Development of an Emergency Nurse Internship to Promote a Healthy Work Environment and Improve Nurse Retention.

INTRODUCTION: Following the COVID-19 pandemic, a community emergency department was facing a staffing crisis with new emergency registered nurse turnover rates as high as 83.3%. There were limited experienced emergency nurses available to train the large number of novice nurses hired to fill vacancies. Based on this, the emergency department needed to restructure the orientation process to better align with evidence-based strategies and available resources. METHODS: The Seven Steps of Evidenced-based Practice were used to identify the best practices for an orientation program specific to the emergency department. Based on the evidence, a 16-week, competency-based, emergency nurse internship was implemented in the 33-bed community emergency department. RESULTS: The primary outcome of this initiative was new emergency nurse retention, which demonstrated a statistically significant reduction from 81.8% (pre-intervention) to 11.1% (post-intervention) (P < .001). Additionally, there was an improvement in the scores for each of the 6 healthy work environment standards. DISCUSSION: Based on the outcomes of this initiative, an emergency nurse internship is an effective method to improve emergency nurse competence and retention, contributing to a healthier work environment.

Survey results of COVID-19 pandemic on female surgical trainees: New normal work environment.

BACKGROUND: The COVID-19 pandemic has had a profound impact on surgical training globally. We aimed to explore and identify the specific challenges faced by women surgeons during the pandemic and provide recommendations for improvement. METHODS: A survey was conducted among trainee members of the Association of Women Surgeons, assessing various aspects of clinical training, mental well-being, and personal and professional life. RESULTS: The respondents were distributed across the United States, with the majority (28%) from the Midwest and Northeast. Training settings were predominantly academic university hospital programs (85%). The majority (92%) were resident trainees and 32% were in research. General surgery, constituting 86% of the respondents, was the most common specialty. There was a decline in surgical cases, research, mental health, and quality of didactics. Limited learning opportunities and challenges in job search were reported. Although virtual conferences were deemed affordable, the lack of networking was noted to be significant. CONCLUSION: The study highlights the need for ongoing support and adaptation in surgical training programs. These programs include the optimization of virtual platforms, prioritizing mental well-being, and ensuring equal opportunities. Strategies to mitigate the impact of future disruptions and promote gender equality are essential. Further research and workflow changes are warranted for effective capacity building.

Occupational groups and lower urinary tract symptoms: A cross-sectional analysis of women in the Boston Area Community Health Study.

OBJECTIVES: The objective of this study is to inform our hypothesis that the workplace toileting environment may impact lower urinary tract symptoms (LUTS); we examined the prevalence of LUTS across occupational groups in the Boston Area Community Health Survey. METHODS: At baseline, women (n = 3205) reported their occupation and frequency of 15 LUTS. Using the US Department of Labor's Standard Occupational Classification (SOC) system, we categorized women into 11 standard occupational groups. Prevalence ratios (PRs) were calculated by log-link generalized linear models, adjusting for age, race, education, fluid intake, and parity. Women classified in Office and Administrative Support were used as the reference group given their potential for fewer workplace toileting restrictions. RESULTS: Of the 3189 women with complete data, 68% of women reported any LUTS, ranging from 57% to 82% across the SOCs. Relative to women in Office and Administrative Support (n = 576), women in Computing, Engineering, and Science (n = 64) were more likely to report any LUTS (PR = 1.2, 95% confidence interval [95% CI]: 1.0-1.4) and urinating again in <2 h (PR = 1.7, 95% CI: 1.4-2.2), and women in Education, Legal, Community Service, Arts, and Media (n = 477), as well as Healthcare Practitioner and Technical Occupations (n = 162), were less likely to report perceived frequent daytime urination (PR = 0.6, 95% CI: 0.5-0.9 and PR = 0.6, 95% CI: 0.4-0.9, respectively). CONCLUSIONS: Our cross-sectional findings suggest that urination frequency varies across understudied occupational groups with various workplace toileting environments. Future studies should examine this relationship prospectively to inform the influence of workplace toileting environments on urination frequency, as well as the development and/or worsening of LUTS.

Left Without Being Seen: Nurse Work Environment and Timely Outcomes in New York and Illinois Emergency Departments.

INTRODUCTION: This study determined the relationship between the emergency nurse work environment and emergency department patient left without being seen rates and lengths of stay. METHODS: Cross-sectional analysis of 215 New York and Illinois emergency departments. The work environment (abbreviated Practice Environment Scale of the Nursing Work Index) was measured by emergency nurses in the 2021 RN4CAST-NY/IL survey and linked with outcomes from Hospital Compare. Regression models estimated the relationship between the nurse work environment and emergency department patient left without being seen rates, median length of stay (in minutes), and median behavioral health patient length of stay. Model coefficients were used to estimate expected additional care minutes gained if emergency department work environments improved. RESULTS: "Mixed" work environments had the longest median overall length of stay (3.4 hours) and the highest median left without being seen rates (2.2%), while "poor" work environments had the longest median length of stay for behavioral health patients (6 hours). Improving the emergency department work environment from poor to mixed (and mixed to better) was associated with a 13-minute reduction in overall length of stay (P ≤ .05), a 33-minute reduction in behavioral health length of stay (P ≤ .01), and a 19% reduction in left without being seen rates (P ≤ .01). We estimated 11,824 to 41,071 additional patients could be seen in emergency departments associated with work environment improvements from "poor" to "better," depending on annual patient volumes. DISCUSSION: Hospital administrators should consider investing in nurse work environments as a foundation to improve timely outcomes.

Workplace Harassment, Cyber Incivility, and Climate in Academic Medicine.

Importance: The culture of academic medicine may foster mistreatment that disproportionately affects individuals who have been marginalized within a given society (minoritized groups) and compromises workforce vitality. Existing research has been limited by a lack of comprehensive, validated measures, low response rates, and narrow samples as well as comparisons limited to the binary gender categories of male or female assigned at birth (cisgender). Objective: To evaluate academic medical culture, faculty mental health, and their relationship. Design, Setting, and Participants: A total of 830 faculty members in the US received National Institutes of Health career development awards from 2006-2009, remained in academia, and responded to a 2021 survey that had a response rate of 64%. Experiences were compared by gender, race and ethnicity (using the categories of Asian, underrepresented in medicine [defined as race and ethnicity other than Asian or non-Hispanic White], and White), and lesbian, gay, bisexual, transgender, queer (LGBTQ+) status. Multivariable models were used to explore associations between experiences of culture (climate, sexual harassment, and cyber incivility) with mental health. Exposures: Minoritized identity based on gender, race and ethnicity, and LGBTQ+ status. Main Outcomes and Measures: Three aspects of culture were measured as the primary outcomes: organizational climate, sexual harassment, and cyber incivility using previously developed instruments. The 5-item Mental Health Inventory (scored from 0 to 100 points with higher values indicating better mental health) was used to evaluate the secondary outcome of mental health. Results: Of the 830 faculty members, there were 422 men, 385 women, 2 in nonbinary gender category, and 21 who did not identify gender; there were 169 Asian respondents, 66 respondents underrepresented in medicine, 572 White respondents, and 23 respondents who did not report their race and ethnicity; and there were 774 respondents who identified as cisgender and heterosexual, 31 as having LGBTQ+ status, and 25 who did not identify status. Women rated general climate (5-point scale) more negatively than men (mean, 3.68 [95% CI, 3.59-3.77] vs 3.96 [95% CI, 3.88-4.04], respectively, P < .001). Diversity climate ratings differed significantly by gender (mean, 3.72 [95% CI, 3.64-3.80] for women vs 4.16 [95% CI, 4.09-4.23] for men, P < .001) and by race and ethnicity (mean, 4.0 [95% CI, 3.88-4.12] for Asian respondents, 3.71 [95% CI, 3.50-3.92] for respondents underrepresented in medicine, and 3.96 [95% CI, 3.90-4.02] for White respondents, P = .04). Women were more likely than men to report experiencing gender harassment (sexist remarks and crude behaviors) (71.9% [95% CI, 67.1%-76.4%] vs 44.9% [95% CI, 40.1%-49.8%], respectively, P < .001). Respondents with LGBTQ+ status were more likely to report experiencing sexual harassment than cisgender and heterosexual respondents when using social media professionally (13.3% [95% CI, 1.7%-40.5%] vs 2.5% [95% CI, 1.2%-4.6%], respectively, P = .01). Each of the 3 aspects of culture and gender were significantly associated with the secondary outcome of mental health in the multivariable analysis. Conclusions and Relevance: High rates of sexual harassment, cyber incivility, and negative organizational climate exist in academic medicine, disproportionately affecting minoritized groups and affecting mental health. Ongoing efforts to transform culture are necessary.

Stress load of Chinese nurses in Fangcang Shelter Hospitals during the COVID-19 pandemic: A latent profile analysis.

The Omicron wave of the COVID-19 pandemic significantly affected Shanghai, China, from March to June 2022. Numbers of Fangcang Shelter Hospitals (FSHs) were conversed from stadiums and exhibition centers to tackle the pandemic. This study aimed to identify the stress load profiles of nurses working in FSHs and explore the characteristics and factors influencing stress load profiles. Totally, 609 out of 700 FSH nurses (with an effective response rate of 87%) participated in an online survey investigating their socio-demographic information, work-related stressors, and stress load. Results of the latent profile analysis identified four classes of stress load, which were labeled as the low (Class 1), mild (Class 2), moderate (Class 3), and high (Class 4) stress load class. Maternity status and self-perceived health condition were significantly different between the four stress load classes by comparisons using the Chi-square test and the Kruskal-Wallis test. The contributors to the stress load profiles were determined by the multinomial logistic regression analysis, including age, education, maternity status, self-perceived health condition, working time in FSHs, and the four dimensions of work-related stressors. Participants who were less healthy (OR = 0.045, 95% CI:0.012,0.171), worked longer time in FSHs (OR = 40.483, 95% CI: 12.103,135.410), faced with more workload (OR = 3.664, 95% CI: 1.047,12.815), and worse working environment (OR = 12.274, 95% CI: 3.029,49.729) were more likely to be classified to the high stress load class. The task arrangement and working environment for FSH nurses should be optimized, and psychological training should be conducted routinely.

Asthenopia in bankers: identification and analysis of risk factors / Astenopia em bancários: identificação e análise dos fatores de risco

Abstract Objective: To evaluate the prevalence of asthenopia in a cohort of bank employees and identify possible associated risk factors. Methods: Cross-sectional study based on information supplied by bankers in response to a standardized electronic questionnaire. Results: The questionnaire was responded by 945 bankers. The frequency of asthenopic symptoms was positively associated with female gender, age over 50 years, and reading or using the computer >6 hours a day. Conclusion: Asthenopic symptoms were found to be significantly associated with gender, age and time spent reading. The most frequently reported symptoms were headache and sore eyes.

Resumo Objetivo: Avaliar a presença de astenopia em bancários e identificar possíveis fatores de risco associados. Metodos: Estudo transversal realizado por meio de informações obtidas em um questionário padronizado, aplicado eletronicamente à trabalhadores da categoria de bancários. Resultados: Responderam ao questionário 945 trabalhadores. Observou-se que a frequência dos sintomas de astenopia foi maior nos grupos que declararam usar computador ou ler por mais de 6 horas por dia. As queixas de astenopia foram significativamente maiores nos trabalhadores com mais de 50 anos e do sexo feminino. Conclusão: Este trabalho identificou uma associação positiva de queixas de astenopia em bancários em relação ao tempo de leitura, sexo e idade. Dentre os sintomas oculares associados à astenopia, foi encontrada uma maior prevalência de dor de cabeça e dor nos olhos.

O risco do uso de drogas no trabalho portuário: estudo no extremo sul do Brasil / The risk of the use of drugs in the harbour work: study in the southern extreme of Brazil

Este é um estudo quantitativo, exploratório e descritivo. Objetivou identificar a realidade do uso de drogas entre os trabalhadores portuários avulsos no microambiente portuário, no extremo sul do Brasil. A amostra constituiu-se de 306 trabalhadores. Os dados foram coletados através de entrevista estruturada e individual e analisados quantitativamente. Dos participantes, 43,14 por cento responderam que seus colegas já trabalharam sob o efeito de drogas, e as mais utilizadas foram o álcool (94,70 por cento) e amaconha (77,27 por cento)...

Estressores no trabalho das enfermeiras em centro cirúrgico: conseqüências profissionais e pessoais / Stressors in surgical nursing work: professional and personal consequences

O estresse tem sido um tema bastante discutido, nos últimos anos, pela comunidade científica. Vários estudos têm apresentado o estresse como causador de doenças, sendo considerado o "mal do século". O centro cirúrgico é um dos ambientes mais complexos do hospital, pois concentra os recursos humanos e materiais necessários ao ato cirúrgico e, freqüentemente, as suas atividades são desenvolvidas em um clima de tensão, pela existência de procedimentos estressantes geradores de ansiedade, quer pela gravidade dos pacientes, quer pela complexidade dos atos anestésico e cirúrgico. Nesta pesquisa, estabelecemos os seguintes objetivos: identificar o estresse das enfermeiras de centro cirúrgico; identificar os estressores do ambiente de trabalho dessas enfermeiras; relacionar o estresse das enfermeiras de centro cirúrgico com o prazer e o sofrimento no trabalho. A amostra foi constituída por 30 enfermeiras que trabalham em sete unidades de centro cirúrgico de hospitais da cidade de Recife-PE, destes dois são hospitais universitários. Os dados foram coletados através do Inventário de Estresse para Enfermeiro e de uma entrevista semi-estruturada com roteiro. Investigaram-se o estresse e os estressores presentes no cotidiano de trabalho da enfermeira e sua freqüência. Os resultados deste estudo tiveram por base a amostra de 30 enfermeiras do sexo feminino, com 60% casada sendo que para 66,7% escolheram a enfermagem como primeira opção no concurso vestibular....