burnout using the Maslach Burnout Inventory (MBI) in nurses before and during the COVID-19 pandemic. The specific objective was to compare nurse burnout scores in terms of emotional exhaustion, depersonalization, and personal accomplishment. Methods A comprehensive search was conducted for studies on nurses' burnout using the MBI published between 1994 and 2022. In total, 19 studies conducted prior to the pandemic and 16 studies conducted during the pandemic were included and compared using the criteria from the Joanna Briggs Institute Critical Appraisal Tool. Results Surprisingly, the results indicated that nurses' burnout scores did not differ significantly before (N = 59,111) and during (N = 18,629) the pandemic. The difference observed was qualitative rather than quantitative. Discussion The outbreak of the COVID-19 pandemic exacerbated an already critical situation, and while COVID-19 may serve as an additional triggering factor for staff mental illness, it cannot solely explain the observed burnout levels. These findings underscore the need for long-term clinical and preventive psychological interventions, suggesting that psychological resources should not be limited to emergencies but extended to address the ongoing challenges faced by nurses. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=399628, identifier: CRD42023399628.
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Affiliation(s)
- Amelia Rizzo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Murat Yıldırım
- Department of Psychology, Faculty of Science and Letters, Agri Ibrahim Cecen University, Agri, Türkiye
| | - Gülçin Güler Öztekin
- Department of Psychology, Faculty of Science and Letters, Agri Ibrahim Cecen University, Agri, Türkiye
| | - Alessandro De Carlo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gabriella Nucera
- Department of Emergency, Fatebenefratelli Hospital, ASST Fatebenefratelli and Sacco, Milan, Italy
| | - Łukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Salvatore Zaffina
- Occupational Medicine Unit, Bambino Gesù Children's Hospital, Scientific Institutes for Research and Care (IRCCS), Rome, Italy
| | - Francesco Chirico
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Health Service Department, Italian State Police, Ministry of the Interior, Centro Sanitario Polifunzionale, Milan, Italy
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Pagnotta A, Antonacci R, Curiale L, Sanzone L, Kapoustina O, Cervantes A, Monaco E, Tsimicalis A. Exploring Novice Nurses' Experiences During the First Wave of the COVID-19 Pandemic. J Nurs Educ 2023; 62:461-466. [PMID: 37561900 DOI: 10.3928/01484834-20230612-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic affected how nurses learn and prepare for their future careers. This study explored the experiences of college-prepared, novice nurses pursuing a baccalaureate degree during the first wave of the pandemic. METHOD This qualitative descriptive study analyzed students' individual reflective assignments describing the effects of the COVID-19 pandemic on novice nurses' personal, professional, and educational lives. RESULTS Three themes emerged: (1) emotions generated in the clinical workplace due to the lack of control and the unknown of working as novice nurses during a pandemic; (2) cognitive dissonance of the nursing role regarding novice nurses' moral distress and their growing empowerment within the scope of practice; and (3) a disconcerted image of nursing with contrasting views of nursing from the public's perspective and a disconnect between frontline workers and decision makers. CONCLUSION Novel pedagogical strategies are needed to help novice nurses cope with stress, uncertainty, and role challenges to foster healthy learning in academic and working environments. [J Nurs Educ. 2023;62(8):461-466.].
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Rodriquez J. Reconfiguring the social organization of work in the intensive care unit: Changed relationships and new roles during COVID-19. Soc Sci Med 2023; 317:115600. [PMID: 36538836 PMCID: PMC9721201 DOI: 10.1016/j.socscimed.2022.115600] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/28/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
The COVID-19 pandemic caused hospitals to make changes to workflow that exacerbated emotional exhaustion and burnout among health care workers. This article examines one of those changes, restricted visitation, showing how it changed the social organization of work by upending established interactional patterns and relationships between health care workers, patients, and patients' families. Based on 40 interviews with intensive care unit (ICU) workers in units that were full of COVID-19 patients and had fully restricted visitation, study findings show that staff took on emotional support roles with patients that had typically been done by families at the bedside. They also faced increased anger, distrust, and misunderstandings from families who were not allowed to see their dying loved one. With each other, staff bonded together with dark humor and candid talk about the scale of deaths, constructing a shared understanding and solidarity amidst the tragedy of the pandemic.
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Affiliation(s)
- Jason Rodriquez
- Department of Sociology, University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA, 02115, USA.
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Lyle-Edrosolo G. The Business Case for Addressing Burnout in Frontline Leaders: A Toolkit of Interventions From Nurse Executives Around the United States. Nurs Adm Q 2023; 47:94-99. [PMID: 36469377 DOI: 10.1097/naq.0000000000000558] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
In 2019, the National Academy of Sciences, Engineering, and Medicine identified clinician burnout as a major problem that required immediate action because of its threat to both health care worker safety and patient safety. Unfortunately, the rise of COVID-19 in 2020 with no signs of a clear ending (as of the summer of 2022) has compounded this problem. Consequently, much focus has been placed by many to address clinician burnout and help alleviate this major threat to safety. Unfortunately, compared with clinician burnout, articles and resources to address frontline leader (FL) burnout are fewer. FLs are key to supporting teams and are integral to their success. They also execute and operationalize organizational strategic plans to ensure patient safety at the point of care. The burnout issue with bedside clinicians is a big issue, a fractured fault line in our health care system. However, without addressing the well-being of FLs, this fault line becomes a chasm. The column shares background from the American Organization for Nursling Leadership longitudinal studies and other pertinent research. It also provides examples of practices across the nation of how nurse executives are supporting their teams and promoting leader support and well-being.
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Hinzmann D, Schütte-Nütgen K, Büssing A, Boenisch O, Busch HJ, Dodt C, Friederich P, Kochanek M, Michels G, Frick E. Critical Care Providers' Moral Distress: Frequency, Burden, and Potential Resources. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:333. [PMID: 36612657 PMCID: PMC9819312 DOI: 10.3390/ijerph20010333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/25/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Critical Care Providers (CCPs) experience situations that challenge their ethics and professional standards and may entail moral distress (MD). AIM To analyze MD perceived by CCPs in intensive care units (ICUs) or emergency departments (EDs) and further clarify whether CCPs who rely on spiritual resources differ in their perception of MD from those who do not utilize these resources. METHODS A cross-sectional anonymous survey was administered using a modified version of the German language version of the Moral Distress Scale (MDS) with 2 × 12 items to assess the frequency and the respective perceived burden of specific situations by applying a 5-point Likert scale. Explorative factor analysis was performed and the sub-constructs of the respective items regarding MD frequency and burden were identified. Job burden and professional satisfaction were measured using visual analogue scales (VAS) and a four-point Likert scale, respectively. The 15-item SpREUK questionnaire was applied to measure spiritual attitudes and behaviours and to differentiate between religious and spiritual persons. Data from 385 German-speaking CCPs were included (55% physicians, 45% nurses). RESULTS Conflict situations are similar for physicians and nurses although they are perceived as more burdensome by nurses. Among physicians, the MDS factor Looking away/Resignation scores highest for assistant physician residents, whereas distress caused by looking away is more often perceived by specialist physicians without a managerial position. Work satisfaction is inversely associated with MD and emotional exhaustion is positively associated with it. Participants' spirituality is marginally associated with MD. The best predictors of both MD frequency and burden are emotional exhaustion with further influences of work satisfaction, being a nurse, and being a non-believer on the frequency of MD perception. Being a nurse, participants' experience in ICU/ED, and being of the male gender are further predictors of MD burden. CONCLUSIONS MD is experienced differently by different groups of CCPs depending on their place in the hierarchy of responsibility. As MD perception is best predicted by emotional exhaustion, these situations should be avoided. Although some CCPs may rely on spiritual resources, all need individual and team support to cope with MD.
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Affiliation(s)
- Dominik Hinzmann
- Department of Anaesthesiology and Intensive Care, University Hospital Rechts der Isar, 81675 Munich, Germany
- School of Medicine, Technical University of Munich, 80333 München, Germany
| | | | - Arndt Büssing
- Quality of Life, Spirituality and Coping, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Olaf Boenisch
- Department of Intensive Care, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Hans-Jörg Busch
- Department of Emergency Medicine, University Hospital Freiburg, 79106 Freiburg, Germany
| | - Christoph Dodt
- Emergency Department, München Klinik, 81925 Munich, Germany
| | | | - Matthias Kochanek
- Department of Intensive Care, University Hospital Cologne, 50937 Cologne, Germany
| | - Guido Michels
- Emergency Department, Sankt Antonius Hospital, 52249 Eschweiler, Germany
| | - Eckhard Frick
- School of Medicine, Technical University of Munich, 80333 München, Germany
- Spiritual Care and Psychosomatic Health, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, 80539 Munich, Germany
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Boston-Leary K, Stone B. The nursing profession circa 2030. Nursing 2022; 52:34-39. [PMID: 36394623 DOI: 10.1097/01.nurse.0000891952.97337.9b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
ABSTRACT The COVID-19 pandemic has forced immediate change and hopefully for the better. Navigating through this new world of care delivery warrants developing new maps to reach a new and acceptable normal. This article outlines urgent issues and necessary steps for measurable change, in nursing practice and work environments by 2030.
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Affiliation(s)
- Katie Boston-Leary
- Katie Boston-Leary is the director of Nursing Programs and Healthy Nurse, Healthy Nation at the American Nurses Association, and Bobbie Stone is the founder, president, and CEO of Bobbie Stone International, an executive search and consulting firm specializing in healthcare, nursing, and philanthropy leadership
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Mental Health of Nurses Working in a Judicial Psychiatry Hospital during the COVID-19 Pandemic in Italy: An Online Survey. MEDICAL SCIENCES (BASEL, SWITZERLAND) 2022; 10:medsci10040061. [PMID: 36412902 PMCID: PMC9680444 DOI: 10.3390/medsci10040061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/13/2022] [Accepted: 10/20/2022] [Indexed: 12/14/2022]
Abstract
The onset of this new pandemic has highlighted the numerous critical issues at the organizational level, which involve both national healthcare and the judicial system. For this reason, nurses working in prisons may exhibit a poor quality of life, mainly related to their high level of work stress. This cross-sectional survey aimed to assess the emotional state of nurses working in the Judicial Psychiatry Hospital of Barcellona PG (Messina, Italy) during the COVID-19 pandemic. Data collection occurred twice: from 1 April to 20 May 2020 (i.e., during the Italian lockdown) and from 15 October to 31 December 2021 (during the second wave). At baseline, the 35 enrolled nurses presented medium to high levels of stress. At T1, they had a reduction in perceived personal achievement (MBI-PR p = 0.01), an increase in emotional exhaustion (MBI-EE p < 0.001), and stress (PSS p = 0.03), as well as anxiety (STAI Y1/Y2 p < 0.001). Most participants underlined the high usability of the online system (SUS: 69.50/SD 19.9). We also found increased stress, anxiety, and burnout risk in nursing staff. The study clearly demonstrates that the first year of the COVID-19 pandemic in Italy caused a worsening of mental health among nurses working in prisons. We believe that monitoring the mental state of healthcare professionals is fundamental to improving their quality of life and healthcare services.
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Bourgault AM. What Will the New Normal Look Like? Crit Care Nurse 2022; 42:8-10. [PMID: 35640894 DOI: 10.4037/ccn2022740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Annette M Bourgault
- Annette Bourgault is Editor of Critical Care Nurse. She is an Associate Professor at the University of Central Florida in Orlando and a Nurse Scientist with Orlando Health
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Conti A, Russotto S, Opizzi A, Ratti M, Nicolini D, Vanhaecht K, Panella M. Work-Related Stress among a Cohort of Italian Long-Term Care Workers during the COVID-19 Pandemic: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105874. [PMID: 35627411 PMCID: PMC9140776 DOI: 10.3390/ijerph19105874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 05/02/2022] [Accepted: 05/10/2022] [Indexed: 12/19/2022]
Abstract
Despite long-term care (LTC) workers having been identified as particularly subject to chronic stress, only a few studies evaluated the impact of the COVID-19 pandemic on stress in this population. As far as the authors know, no studies have investigated the relationship between work-related stress and chronic stress in the LTC setting. This retrospective observational study aimed to assess the level of chronic stress in LTC workers, to identify some possible predictors and vulnerability factors, and to measure the impact of the COVID-19 pandemic on work-related stress. The study was based on the information gathered from two different questionnaires administered before and one year after the beginning of the pandemic, to a cohort of Italian LTC workers. We found that chronic stress was associated with lower resilience to stress scores (57.42 vs. 60.66) and with higher work-related stress scores (30.48 vs. 20.83). Interestingly, the overall level of work-related stress did not differ between the two questionnaires (27.84 vs. 29.08). However, the main components of the questionnaires changed; fatigue and burnout symptoms became more relevant after the pandemic. Results of this study suggests deepening knowledge of the components of stress to develop and implement effective stress mitigation interventions.
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Affiliation(s)
- Andrea Conti
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (S.R.); (A.O.); (M.R.); (D.N.)
- Correspondence: (A.C.); (M.P.)
| | - Sophia Russotto
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (S.R.); (A.O.); (M.R.); (D.N.)
| | - Annalisa Opizzi
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (S.R.); (A.O.); (M.R.); (D.N.)
| | - Matteo Ratti
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (S.R.); (A.O.); (M.R.); (D.N.)
| | - Daniele Nicolini
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (S.R.); (A.O.); (M.R.); (D.N.)
| | - Kris Vanhaecht
- KU Leuven Institute for Healthcare Policy, 3000 Leuven, Belgium;
| | - Massimiliano Panella
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (S.R.); (A.O.); (M.R.); (D.N.)
- Aging Project Unit, Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy
- Correspondence: (A.C.); (M.P.)
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