Tragedy or transformation? Online survey of nurse spirituality during the COVID pandemic.

AIM: To describe positive and negative spiritual responses to providing COVID-related nursing care among nurses working in hospitals. BACKGROUND: The COVID pandemic has intensified and publicised the threats to nurse well-being. Absent from the recommendations for promoting nurse well-being is recognition of how nurses' spirituality and/or religiosity is affected by the strain of COVID caring or how it may be affecting their well-being. DESIGN: Cross-sectional, descriptive observational, mixed methods study. METHODS: Data were collected from 523 registered nurses employed in three Southern California hospitals during March-May, 2022 when these hospitals' COVID case counts were <15%. Using Online survey methods, data were obtained using the Religious/Spiritual Struggles Scale-Short Form, Moral Injury Symptom Scale-Healthcare Professionals, Post-traumatic Growth Inventory and demographic and work-related items. STROBE guidelines for cross-sectional observational studies were observed. RESULTS: The mean for religious/spiritual struggles was 1.98 (range of 1-5, comparable to a little bit). Although roughly half of the sample reported the struggles were not experienced/did not apply, 23%-36.5% reported experiencing these struggles at least somewhat. The most frequent struggle was to find ultimate meaning. The mean observed for moral injury was 6.5 (range of 1-10); applying established criteria indicated it was troubling for at least 50%. The mean for post-traumatic growth was 4 (on a scale of 0-6); using established criteria, 41% experienced PTG. Quantitative findings were illustrated by the qualitative responses that occasionally expressed spiritual tragedy and transformation concurrently. CONCLUSION: The professional work of nursing impacts nurses in invisible, spiritual ways that can be tragic and/or transformative. RELEVANCE TO CLINICAL PRACTICE: Interventions to address nurses' mental health challenges must include attention to these invisible struggles. Nurses' mental health challenges must be met in part by addressing how they can surmount spiritual tragedy-and allow spiritual transformation.

Advancing EBP culture and competencies through an academic-research partnership: Process and outcomes of an EBP scholar program.

BACKGROUND: Evidence-based practice (EBP) is increasingly being adopted in healthcare organizations to improve patient care and outcomes. Yet, barriers remain that prevent consistent implementation of EBP in clinical settings. AIMS: To increase EBP competencies and promote practice change, a regional academic-community hospital in Los Angeles, California, jointly with a university school of nursing, developed and implemented an EBP scholar program. METHODS: A multistep EBP process was delivered during monthly didactic workshops to ensure optimal delivery and acquisition of EBP core competencies. The Iowa Model of Evidence-Based Practice to Promote Quality Care was integrated into the curriculum to assist program scholar's efforts to systematically direct EBP implementation at the organizational level. Additional strategies were incorporated including one-to-one mentoring, institutional recognition, and protected time. The 13-item EBP Competency Scale for practicing registered professional nurses was used to measure EBP competency at baseline and post-program completion. RESULTS: Five recruited scholars completed the baseline survey and three completed the postsurvey. EBP competency increased from 52.9% to 62.75%. Scholars submitted abstracts for conference poster presentation, podium presentations, and conference poster awards. One article was submitted and accepted for journal publication. LINKING EVIDENCE TO ACTION: A multistep EBP process can enhance EBP delivery, improve EBP competency, and facilitate dissemination.

Sanctification of work and hospital nurse employment outcomes: An observational study.

AIM: To explore nurse ascriptions of sacredness to work and measure its association with the employment outcomes of job satisfaction, burnout, organisational commitment, employee engagement and turnover intention. BACKGROUND: High portions of hospital nurses experience burnout. Many factors contributing to burnout also contribute to job dissatisfaction and other negative employment outcomes. Personal factors, such as religiosity, help nurses to cope with work. METHODS: Questionnaires measuring study variables were distributed to all nursing personnel at a faith-based hospital in Los Angeles; 463 responded. Regression analyses allowed measurement of how sacredness ascribed to work (measured by Sanctification of Work Scale) and religiosity (measured by Duke Religiosity Index) were associated with the various employment outcomes. RESULTS: Sanctification of work consistently was found to be associated with less burnout and intention to leave, and more job satisfaction, employee engagement and organisational commitment. CONCLUSION: The sacredness with which a nurse views work explains, in part, positive employment outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: Nurturing a sense of sacredness for work in nurses may provide them with an internal buffer against negative employment outcomes. Suggestions for creating rituals and educating nurses are offered.