The factors of job crafting in emergency nurses: regression models versus qualitative comparative analysis.

BACKGROUND: Job crafting is defined as a series of proactive behaviors exhibited by employees in order to balance work resources and needs, which has a significant positive impact on the nurses. It is necessary to find the core factors that influence the job crafting, as emergency nurses deal with the most complex tasks, so as to improve their job satisfaction. OBJECTIVES: To investigate the core factors of job crafting among emergency nurses. METHODS: A cross-sectional design was used in the study. A total of 255 nurses were recruited from two hospitals in Zhengzhou and Shenzhen, China in December 2021. 255 nurses completed an online questionnaire. Hierarchical regression models and fsQCA models were used to explore the factors influencing job crafting among emergency nurses and helped us to identify core factors. RESULTS: The hierarchical regression model and the fsQCA model found that the occupational benefit, psychological empowerment, and research experience were the core factors affecting their job crafting. Job involvement was not significant in the regression model, but the QCA model indicated that it needs to be combined with other factors to impact on job crafting. The QCA model uncovered seven key conditional configurations that led to high and low job crafting among emergency nurses, explaining 80.0% of the results for high job crafting and 82.6% of the results for the low job crafting, respectively. CONCLUSIONS: The results of this study provide valuable insights into the job crafting experienced by emergency nurses. Junior emergency nurses should be granted a high level of psychological empowerment without assigning them overly complex tasks, such as research tasks, as these challenges can stop their job crafting. Intermediate and senior emergency nurses, on the other hand, can be assigned research tasks coupled with high psychological empowerment to enhance their job crafting.

When is a fracture not just a fracture? Exploring emergency nurses' knowledge of osteoporosis in the West of Ireland.

BACKGROUND: Osteoporosis and fragility fractures are set to rise with the global ageing population. Prevalence will continue to significantly impact people's quality of life and healthcare expenditure. Emergency nurses are ideally placed to highlight the importance of screening, and treatment, to the public. For emergency nurses to impart information to patients it is essential they have accurate, evidence-based knowledge. This study aims to determine if emergency nurses' knowledge of osteoporosis is sufficient to educate the public. METHOD: A cross sectional descriptive design of 210 emergency nurses using the 'Osteoporosis Knowledge Questionnaire' (OKQ) was administered in four hospitals in the West of Ireland. Data was analysed using SPSS v28. RESULTS: A 66 % response rate was achieved. The mean score on the OKQ was 12.13 out of a possible 22. This suggests emergency nurses' knowledge of osteoporosis is substandard. Level of education has the greatest impact on participants (p = 0.005). Results indicated that emergency nurses acknowledge their responsibility regarding health promotion but lack the knowledge to undertake the role. CONCLUSION: Emergency nurses play a pivotal role in reducing osteoporosis and fragility fractures, by disseminating information to patients on prevention and management. This study highlighted that educational initiatives are required to address the deficiencies amongst emergency nurses' understanding of osteoporosis. Enhancing knowledge will inevitably lead to increased public awareness in tackling this global health crisis.

Assessing the Level of Electrocardiographic Interpretation Competency among Emergency Nurses in Palestine.

Introduction: The use of electrocardiograms (ECGs) is widespread among emergency room (ER) nurses for diagnosis and triage, making it crucial for them to have the appropriate level of competency in interpreting ECGs. This can lead to better healthcare and patient outcomes. Objectives: This study aims to assess the competency level of emergency nurses in Palestine in interpreting normal ECG and certain cardiac arrhythmias, and to explore the association between socio-demographic characteristics and their ECG interpretation competency. Methods: The study used a cross-sectional descriptive design, and 196 ER nurses were conveniently recruited to fill out a self-administered questionnaire based on previous literature. The data collected were analyzed using SPSS with strict adherence to ethical considerations. Results: The results showed that 70.9% of the nurses were males, 65.3% held a bachelor's degree in nursing, 46.9% had 1-5 years of experience, and 60.7% had received previous courses on ECG interpretation. The mean competency level of the ER nurses was satisfactory at 60.714%, but 38.8% had a poor level of competency. This was significantly higher among nurses with higher educational levels (p-value < 0.001), those who had taken previous ECG courses (p-value = 0.045) and life support (p-value < 0.05), and those who were exposed to more ECG interpretations per day (p-value = 0.001). Conclusion: There is a need to focus more on ECG competency levels in Palestinian literature and compare them between different departments. It is also essential to evaluate nurses' needs for continuous education.

The moral distress and resilience among emergency nurses in Arar city: Saudi Arabia.

BACKGROUND: Understanding moral distress and resilience is crucial for supporting the well-being of emergency nursing staff and improving patient care. However, there is limited research specifically examining moral distress and resilience among emergency nursing staff in ARAR city hospitals. AIMS: This study aims to examine moral distress and resilience levels among emergency nursing staff in ARAR city hospitals. Specifically, the study seeks to determine the correlation between moral distress and resilience among emergency nursing staff and examine differences in the levels of moral distress and resilience among different demographic and occupational characteristics. METHODS: A cross-sectional study design was employed, involving a non-probability stratified sample of emergency nursing staff from two hospitals in ARAR city. The participants completed a Brazilian Moral Distress Scale in Nurses (MDSN-BR) and Rushton Moral Resilience Scale in Nurses (RMRS). Statistical analyses, including descriptive statistics and one-way- ANOVA, were conducted to analyze the data. RESULTS: The study found that emergency nursing had a moderate level of moral distress, with a mean frequency of 2.70 (SD = 1.02) and a mean intensity of 2.79 (SD = 1.04). The overall self-reported moral resilience was also moderate, with a mean score of 2.48 (SD = 0.77). Significant positive correlations were observed between resilience and both moral distress frequency (r = 0.48, p = 0.001) and intensity (r = 0.48, p = 0.001). Educational levels and nursing positions were associated with variations in moral distress and resilience. Postgraduate diploma emergency nursing reported the highest levels of moral distress frequency (3.12, SD = 1.14) and intensity (3.21, SD = 1.16). A bachelor's degree in nursing exhibited higher levels of personal integrity (3.06, SD = 0.87), while a master's degree in nursing showed higher levels of moral efficacy (2.88, SD = 1.09). Head nurses experienced higher levels of moral distress compared to other positions (3.08, SD = 1.37 for frequency; 3.18, SD = 1.29 for intensity). CONCLUSION: The study revealed that emergency nursing experienced relatively moderate levels of moral distress, which could be attributed to insufficient multidisciplinary teams and unprepared actions. The findings also highlighted moderate levels of moral resilience, particularly in relational integrity. Educational levels and nursing positions were found to influence moral distress and resilience. These results underscore the need for targeted interventions to support the well-being of emergency nurses and enhance ethical decision-making.

Development of a Reliable and Valid Survey Instrument to Measure Nurses' Health Behaviors Towards an Infectious Disease.

Background and Purpose: The purpose of this study is to describe the process for developing a reliable and valid survey instrument guided by the protection motivation theory (PMT) to evaluate nurses' health behaviors toward an infectious disease such as Ebola. Methods: The instrument was developed and tested through a systematic process that included a literature review, focus group, validity testing, and reliability testing. Results: The outcome variable, protection motivation, contained two elements, determined by principal component analysis. The instrument's internal consistency had a Cronbach's alpha of .80 or greater. Conclusion: The development and testing of an instrument based on PMT constructs as the theoretical framework have demonstrated a relationship between the perceived threat toward the disease and the proposed coping process needed to address the disease.

Management of Pediatric Convulsive Status Epilepticus From the Perspective of Emergency Nurses: A Cross-sectional, Multicenter Study.

INTRODUCTION: Pediatric convulsive status epilepticus is one of the most common neurologic emergencies and should be managed by health care professionals as soon as possible based on current guidelines. This study aimed to determine the nursing approaches and management of pediatric convulsive status epilepticus from the perspective of emergency nurses in Turkey. METHODS: A cross-sectional, multicenter study was conducted with 162 emergency nurses working in emergency departments in 35 different provinces in Turkey. The data were collected via an online form. Descriptive statistical methods were used in data analysis. RESULTS: Most emergency nurses (72.2%) attempted an intravenous access immediately to administer antiseizure medications during the stabilization phase. Approximately half the emergency nurses stated that rectal diazePAM was frequently administered in the initial therapy phase and intravenous diazePAM was administered in the second therapy phase. The emergency nurses had most difficulties attempting intravenous access, determining status epilepticus types, and calming the parents. DISCUSSION: As health care professionals and important members of the health team, emergency nurses have the responsibility to manage pediatric convulsive status epilepticus in the fastest and the most appropriate way based on current practice guidelines in emergency departments. When intravenous access is not available, nonintravenous benzodiazepines should be considered in the first-line treatment of pediatric convulsive status epilepticus, followed by immediate intravenous access.

Moral disengagement, moral identity, and counterproductive work behavior among emergency nurses.

BACKGROUND: Morality is a fundamental component of nurses' daily work. Nurses' cognitive tendencies toward moral disengagement in high-stress work environments can easily lead them to engage in counterproductive work behaviors that are not conducive to the organization. However, there is limited research on how to mitigate the impact of moral disengagement on counterproductive work behavior. OBJECTIVE: The objective was to explore the impact of moral disengagement on counterproductive work behavior, as well as the reverse regulatory mechanism of moral identity on the relationship between moral disengagement and counterproductive work behavior. RESEARCH DESIGN: This was a quantitative, cross-sectional study. PARTICIPANTS AND RESEARCH CONTEXT: From September to October 2023, nurses from emergency departments of major hospitals in Hunan Province were recruited, and 500 questionnaires were distributed and collected using the WeChat app Credamo Seeing Numbers. ETHICAL CONSIDERATION: All study procedures were approved by the Ethics Committee of Hunan Normal University (No. 2023-388). FINDINGS: Moral disengagement had a positive effect on counterproductive work behavior directed at the organization (CWB-O) as well as counterproductive work behavior directed at individuals (CWB-I). Moral identity was not significant in moderating the relationship between moral disengagement and CWB-O. Moral identity had an inverse moderating effect on the mechanism of action between moral disengagement and CWB-I. CONCLUSION: Counterproductive work behavior guided by moral disengagement is detrimental to organizations, and moral identity can inhibit the effect of moral disengagement on CWB-I. Nursing administrators should focus on improving nurses' moral identity and improving the healthcare workplace environment so that moral identity can better exert its inhibitory effect on counterproductive work behavior among nurses.

A latent profile analysis of resilience and the associations with flourishing in emergency nurses exposed to workplace violence in China.

Workplace violence (WPV) exposure has been particularly prevalent in emergency nurses, coupled with negative mental health outcomes. Few explored resilience after WPV exposure using the perspective of positive mental health. We aimed to identify latent profiles of resilience and examine associations with flourishing in emergency nurses with WPV exposure. A total of 1241 Chinese emergency nurses were surveyed on the frequency of WPV exposure, resilience, and flourishing. Eight hundred and twenty five participants (90.1% female, 86.6% aged 20-39) reported WPV exposure at least once in the past 3 months. Latent profile analysis identified profiles of resilience as low resilience (15.0%), moderate decision respond and interpersonal link with low rational thought and flexible adaption (18.0%), moderate resilience (31.0%), high decision respond, interpersonal link, and rational thought with moderate flexible adaption (16.0%), and high resilience (20.0%). Higher flourishing was observed in profiles of moderate resilience, high decision respond, interpersonal link, and rational thought with moderate flexible adaption, and high resilience. We differentiated profiles of resilience and the associations with flourishing in emergency nurses with WPV exposure, which informed targeted interventions for promoting positive mental health.

Post-traumatic growth among emergency nurses after COVID-19 in Shanghai, China: a qualitative study.

OBJECTIVES: This study aims to investigate the post-traumatic growth of emergency nurses (ENs) in Shanghai, China, in 2022 following the COVID-19 pandemic. DESIGN: A phenomenological qualitative research approach was employed, with 17 ENs being interviewed between July and August 2022. Data collection was conducted through semistructured, in-depth interviews, and data analysis was carried out using the Colaizzi's seven-step analysis method. SETTING: A third-level hospital in Shanghai. PARTICIPANTS: A total of 17 ENs were interviewed through face-to-face, semistructured, in-depth interviews. RESULTS: Three main themes and eight subthemes were extracted from the data: (a) stress, (b) restructuring and (c) growth. CONCLUSION: Significant stress was imposed on ENs by the Shanghai COVID-19 pandemic, but cognitive restructuring was successfully undergone by them, leading to the experience of growth. It is recommended that post-traumatic growth levels be enhanced through professional psychological counselling and tailored support measures for different stages.

Anxiety and Depression Among Pediatric Emergency Nurses and Physicians During the Coronavirus Disease 2019 Pandemic.

INTRODUCTION: To determine anxiety and depression levels among pediatric acute care nurses and physicians before and after vaccine implementation during the coronavirus disease 2019 pandemic. METHODS: Prospective cross-sectional study of emergency medicine and urgent care providers at a metropolitan quaternary pediatric emergency department, including 2 satellite emergency departments and 7 urgent care sites. Anxiety and depression symptoms were assessed using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-2. Nurses and physicians were surveyed twice using the Generalized Anxiety Disorder-7 in May 2020 and March 2021 and once with the Patient Health Questionnaire-2 in March 2021. RESULTS: In total, 189 surveys were completed in May 2020 (response rate 48%), and 243 surveys were completed in March 2021 (response rate 52%). Nurses reported higher Generalized Anxiety Disorder-7 scores compared to physicians for both years, though Patient Health Questionnaire-2 scores were similar. Mean Generalized Anxiety Disorder-7 scores decreased for both nurses and physicians between the 2 response periods. Amongst those who had a history of anxiety, chronic medical conditions, or were living with a high-risk individual, higher rates of anxiety were observed. Respondents endorsed the need for increased psychological support during a pandemic, with adequate and timely psychological support provided by the hospital, and stated their households were financially affected by the pandemic. Respondents reported fewer feelings of anxiety after self and public vaccination. DISCUSSION: Study findings support increased psychological support for frontline nurses and physicians during a pandemic, particularly for those with a history of anxiety or chronic medical conditions, or those living with a high-risk individual.

Exploring the relationship between family care, organizational support, and resilience on the professional quality of life among emergency nurses: A cross-sectional study.

BACKGROUND: The professional quality of life (ProQOL), encompassing emotional, physical, and psychological well-being, is profoundly influenced by the unique nursing experiences of emergency nurses. Understanding and effectively enhancing their professional well-being are of paramount importance. This study aimed to explore the relationship between family care, organizational support, and resilience with the ProQOL among emergency nurses. METHODS: This cross-sectional study, conducted between May 1 and June 1, 2023, involved 118 emergency nurses from Hunan Provincial Brain Hospital. Demographic and work-related information were collected. ProQOL, family care, organizational support and resilience were assessed using validated scales. Statistical analysis was conducted to examine the associations between these variables. RESULTS: Significant differences were observed in the two dimensions of ProQOL (compassion satisfaction and burnout) among emergency nurses with different age, marital status, technical titles, work experience and night shift frequency (P < 0.05). Furthermore, both organizational support and resilience demonstrated a significant positive correlation with compassion satisfaction, while exhibiting a significant negative correlation with burnout (P < 0.05). Additionally, the third dimension of ProQOL (secondary trauma stress) was significantly negatively correlated with resilience (P < 0.05). CONCLUSION: This study elucidates the pivotal role of organizational support and resilience in influencing the professional quality of life among emergency nurses, highlighting the specific needs of younger and less-experienced practitioners. Our findings lay the groundwork for targeted interventions aimed at enhancing the occupational well-being and job satisfaction of nursing staff.

Emergency Nurses' Perceived Barriers and Solutions to Engaging Patients With Life-Limiting Illnesses in Serious Illness Conversations: A United States Multicenter Mixed-Method Analysis.

INTRODUCTION: This study aimed to assess emergency nurses' perceived barriers toward engaging patients in serious illness conversations. METHODS: Using a mixed-method (quant + QUAL) convergent design, we pooled data on the emergency nurses who underwent the End-of-Life Nursing Education Consortium training across 33 emergency departments. Data were extracted from the End-of-Life Nursing Education Consortium post-training questionnaire, comprising a 5-item survey and 1 open-ended question. Our quantitative analysis employed a cross-sectional design to assess the proportion of emergency nurses who report that they will encounter barriers in engaging seriously ill patients in serious illness conversations in the emergency department. Our qualitative analysis used conceptual content analysis to generate themes and meaning units of the perceived barriers and possible solutions toward having serious illness conversations in the emergency department. RESULTS: A total of 2176 emergency nurses responded to the survey. Results from the quantitative analysis showed that 1473 (67.7%) emergency nurses reported that they will encounter barriers while engaging in serious illness conversations. Three thematic barriers-human factors, time constraints, and challenges in the emergency department work environment-emerged from the content analysis. Some of the subthemes included the perceived difficulty of serious illness conversations, delay in daily throughput, and lack of privacy in the emergency department. The potential solutions extracted included the need for continued training, the provision of dedicated emergency nurses to handle serious illness conversations, and the creation of dedicated spaces for serious illness conversations. DISCUSSION: Emergency nurses may encounter barriers while engaging in serious illness conversations. Institutional-level policies may be required in creating a palliative care-friendly emergency department work environment.

Role stress, occupational burnout and depression among emergency nurses: A cross-sectional study.

BACKGROUND: Emergency nurses are a professional group at a high risk of burnout and depression. This may influence their mental state and physical health. AIMS: The aim of the study was to explore the relationship between role stress, occupational burnout and depression among emergency nurses. METHODS: A cross-sectional study was carried out among 295 emergency nurses from eight tertiary hospitals in western China. The Role Stress Scale, the Maslach Burnout Inventory-Human Services Survey and the Center for Epidemiologic Studies Depression Scale were employed. Descriptive statistics, independent sample t-tests, one-way analysis of variance, Pearson's correlation analysis and regression analysis were performed. RESULTS: Of the study participants, 54.6% were found to have depressive symptoms and 48.1% had severe occupational burnout. Positive correlations were observed between the scores of role stress and burnout and depression. Approximately 37.1% of the variation in depression was explained by the components of occupational burnout. CONCLUSIONS: Emergency nurses experience high levels of role stress, occupational burnout and depression. Preventive approaches to role stress, burnout and depression are needed to improve their psychological condition and quality of work life.

Thriving at work, career calling, and moral distress among nurses.

BACKGROUND: Emergency nurses who thrive at work experience positive emotions that help reduce burnout and thus enhance career calling. However, few studies have focused on the relationships among thriving at work, career calling, and moral distress among emergency nurses. OBJECTIVES: To investigate the relationships among thriving at work, career calling, and moral distress and to explore the mediating role of career calling in the relationship between thriving at work and moral distress among emergency nurses. DESIGN: A quantitative, cross-sectional study. METHODS: A cross-sectional study was conducted by reference to 390 emergency nurses in China using an online survey that include the Thriving at Work Scale, the Career Calling Scale, and the Moral Distress Scale-Revised. The data were analyzed using SmartPLS software. ETHICAL CONSIDERATION: The study was approved by the Ethics Committee of Hunan Normal University (No. 2023-388). FINDINGS: Among emergency nurses, thriving at work is positively associated with career calling, while career calling is negatively associated with moral distress. Career calling negatively and completely mediates the relationship between thriving at work and moral distress (ß = -0.087, p < 0.01). DISCUSSION: Theoretically, the findings enhance our understanding of the relationships among thriving at work, career calling, and moral distress among emergency nurses. CONCLUSION: By emphasizing the benefits of thriving at work, nursing managers can improve nurses' level of thriving at work by providing a favorable environment, a flexible scheduling system, and appropriate authorization as well as by ensuring organizational fairness and providing training opportunities in a hierarchical manner.

Assessing the Prevalence, Predictors, and Consequences of Secondary Traumatic Stress Among Emergency Nurses in Palestine During the COVID-19 Pandemic.

Introduction: Emergency nurses who are working in direct contact with COVID-19 patients are at an increased risk of developing secondary traumatic stress disorder. This study aimed to assess the prevalence, predictors, and consequences of secondary traumatic stress among emergency nurses in Palestine during the COVID-19 pandemic. Methods: The study utilized a cross-sectional design and recruited a total of 189 emergency nurses from multiple healthcare centers in Palestine. Data collected from January 21, 2021, to March 31, 2021. Results: The study revealed that emergency nurses had a high degree of secondary traumatic stress with the prevalence of high to severe symptoms of secondary traumatic stress being 61% of the total participants. In terms of predictors, the results showed that years of experience, level of education, burnout, and organizational support were significantly correlated with secondary traumatic stress and thus that years of experience and burnout are predictors of secondary traumatic stress. Conclusion: Based on our findings, nurses in emergency departments in Palestine have a high degree of secondary traumatic stress disorder which impacts their lives on a personal and professional level.

Promotion factors of emergency nurses' post-traumatic growth during the COVID-19 pandemic in Shanghai: a qualitative study.

BACKGROUND: Since March 2022, Shanghai, China, has experienced a severe wave of SARS-CoV-2 transmission caused by the Omicron variant strain. The pandemic has severely constrained the local healthcare system. After treating critically ill COVID-19 patients, emergency nurses may experience some positive changes due to new insights or gains in their work, even if they have had traumatic experiences. This study aimed to explore the promoting factors of emergency nurses' post-traumatic growth during the COVID-19 pandemic in Shanghai. We hoped to provide a new perspective and theoretical basis for intervening in and promoting the psychological rehabilitation of medical staff after traumatic circumstances. METHODS: This study employed a qualitative design based on the phenomenological approach. 18 participants from the emergency department of a third-level class-A hospital in Shanghai who participated in treating COVID-19 patients were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation. The seven-step Colaizzi process was used for data analysis. RESULTS: The investigation uncovered two themes and six subthemes. Internal factors contained self-affirmation, deliberate rumination, and cognitive restructuring, which constituted attitudes and behaviours that participants could subjectively determine. External factors included social support, transformational leadership, and role modelling, which constituted factors influenced by others or the environment. CONCLUSIONS: The promoting factors of PTG of emergency nurses originated from different sources such as individuals, organizations, and society. In addition to good psychological adjustment of the individual, society, hospitals, and nursing managers should focus on establishing supportive PTG strategies. The ultimate purpose is to improve the retention rate and career growth of nurses.

A Survey of Emergency Nurses' Perceptions and Practices to Support Patients' Families as Surrogate Decision Makers.

INTRODUCTION: Family members acting as surrogate decision makers for severely ill patients in emergency and critical care centers face psychological burdens. This study aimed to investigate the actual situation of emergency nurses' perceptions and practices to support patients' families and its structural elements. METHODS: We created an original 25-item questionnaire and surveyed 164 emergency nurses from 64 emergency and critical care centers regarding their perceptions of caring for people making surrogate decisions. Participants averaged 35.6 years old and 5.1 years as emergency nurses. RESULTS: Cronbach's α coefficients for importance and practice on the original questionnaire were 0.936 and 0.933, respectively. We identified 4 elements of necessary support for patient families making surrogate decisions according to emergency nurses: "collaboration in understanding the condition of the patient as well as empathetic support," "care that addresses the needs of patient's family members," "confirming the role of nurses and surrogate decision making," and "participation in meeting with a doctor and patient families." In addition, we identified 5 elements that indicate the current state of practice: "support from specialists such as nurses and other professionals," "compassionate care for family members and those who are providing support to family members," "empathetic support for family members," "support for making arrangements that address the needs of family members," and "considerations for family members." DISCUSSION: According to the findings of this study, emergency nurses should coordinate with other professionals and talk with family members and physicians to increase their understanding of the need to assist in surrogate decision making. In addition, emergency nurses also need to explain to patients' relatives how to support them in surrogate decision making.

The influence of practice experiences on feelings of role proficiency in emergency nurse practitioners: A phenomenological study.

INTRODUCTION: This research explores how emergency nurse practitioners (ENPs) become role proficient given experience variation and lack of role standardisation. AIM: To understand how ENPs experiences in practice influence their feelings of role proficiency. METHODS: A hermeneutic phenomenological study was undertaken utilizing an interpretive standpoint. A two-phase approach was adopted with ten participants using a digital diary informing a semi-structured interview. A three-stage data analysis approach was applied. FINDINGS: Six themes emerged: the meaning of role proficiency, relationships, confidence, learning and knowledge, exposure and experience, and care. Models of proficiency and its development are presented. DISCUSSION: Proficiency is defined where confidence in the components that proficiency consists of and their application to each clinical presentation is required. Proficiency is a continuum supported by regulatory mode theory. Inconsistency of role understanding gives rise to three ENP groups, resistors, maintainers, and innovators. CONCLUSION: Role clarity is required to establish a consistent culture within organisations founded on the voice of the ENP as captured in this research. This model of proficiency be incorporated in ENP role development for current and future ENPs.

Current status of post-traumatic stress disorder among emergency nurses and the influencing factors.

Objective: To gain a better understanding of the current state of traumatic stress experienced by emergency nurses of Grade III Level A hospitals in Jiangsu Province, as well as their coping styles after experiencing such traumatic events. Additionally, this study aims to identify the primary factors that influence the responses of these nurses to traumatic events. Methods: Using a cluster random sampling method, we enrolled 265 nurses working in the emergency departments of five Grade III Level A hospitals in Jiangsu Province. These nurses participated in a questionnaire survey that included inquiries regarding general information, previous traumatic experiences, and a post-traumatic stress disorder self-assessment scale (PCL-C) for emergency department nurses. Results: A total of 290 questionnaires were distributed, resulting in 265 valid questionnaires and an effective rate of 91.38%. These findings indicated that emergency nurses who participated in public health emergencies such as the COVID-19 pandemic (45.66%) and sudden health deterioration and death of patients (43.77%) encountered the most traumatic events. The top two traumatic events that had a moderate or greater impact on emergency nurses were verbal abuse from patients or their family members (39.24%) and verbal or physical threats by patients or their family members (35.09%). The mean PCL-C score of nurses who experienced traumatic events was 33.62 ± 11.37, with a positive rate of 26.04%. Results from the one-way analysis of variance and multiple linear regression analysis demonstrated that the working years, monthly income, and personal health status of emergency nurses were the main factors contributing to post-traumatic stress disorder. Conclusion: Emergency nurses are susceptible to severe traumatic stress following traumatic events, and effective interventions are necessary to address the diverse factors that contribute to their psychological well-being.

"Feeling Like an Island": Perceptions of Professional Isolation Among Emergency Nurses.

INTRODUCTION: Professional isolation, feelings of being isolated from one's professional peers and lacking mentoring and opportunities for professional interaction, collaboration, and development, is a challenge for workers across the labor market. The notion of professional isolation is particularly prevalent in low-resource health care settings and is common among emergency nurses. METHODS: This study explored the perceptions of professional isolation among emergency nurses working in a low-resource environment using individual interviews with 13 participants in 5 settings in Lesotho. RESULTS: The data were analyzed using qualitative content analysis and revealed an overarching theme of "feeling like an island" containing 3 categories, namely lack of interprofessional collaboration and consultation, skills mismatch, and enforced loneliness. DISCUSSION: This study suggests that lack of interprofessional collaboration and consultation, skills mismatch, and enforced loneliness have influenced feelings of professional isolation among emergency nurses working in low-resource environments. The findings of this research lend support to the idea that communities of practice may have a potential impact in addressing professional isolation.