Resilience as a mediator between compassion fatigue,nurses' work outcomes,and quality of care during the COVID-19 pandemic

BackgroundNurses in the frontline of the battle against COVID-19 are highly vulnerable to compassion fatigue (CF), which may affect their mental health, work effectiveness, and patient safety outcomes. However, no studies have investigated nurses' CF in relation to job outcomes and care quality during the pandemic.AimsThis study aims to examine the mediating role of resilience in the relationship between CF and frontline nurses' job outcomes (job satisfaction and turnover intention) and care quality.DesignAn online, cross-sectional survey containing five self-report scales was used to collect data from 270 frontline nurses in selected hospitals in the Philippines.ResultsOverall, 38.5% of frontline nurses experienced medium to high CF during the second wave of the pandemic. Increased CF was associated with poorer nurse-reported quality of care (β = −0.145, p = 0.019), lower job satisfaction (β = −0.317, p = 0.001), and higher organizational turnover intention (β = 0.301, p = 0.001). Moreover, resilience fully mediated the relationship between CF and quality of care (β = −0.088, p = 0.169), and partially mediated the relationship between CF and job satisfaction (β = −0.259, p = 0.001), and CF fatigue and organizational turnover intention (β = 0.272, p = 0.001).ConclusionFrontline nurses are at risk of developing CF during the pandemic. Psychological resilience reduces the negative impact of CF on frontline nurses' job satisfaction, turnover intention, and the quality of care in their assigned unit. Proactive measures to reduce CF should be prioritized by nursing administrators. Resilience-promoting interventions could foster job satisfaction and retention in nurses and, hence, the quality of care delivered in their units.     

The effects of a preceptorship program on newcomer nurses’ turnover intention,commitment and job satisfaction: Quasi-experimental study

AimThe aim of the present study was to examine the effect of an organizational socialization model-based preceptorship program on the organizational outcomes of newcomer nurses.BackgroundPreceptorship programs need to be strengthened to ensure the organizational socialization of newcomer nurses.DesignThis study was conducted with a one group pretest-posttest design.MethodsThe sample consist of newcomer nurses from the university hospital of İzmir (N = 56) in Turkey. Data were collected using scales on turnover intention, professional and organizational commitment and job satisfaction. The dependent t-test was used for data analyses.ResultsThe newcomer nurses’ intention to leave their unit and profession, organizational and professional continuance commitment, professional normative commitment and job satisfaction levels were similar at the end of the one-year preceptorship program compared with the baseline (p > .05). It was also determined that the participants’ intention to leave the organization increased (t = −4.153, p < .001), while their affective (t = 4.443, p < .001) and normative commitment to the organization (t = 3.443, p < .001) and their professional affective commitment decreased (t = 7.390, p < .001) by the end of the program.ConclusionsThe organizational socialization model has the potential to be used as an effective framework to improve the organizational outcomes of new graduate nurses. Although organizational socialization meets some dimensions of institutional and professional needs of newcomer nurses in the first year, there is still a need to use different strategies and enrich organizational socialization to support their adaptation process.     

Clinical supervision and ward orientation predict new graduate nurses’ intention to work in critical care: Findings from a prospective observational study

IntroductionClinical supervision and transitional support programs are important in supporting the successful transition and retention of new graduate nurses and their intention to work in specialty settings. However, little is known about which elements of support programs influence this intention. This study aimed to examine new graduate nurses' perceptions of clinical supervision and the practice environment, and how these influenced their intention to stay in critical and non-critical care areas following their transitional support program.MethodsBetween May 2012 and August 2013, new graduate nurses (n = 87) were surveyed towards the end of their 12-month transitional support program. In addition to demographic and ward details, participants completed the Manchester Clinical Supervision Scale (MCSS) and the Practice Environment Scale Australia (PES-AUS). The ‘Intention to Stay in a Clinical Specialty’ survey was used to measure new graduate nurses’ intention to remain working in their current ward or unit.ResultsPredictors of new graduate nurses' intention to stay in their current ward/unit were not having to practise beyond personal clinical capability (AOR: 4.215, 95% CI: 1.099–16.167) and working in a critical care specialty (AOR: 6.530, 95% CI: 1.911-22.314). Further analysis of those nurses who indicated an intention to remain in critical care revealed that high satisfaction with clinical supervision (AOR: 3.861, 95% CI: 1.320–11.293) and high satisfaction with unit orientation (AOR: 3.629, 95% CI: 1.236–10.659) were significant predictors.ConclusionWhile this study identified that new graduates who worked within their scope of practice were more likely to report their intention to remain in their current ward, new graduates assigned to critical care were six times more likely to indicate their intention to remain than new graduates in other wards/units. Ensuring new graduate nurses assigned to critical care areas receive good unit orientation and clinical supervision increases their intention to remain in this setting.     

Surface acting,emotional exhaustion,career calling and turnover intention among student nurses: A cross-sectional study

AimThis study aims to explore the mediating role of emotional exhaustion and the moderating role of career calling in the linkage of surface acting and turnover intention among student nurses in the final clinical practicum.BackgroundTurnover rates are especially high for graduating nursing students. Surface acting is considered an important factor that affects this rate among nurses. However, little is known about the relationships between surface acting and turnover intentions among graduating nursing students in the final clinical practicum.DesignThe current research is a cross-sectional study, and the data were collected from 8 January 2022–22 January 2022.MethodsA survey was completed by 275 graduating nursing students. This survey included Chinese translations of scales measuring surface acting, emotional exhaustion, career calling and turnover intentions.ResultsBoth surface acting (r = 0.47, p < 0.001) and emotional exhaustion (r = 0.59, p < 0.001) correlated positively with turnover intentions. Both surface acting (r = −0.41, p < 0.001) and emotional exhaustion (r = −0.62, p < 0.001) correlated negatively with career calling and career calling (r = −0.72, p < 0.001) correlated negatively with turnover intentions. The association between surface acting and turnover intention was mediated by emotional exhaustion. In addition, career calling moderated the relationship between surface acting and emotional exhaustion.ConclusionsSurface acting results in higher emotional exhaustion and higher turnover intention among graduating nursing students, which was more pronounced among nursing students with a lower sense of career calling.     

A cross-sectional study of clinical emergency department nurses’ occupational stress,job involvement and team resilience

IntroductionThe occupational stress of clinical nurses has drawn increasing attention. It has been proven that occupational stress is related to job involvement, and job involvement affects team resilience. However, research on the relationship between emergency nurses’ occupational stress, job involvement and team resilience is lacking.AimTo explore relationships between occupational stress, job involvement, and team resilience among a sample of emergency nurses and determined significant influencing factors of occupational stress in emergency departments.MethodsIn four hospitals in Shandong, China, 187 emergency room nurses participated in a study. The Utrecht Work Engagement Scale, the Chinese version of the Stressors Scale for Emergency Nurses, and a scale for evaluating the team resilience of medical professionals were used to collect data.ResultsThe overall occupational stress score of nurses working in the emergency departments in Shandong province was 81.07 ± 25.80. The results of Single-factor analysis demonstrated that the scores indicating the occupational stress for emergency nurses differed significantly with respect to age, education level, marital status, children, professional title, work experience and work shift (P < 0.05). Additionally, there is a negative correlation between job involvement and team resilience and occupational stress. Multiple linear regression results showed that the job involvement, team resilience and work shift were statistically significant influencing factors of the level of occupational stress (change R² = 17.5 %, F = 5.386, P < 0.001).ConclusionsStronger team resilience and more active job involvement resulted in lower occupational stress levels experienced by emergency nurses.     

The relationship between secondary traumatic stress and burnout in critical care nurses: The mediating effect of resilience

PurposeTo examine the mediating factor on the association of secondary traumatic stress and burnout among critical care nurses.DesignA correlational study.MethodsData were collected from a convenience sampling of 147 nurses from two general hospitals who had six or more months of experience working in an intensive care unit. The collected data were analyzed through t-test, ANOVA, Scheffé test, Mann-Whitney test, Kruskal-Wallis test, Bonferroni correction, and Pearson’s correlation coefficient using SPSS 25.0. The mediating effect of resilience was analyzed through the three-stage mediation effect test procedure using hierarchical regression analysis and the Sobel test.ResultsSecondary traumatic stress had a statistically significant positive correlation with burnout (r = 0.45, p <.001), and a statistically significant negative correlation between burnout and resilience (r = −0.54, p <.001) was observed. Secondary traumatic stress was found to have a statistically significant effect on resilience, which was the mediating variable (β = −0.17, p =.042). Additionally, secondary traumatic stress had a statistically significant effect on burnout (β = 0.45, p <.001). The significance of the mediating effect of resilience on the relationship between secondary traumatic stress and burnout was investigated using the Sobel test, and the mediating effect of resilience was found to be statistically significant (Z = 1.98, p =.048).ConclusionResilience was found to have a partial mediating effect in the relationship between critical care nurses’ secondary traumatic stress and burnout. The study thus provides basic data on the importance of resilience in preventing burnout from secondary traumatic stress.     

Building nurse resilience in the workplace

AimsThe aims of the study were 1) to replicate the research based on the pilot study; 2) to increase resilience in nurses working on all units at four hospitals and 3) to determine which interventions were preferred and most effective.BackgroundWork stress mediates resilience and resilience moderates work stress. Resilience building activities in the literature are often time consuming, complex and done outside work hours. This study investigated use of portable, accessible and brief interventions by nurses to decrease stress and increase resilience during work hours.MethodsThis study used a cross sectional, longitudinal, repeated measures survey design. The study took place in October 2018 to January 2019. Toolkits included written instructions for completing the study protocol, and six activities. Nurses completed surveys at baseline, at 10 time points over a four- to six-week period, and at study conclusion.ResultsConnor-Davidson Resilience Scale-10 instrument scores showed resilience increased significantly at four weeks and the effect continued at three months (p < .02). Self-reported stress levels decreased over the study period and nurses self-selected to continue use of the interventions.ConclusionThe interventions used during work hours decreased self-reported stress and increased resilience. Nurse leaders may easily adopt these options to promote a less stressed workforce. Resilience can increase the ability of nurses to tolerate high stress in the workplace, which may decrease burnout and turnover. In the pandemic, resilience is even more important as hospitals struggle to retain nurses.     

Coronavirus disease 2019 pandemic promotes the sense of professional identity among nurses

BackgroundUnder the COVID-19 pandemic, nurses are the mainstay in the fight against the pandemic.PurposeTo evaluate potential impact of the pandemic on nurses’ professional identity.MethodSelf-report questionnaires were distributed online. Data collected were compared with available norms. Multivariate logistic regression analyses were employed to calculate the OR of frontline vs. nonfrontline nurses.FindingsThe mean of the total score of the scale was 121.12 out of 150. Both the total score and scores on the five dimensions were significantly higher than norms. Frontline nurses had a significantly higher professional identity than non-frontline nurses (total score: odds ratio [OR], 1.19; professional identity evaluation: OR, 1.27; professional social support: OR, 1.18; professional social proficiency: OR, 1.33; and dealing with professional frustration: OR, 1.19). The most frequently mentioned tags were Hope, Frontline, Protection, Outbreak, Work, Situation.DiscussionCOVID-19 outbreak was associated with an enhancement in the professional identity of nurses.     

Valoración del entorno de práctica profesional por enfermeras españolas que participan en foros de Internet

AimTo assess the professional work environment by Spanish nurses who participate in professional discussion groups on the Internet.MethodA cross-sectional study (online survey) developed in 2011. The study variables were: socio-demographic and professional data; nursing practice environment, using the questionnaire Practice Environment Scale of the Nursing Work Index (PES-NWI).ResultsOut of a total of 295 questionnaires received, 214 were valid (72.54%). Most of the nurses were female (70.6%), with an average age of 43.55 years (SD = 9.82). The average score of the PES-NWI was 2.45 (SD = 0.63). The work environment was assessed as a mixed type, as three subscales scored over 2.5 (nursing foundations for quality of care, nurse manager leadership and support of nurses, and nurse-physician relations). The work environment assessment was influenced by several factors: professional category (P <.001); function (P <.001); and type of centre, which only affected the perception of the nurse-physician relations subscale.ConclusionsThe work environment received a moderate evaluation by participants. The staffing and resource adequacy subscale scored the worst, while the nursing foundations for quality of care was the highest scored. Nurses with management function and those with higher positions tended to give a better assessment of the work environment. The nurse-physician relations dimension was higher rated in primary care and nursing homes than in hospitals.     

Job control,work-family balance and nurses’ intention to leave their profession and organization: A comparative cross-sectional survey

BackgroundThe shortage of nurses is a problem in many countries. In Japan, the distribution of nurses across different care settings is uneven: the shortage of nurses in home healthcare and nursing homes is more serious than in hospitals. Earlier research has identified numerous factors affecting nurses’ intention to leave work (e.g., job control, family-related variables, work-family conflict); however, these factors’ levels and effect size may vary between nurses in hospitals, home healthcare, and nursing homes.ObjectivesThis study measured job control, family-related variables, and work-family conflict among nurses in hospitals, home healthcare, and nursing homes, and compared these variables’ levels and effect size on nurses’ intention to leave their organization or profession between these care settings.DesignThe research design was cross-sectional.MethodsParticipating nurses from hospitals, home healthcare facilities, and nursing homes self-administered an anonymous questionnaire survey; nurses were recruited from the Kyushu district of Japan. Nurses from nine hospitals, 86 home healthcare offices, and 107 nursing homes participated. We measured nurses’ intention to leave nursing or their organization, perceived job control, family variables and work-family conflict. We analyzed 1461 participants (response rate: 81.7%).ResultsThe level of job control, family variables, and work-family conflict affecting nurses varied between hospitals, home healthcare, and nursing homes; additionally, these variables’ effect on nurses’ intention to leave their organization or profession varied between these care settings. Work-family conflict, family variables, and job control most strongly predicted nurses’ intention to leave their organization or profession in hospitals, home healthcare, and nursing homes, respectively.ConclusionsInterventions aiming to increase nurse retention should distinguish between care settings. Regarding hospitals, reducing nurses’ work-family conflict will increase nurse retention. Regarding home healthcare, allowing nurses to fulfill family responsibilities will increase nurse retention. Regarding nursing home nurses, increasing nurses’ job control will increase nurse retention.     

The Chinese Version of the Work Control Scale for Nurses: Modifying the Translation and Psychometric Testing

PurposeThe aim of the study was to modify and test the psychometric properties of the Chinese version of the work control scale (C-WCS).MethodsThe translated scale was administered to 840 nurses in Shanghai. Validity was assessed in terms of content validity and construct validity using exploratory factor analysis and confirmatory factor analysis. Internal consistency and test–retest reliability were estimated using Cronbach α and the intraclass correlation coefficient.ResultsPsychometric analyses of the C-WCS indicate high reliability and good content and construct validity.ConclusionThe C-WCS has good psychometric properties and can be used as a valid tool for measuring work control among nurses in China. The C-WCS will help to further explore the correlations between perceived work control and organizational quality indicators such as nurses' satisfaction, job stress, well-being, or intention to stay. It can also be used in nursing outcome studies of work control strategies.     

Influencing Factors and Consequences of Workplace Bullying among Nurses: A Structural Equation Modeling

Purpose

The purpose of this study was to build and test a model outlining the factors related to workplace bullying among nurses. The hypothesized model included authentic leadership and a relationship-oriented organizational culture as influencing factors, symptom experience and turnover intention as consequences, and positive psychological capital as a mediator of workplace bullying among nurses.