Caring Knowledge as a Strategy to Mitigate Violence against Nurses: A Discussion Paper.

Violence against nurses is a disturbing trend in healthcare that has reached epidemic proportions globally. These violent incidents can result in physical and psychological injury, exacerbating already elevated levels of stress and burnout among nurses, further contributing to absenteeism, turnover, and intent to leave the profession. To ensure the physical and mental well-being of nurses and patients, attention to the development of strategies to reduce violence against nurses must be a priority. Caring knowledge-rooted in the philosophy of care-is a potential strategy for mitigating violence against nurses in healthcare settings. We present what caring knowledge is, analyze its barriers to implementation at the health system and education levels and explore potential solutions to navigate those barriers. We conclude how the application of models of caring knowledge to the nurse-patient relationship has the potential to generate improved patient safety and increased satisfaction for both nurses and patients.

An arts-based approach to system improvement: provider experiences of COVID-19 in a group home

BackgroundThe devastating effect of COVID-19 has been felt worldwide. Hospitals garnered significant attention, but the immense vulnerabilities in community settings-including nursing homes and assisted-living facilities-were quickly realized. As the crisis subsides, it is critical we learn from professionals who worked during this time, and generate evidence for informing resilience, particularly in long-term care. In respect of the traumatic, individualized, and sensitive nature of these experiences, and in appreciation of the need for depth of information from which to advance improvement, a qualitative approach is essential.Objectives1) Describe the experiences of providers caring for residents with disabilities during a COVID-19 outbreak;2) critically examine the enablers/challenges regarding their emotional well-being during the outbreak;and 3) develop context-specific strategies for change, and determining disaster preparedness.MethodsProviders from a group home for adults with developmental and physical disabilities were recruited for this arts-based case study;in spring 2020 they had a COVID-19 outbreak and six residents died. Participants are making art (e.g., painting, poems) to express their experience, which is further explored in interviews/focus groups.ResultsEleven providers have volunteered. They describe the outbreak as life-altering. A repeated descriptor is ‘war zone’;participants were not sure they would survive it. Unwillingness to leave residents-viewed as family-made for feelings of guilt when providers finally relented to going home despite having worked a 16-hour shift. Additional results will be shared.ConclusionsOne participant stated, ‘I think what we went through will be informative to others and I would hope to experience some healing through it as well.’ Meaningful, sustained improvement will not occur unless we systematically, respectfully document the words and unpack the complexities of what it was like for those who provided care during the crisis of COVID-19;only then can we build anew.