Working conditions in COVID-19 hospital units: perceptions of nursing workers.

OBJECTIVE: To know the perceptions of nursing workers about their working conditions in COVID-19 hospital units. METHOD: Qualitative, descriptive, multicenter study, carried out in September 2020 and July 2021 with 35 nursing workers from COVID-19 units of seven hospitals in Rio Grande do Sul, Brazil. Data were produced through semi-structured interviews and submitted to thematic content analysis with the support of NVivo software. RESULTS: The participants reported availability of material resources and personal protective equipment, but perceived a lack of human resources, multiprofessional support and extra absorption of tasks, resulting in the intensification of work and culminating in overload. Professional and institutional aspects were also mentioned, such as fragility in professional autonomy, wage lag, payment delays and little institutional appreciation. CONCLUSION: Nursing workers in the COVID-19 units lived with precarious working conditions, worsened by organizational, professional and financial elements.

From Recruitment to Retention: Evaluating the Experiences of Internationally Educated Nurses in the Supervised Practice Experience Partnership.

Accompanied by an unparalleled nursing shortage, the COVID-19 pandemic has prompted a nationwide health human resource recruitment drive focused on internationally educated nurses (IENs). The Supervised Practice Experience Partnership (SPEP) is a provincial strategy that provides IENs the opportunity to attain their supervised practice experience in Ontario. In order to sustain the nursing workforce, there is a need to go beyond recruitment strategies and implement evidence-informed approaches that retain IENs after meeting their registration requirements. Mixed-methods surveys and focus groups were used to evaluate the experiences of IENs, their preceptors and nurse leaders working with the SPEP. The findings highlight the value of mentorship and support from nurse leaders in developing communication skills, building connections with teams, fostering cultural integration and establishing support networks for IENs. This paper enhances nurse leaders' understanding of the experiences of IENs and establishes a foundation for innovative ideas that facilitates their integration and retention.

Qualitative evaluation of a brief positive psychological online intervention for nursing staff.

AIM: The aim of this study is to evaluate a brief positive psychological intervention with regard to the mental health of nursing staff in German hospitals. It addresses the question of how positive-psychological online exercises should be designed. BACKGROUND: Nurses in hospitals are known to suffer from mental strain and risk depressive as well as anxiety disorders. The covid-19-pandemic leads to a further aggravation of the situation. Opposed to that, positive psychological interventions can increase resilience by promoting self-management competences and mental strength. RESEARCH METHODS: A 90 min positive-psychological workshop was conducted with six nurses who worked in German hospitals. It consisted of imparting knowledge on positive psychology and learning different positive psychological practices. Afterwards, guideline-based interviews were conducted with six nurses. The outcomes of interest were how the intervention was evaluated, to what extent the intervention led to a reflection and a promotion of self-management competences and whether it allowed the participants to transfer the learnings into everyday life. RESULTS: The intervention led to a reflection of the application competence of positive-psychological techniques by the participating nurses. A promotion of the competences could not be reached. Especially the reflection and promotion of humour competence manifested itself as difficult. CONCLUSION: Despite its short-term nature, the online intervention resulted in a reflection of the nurses' application competence of positive psychology indicating its resource-promoting potential. Follow-up exercises or peer groups should be used for further development, while a training of humour competence might be part of a separate intervention.

Perceived Organizational Support and Reduced Job Performance During COVID-19.

Current research aims to identify a framework to enhance the performance of employees in government sector healthcare during the COVID-19 pandemic. Perceived organizational support was identified to enhance employees' performance through the intervention of a psychological process containing 3 states, that is, psychological safety, felt obligation and organization-based self-esteem. Job performance is considered as planned behavior, and psychological links are developed on the basis of the theory of planned behavior. This study is quantitative and used an empirical survey. Respondents of the study were nursing staff of government hospitals in Pakistan. The data were collected during the first wave of COVID-19 in Pakistan through online distributed questionnaires, and the data were analyzed using Smart PLS. Results show that perceived organizational support positively affects job performance during the COVID-19 crisis, and all the psychological states mediate the relationship. The study results are helpful for decision-makers of public sector organizations dealing with the most common problem of performance reduction during COVID-19. Results are also helpful for policymakers to address reduced performance in most government hospitals. Future research should consider antecedents of the perception of organizational support in the context of government and private hospitals.

Transition and pathway programs from second to first level nursing: A scoping review.

BACKGROUND: Second-level nurses comprise a large proportion of the nursing workforce in many countries. Despite differences in nomenclature, these nurses work under the supervision of first-level registered nurses and possess a more restricted scope of practice. Transition programs facilitate second-level nurses upgrading their qualifications to become first-level nurses. Globally, the impetus for transition of nurses to higher levels of registration has been to increase the skill mix demands in health care settings. However, no review has sought to explore these programs internationally and experiences of those making the transition. OBJECTIVES: To explore what is known about transition and pathway programs from second to first level nursing. DESIGN: Scoping review informed by the work of Arksey and O'Malley. DATA SOURCES: Four databases were searched, CINAHL, ERIC, Proquest Nursing and Allied Health and DOAJ, using defined search strategy. REVIEW METHODS: Titles and abstracts were uploaded into the online program Covidence for screening, followed by full-text screening. Two members of the research team screened all entries at both stages. Quality appraisal was performed to assess overall quality of research. RESULTS: Transition programs are often undertaken to open up career pathways, job and financial advancement. These programs can be challenging as students seek to maintain dual identities, grapple with academic requirements and juggle work, study and personal demands. Despite their prior experience, there is a need for students to receive support as they adjust to their new role and scope of practice. CONCLUSION: Much of the existing research around second to first-level nurse transition programs is dated. There is a need for longitudinal research to examine students' experiences as they transition across the roles.

"Now I Understand You": Changes in the Communication of Professionals in Nursing Homes After Receiving Training in the Validation Method.

Caring for older persons is a challenge for professionals who work in nursing homes. Problems in maintaining effective communication with a person with dementia in an effort to understand their needs is a major barrier to good care. Therefore, the main goals of this study were to explore communication barriers between professionals and people with dementia and to observe changes in communication patterns between them after completing Naomi Feil's introductory training in the bases of the validation method (BVM). The 11 professionals who worked in nursing homes attended a 16-hour introductory course on BVM. Participants were interviewed individually three times. The goal was to observe qualitatively the changes in relationships and communication patterns with people with dementia. The results were analyzed thematically. The professionals highlighted how, after the training, they had a different understanding of the person with dementia and a more humane perspective. These changes also reflected how the professionals experienced improvements in job satisfaction, security, and confidence. This study concluded that training nursing home staff in BVM for person-centered and human care has positive implications on how the professionals view their daily work and their way of interacting with older residents. [J Contin Educ Nurs. 2023;54(4):157-168.].

Time to solve persistent, pernicious and widespread nursing workforce shortages.

AIM: This paper discusses four main strategies for addressing nursing shortages that have been persistent, widespread and growing. Fallout from the COVID-19 pandemic might offer valuable impetus to address this tenacious challenge. BACKGROUND: Nursing shortages are common, widespread and have been persistent for most of a century. Many of the reasons behind these shortages are well known and are themselves enduring, as are the types of strategies put forward for addressing them. These strategies can generally be classified into four main categories: enhancing retention, improving recruitment, encouraging return to practice and drawing on international human resources. The COVID-19 pandemic is the latest major threat to ensuring a sufficiently sized and skilled nursing workforce. Many nurses have succumbed to burnout as well the plethora of factors that predated the pandemic and have a negative impact on nurse wellbeing, turnover and intention to leave. SOURCES OF EVIDENCE: This discussion paper draws on international sources of evidence. DISCUSSION/CONCLUSION: This paper highlights how many of the factors behind and strategies for addressing nursing shortages at the local, national and global levels are widely studied and known. A sustained combination of strategies that focus both within and beyond health and nursing, including on the broader social context, is necessary. While COVID-19 has been extremely damaging, it might present an opportunity to make sustainable, effective reforms to address nursing shortages. IMPLICATIONS FOR POLICY: Knowledge users must recognise that a combination of approaches across the gamut of policies that influence nursing workforces is necessary to address nursing shortages. Attention must also focus on factors beyond nursing and healthcare if shortages are to be remedied.

Mental health of healthcare professionals during the ongoing COVID-19 pandemic: a comparative investigation from the first and second pandemic years.

Healthcare staff have been facing particular mental health challenges during the COVID-19-pandemic. Building on a first study at the beginning of the pandemic in March 2020, we aimed to investigate among healthcare professionals in Germany and Austria (1) how mental health may have changed in professionals over the course of the ongoing pandemic, (2) whether there are differences between different professional groups regarding mental health, (3) which stress factors may explain these mental health outcomes and (4) whether help-seeking behaviour is related to caretaker self-image or team climate. Between March and June 2021, N=639 healthcare professionals completed an online survey including the ICD-10 Symptom Rating checklist, event-sampling questions on pandemic-related stressors and self-formulated questions on help-seeking behaviour and team climate. Findings were analysed using t-tests, regressions and comparisons to a sample of healthcare professionals assessed in 2020 as well as to norm samples. Results show that mental health symptoms, particularly for depression and anxiety, persist among healthcare staff in the second pandemic year, that symptom prevalence rates are higher among nursing staff compared with physicians and paramedics and that team climate is associated with mental health outcomes. Implications of these findings in relation to the persisting pandemic and its aftermath are discussed.

Exploring Nursing Staff's Experiences and Perspectives of COVID-19 Lockdown in a Residential Aged Care Setting in Australia.

An exploratory qualitative study was performed to evaluate the experiences of nursing staff (N = 10) working in a residential aged care facility (RACF) during the coronavirus disease 2019 (COVID-19) pandemic lockdown. Semi-structured, in-person interviews were performed, and thematic analysis was used to analyze the data. Care staff had little or no knowledge of how to cope with a lockdown necessitated by a pandemic. However, management developed proactive plans as they aligned with the changing care circumstances and ongoing government directives. Five major themes were identified: Prolonged Use and Shortage of Personal Protective Equipment; "Blind Leading the Blind"; Communication and Teamwork; Lack of Education; and Resident Response. RACF staff described working under stressful conditions during the initial COVID-19 pandemic lockdown; yet with experience, care staff and the management team adapted to pandemic requirements to meet the needs of residents in their care. RACFs should be prepared for the impact of pandemics on staff and ensure care resources and support are available for the continuity of safe and quality care of residents. [Journal of Gerontological Nursing, 49(3), 34-39.].

Should I stay or should I go? Why nurses are leaving community nursing in the UK.

Worsening working conditions for nursing workforce has seen a massive exodus of staff, particularly in community nursing in the UK. AIM: The study aim was to map working conditions as well as identify differentiating characteristics of community nurses that intend to leave their profession. DESIGN: Eligibility criteria were community nurses working in all 4 UK countries. All data was collected by means of a cross-sectional survey via the largest closed, private community nursing online-forum. Logistic regression was carried out to ascertain the effects of the variables on the intention to leave. RESULTS: The total number of respondents was 533. Findings showed that one in two of all community nurses (≈46%) are reporting job dissatisfaction. Length of unpaid overtime per shift (odds increase by 30% for each hour of overtime), manager support, proportion of permanent staff, team size, shift length, travel mileage, worsened conditions in the last year and overall self-rated working conditions were differentiating factors between those that intended to leave the job. The proportion of permanent staff on the team and perceived lack of support from management best predicted the likelihood of leave rates. Our findings imply that low nurse retention will fuel an even higher exodus because job dissatisfaction is highest on teams with lowest permanent staff ratios. Poor management that is inept at supporting frontline staff means that the fundamental retention issues are exacerbated and will not stop the unprecedented crisis that is predicted to lead to a collapse of care provision in community settings. Nurses play a central role and are 'key' to delivering the much- desired patient-centred care' therefore their well-being and job satisfaction should become a priority for policymakers.

A Fresh Look at the Nursing Home Workforce Crisis: Transforming Nursing Care Delivery Models.

The current State of the Science Commentary focuses on workforce challenges in the nursing home (NH) setting that lie within the purview of professional nursing-what professional nurses can do to promote high-quality person-centered care within a context of existing resources-individually and broadly across the collective profession. Historically, three models of care delivery have characterized the way in which nursing care is organized and delivered in different settings: primary nursing, functional nursing, and team nursing. Based on the existing evidence, we call for scientific leadership in the redesign, testing, and implementation of a nursing care delivery model that operationalizes relationship-centered team nursing. This integrative model incorporates successful evidence-based approaches that have the potential to improve quality of care, resident quality of life, and staff quality of work life: clear communication, staff empowerment, coaching styles of supervision, and family/care partner involvement in care processes. In addition to the needed evidence base for NH care delivery models, it is imperative that educational programs incorporate content and clinical experiences that will enable the future nursing workforce to fill the leadership gap in NH care delivery. [Research in Gerontological Nursing, 16(1), 5-13.].

Retaining the Best: Recognizing What Meaningful Recognition Is to Nurses as a Strategy for Nurse Leaders.

OBJECTIVE: The purpose of this study was to identify what meaningful recognition is to nurses in a postpandemic healthcare landscape. BACKGROUND: The COVID pandemic has exacerbated the critical need to retain our nursing workforce. Meaningful recognition as a component of a healthy work environment can be a strategy to retain nurses. Identifying what is considered meaningful recognition to nurses will optimize organizational use of it. METHODS: A descriptive correlational design was used. Members of Sigma Theta Tau in the state of Maryland were asked to respond to an online survey consisting of demographic data and questions exploring meaningful recognition and the healthy work environment using tools with established reliability and validity. Deidentified data from 163 respondents were collected. RESULTS: Meaningful recognition strategies that meant the most to nurses in this study were: 1) reasonable payment for level of service provided; 2) public recognition within the organization and the profession; and 3) opportunities for professional development. Trends in desired meaningful recognition varied across ethnic/racial and gender groups. CONCLUSIONS: Meaningful recognition to nurses is as diverse as the nursing population. It is important that instruments be developed to capture the rich cultural and ethnic differences in relation to what is considered meaningful recognition to the nursing workforce. Although pay, public recognition, and opportunities for advancement were seen in this study as important forms of meaningful recognition, a deeper exploration across ethnic, racial, and gender groups is needed. This study underscored that one size of meaningful recognition does not fit all.

Resident Mortality And Worker Infection Rates From COVID-19 Lower In Union Than Nonunion US Nursing Homes, 2020-21.

Since the start of the COVID-19 pandemic, nursing home residents have accounted for roughly one of every six COVID-19 deaths in the United States. Nursing homes have also been very dangerous places for workers, with more than one million nursing home workers testing positive for COVID-19 as of April 2022. Labor unions may play an important role in improving workplace safety, with potential benefits for both nursing home workers and residents. We examined whether unions for nursing home staff were associated with lower resident COVID-19 mortality rates and worker COVID-19 infection rates compared with rates in nonunion nursing homes, using proprietary data on nursing home-level union status from the Service Employees International Union for all forty-eight continental US states from June 8, 2020, through March 21, 2021. Using negative binomial regression and adjusting for potential confounders, we found that unions were associated with 10.8 percent lower resident COVID-19 mortality rates, as well as 6.8 percent lower worker COVID-19 infection rates. Substantive results were similar, although sometimes smaller and less precisely estimated, in sensitivity analyses.

Internet delivered, non-inferiority, two-arm, assessor-blinded intervention comparing mindfulness-based stress reduction and cognitive-behavioral treatment for insomnia: a protocol study for a randomized controlled trial for nursing staff with insomnia.

BACKGROUND: Insomnia and poor sleep quality are highly prevalent conditions related to coronavirus disease 2019 (COVID-19) complications among clinical nurses. Although cognitive behavioral therapy for insomnia (CBT-I) is a first-line treatment, CBT-I suffers from several major drawbacks. This study investigates whether the application of the internet-delivered mindfulness-based stress reduction (iMBSR) intervention will produce effects that are non-inferior to the internet-delivered CBT-I (iCBT-I) intervention in reducing the severity of insomnia in clinical nurses with insomnia at the end of the study. METHODS: This study protocol presents an internet-delivered, parallel-groups, assessor-blinded, two-arm, non-inferiority randomized controlled trial. The primary outcome is sleep quality, assessed by the Insomnia Severity Index. Secondary outcomes include depression, dysfunctional beliefs, five facets of mindfulness, and client satisfaction. CONCLUSION: It is expected that this study may address several gaps in the literature. The non-inferiority study design is a novel approach to evaluating whether a standardized, complementary treatment (i.e., MBSR) is as practical as a gold standard treatment rather than its potential benefits. This approach may lead to expanded evidence-based practice and improve patient access to effective treatments. TRIAL REGISTRATION: Trial registration number: ISRCTN36198096 . Registered on 24th May 2022.

Deaths of doctors and nursing staff by COVID-19 in Brazil: a sociological approach. / Óbitos de médicos e da equipe de enfermagem por COVID-19 no Brasil: uma abordagem sociológica.

The article addresses the most basic nuances and key issues involved in the high mortality of doctors, nurses, technicians and nursing assistants, as a result of COVID-19 in Brazil. This is a study based on data from the Federal Councils of Medicine and Nursing (CFM and Cofen, respectively) and the study on the death inventory of the Oswaldo Cruz Foundation (Fiocruz), and aims to understand and analyze this reality in the light of the sociology of professions. The work makes a relevant and unprecedented contribution to the understanding of the past, present and future of working class segments that work at the bedside, on the front line, providing direct care to patients.

O artigo aborda as nuances mais básicas e as questões capitais envolvidas na alta mortalidade de médicos, enfermeiros, técnicos e auxiliares de enfermagem em decorrência da COVID-19 no Brasil. Trata-se de estudo realizado com base em dados dos conselhos federais de Medicina e Enfermagem (CFM e Cofen, respectivamente) e do estudo sobre o inventário de óbitos da Fundação Oswaldo Cruz (Fiocruz), e visa conhecer e analisar essa realidade à luz da sociologia das profissões. O trabalho presta contribuição relevante e inédita para a compreensão do passado, do presente e do futuro de seguimentos da classe trabalhadora que atuam na beira do leito, na linha de frente, prestando assistência direta a pacientes.

Coping strategies in the face of the health crisis: A comparative study in nurses from the Ecuadorian coast and highlands / Estrategias de afrontamiento ante la crisis sanitaria: un estudio comparativo en enfermeros de costa y sierra ecuatoriana

Se realizó una encuesta transversal de dos muestras separadas por conveniencia de enero a marzo de 2021 a fin de comparar la prevalencia de percepción de riesgo e identificar diferentes estrategias de afrontamiento en enfermeros de la costa y la sierra ecuatoriana. Las muestras incluyeron dos grupos de profesionales de enfermería para un total de 518. El 49,0% (n= 254) de los participantes laboraban en la sierra ecuatoriana y el 50,8% (n= 263) prestaban sus servicios en la costa ecuatoriana. Muestreados provenientes de varias clínicas, tanto en la costa como en la sierra ecuatoriana, fueron abordados aleatoriamente por el entrevistador para participar en el estudio. Se examinaron y compararon los resultados de las pruebas de las tres muestras. Los grupos se eligieron en función de la conveniencia del muestreo y la supuesta conciencia de los factores de riesgo de COVID-19. En cuanto a la percepción de riesgo, su prevalencia es significativamente mayor para las enfermeras de la costa que las de la sierra. Las enfermeras que prefieren trabajar en equipo durante la crisis sanitaria tenían probabilidades alrededor de 0,30 más bajas, lo que puede interpretarse como un factor protector. Respecto al miedo al contagio no se hallaron diferencias entre enfermeras de la costa o la sierra(AU)

A cross-sectional survey of two samples separated by convenience was carried out from January to March 2021 to compare the prevalence of risk perception and identify different coping strategies in nurses from the Ecuadorian coast and highlands. The samples included two groups of nursing professionals for a total of 518. 49.0% (n= 254) of the participants worked in the Ecuadorian highlands and 50.8% (n= 263) provided their services on the ecuadorian coast. Samples from various clinics, both on the coast and in the Ecuadorian highlands, were randomly approached by the interviewer to participate in the study. The test results of the three samples were examined and compared. Groups were chosen based on sampling convenience and presumed awareness of COVID-19 risk factors. Regarding the perception of risk, its prevalence is significantly higher for nurses from the coast than those from the mountains. Nurses who prefer to work in a team during the health crisis had probabilities around 0.30 lower, which can be interpreted as a protective factor. Regarding the fear of contagion, no differences were found between nurses from the coast or the mountains(AU)

Biological risks, working conditions and psychological effects of COVID-19 in nursing personnel / Riesgos biológicos, condiciones de trabajo y efectos psicológicos del COVID-19 en personal de enfermería

Los profesionales de enfermería están relacionados con la atención directa del paciente con Covid- 19, dejándolos expuestos a riesgos biológicos y condiciones de trabajo modificadas que podrían causar efectos psisociales significativos. Como objetivo, se realizo una revisión bibliográfica para determinar las condiciones de trabajo y efectos psicológicos del COVID-19 en personal de enfermería durante el período 2020-2021. El estudio fue descriptivo, con una muestra de 39 articulos resultantes de la aplicación criterios de exclusión, las fuentes de datos utilizados fueron: EBSCO Host, Hinari, ProQuest, PubMed, Scopus, Web of Science, Wiley Online, Library, Redalyc, SciELO; se incluyó la búsqueda de palabras clave mediante los tesauros en DeCS y MeSH, las cuales se formularon ecuaciones con los operadores boléanos AND y OR con descriptores de búsqueda como: WorkingCondition/Labor condition, Covid-19/ SARS-CoV-2/ Coronavirus Infections, Nurse emotions/emotion/emotions/emotional/Feelings/Regrets, Nurse/nurses/nursing, y Method/ Methodology/ Model. Como resultado, a nivel de riesgo biológico, las condiciones inseguras repercutían en deficiencia y escases de equipos de protección personal, infraestructura y equipamiento, así mismo, las condiciones laborales a nivel organizacionales aludían a ausencia de políticas y directrices, bajos salarios, carga e inestabilidad laboral, además de esto, los efectos psicológicos del COVID-19 en personal de enfermería se pudieron evidenciar de manera positiva a través de decisión, motivación y orgullo y, negativa con ansiedad, depresión, estrés, inseguridad, molestia y temor. Como conclusión, es indispensable ofrecer infraestructura, condiciones y equipamiento al personal de enfermería, además de actividades de descanso para disminuir el estrés y la presión que generan agotamiento y efectos psicosociales(AU)

Nursing professionals are related to the direct care of patients with Covid-19, leaving them exposed to biological risks and modified working conditions that could cause significant psychosocial effects. As an objective, a bibliographic review was carried out to determine the working conditions and psychological effects of COVID-19 on nursing personnel during the 2020-2021 period. The study was descriptive, with a sample of 39 articles resulting from the application of exclusion criteria, the data sources used were: EBSCO Host, Hinari, ProQuest, PubMed, Scopus, Web of Science, Wiley Online, Library, Redalyc, SciELO; the search for keywords was included using the DeCS and MeSH thesauri, which were formulated with Boolean operators AND and OR with search descriptors such as: WorkingCondition/Labor condition, Covid-19/ SARS-CoV-2/ Coronavirus Infections , Nurse emotions/emotion/emotions/emotional/Feelings/Regrets, Nurse/nurses/nursing, and Method/ Methodology/ Model. As a result, at the level of biological risk, the unsafe conditions affected deficiency and scarcity of personal protective equipment, infrastructure and equipment, likewise, the working conditions at the organizational level alluded to the absence of policies and guidelines, low wages, workload and instability. In addition to this, the psychological effects of COVID-19 on nursing staff could be evidenced positively through decision, motivation and pride, and negatively with anxiety, depression, stress, insecurity, annoyance and fear. In conclusion, it is essential to offer infrastructure, conditions and equipment to nursing staff, as well as rest activities to reduce stress and pressure that generate exhaustion and psychosocial effects(AU)