The Relationship Between Social Media Use, Nurse Characteristics, and Job Decision-Making.

OBJECTIVE: To describe nurses' use of social media and examine the relationship between social media use, nurse characteristics, and job decision-making. BACKGROUND: Social media shares information, connects, and influences thought. A gap remains in understanding how nurses use social media for professional purposes. METHODS: A national survey of RNs and advanced practice RNs included demographics, questions about which social media platforms respondents use personally and professionally, and engagement activities on each platform. Data analysis included descriptive statistics, Cramér's V test, and binomial logistic regression. RESULTS: Eight hundred twelve nurses participated. Platforms and activities used by nurses varied significantly by age, job title, and employment. The majority (61%) of respondents were satisfied or highly satisfied with their job, yet about one-third intended to leave their position or organization within 1 to 12 months. CONCLUSIONS: Nurse leaders should adopt a strategic, data-informed approach to leverage social media in attracting and retaining a diverse nursing workforce.

Labor trafficking of migrant registered nurses.

BACKGROUND: Labor trafficking of registered nurses (RNs) in the USA impedes justice by denying inalienable human rights and equal economic opportunities. Nursing shortages in developed countries, poverty, social upheaval, and government actions influence migration, as do other factors related to determinants of health. Migrant RNs are visa workers, displaced, refugees, immigrants, or asylum seekers. Labor traffickers target vulnerable migrant RNs seeking employment outside their home country. Unlike ethical recruiters, traffickers lure migrant RNs into indentured contracts in work environments that result in health-threatening conditions, long shifts, and exorbitant fines that threaten families with financial retribution. PURPOSE: The purpose of the paper is to raise awareness. METHODS: Authors explain the background of influences and nuances in migrant RN labor trafficking. DISCUSSION: Identifying labor traffickers' deceitful, coercive, fraudulent, and illegal methods, assist organizational approaches for establishing Total Worker Health, trauma-informed care, coordinated community response, and No Door Closed actions when wanting to mitigate or eradicate labor trafficking of migrant RNs.

COVID-19 Stressors and Resilience Among Nurse Leaders.

The COVID-19 pandemic introduced many new stressors to nurses in general, yet little is known about COVID-19-related stressors and resilience among nursing leaders. The aims of this study were to explore (1) the COVID-19-related stressor and resilience by personal and work demographics, (2) the relationship between COVID-19 stressors and resilience, and (3) resilience strategies used by leaders and their recommendations to other nurse leaders. This descriptive, cross-sectional study employed an electronic survey to measure COVID-19-related stressors and resilience and included qualitative open-ended questions. A total of 57 nurse leaders responded to the survey. Nurse leaders who were female, African American, chief nurse executive or nursing director, and had more than 10 years of experience reported highest COVID-19 stress in most of subscales. Nurse leaders who were male, African American, chief nurse executive or nursing director, and had more than 10 years of experience reported highest resilience scores. Nurse leaders with higher resilience levels had lower levels of COVID-19 stress in all subscales. Nurse leaders reported the top 3 resilience strategies as (1) prayer and faith, (2) social support, and (3) self-care and the top 3 recommendations to other nurse leaders as (1) disconnect, (2) positive and creative thinking, and (3) self-care.

Comparison of Alabama Nurse Experiences Between Practice Areas During the Early COVID-19 Pandemic.

BACKGROUND: According to the Total Worker Health® framework, safety culture including a reasonable workload among healthcare workers is essential to the security and well-being of patients, staff, and healthcare organizations. Evaluating the impact of the pandemic on the nursing workforce in different practice areas is critical for addressing workforce health and sustainability. The purpose of this study was to compare work and selfcare experiences among Alabama nurses between practice areas and the early pandemic years (2020 vs. 2021). METHODS: A secondary analysis of cross-sectional Alabama State Nurses Association (ASNA) survey data was conducted. Kruskal-Wallis analysis of variance, Wilcoxon rank, and false discovery rates were examined. RESULTS: There were 1,369 and 2,458 nurse survey responses in 2020 and 2021, respectively. By 2021, nurses reported worsening staff shortages, a greater need for retired and new graduate nurses to help with the workload burden, and perceptions of heavier emergency department workloads. Lower proportions of nurses reported the ability to engage in self-care activities and satisfaction with state and federal crisis management. Intensive care nurses were more likely to report staffing shortages while also reporting the lowest ability to engage in self-care. CONCLUSIONS: Overall, the Alabama nursing workforce perceived worsening work conditions in 2021 compared to when the pandemic began. Practice areas varied greatly in their responses, with acute and intensive care areas perceiving more difficult work conditions. Total Worker Health® programs should be designed to promote and support nurses' well-being based on their experience and the needs of specific practice areas.

Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE): An Evidence-Based Wellness Program.

Poor well-being and burnout among the nursing workforce were heightened by the COVID-19 pandemic. The purpose of this study was to deliver, spread, and sustain an evidence-based wellness program, Workforce Engagement for Compassionate Advocacy, Resilience, and Empowerment (WE CARE), for nurse leaders, staff registered nurses (RNs), and patient care technicians (PCTs) to ameliorate or prevent burnout, promote resilience, and improve the work environment. The program included Community Resiliency Model (CRM) training provided by a certified 6-member wellness team. A baseline and 6-month follow-up survey included measures of well-being, moral distress, burnout, resilience, perceived organizational support (POS), job satisfaction, intent to leave (ITL), and work environment. A total of 4900 inpatient RNs, PCTs, and leaders of a 1207-bed academic medical center in the southeastern United States were analyzed. From baseline (n = 1533) to 6-month follow-up (n = 1457), well-being, moral distress, burnout, job satisfaction, and work environment improved; however, resilience, POS, and ITL did not. Although we have seen some improvements in well-being and mental health indicators, it is still early in the intervention period to have reached a critical mass with the training and other interventions. The mental health and work environment issues among nurses are so complex, no one-size-fits-all intervention can resolve.

Filial piety and older adult caregiving among Chinese and Chinese-American families in the United States: a concept analysis.

BACKGROUND: The culturally sensitive nursing practice has not embedded filial piety as a cultural value and stance pertaining to caregiving among aging Chinese and Chinese-American (CCA) families in the United States, yet it is critical for healthy aging among CCAs. PURPOSE: To understand filial piety when caring for aging CCAs and conceptualize an operational definition and framework. METHODS: A systematic search was conducted in CINAHL, PubMed, Scopus, and PsycINFO databases. Analysis of the concept of filial piety among CCAs used Walker and Avant's methods. Twenty-six studies were selected in the final full-text analysis. FINDINGS: Synthesis of evidence identified four antecedents: (a) filial obligation as a 'cultural gene', (b) sense of altruism, (c) familial solidarity, and (d) societal expectation of 'birth right'. Attributes included familial material and emotional support, obedience, pious reverence, and societal norms. Consequences were related to caregiver burden, psychological and physical well-being, quality of life, and health equity. CONCLUSION: Filial piety is an intrinsic desire to support aging parents and an extrinsic desire to adhere to Chinese societal moral tenets. The proposed operational framework "Caregiving for aging CCAs in the United States" merits further study.

Using item response theory to develop a shortened practice environment scale of the nursing work index.

The 31-item Practice Environment Scale of the Nursing Work Index (PES-NWI) has been frequently used globally to measure the nurse work environment. However, due to its length and subsequent respondent burden, a more parsimonious version of the PES-NWI may be desirable. Item response theory (IRT) is a statistical technique that assists in decreasing the number of items in an instrument without sacrificing reliability and validity. Two separate samples of nurses in the United States (one called the "internal data source" and the other called "external data source"; sample sizes = 843 and 722, respectively) were analyzed. The internal data source was randomly split into training (n = 531) and validating data sets (n = 312), while a separate whole external data source was used as the final validating data set. Using IRT with training data, we removed nine items; two additional items were removed based on recommendations from a previous study. Confirmatory factor analyses supported the validity of the measurement model with the 20-item of PES-NWI in both internal and external validation data sources. The correlations among subscales between 31- and 20-item versions were high magnitude for five subscales in both validation data sets (τ = 0.84-0.89). Ultimately, we identified a 20-item version of the PES-NWI which demonstrated adequate validity and reliability properties while decreasing data collection burden yet maintaining a similar factor structure to the original instrument. Additional research may be necessary to update the items themselves on the PES-NWI.

Identifying and Decreasing Sharps Injuries Through Root Cause Analysis in a Large Urban Hospital System.

BACKGROUND: Despite safety mandates and interventions, sharps injuries remain an occupational risk for registered nurses (RNs). Sharps and needlestick injuries increase the risk of exposure to blood-borne pathogens. Post-exposure direct and indirect costs of these percutaneous injuries have been estimated at about US$700 per incident. The goal of this quality improvement project was to identify root causes of sharps injuries for RNs at a large urban hospital system. METHODS: A retrospective evaluation of sharps injuries sustained by RNs, identification epsication of themes or root causes, and the development of a fishbone diagram to sort the causes into categories to identify workable solutions were conducted. Fisher's exact tests were performed to identify association between variables and root causes. FINDINGS: A total of 47 sharps injuries were reported from January 2020 through June 2020. Among sharps injuries sustained by nurses, 68.1% were among nurses 19 to 25 years of age and 57.4% reported job tenure of 1 to 2 years. There was a statistically significant association between root causes and tenure range, gender, and procedure type (p < .05) with moderate effect size (Cramer's V = 0.35-0.60). Technique also was a primary cause of sharps injuries for blood draw (77%), discontinuing line (75%), injection (46%), intravenous (IV) start (100%), and suturing (50%). CONCLUSIONS/APPLICATIONS TO PRACTICE: Technique and patient behavior were primary root causes of sharps injuries in this study. More sharps injuries caused by technique occurred among nurses with job tenure of 1 to 10 years, female, blood draw, discontinuing line, injection, IV start, and suturing procedures. The root cause analysis identified tenure, technique, and behavior as potential root causes of sharps injuries specifically occurring most during blood draw and injections at a large urban hospital system. These findings will inform nurses, especially new nurses in the proper use of safety devices and behaviors to prevent injury.

Work environment, resilience, burnout, intent to leave during COVID pandemic among nurse leaders: A cross-sectional study.

AIMS: The aims of this work are to (1) investigate the work environment, resilience, burnout, and turnover intention and (2) examine how work environment and personal resilience impact burnout and turnover intention among nurse leaders in the midst of the COVID-19 crisis. BACKGROUND: The COVID-19 pandemic introduced tremendous stressors to nurse leaders, for example, managing the complex staffing situation while balancing patients' and family's needs. METHODS: During May to September 2021, an electronic survey was sent out to nurse leaders in Birmingham, Alabama, USA, and surrounding areas. RESULTS: Fifty-six respondents were included in the study. The composite score of the work environment measure was moderately to highly related to resilience [ρ (rho) = .59] and burnout [ρ = -.63 to -.68] but had small association to intent to leave [ρ = -.30]. The resilience was highly correlated to burnout [ρ = -.53 to -.59] and moderately associated to intent to leave [ρ = -.32]. CONCLUSIONS: A better work environment for nurse leaders is related to higher resilience, lower burnout, and lower turnover intention. Resilience impacts burnout and turnover intention among nurse leaders. IMPLICATIONS FOR NURSING MANAGEMENT: Health care organizations and stakeholders should implement effective strategies to improve the work environment, which could lead to enhanced resilience, reduced burnout, and lower turnover intention of their nurse leaders especially during and following this pandemic.

Values elicitation among adults making health-related decisions: A concept analysis.

AIM: To conduct a concept analysis of values elicitation in the context of health care and treatment decision-making and formulate a conceptual definition. BACKGROUND: Values elicitation is a commonly cited term for an activity to help patients identify values and evaluate their application in health care decision-making, yet it remains ambiguous and difficult to differentiate from similar concepts. DESIGN: Concept analysis. DATA SOURCE: Three databases, including PubMed, CINAHL Plus, and Scopus, were searched from inception to February 2021. REVIEW METHODS: Walker and Avant's eight-stage method was used to identify attributes, cases, antecedents, consequences, and empirical referents and formulate a conceptual definition. RESULTS: The concept analysis identified 3 attributes, 10 consequences, 7 antecedents, and 3 empirical referents. Our analysis defines values elicitation as an intentional process whereby individuals explore their core beliefs, alone or with others, to (1) determine their preference, or a lack thereof, between health or treatment options, and (2) frame decisions. CONCLUSIONS: The findings have the potential to influence the identification, discussion, and measurement of values elicitation by nurses and researchers across disciplines. Further exploration of this concept is warranted as the literature continues to emerge.