The perceived helpfulness and acceptability of a bespoke psychological therapy service for registered nurses experiencing psychological distress: A qualitative study

AIM

To understand the perceived helpfulness and acceptability of a bespoke psychological therapy service for registered nurses. The service provided a free and confidential specialist mental health service to all healthcare professionals, including nurses and nursing students.

DESIGN

An exploratory study using a descriptive qualitative approach.

METHODS

A purposive sample of 20 registered nurses accessing a bespoke psychological therapy service in Wales participated in audio-recorded semi-structured interviews in January 2022. Transcribed data were analysed using reflexive thematic analysis.

RESULTS

Four interrelated themes were identified from the data analysis: COVID [SARS-CoV-2] changed things; You're a nurse, you're human; I've got 'me' back; and pretty close to miracle workers.

CONCLUSION

Participants attempted to live up to an idealized image of a nurse, generating self-stigmatizing beliefs that negatively affected their mental health. The psychological therapy service enabled participants to put their roles into perspective, that is, separate themselves from their role, be vulnerable, and develop confidence and adaptive coping strategies. Participants valued the minimal barriers and ease of access to support.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

The complex relationship between nurse identity and the challenges of the workplace needs to be central to nurse education. Nurses can benefit from rapid access to a timely, confidential, and independent self-referring psychological therapy service.

IMPACT

This qualitative study explored the helpfulness and accessibility of psychological support for nurses. The main themes were that COVID changed things; You're a nurse, you're human; I've got 'me' back; and pretty close to miracle workers. The findings will impact how nurses are supported in the United Kingdom and worldwide.

REPORTING METHOD

This report adheres to the standards for reporting qualitative research (SRQR).

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Evaluating a brief online compassion-focused intervention for intensive care nurses

BACKGROUND

High levels of stress have been found within health care staff, particularly in the nursing population, which is somewhat attributed to the Covid-19 pandemic. The development of self-compassion, a protective psychological construct, may promote well-being in the health care staff population. As part of a service development project, the authors delivered and evaluated a brief online compassion-focused intervention with nurses working within Intensive Care Units (ICUs).

AIMS

Aims were to explore feasibility within the ICU nursing population and consider potential benefits to psychological well-being.

METHODS

ICU nurses registered for an online, 4 week, compassion-focused intervention as part of a service development project. Measures of compassion, burnout, trauma, and the emotional climate of their work environment were analysed in two groups; those who completed the intervention and those who did not. Baseline and post-intervention measures were analysed to infer the potential benefits of the intervention.

RESULTS

Compared with their baseline scores, those who completed the intervention showed improvements on measures of compassion, soothing in emotional climate, and reductions in burnout, trauma and threat in emotional climate. At baseline, those who did not complete the intervention scored lower on measures of compassion and soothing within their emotional climate, as well as higher levels of trauma and threat within the emotional climate, compared with those who engaged with the intervention.

CONCLUSIONS

Brief online compassion-focused interventions may be a useful platform to promote well-being in ICU nurses, but possibly only for those who have a pre-established level of self-compassion.

RELEVANCE TO CLINICAL PRACTICE

This study demonstrates the value of offering online interventions to improve the mental health of nursing staff. The findings suggest that nurses may benefit from being offered online interventions as welll as traditional psychological interventions. This may shape further service provision by offering nurses who require support a wider range of treatment options.

What Role Does "Emotional Medicine" Play in Oncology Nursing?

The Susan D. Flynn Oncology Nursing Fellowship is an eight-week immersive experience that allows rising senior nursing students to gain clinical experience and promotes professional development in oncology nursing.

Bullying experience and the work environment in nurses: a cross-sectional data analysis

AIMS

This study aimed to examine the degree and severity of workplace bullying in nurses, and to assess the relationship between bullying and work environment factors.

BACKGROUND

Workplace bullying occurs in nursing at an alarming rate and may escalate with more adverse working conditions.

METHODS

Online survey data from a nationally representative sample of 1170 US registered nurses, collected between 2019-20 were analyzed. Five items measuring workplace bullying were used to identify bullying subgroups: unbullied, bullied but unrecognized, moderate bullying, severe bullying) using latent profile analysis. Ordinal logistic regression examined relationships between workplace factors and bullying, RESULTS: Over 40% of nurses reported being bullied in the past year. Four bullying subgroups were distinguished. Inadequate staffing, lack of time to get the job done, and lack of breaks away from the work area were all significantly associated with severe bullying.

CONCLUSION

Ensuring adequate staffing based on patient needs and nurse competency can mitigate workplace bullying in nurses. Further studies are needed to examine the effectiveness of stress reduction programs on bullying using longitudinal designs.

IMPLICATIONS FOR NURSING MANAGEMENT

This result indicates a critical need to improve nursing work environments, which could provide many benefits for nursing workforces, including potential to lessen bullying severity that adversely affects nurse well-being.

Perceptions of US nurses and nurse leaders on authentic nurse leadership, healthy work environment, intent to leave and nurse well-being during a second pandemic year: A cross sectional study

AIM

The main aim of this study was to determine the perceptions of clinical nurses and nurse leaders about authentic nurse leadership, work environment, pandemic impact, well-being and intent to leave their position and profession during the second year of the pandemic.

BACKGROUND

This research team studied the variables pre-pandemic and in year one of the pandemic. As the pandemic continued, subsequent reports of workforce instability, deteriorating work environment and vulnerable well-being called for an understanding of the current state to inform needed actions by leadership.

METHODS

This study is a cross-sectional, descriptive, correlational analysis using national survey data from 1795 US clinical nurses and nurse leaders in the fall of 2021.

RESULTS

Pandemic impact was high, authentic nurse leadership was present, healthy work environment was not present and nurse well-being was at-risk and negatively correlated to both healthy work environment and authentic nurse leadership. Within our sample, 61.8% of nurses had no intention to leave their positions, and 82.5% had no intention to leave the profession. Compared with clinical nurses, nurse managers had significantly higher scores on all instruments.

CONCLUSIONS

The findings of this study support leadership as positively related to a healthy work environment. Authentic nurse leadership, a healthy work environment and nurse well-being are all critical components of efforts to stabilize the nursing workforce as we recover and rebuild post-pandemic.

IMPLICATIONS FOR NURSING MANAGEMENT

This is a call to action for leadership that will serve the goals of retaining nurses, rebuilding work environments and improving well-being.

Preventing Stress-Related Ill Health Among New Registered Nurses by Supporting Engagement in Proactive Behaviors-A Randomized Controlled Trial

BACKGROUND

New registered nurses (RNs) are at risk of developing symptoms of stress-related ill health.

OBJECTIVES

To evaluate the effect of a 3 × 3 hour group intervention aiming to prevent symptoms of stress-related ill health among new RNs by increasing engagement in proactive behaviors. The intervention involves discussions and models of newcomer experiences and stress and the behavior change techniques reinforcing approach behaviors, systematic exposure, and action planning.

DESIGN

A randomized parallel group trial with an active control condition.

PARTICIPANTS

The study sample consisted of 239 new RNs participating in a transition-to-practice program for new RNs in a large county in Sweden.

METHODS

Participants were randomized to either the experimental intervention or a control intervention. Data on experiences of stress, avoidance of proactive behaviors, engagement in leisure activities, role clarity, task mastery, and social acceptance were collected before and after the intervention. Effects were evaluated using multilevel model analysis and regression analysis. Missing data were imputed using multiple imputation.

RESULTS

The control group experienced a statistically significant increase in experiences of stress during the period of the study (t(194.13) = 1.98, p = .049), whereas the level in the experimental group remained stable. Greater adherence to the intervention predicted a greater effect on experiences of stress (β = -0.15, p = .039) and social acceptance (β = 0.16, p = .027).

LINKING EVIDENCE TO ACTION

Transition-to-practice programs may benefit from adding an intervention that specifically addresses new RNs' experiences of stress to further support them as they adjust to their new professional role. However, replication studies with larger samples, more reliable measures, and longer periods of follow-up are needed.

Understanding how nurse managers see their role in supporting ICU nurse well-being-A case study

AIM

To explore how nurse managers perceive and experience their role in supporting the well-being of intensive care nurses.

BACKGROUND

While it is known that nurse manager behaviours affect nurse well-being, literature indicates that intensive care nurses may not receive the support they require. Understanding how nurse managers see their role in supporting nurse well-being is crucial to offer recommendations for improvement.

METHODS

Qualitative multiple case study design. Twelve semi-structured, in-depth interviews were conducted with nurse managers from Australian intensive care unit settings. Data were analysed using thematic analysis.

RESULTS

Nurse manages felt unsure about what their supportive role involved, lacked training on how to support nurse well-being and called for organisational backup to carry out their role effectively. The study also provided insight into the strategies that enabled nurse managers to support nurse well-being.

CONCLUSION

There is currently no consensus on the role of the nurse manager in supporting nurse well-being resulting in inconsistencies and wide practice variations. Furthermore, nurse managers need support and training if they are required to support nurse well-being.

IMPLICATIONS FOR NURSING MANAGEMENT

A clear definition of the nurse manager supportive role describing the purpose and core functions involved in this role must be developed to support nurse well-being.