Implementing a Zen Room to Influence Well-Being in Rural Hospital Employees

Purpose: The COVID-19 pandemic significantly increased work-related stress and anxiety in healthcare workers worldwide, increasing their potential for burnout. Rural hospitals experienced additional challenges as they often provided care with limited resources and staff. Efforts are made by rural hospitals to mitigate employees' work-related stress and anxiety, but few studies or projects have been published that highlight these efforts. Our evidence-based practice project aimed to answer the question, does the use of a "Zen" or recovery room influence rural healthcare staff stress and anxiety levels during their shift? Sample: The project's convenience sample included 36 healthcare workers and hospital staff in an acute care facility, solely servicing a rural county in north-central Texas. Method: Following the IOWA Model, a literature search was conducted, and IRB review of the project was obtained. A private, restful space was created in a room with soft lighting, a massage chair, aromatherapy, and other various tools for relaxation. From June 2021 – January 2022, all staff were invited to use the room and complete a brief voluntary anonymous survey when they entered and exited the room. An additional short-answer survey was conducted in March 2022 to explore employees' perceptions of the project. Findings: On average, participants reported significantly lower levels of stress and anxiety after using the Zen room. Pre-room anxiety scores significantly predicted participants' post-room stress levels. Barriers to room use included employee's perception of available time and enough staff during the shift to step away from their duties. Conclusion: The availability of private, uninterrupted space decreased staff stress and anxiety and allowed them to return to work with a renewed sense of energy. Rural hospitals would benefit in implementing such a space and conducting further research on the effects of stress and anxiety levels, even as COVID-19 shifts to an endemic disease.

Connecting lived experiences of pre-nursing students during COVID-19 with learner well-being: A qualitative inquiry.

AIM: To explore pre-nursing students' experiences and identify factors influencing their well-being as learners during COVID-19. DESIGN: A qualitative descriptive design was used. METHODS: Short answer study data (n = 289) were collected in Fall 2020 as part of a larger IRB-approved survey-based study focused on pre-nursing students. Participants were presented with three short answer questions designed to elicit a description of their experiences as a pre-nursing student. NVivo and reflexive thematic analysis were used to analyse participant responses. RESULTS: Six themes related to learner well-being emerged from the data. Learner well-being was supported by achieving academic goals, experiencing positive feelings about current course content, creating connections with peers and envisioning themselves as nurses in the future. Negative contributors to pre-nursing student well-being included managing fears of program rejection and juggling multiple roles and demands. Online learning necessitated by COVID-19 created opportunities for loneliness and isolation from peers, technological difficulties and additional psychological stress, which also contributed negatively to learner well-being. CONCLUSION: These findings illustrate pre-nursing students' experiences and provide support for the influence of the learning environment and factors within the individual on the well-being of learners. IMPACT: Students preparing to apply to nursing programs are an understudied population and little is known about their well-being as learners. Survey-based open-ended short answer questions can be utilized to gain rich insight into their experiences. The study themes and sub-themes can be utilized for discussion and reflection in courses with pre-nursing students and as a starting point for additional conversations between pre-nursing students and educators regarding improving the support of well-being in learners. Additional research and evidence-based interventions that promote learner well-being in pre-nursing students are needed as they prepare for nursing program admission and to support their academic progression. PATIENT OR PUBLIC CONTRIBUTION: Members of the public were not involved in the design or conduct of the study, analysis, or interpretation of the data, or in the preparation of the manuscript because the study focus is on gaining an understanding the experiences of pre-nursing students and their well-being.

Well-being in acute care nurse managers: A risk analysis of physical and mental health factors.

BACKGROUND: Nurse managers have experienced tremendous stress during the COVID-19 pandemic, contributing to negative psychological outcomes. Positive professional well-being is a construct that can be promoted to mitigate poor psychological outcomes and burnout in nurses. Little is known about the health, healthy behaviors, effects of stress on homelife, and well-being of nurse managers in the United States (U.S.). AIMS: The aims of the study were to explore nurse managers' well-being related to self-reported stress and health perceptions and habits. METHODS: A sample of 80 (41% response rate) nurse managers responded to a cross-sectional web-based survey sent via email in a southwestern U.S. 13-hospital system. Nurses answered 39 quantitative questions about demographics, well-being (9-item Well-Being Index [WBI]), perceptions of stress affecting homelife, and perceptions of health and health-related behaviors. RESULTS: Mean WBI (2.9 [2.7]) indicated risk for poor psychological outcomes. Managers (75%) reported stress from work affected their personal lives and a decline in overall health during the pandemic. Most (80%) reported burnout and emotional problems. Nurse managers had 8.1 times increased risk of poor WBI scores if stress from work affected their personal life than if they reported no spillover stress into their personal life (OR = 8.1, 95% CI [2.6, 25.0]). LINKING EVIDENCE TO ACTION: Findings from this study add a nuanced understanding of nurse managers' well-being. The strongest risk factor for poor WBI scores was stress levels affecting personal life. Interventions to improve well-being in nurse managers are needed. Limitations are the convenience sampling, limited geographic location, and response rate of <50%. Further research is needed to support nurse managers in stress reduction and development of boundaries that prohibit the spillover effect of workplace stress. Organizations may consider a combination of administrative support and changes as well as provision of on-the-job training of interventions that support individual well-being.

Online prelicensure nursing students' experiences of academic incivility during COVID-19: A qualitative inquiry.

AIM: The aim of this study was to describe online prelicensure nursing students' experiences of incivility during COVID-19. DESIGN: Qualitative descriptive. Five optional open-ended questions were presented to nursing students to share their experiences with incivility during the pandemic. METHODS: Data were collected from September to October 2020 as a part of a larger multimethod study on stress, resilience and incivility with nursing students and faculty (n = 710) from a large public undergraduate nursing programme in the southwestern United States. Out of the initial 675 students who completed the survey, 260 individuals responded to three or more of the open-ended questions which were reviewed and coded using reflexive thematic analysis. RESULTS: Thirteen themes were organized into four analytical categories: (1) experiencing incivility, (2) causes and consequences of incivility, (3) the pandemic and academic incivility and (4) promoting civility in the academic setting. CONCLUSIONS: Prelicensure nursing students perceived unrealistic expectations, a lack of awareness and miscommunication hindered academic performance, as well as, created feelings of stress, discouragement and inadequacy. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Fostering academic civility during virtual educational experiences may require training in proper coping strategies when challenged with incivility. IMPACT: As the body of research emerges concerning the effects of COVID-19 and undergraduate nursing education, understanding prelicensure students' experiences of academic incivility could prove to be beneficial to designing strategies co-created with students to promote positive educational outcomes. Understanding students' viewpoints of uncivil experiences revealed prioritizing civility awareness is essential in creating healthy academic environments, improving clinical performance and providing safe patient care. REPORTING METHOD: The COREQ (COnsolidated criteria for REporting Qualitative research) checklist was used. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Resilience, Stress, Anxiety, and Depression: Exploring the Mental Health of New Graduate Nurses Transitioning to Practice During COVID-19.

Background Transitioning to practice during the COVID-19 pandemic multiplied the stressors and challenges typically encountered by new graduate nurses (NGNs), yet research exploring mental health variables of this subset of nurses remains sparse. Method This study used an observational design and convenience sampling. NGN alumni (n = 192) from a pre-licensure nursing program were surveyed during the summer of 2021 regarding their experiences with resilience, anxiety, depression, and stress while transitioning to practice during the COVID-19 pandemic. Results Participants reported moderate to severe levels of stress (76%), anxiety (27.6%), and depression (31.2%) while transitioning to practice. Most (79%) described themselves as resilient. The highest mean scores for stress, anxiety, and depression occurred during the fourth to eighth month of practice. Conclusion Nursing professional development specialists, managers, and other stakeholders need effective strategies to monitor and promote NGNs' well-being and mental health to prevent burnout and turnover throughout the first year of practice. [J Contin Educ Nurs. 2022;53(12):533-543.].

Relationships Among Resilience, Stress, and Persistence in Prenursing Students During COVID-19.

BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic has created personal, financial, and academic challenges for prenursing students, which may hinder academic persistence. Understanding and supporting their well-being is important, as they prepare to apply to nursing programs. PURPOSE: The purpose of this study was to explore relationships among stress, resilience, and academic persistence in prenursing students intending to apply to either an on-campus or accelerated online nursing program. METHODS: A cross-sectional descriptive correlational research design was used. Online survey data (N = 364) were collected during the COVID-19 pandemic. RESULTS: Campus-based prenursing students reported higher levels of stress and lower levels of resilience than their accelerated online counterparts. A significant negative relationship was noted between stress and scores on resilience and persistence measures in both groups. CONCLUSIONS: Program-specific interventions promoting resilience and stress management techniques are needed to support prenursing student persistence, especially as they prepare for admission to nursing programs.

Association of stress, resilience, and nursing student incivility during COVID-19.

Although incivility in nursing education is linked with negative physical and psychological effects on students, it is unclear how resilience and stress interact and relate to student incivility. The purpose was to understand the role of resilience and stress with peer incivility in a sample of prelicensure nursing students during coronavirus disease 2019. The study design was cross-sectional and correlational. Data were from an online survey administered to undergraduate nursing students of one college of nursing in a southwestern US state during September-October 2020. In a sample of 490 students, ordinal regression model results supported that including a stress and resilience interaction term resulted in a nonsignificant effect of stress and resilience, as the main effect correlates on low-level uncivil student behavior. More research is needed to understand the prevalence of stress and resilience at different points in prelicensure nursing education so that targeted interventions can be developed and deployed to assist students.

Relationships among stress, resilience, and incivility in undergraduate nursing students and faculty during the COVID-19 pandemic: Policy implications for nurse leaders.

BACKGROUND: Developing successful targeted interventions to reduce incivility for undergraduate nursing students and educators will require understanding the differences in their unique experiences. Although resilience may act as protective buffer against stressors, little is known about the relationships between stress, resilience, and perceptions of the frequency of incivility in the academic environment. PURPOSE: The purpose of this study was to compare relationships among and differences between perceptions of incivility frequency and self-reported stress and resilience levels in undergraduate nursing students and faculty during the COVID-19 pandemic. METHOD: A comparative descriptive and correlational research design was utilized. An online survey was used to collect data from undergraduate nursing students and faculty (n = 710) at one public university. RESULTS: Students were significantly more stressed and less resilient than faculty. Faculty reported significantly greater low and high-level student and low-level faculty incivility behaviors than students. CONCLUSION: Understanding student and faculty perceptions of uncivil behavior frequency occurring at the intersection of high stress and moderate resilience levels is key to the creation of targeted interventions and policy development.