Stressors, emotions, and social support systems among respiratory nurses during the Omicron outbreak in China: a qualitative study.

BACKGROUND: Respiratory nurses faced tremendous challenges when the Omicron variant spread rapidly in China from late 2022 to early 2023. An in-depth understanding of respiratory nurses' experiences during challenging times can help to develop better management and support strategies. The present study was conducted to explore and describe the work experiences of nurses working in the Department of Pulmonary and Critical Care Medicine (PCCM) during the Omicron outbreak in China. METHODS: This study utilized a descriptive phenomenological method. Between January 9 and 22, 2023, semistructured and individual in-depth interviews were conducted with 11 respiratory nurses at a tertiary hospital in Wuhan, Hubei Province. A purposive sampling method was used to select the participants, and the sample size was determined based on data saturation. The data analysis was carried out using Colaizzi's method. RESULTS: Three themes with ten subthemes emerged: (a) multiple stressors (intense workload due to high variability in COVID patients; worry about not having enough ability and energy to care for critically ill patients; fighting for anxious clients, colleagues, and selves); (b) mixed emotions (feelings of loss and responsibility; feelings of frustration and achievement; feelings of nervousness and security); and (c) a perceived social support system (team cohesion; family support; head nurse leadership; and the impact of social media). CONCLUSION: Nursing managers should be attentive to frontline nurses' needs and occupational stress during novel coronavirus disease 2019 (COVID-19) outbreaks. Management should strengthen psychological and social support systems, optimize nursing leadership styles, and proactively consider the application of artificial intelligence (AI) technologies and products in clinical care to improve the ability of nurses to effectively respond to future public health crises.

Young oncologists benefit more than experts from deep learning-based organs-at-risk contouring modeling in nasopharyngeal carcinoma radiotherapy: A multi-institution clinical study exploring working experience and institute group style factor.

Background: To comprehensively investigate the behaviors of oncologists with different working experiences and institute group styles in deep learning-based organs-at-risk (OAR) contouring. Methods: A deep learning-based contouring system (DLCS) was modeled from 188 CT datasets of patients with nasopharyngeal carcinoma (NPC) in institute A. Three institute oncology groups, A, B, and C, were included; each contained a beginner and an expert. For each of the 28 OARs, two trials were performed with manual contouring first and post-DLCS edition later, for ten test cases. Contouring performance and group consistency were quantified by volumetric and surface Dice coefficients. A volume-based and a surface-based oncologist satisfaction rate (VOSR and SOSR) were defined to evaluate the oncologists' acceptance of DLCS. Results: Based on DLCS, experience inconsistency was eliminated. Intra-institute consistency was eliminated for group C but still existed for group A and group B. Group C benefits most from DLCS with the highest number of improved OARs (8 for volumetric Dice and 10 for surface Dice), followed by group B. Beginners obtained more numbers of improved OARs than experts (7 v.s. 4 in volumetric Dice and 5 v.s. 4 in surface Dice). VOSR and SOSR varied for institute groups, but the rates of beginners were all significantly higher than those of experts for OARs with experience group significance. A remarkable positive linear relationship was found between VOSR and post-DLCS edition volumetric Dice with a coefficient of 0.78. Conclusions: The DLCS was effective for various institutes and the beginners benefited more than the experts.

Do Confucian values and working experience matter? The impact of provincial governors' characteristics on the management level of major road accidents in China.

Upper echelons theory (UET) proposes that organizational outcomes are directly affected by the experiences, personalities, and values of individuals who occupy critical managerial roles within an organization. Using the lens of UET, this study investigates how governors' characteristics affect the management level of major road accidents (MLMRA). The empirical work is based on fixed effects regression models that are applied to Chinese provincial panel data from 2008 to 2017. This study uncovers that the MLMRA is associated with governors' tenure, central background, and Confucian values. We further document that the effect of Confucianism on the MLMRA is stronger when traffic regulation pressure is high. This study has the potential to advance our understanding of the impact of leaders' characteristics on organizational outcomes in the public sector.

Experiences of nurses working in nurse-led clinics in Traditional Chinese Medicine hospitals: A focused ethnographic study.

BACKGROUND: Traditional Chinese Medicine (TCM) nurse-led clinics (NLC) is an innovative working model in China, representing the specialization and extension of nurses' role. However, as a pioneer in TCM nursing, this new model of working is facing both opportunities and challenges because it is known little about the operational status of NLCs. AIMS: To explore the experiences of nurses who work in NLC in TCM hospitals. MATERIALS & METHODS: A focused ethnographic study was conducted in three TCM hospitals affiliated with Guangzhou University of Chinese Medicine. We interviewed eleven nurses in those hospitals and observed seven of them working with patients. We used snowball sampling for data collection including interview, non-participant observation and documents from medical records. All the data were processed as following steps: (a) coding for descriptive labels; (b) sorting for patterns; (c) identifying outliers or negative cases; (d) generalizing with construction and theories and (e) noting reflective remarks. RESULTS: Nurse-led clinics help nurses develop their skills and knowledge that are highly recognized by public since they meet the growing needs of patients and also relieve the workload of physicians in the hospitals. However, lack of specialization is still a major challenge in NLCs due to insufficiency of full-time staff with specialized education, nurse-led practice without standardized guidelines, restrictions on prescription right of nurses, and also inadequate support from hospitals. DISCUSSIONS: As a revolutionary innovation of working model for nurses in TCM hospitals, NLCs could improve quality of care and lead to a comprehensive promotion of nursing career. However, there are several challenges on providing high quality care for patients whilst improving educational development of nurses. This study suggests that nurses, hospital administration and the government should cooperate with each other to develop standard nursing programs for NLCs. CONCLUSIONS: It is imperative to identify nursing roles, collect available resources, and develop supportive policies and training programs to enhance the quality of NLCs.

Do Contextual and Demographic Factors Help Malaysian Nurses Prepare in Dealing with the COVID-19 Pandemic?

As of 11 October 2020, Sabah comprised a quarter of all COVID19 cases reported in Malaysia since the start of the pandemic last January 2020. In this pandemic, nurses serve in vital roles to mitigate the effects of COVID-19. This study aims to explore the nurses' preparedness in managing the COVID-19 outbreak situation in Sabah, Malaysia, examining the contextual (e.g., participated in an actual major disaster event) and demographic factors (e.g., age and working experience that may influence nurses' preparedness for managing the COVID-19 pandemic). A total of 317 nurses in Sabah, Malaysia were involved in this study. The Emergency Preparedness Information Questionnaire (EPIQ) contained 41 items and was used to assess civilian nurses' perceived familiarity with 9 competency dimensions of preparedness. The mean scores of nurses' preparedness indicated a moderate level of nurses' preparedness in managing the COVID-19 pandemic (mean ranging from 2.89 to 3.79). The results indicated that there was a significant difference between the nurses who actively participate in an actual major disaster event and who were not active in a total of preparedness and all dimensions (t = 2.79, df = 285, p = 0.006) (except in familiarity with decontamination and familiarity with special populations), across working experience (F(2,291) = 5.09, p = 0.007) (except familiarity with Incident Command System and role), and age among nurses ((F(3,290) = 2.68, p = 0.047)) (total of preparedness, familiarity with ethical issues in triage, epidemiology, and surveillance, and psychological issues). Overall, this study has made a significant theoretical contribution, as well as in clinical implications in the field of nursing practice, by addressing the impact of contextual and demographic factors on nurses' preparedness in managing the COVID-19 outbreak situation. This study will help nurses to understand the skills, abilities, knowledge, and actions needed to respond, mitigate, and prepare for emergencies during pandemics and disasters.

Registered nurses' role experiences of caring for older stroke patients: a qualitative study.

BACKGROUND: With China's population ageing rapidly, stroke is becoming one of the major public health problems. Nurses are indispensable for caring for older patients with acute and convalescent stroke, and their working experiences are directly linked to the quality of care provided. The study aims to investigate registered nurses' experiences of caring for older stroke patients. METHODS: A qualitative descriptive design was adopted. Data were collected via semi-structured interviews with 26 registered nurses about their lived experiences of caring for older stroke patients. Thematic analysis was used to analyze the data. RESULTS: Two main themes were identified. First, the nurses identified an obvious gap between their ideal role in elderly care and their actual practice. The unsatisfactory reality was linked to the practical difficulties they encountered in their working environment. Second, the nurses expressed conflicting feelings about caring for older stroke patients, displaying a sense of accomplishment, indifference, annoyance, and sympathy. Caring for older stroke patients also affects nurses psychologically and physically. The nurses were clear about their own roles and tried their best to meet the elderly people's needs, yet they lack time and knowledge about caring for older stroke patients. The factors influencing their working experiences extend beyond the personal domain and are linked to the wider working environment. CONCLUSIONS: Sustaining the nursing workforce and improving their working experiences are essential to meet the care needs of older people. Understanding nurses' lived working experiences is the first step. At the individual level, nurse mangers should promote empathy, relieve anxiety about aging, and improve the job satisfaction and morale of nurses. At the institutional level, policymakers should make efforts to improve the nursing clinical practice environment, increase the geriatric nursing education and training, achieve a proper skill mix of the health workforce, and overall attract, prepare and sustain nurses regarding caring for older people in a rapidly aging society.

Indispensable outsiders: A qualitative study of the working experiences of hospital care workers in China.

AIMS: To explore the working experiences of Chinese hospital care workers from their own perspectives. BACKGROUND: Many countries face an increasing demand for nursing care and an acute shortage of registered nurses. As a result, much of the care work at hospitals is delegated to assistant staff, such as care workers. METHODS: Data were collected by semi-structured interviews with 22 hospital care workers in three hospitals of Guangzhou City, China. Thematic analysis was used to analyse the data. RESULTS: Hospital care workers are mainly rural-to-urban migrant women, partaking in caregiver jobs to make a living. They play a significant role in the hospital to aid patients as well as nurses. Hospital care workers experience a sense of ambiguity towards their job, viewing it as "low" and "isolated", yet at the same time, "acceptable" and "helping". CONCLUSION: Hospital care workers are a workforce that is not well supported, trained or regulated. Their working experiences suggest that attention needs to be given to protecting this vulnerable group. IMPLICATIONS FOR NURSING MANAGEMENT: The working conditions of hospital care workers should be improved. Hospital care workers need improved status, increased rewards, and channels for further training and opportunities for continued career advancement.

[Qualitative study on working experience of COVID-19 care nurses].

OBJECTIVE: To study the working experience of COVID-19 care nurses. METHODS: Twenty two nurses taking care of COVID-19 patients were interviewed by means of descriptive phenomenology. All the data were transcribed and recorded, and then processed into WORD documents. The Colaizzi 7 footwork was used to classify, encode, establish nodes and extract themes based on Nvivo11.0 software. RESULTS: Two main themes were extracted: one is the positive feelings of nurses, including the sense of professional mission and pride, the sense of achievement and happiness, the improvement of self-worth and ability, the powerful support system and the power of role models; the other is the negative experience of nurses, including the worry and anxiety at work, the lack of experience and trust, the difficulty of work, and the inconvenience of isolating life. CONCLUSIONS: s While fully affirming the work value of nurses, it is necessary for the society, hospitals and patients to give extensive and continuous support, care and respect to nurses, so as to stimulate their working enthusiasm and sense of professional achievement. Hospital managers need to implement all kinds of security work, meet the safety needs of nurses, pay attention to the physical and mental health of nurses, strengthen the training of nursing talents for critical and severe diseases and infectious diseases, improve the allocation of human resources, and enhance the ability of material allocation and reserve for major health events, so as to make adequate preparations for coping with public health events in the future.

The experiences of foreign doctors in Saudi Arabia: A qualitative study of the challenges and retention motives.

BACKGROUND: The Saudi healthcare system is mainly staffed by foreign doctors who constitute about 73% of the total medical workforce. But, the high rate of turnover among these foreigners had deposited an additional unbearable cost and threatens the stability of the provided healthcare services in the country. OBJECTIVES: This study was conducted to explore the professional and personal challenges that were experienced by foreign medical doctors while working in one of the major governmental tertiary-care hospitals in Riyadh city. The study also seeks to explore the factors that could influence or motivate their retention. METHODS: A qualitative study based on semi-structured interviews was conducted on January 2018. A total of 16 foreign doctors were recruited purposefully using a maximum variation sampling strategy. The interviews were recorded, transcribed verbatim, and analyzed using thematic analysis technique. RESULTS: Three primary themes have been emerged based on the data analysis: (1) Work-related challenges such as; communication and discrimination challenges. (2) Living-related challenges such as; supportive services and restricted movement challenges. (3) Factor motivating retention such as providing good children education, offering flexible traveling regulations, and providing professional development opportunities. CONCLUSIONS: The findings of this study have indicated that there are more important motivators than money for improving the retention of foreign doctors in the country. Several policy actions have been recommended to maintain their essential role. For example; implementing an ethical code to protect them from receiving deceptive hiring information, developing a specialized pocket dictionary to overcome language barriers, embracing "workforce diversity management" techniques to minimize discrimination at institutional level, and finally it is also recommended to include the foreign doctors' family needs and other living related challenges in any future retention strategies.

The working experiences of male nurses in China: Implications for male nurse recruitment and retention.

AIMS: To understand the working experiences and career trajectories of male nurses in China. BACKGROUND: Compared with developed countries, men were far more under-represented in the nursing profession in China. Little is known about the working experiences of Chinese male nurses and the contextual factors that contribute to their low participation rate in the nursing profession. METHODS: In-depth interviews with twenty-five male nurses and two hospital administrators were conducted. All interviews were analysed using thematic analysis. RESULTS: Chinese male nurses had better career prospects and promotion chances compared with female nurses. The extremely low participation rate of men in nursing was related to the prejudice among the general public as well as the low professional status and salary. Two unique contextual factors influenced the career trajectories of male nurses in China: (1) the major assignment mechanism in the college entrance examination and (2) the implementation of the two-child policy. CONCLUSION: Although Chinese male nurses enjoyed many advantages compared with female nurses, they also encountered many difficulties related to working in a female-dominated profession. IMPLICATIONS FOR NURSING MANAGEMENT: Appropriate measures should be taken to shift public attitudes towards male nurses, improve the professionalization of nursing and promote gender diversity and equity.

Compensation claims for work-related musculoskeletal disorders among hairdressers in France, 2010-2016.

Background. Hairdressers in France experience occupational illness as well as stressful working conditions which can result in permanent incapacity mainly due to work-related musculoskeletal disorders (WRMSDs), yet WRMSDs in this workforce remain largely unstudied. Objective. The aim of this study was to analyze trends in compensation claims for WRMSDs among hairdressers. Methods. Data concerning gender, age, permanent incapacity, working experience and lost work days (LWD) of claimants were extracted from the French National Health Insurance Fund for Salaried Workers. Results. The claim rate increased non-significantly by 12.8% during the study period. The incidence rate of permanent incapacity increased significantly by 16.0%. In proportion, significant differences were observed between age groups, with age 35-49 years ranking first (45.8%), and also in claimants with working experience > 10 years (43.1%). Overall, there were 666,461 LWD during the study period with a significant increase of 16.2% (p < 0.001). Conclusion. Although the claims rate did not increase significantly, the incidence rate of permanent incapacity increased significantly and some groups at risk have been indentified.

Registered nurses' own experience of using a nurse-initiated pain protocol based on their working experience.

AIMS AND OBJECTIVES: To explore registered nurses' (RNs) own experience of using the nurse-initiated pain protocol (NIPP) in the emergency department (ED) based on their working experience. BACKGROUND: Pain is known to be one of the most common symptoms among adult patients seeking care at the ED. Several strategies aiming to improve pain management have been developed. Despite some improvements in pain management using NIPP, a large number of patients continue to have inadequate pain treatment when cared for in EDs. DESIGN AND METHOD: A cross-sectional study design based on a questionnaire was used. The variable working experience was based on a theory that experience will make a change in RNs' knowledge. Descriptive statistics and Pearson's chi-square tests were used for analysing quantative data. Qualitative data were analysed by summative content analysis. RESULTS: Seventy RNs answered the questionnaire (response rate 42%) and 61% considered the NIPP adequate to relieve patients' acute pain at the ED. No significant difference was found on how the RNs used the NIPP. However, qualitative data showed that more experienced RNs adapt the NIPP according to the patients' needs in a higher extent. CONCLUSION: A majority of the RNs consider the NIPP to be adequate to relieve patients' acute pain in the ED. An increase in working experience showed an impact on how the NIPP was used, with an increase in pain management that is personalised depending on individual patients' needs. The RNs used several alternatives to both dosage and type of medication when the ED becomes crowded. RELEVANCE TO CLINICAL PRACTICE: Registered nurses' working experience should be considered when planning nursing schedules to be better able to meet patients' needs. Guidelines should be developed and evaluated by both healthcare professionals and patients.

Ambulance personnel's management of pain for patients with hip fractures; based on ambulance personnel's gender and years of experience.

According to the World Health Organization (WHO) the goal of health care is for the entire general population to have good health and receive care on equal terms. Little is known about gender differences in the management of patients in the ambulance service. There is also a lack of studies investigating how the characteristics of health care personnel, such as gender and work experience, impact on patient care Therefore, the aim of this study was to describe ambulance personnel's assessments and the pain relief they provide for patients with hip fractures, based on the ambulance personnel's gender and years of experience. METHOD: A retrospective study of patients (>65 years) with hip fracture who, during 2011, were transported by ambulance to hospital. RESULT: Seven hundred and twenty two patients were included. Most patients reported experiencing pain and 50% received pain medication. Ambulance personnel with working experience of <10 years administered more pain medication compared to those with experience of >10 years. There was a tendency for male ambulance personnel to give pain medication more often compared to female personnel, but this tendency showed no significance. CONCLUSION: The main finding of our study is that personnel with working experience of less than 10 years administer more pain relief, even though only half of the patients received pain medication during ambulance transportation.

A qualitative study on working experience of rural doctors in malappuram district of kerala, India.

BACKGROUND: Improving the working conditions of rural doctors is an important issue to increase the quality of health services to target groups. OBJECTIVES: To assess the working experience of rural doctors at primary health care level. MATERIALS AND METHODS: This qualitative study was conducted among 30 medical officers from 21 primary health centers in Malappuram district of Kerala, India. In-depth interview was conducted, and content analysis was performed with the identification of themes based on the responses obtained. RESULTS: There were 19 males and 11 females belonged to 25 to 55 years age group. About 70% (21) of them were graduates with MBBS qualification, and the rest were postgraduates. About 2/3(rd) of them (20) had experience of less than 5 years. They expressed difficulty in managing the work in stipulated time period. However, this had never affected their OP management in anyway. They told that higher authorities were supportive, but they faced some opposition from the public in implementation of national program. Few opined that the training received was grossly insufficient in running the administrative affairs of the health center. Most of them satisfied with physical infrastructure, but manpower including medical officers and supporting staff were not sufficient. Some opined that the age of retirement is too early and should be increased. They participated in Continuing Medical Education, but expressed that it's content should suit to primary health care level. CONCLUSION: This study highlighted their concern to patient care and time, field work, administrative work, infrastructure, professional development, and future prospects. Further large scale evaluation studies will explore the situational analysis of it.