Nurses' disaster core competencies and resilience during the COVID-19 pandemic: A cross-sectional study from Turkey.

AIM: The aim of this study is to determine nurses' disaster core competency levels, compare them based on characteristics and examine the relationships with psychological resilience. BACKGROUND: Since nurses constitute a critical part in the health care services, it is important to understand the competencies and effective factors in their disaster preparedness. METHODS: The data were collected from 489 nurses between January and February 2021 with an introductory information form, the Nurses' Perceptions of Disaster Core Competencies Scale and the Connor-Davidson Resilience Scale. RESULTS: The nurses' level of disaster core competencies was above the average, and it was positively correlated with their psychological resilience. The nurses' disaster experiences made higher differences on their disaster core competencies when compared to their personal and professional characteristics. CONCLUSIONS: It is important to provide disaster training and drills to all nurses on a regular basis. However, under disaster conditions, resilience should also be considered and included in the preparation plans for nurses to support their professional competencies and qualifications. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should play a leadership role in planning disaster preparedness training for nurses, and these trainings should be addressed to cover both professional competencies and resilience for nurses to respond effectively to disasters.

Association between the Nursing Practice Environment and Safety Perception with Patient Safety Culture during COVID-19.

AIMS: In this study, we aimed to identify the relationship between nursing practice environments (NPEs) and safety perceptions with patient safety culture (PSC) during COVID-19. DESIGN: We conducted a quantitative, non-experimental, correlational, and cross-sectional study. We interviewed 211 nurses from Peru using two scales: PES-NWI and HSOPSC. We used the Shapiro-Wilk test and Spearman's coefficient and estimated two regression models. RESULTS: NPE was reported as favorable by 45.5% of the participants, and PSC was reported as neutral by 61.1%. Safety perception, the workplace, and NPE predict PSC. All NPE factors were correlated with PSC. However, safety perception, support of nurses subscale, the nurse manager's ability, and leadership were predictors of PSC. CONCLUSION: To promote a safe work culture, health institutions should foster leadership that prioritizes safety, strengthens managers' abilities, encourages interprofessional collaboration, and considers nurses' feedback for constant improvement.

Exploration of System Chief Nurse Executive's Leadership Practices to Support, Mentor, Develop, and Retain Nurse Leaders.

In 2019, the National Academy of Science identified clinician burnout as a growing public health concern. The COVID-19 pandemic has only compounded this crisis and transformed it into an escalating fracture within the US health care system. Concurrently evolving with this emergency is a rise in the number of nurses who intend to leave the profession. Frontline nurse leaders are the lynchpin in ensuring health care systems function. These leaders have accountability over patient care and clinician well-being. Focused efforts must address clinician burnout. However, without addressing the well-being of frontline nurse leaders, the fault line in our health care system becomes a vast chasm. Recently, published literature began to emerge describing and addressing frontline clinician burnout. Unfortunately, only a few, if any, address issues related to leaders. The aim of this qualitative case study research was to explore and discover general themes in system chief nurse executive leadership practices that support, mentor, develop, and retain nurse leaders as a basis for future research. Three major themes were identified for future study and exploration: enhancing leadership development programs; improving leader work environments; and focusing on leader well-being and support. Further research is needed to evaluate the effectiveness of these themes.

Leadership Development Recommendations for Clinical Nurse Managers to Bolster the Postpandemic Workforce.

The postpandemic atmosphere has created a perfect storm that has necessitated a renewed prioritization to bolster support for the role of the clinical nurse manager. Role transition, competencies, mentorship, and ongoing development for the clinical nurse manager have been solidly supported in nursing leadership literature for decades. Preparing competent, ready-to-respond, people-oriented, transformational nurse leaders for these positions is essential to survival of our health care workforce. This article includes a summative review of comprehensive published findings related to nurse manager competency, development, and support. Findings have been correlated with one health system's postpandemic internal surveys, focus groups, reaction panels, and gap analysis to validate historic recommendations and prepare for program development. The purpose of this project was to endorse manager support and development recommendations and implement an evidence-based program to better prepare clinical nurse managers in today's health care leadership reality.

The association between nurse managers' transformational leadership and quality of patient care: A systematic review.

AIM: To examine and summarize the reported association of nurse managers' transformational leadership and quality of patient care based on the perceptions of registered nurses. BACKGROUND: Transformational leadership behaviors of nurse managers result in staff nurses' satisfaction and retention and patient satisfaction. Patient safety and quality of care are vital to high-performing healthcare organizations. Perceptions of registered nurses are important because nurses are frontline healthcare providers fundamental to patient safety and quality of care and are considered the final line of defense in preventing adverse events and errors and improving the safety of patients. MATERIALS AND METHODS: We  searched the CINAHL, ProQuest, PubMed, Science Direct, and Web of Science databases for evidence published between 2018 and 2022 in the English language. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in carrying out this meta-analysis. RESULTS: Nine quantitative studies were appraised using the Joanna Briggs Institute checklists and were included in the final review that involved a total sample of 3633 registered nurses. The included studies were reported across Asian, Middle East, and European countries within the past five years. The association between the transformational leadership behaviors of nurse managers and the quality of patient care was found in varying degrees (i.e., insignificant, weak, indirect, and strong direct association) based on the perceptions of registered nurses. CONCLUSIONS: There is a direct and indirect association between the transformational leadership behaviors of nurse managers and the quality of patient care internationally. This association is influenced by confounding and mediating factors, including gender, organizational culture, structural empowerment, and job satisfaction. IMPLICATIONS FOR NURSING AND HEALTH POLICIES: Healthcare organizations need to support nursing leaders to have a stronger transformational leadership style by considering several factors that influence their leadership to improve the quality of patient care their staff nurses provide at the bedside.

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.

Nursing managers' experiences of facing the COVID-19 pandemic in their work: A systematic review.

AIM: There is far little evidence available on nursing managers' experiences during this global crisis. This systematic review aimed to provide the first comprehensive summary of the findings of published studies describing data concerning nursing managers' experiences of the COVID-19 outbreak. DESIGN: Studies published between January 2019 and the end of December 2021 were retrieved from CINAHL, Medline and PubMed databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to guide the search methodology. METHODS: In total, 14 relevant articles were assessed using the Joanna Briggs Institute Critical Appraisal Tools and subjected to thematic content analysis. RESULTS: Our findings revealed five main themes describing nursing managers' experiences: an expanding and changing role, ensuring the well-being of staff, communication, support received, development and learning. Nursing managers found the task of operational management confusing, as objectives have been constantly changing as the pandemic has progressed. The results should be used in preparation for future crises similar to the COVID-19 pandemic.

Relationships between leadership behaviour of nurse managers and nurses' levels of job satisfaction and compassion fatigue during the COVID-19 pandemic.

AIM: To reveal the relationships between the leadership behaviour of nurse managers and nurses' levels of job satisfaction and compassion fatigue during the COVID-19 pandemic. DESIGN AND METHODS: This descriptive and cross-sectional study was performed with 353 nurse professionals participating from 32 cities across Turkey. The data were collected online between August and November 2020 by using the introductory information form, Minnesota Satisfaction Questionnaire, Leadership Behaviour Questionnaire and Compassion Fatigue subdimension of the Professional Quality of Life Scale. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were followed in the study. RESULTS: Nurses mostly stated their managers as employee-oriented and change-oriented leaders. Nurses' intrinsic and overall satisfaction was high, extrinsic satisfaction was low and their compassion fatigue was at a critical level during the pandemic. According to nurses' personal and professional characteristics, there were significant differences in job satisfaction, compassion fatigue and change-oriented leadership scores. When nurse managers exhibit employee-oriented leadership behaviour, nurses' compassion fatigue decreases and job satisfaction increases.

Nurses' safety-related organisational challenges during the COVID-19 pandemic: A qualitative study.

AIM: To explore nurses' perspectives on and experiences of safety-related organisational challenges during the coronavirus disease 2019 (COVID-19) outbreak by Iranian nurses. BACKGROUND: In different clinical contexts, nurses face numerous organisational challenges threatening their safety because of the COVID-19 pandemic. INTRODUCTION: Exploring nurses' perceptions towards safety-oriented organisational challenges might inform nurse managers, healthcare managers, educators and policymakers on the priorities that should be considered to increase organisations' readiness and safety. METHODS: This qualitative descriptive study is reported according to the Consolidated Criteria for Reporting Qualitative Research guidelines. Through purposeful sampling, 19 participants were involved. The research data were collected from March to August 2021 by conducting semi-structured interviews that were analysed through the content analysis approach. FINDINGS: Three organisation-related safety challenges experienced were related to (1) human resource, (2) educational and (3) workforce protection issues. DISCUSSION: Nurses experienced several safety issues related to the complexity faced by the health care organisations during the pandemic, exacerbated by previous frailties of the nursing system. CONCLUSION: The three challenges that emerged might be considered a priority in building pandemic plans, transforming the experiences of nurses as a source of learning for all, capitalising on their suggestions and rendering healthcare facilities ready to deal safely with future crises. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Adopting appropriate measures to decrease human resource issues and that related to education, and promoting workforce health protection, are both recommended to improve nurses' work environment and satisfy their safety needs.

Perceptions of Authentic Nurse Leader Attributes Among Clinical Nurses and Nurse Leaders.

OBJECTIVE: This study aimed to develop and validate a tool to measure authentic nurse leadership (ANL) from the perspective of nurse leaders. BACKGROUND: The COVID-19 pandemic heightened the need for ANL to establish healthy work environments (HWE) that promote positive outcomes. METHODS: A nonexperimental design and exploratory psychometric analysis developed and validated the Authentic Nurse Leadership Questionnaire for Nurse Leaders (ANLQ-NL) instrument. Relationships were explored between ANLQ-NL and HWE, as measured by the Areas of Worklife Survey (AWS). The Marlowe-Crowne Social Desirability Scale (MC-SDS) was used to measure the nurse leaders' tendency to produce socially desirable responses. The sample consisted of 188 nurse leaders from several US hospitals. RESULTS: The ANLQ-NL instrument was found to be valid and highly reliable. Each of the constructs aligned with the ANL conceptual framework. CONCLUSION: The ANL conceptual framework and instruments (ANLQ and ANLQ-NL) can be used for educational programs aimed at developing ANL attributes among nurses.

A Year Later: Beyond Gratitude: A Tribute to Nurse Managers.

"Not expressing gratitude is like wrapping a present and never giving it." -William Ward Regular expressions of gratitude and meaningful recognition are beginning to make a difference for nurse managers. Beyond Gratitude: A Tribute to Nurse Managers illustrates how the power of a partnership of 2 foundations can make a difference.

An Evaluation of a Web-Based Crisis Management Training Program for Nurse Managers: The Case of the COVID-19 Crisis.

OBJECTIVE: The effective management of nursing services, the main power in patients' care and treatment in the front line of the fight against the COVID-19 pandemic, and nurse managers' effective leadership behaviors in the fight against the pandemic have been important key factors. It is thus critical to support nurse managers, strengthen them through training, and increase their competency so that they can successfully manage crises, disasters, or pandemics. This study aims to assess the effect of a web-based training program on the knowledge levels of nurse managers who worked during the COVID-19 pandemic. METHODS: This is a randomized controlled experimental study. The study population consisted of the members of the Nurse Managers Association. The intervention group had 30 participants, and the control group had 31 participants in the final. RESULTS: There was no statistically significant difference between the intervention and control groups' mean number of correct pre-test responses (P = 0.843). However, the intervention group's mean number of correct post-test responses was statistically significantly higher than the control group's after the web-based training program (P < 0.001). CONCLUSIONS: Web-based training programs can effectively increase nurse managers' knowledge levels. Therefore, web-based training programs should be developed in ordinary times for the management of crisis situations.

Experience of clinical nurses engaged in caring for patients with COVID-19: A qualitative systematic review and meta-synthesis.

AIMS AND OBJECTIVE: This qualitative review summarises and synthesises the available evidence on subjective experiences of clinical nurses who cared for patients with COVID-19. BACKGROUND: Nurses are first responders and play a vital role in emerging infectious disease epidemics such as the COVID-19 pandemic. In this context, they also face many difficulties and challenges related, for example to the imbalance between extensive demands and low control over work tasks. DESIGN AND METHOD: A systematic review of qualitative studies and meta-synthesis focused on the experiences of clinical nurses caring for patients with COVID-19 during the pandemic was carried out. RESULTS: A total of 279 findings were extracted, aggregated into 21 categories and combined into seven synthesised findings, namely (1) professional nursing practice during the pandemic, (2) support systems, (3) somatic sensations and psychological experiences, (4) difficulties and challenges, (5) coping strategies and behaviour, (6) impact on life, profession and values, and (7) needs and expectations for the future. CONCLUSION: Nurses encountered considerable difficulties and challenges in caring for patients with COVID-19. Nurses caring for patients with COVID-19 need more support from organisations, families and society. It is essential to explore positive coping strategies suitable for working in different cultural backgrounds. Policymakers and decision-makers should pay attention to the experiences and voices of nurses. RELEVANCE TO CLINICAL PRACTICE: It is critical for nurse managers to consider how to enhance the support system and help nurses develop adaptive coping strategies in response to COVID-19. Nurses' experiences and voices are valuable in improving health emergency response systems. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution.

Nurse managers' challenges and opportunities in the COVID-19 pandemic crisis: A qualitative descriptive study.

AIM: The study was conducted to understand the experiences of nurse managers with regard to the difficulties and opportunities they encountered during the pandemic. BACKGROUND: Although many studies have been carried out to understand how nurses were affected in the COVID-19 pandemic, there are few studies that treat the experiences of nurse managers. METHODS: In this qualitative descriptive study with 19 nurse managers working in pandemic management at a university hospital in Turkey during the first three waves of the pandemic, data were collected between April and July 2021 using the semi-structured interview method. Content analysis was performed to analyse the data. RESULTS: Six themes were identified with respect to the experiences of nurse managers during the pandemic. These themes were initial reactions to the crisis, ineffective crisis management, excessive workload, the moral burden in decision-making, support of colleagues and other multidisciplinary team and nurse manager empowerment. CONCLUSIONS: The nurse managers had difficulties in their managerial roles during the pandemic. However, they also viewed the crisis as an opportunity because they were able to note the deficiencies in management at all levels of the hospital and their leadership and decision-making roles took on more importance. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers may use the results of this study to be prepared for the continuing COVID-19 pandemic and any other emergency circumstances that they may have to face in the future.

Competencies of Nurse Managers as Predictors of Staff Nurses' Job Satisfaction and Turnover Intention.

Nurse managers have played an integral role in stabilizing the nursing work environment and workforce in the face of the COVID-19 pandemic, yet the competencies required for such a feat are largely unknown. This study was conducted during the pandemic to identify the specific domains of nurse manager competencies that associate with nurse outcomes. A cross-sectional survey was conducted on a convenience sample of 698 staff nurses to measure the perceived competence of their nurse managers and their job satisfaction and turnover intention levels. The overall perceived nurse manager competency level in our sample was 3.15 out of 5 (SD = 0.859). The findings indicated that 34.3% of nurses were dissatisfied with their current jobs, and 36.3% of nurses were considering leaving their current workplace. Regression analyses identified "Team Communication and Collaboration" (ß = 0.289; p = 0.002), "Staff Advocacy and Development" (ß = 0.229; p = 0.019), and "Quality Monitoring and Pursuance" (ß = 0.213; p = 0.031) as significant predictors of staff nurses' job satisfaction and "Staff Advocacy and Development" (ß = -0.347; p < 0.000) and "Team Communication and Collaboration" (ß = -0.243; p = 0.012) as significant predictors of nurses' turnover intention. The findings of the study have implications for the future recruitment, training, and performance evaluation of nurse managers.

The experience of moral distress by chief nurse officers during the COVID-19 pandemic: A descriptive phenomenological study.

AIM: The aim of this study is to explore the moral distress experiences of nurse officers during the COVID-19 pandemic. BACKGROUND: Moral distress has emerged as a challenge for nurses ad nurse leaders, revealing the need for health professionals and health care managers to examine, understand and deal with moral distress un Nurse leaders. METHODS: It is a descriptive phenomenological study that used content analysis. RESULTS: Thirteen chief/assistant nurse officers were interviewed, and four themes were identified: being a manager in the pandemic, situations that cause moral distress, effects of moral distress and factors that reduce moral distress. CONCLUSION: Faced with various expectations, such as the management of unusual and uncertain processes, and the management of the psychological responses of both employees and themselves, chief nurse officers struggled significantly to maintain their moral integrity and experienced moral distress during the COVID-19 pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: Extraordinary situations such as pandemics have factors that led to moral distress for a Chief Nursing Officer (CNO). Health care systems in which nurse managers are excluded from decision-making processes have a traditional hierarchical structure that ignores CNOs professional autonomy, contributing to the development of moral distress. Therefore, CNOs should engage in self-reflection to recognize their own moral distress experiences, examine the existing health system to identify the factors that cause moral distress and take actions to implement changes to eliminate these factors. To cope with moral distress, CNOs should also improve their communication skills, team collaboration skills and the use of scientific knowledge and take responsibility in their managerial role.

Nursing Education Leaders Decision-Making During a Pandemic Crisis.

ABSTRACT: Academic nursing leaders faced unprecedented decision-making during the recent global pandemic. Although some universities had emergency response plans, many did not, and those that did have plans did not address the specific needs of nursing education programs. This descriptive survey study sought to describe the decision-making and response of nursing education leaders during the pandemic and provide recommendations for the future. Themes identified in the study include preparedness, emergency response, uncertainty, leadership and policy, and communication. Results of the study provide nursing program administrators with insights for preparing to lead in future emergencies.