Floating to intensive care units: Nurses' messages for instant action to promote patient safety.

BACKGROUND: The overwhelming number of patients admitted to intensive care units (ICUs) combined with a nursing staff deficit sometimes requires the redeployment of nurses from other areas, meaning non-critical care nurses are asked to assist in treating critically ill patients. This may affect patient safety, especially in poorly resourced ICUs with financial constraints, such as in some developing countries. Nurses and nurse managers need specific strategies to address this issue and ensure patient safety. AIM: To explore ICU and floating nurses' perspectives of the floating experience and describe how the use of floating nurses could threaten the safety of patients in Egyptian ICUs. STUDY DESIGN: This was a qualitative descriptive study. Data were collected in in-depth interviews and analysed using Colaizzi's method of analysis. Forty-seven interviews were conducted, 22 with ICU nurses/managers and 25 with floating nurses. RESULTS: Two main themes were extracted: (1) Lived work experience of floating and ICU nurses during the floating period which included three subthemes: Being a floating nurse: living a double experience of a professional role, Being an ICU nurse: feeling overloaded, and small failures leading to bigger, more serious issuses; and (2) Messages for patient safety from floating and ICU nurses' perspectives which also comprised three subthemes: education and training, putting the patient in the safety zone, and poilcy reform. CONCLUSIONS: Promising strategies for ICUs to ensure patient safety when transferring nurses from other units include providing ongoing education and appropriate training for floating nurses to put patients in the safety zone. RELEVANCE TO CLINICAL PRACTICE: Our findings provide a foundation for nursing practitioners, managers, and policymakers to prevent medical errors and optimize nursing workforce allocation. Nursing managers should consider floating nurses' competence levels when assigning ICU patients. Moreover, teamwork and communication between ICU nurses/managers and floating nurses should be strengthened. Close supervision and use of technology to minimize medical errors are potential strategies to ensure patient safety when using floating nurses.

Managing during the COVID-19 pandemic: A cross-sectional study of health care workers' perceived organizational support and its consequences on their compassion, resilience and turnover intention.

AIM: The aim of this study is to evaluate health care professionals' perceived organizational support and its effect on their compassion, resilience and turnover intention in the United Arab Emirates. BACKGROUND: The COVID-19 pandemic exerted unprecedented pressure on health care systems, professionals and management systems. Health care organizations begin to explore their roles and function in relation to risks and resilience, in addition to ascertain what level of organization support they are providing to their workers. METHODS: A cross-sectional study was conducted with a questionnaire administered to 538 health care workers, to examine their personal resources and organizational support during the pandemic. RESULTS: A total of 37.7% of nurses were found to have a moderate level of resilience, logistic regression showed that being married is a protective factor against resigning from the profession (OR = 0.462, P = .012, 95% CI: 0.254-0.842), and health care workers who perceived higher organizational support were approximately 50% less likely to have a turnover intention (OR = 0.506, P = .009, 95% CI: 0.303-0.845). Multiple linear regression model indicated significantly higher resilience among physicians (ß = 0.12, P < .05) and allied health care practitioners (ß = 0.12, P = .022). Organizational support had a significant positive relationship with resilience scores (ß = 0.20, P < .001); adequate training was significantly related to higher compassion levels (ß = 0.11, P < .05) and high organizational support scores were associated with increased compassion scores (ß = 0.27, P < .001). CONCLUSIONS: Front-line health care workers reported moderate organizational support during the pandemic, commensurately reflected in moderate levels of personal resilience and self-compassion. Continued and better support is vital for employee sustainability and the increased health system performance, including quality of care and patient outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should help health care workers improve self-care strategies by strengthening personal resources, including shortened duty hours, offering adequate break time, providing a safe work climate and purveying adequate personal protective equipment and supplies to combat infections. They should build an empathetic work environment through understanding the needs of staff, helping tackle their work stress and sustaining cultures of compassion through promoting rewarding and flexibility strategies. Moreover, policymakers and nurse mangers should create a rewarding culture for nurses and other health care workers to increase their commitment to their jobs.