Psychological detachment from work during nonwork time as a moderator and mediator of the relationship of workload with fatigue and sleep in hospital nurses.

OBJECTIVES: To examine differences in psychological detachment from work during nonwork time by nurses' personal and work-related characteristics, and to examine the moderating and mediating effects of psychological detachment on the relationships between nursing workload and fatigue and sleep. METHODS: This study employed a cross-sectional design with a self-administered online survey. Survey data from 827 hospital nurses providing direct patient care in the United States were used. Moderating and mediating effects of psychological detachment between workload and fatigue/sleep relationships were assessed using Hayes' PROCESS macro in SPSS. RESULTS: There were significant differences in psychological detachment from work based on age, highest nursing degree, work experience, shift length, weekly work hours, and frequency of providing care to patients with COVID-19. The associations of workload with physical fatigue, mental fatigue, and sleep quality were weakened when psychological detachment was high. Psychological detachment statistically mediated the associations between workload and fatigue and sleep problems. CONCLUSION: Healthcare organizations are encouraged to facilitate nurses' psychological detachment during time-off to protect them from fatigue and sleep problems.

State of Mental Health, Healthy Behaviors, and Wellness Support in Big 10 University Nursing and Health Sciences Faculty, Staff, and Students During COVID-19.

BACKGROUND: Federal and national entities urge organizations to assess healthcare professionals' mental health and well-being as the COVID-19 pandemic has compounded the issue. AIMS: This study aimed to (1) describe rates of mental health issues, healthy lifestyle behaviors, and perceptions of COVID-19's impact among Big 10 University nursing and health sciences faculty, staff, and students; (2) identify predictors of depression, anxiety, stress, and burnout; and (3) assess the relationships among perceived school wellness support, healthy lifestyle behaviors, physical/mental health, and mattering. METHODS: A cross-sectional descriptive correlational design was used. Nursing and health science deans emailed invitations to faculty, staff, and students concerning an anonymous wellness assessment survey. Correlation coefficients tested associations among mental health indicators and wellness cultures. Multiple linear regression examined factors associated with mental health indicators. RESULTS: Faculty, staff, and students responded (N = 1345). Findings indicated that most respondents were not getting adequate sleep, meeting physical activity recommendations, or eating the daily recommended number of fruits/vegetables. Fourteen to 54.9 % of participants reported depression, anxiety, and burnout. Overall, students, faculty and staff at colleges that operated under a strong wellness culture had better outcomes. CONCLUSION: Wellness cultures impact the mental and physical health of faculty, staff, and students.

Workplace verbal abuse, nurse-reported quality of care and patient safety outcomes among early-career hospital nurses.

AIMS: To examine the differences in early-career nurses' verbal abuse experiences based on their sociodemographic characteristics, and to investigate the associations of verbal abuse experiences with nurse-reported care quality and patient safety outcomes. BACKGROUND: Few studies have examined the relationships between early-career nurses' verbal abuse experiences and nurse-reported patient care quality and safety outcomes. METHODS: Cross-sectional survey data from 799 early-career hospital nurses in the United States were analysed. Items assessed verbal abuse experiences from patients or their families, physicians and other employees. Associations between verbal abuse experiences and nurse-reported care quality and patient safety outcomes were examined using multiple logistic regression analyses. RESULTS: There were significant differences in verbal abuse experiences by age, gender and work unit. Nurses who experienced verbal abuse, regardless of the perpetrator, were less likely to report high-quality care and a favourable safety grade. Nurses who experienced verbal abuse specifically from physicians or other employees were also less likely to feel comfortable reporting safety problems. CONCLUSION: Managing verbal abuse may be important for improving patient care quality and safety. Future intervention study is needed to reduce verbal abuse. IMPLICATIONS FOR NURSING MANAGEMENT: To optimize patient safety, managers should thoroughly monitor verbal abuse and organisations' need to establish clear expectations and ramifications for when verbal abuse occurs.

Identifying patterns of occupational stress trajectories among newly graduated nurses: A longitudinal study.

BACKGROUND: Newly graduated nurses have comparatively high levels of occupational stress. Previous studies have evaluated stress across this population as a whole; however, little is known about potentially different occupational stress responses among new nurses and the impact of demographic and work-related characteristics on occupational stress responses. OBJECTIVES: To determine differences in occupational stress levels of newly graduated nurses at different time points during the first 3 years of practice; to identify potential subgroups of nurses who perceive different occupational stress levels over time; and to evaluate differences in identified subgroups based on demographic and work-related characteristics. DESIGN: An observational longitudinal study. SETTINGS: Four tertiary hospitals in Shanghai were selected randomly using a computer-generated random number table. PARTICIPANTS: All 343 newly graduated nurses employed in the selected hospitals were invited to participate. The inclusion criteria were (1) newly graduated without nursing experience, excluding nursing internship; (2) current employment in in-patient departments/ICU/operation room; and (3) consented to participate. A total of 152 participants met criteria and completed all four points of data collection. METHODS: Participants completed an annual paper survey. Occupational stress levels were measured using the Job Stress Scale for Newly Graduated Nurses. Occupational stress scores at different time points were compared using latent growth modeling. Group-based trajectory modeling was performed to identify subgroups of occupational stress trajectory. ANOVA and Fisher's exact test were conducted to examine the differences of demographic characteristics between classes. RESULTS: The entire sample of newly graduated nurses experienced a significant decrease in occupational stress during the first three years. The best-fitting group-based trajectory model described three distinctive trajectories: low occupational stress (19.1% of sample); medium occupational stress (67.1%) and high occupational stress (13.8%). The low occupational stress subgroup had a higher proportion of nurses from Shanghai, and the majority were employed as contact- based nurses. In comparison, the high occupational stress subgroup had the largest proportion of nurses from other provinces (outside of Shanghai), almost half of participants were employed as "bianzhi" nurses, and the majority reported to be assigned preceptor by shift. CONCLUSIONS: Newly graduated nurses perceived occupational stress differently over time. Identified subgroups with different demographic characteristics have significantly different perceptions of occupational stress over the first three years of practice and future intervention programs such as peer-support programs or a standardized preceptorship should be tailored to meet the unique needs of these different subgroups.