Evaluating and Enhancing Nursing Caregiver Well-being Using a Systematic Approach.

OBJECTIVE: The aims of this study were to evaluate nursing caregiver well-being and identify interventions for improving well-being and practice environments. BACKGROUND: Healthcare worker well-being and burnout command increasing attention in the wake of the pandemic. Experts recommend utilization of validated measurements to assess burnout, well-being, and contributing factors. METHODS: Using a descriptive, cross-sectional, mixed-methods study design, an online survey, which included the Professional Quality of Life-5, Meaning and Joy in Work Questionnaire, and open-ended questions, was administered to nurses and unlicensed assistive caregivers in an academic health system. RESULTS: Caregivers reported moderate compassion satisfaction, low burnout and compassion fatigue, and low-moderate levels of meaning and joy in work. Overall and subscale scores varied primarily based on age, experience, and role. Top causes of stress and recommendations for improvement were identified. CONCLUSION: The levels of meaning and joy in work among nursing caregivers continue to be of concern for organizational leaders. The engagement of nurses and other caregiver team members in a systematic mixed-methods approach, including using validated tools to evaluate caregiver well-being, can lead to meaningful, data-driven action planning to promote well-being and increase the meaning and joy of the work they perform.

Strategies to Stay: Role Enrichment Models for Retaining Millennial Nurses.

Nurse retention strategies are top of mind for nurse leaders as they face an unprecedented staffing crisis. A strategic approach that includes innovative models to enhance nurse satisfaction and nurse retention may include role enrichment strategies such as blended roles, alternative work arrangements, and shared staffing. Effective implementation requires authentic, transformational leadership, as well as structures and processes for replication, sustainability, and improved outcomes. This case study illustrates the potential of this strategy to positively influence key factors contributing to nurse retention, especially for millennial nurses. Nurse leaders in one critical care unit shared their experience with cross-training for blended roles, skill expansion for professional development for unit staff as well as float team members, leadership development opportunities, and shared staffing. Creating a staffing strategy that includes the leadership and infrastructure to support blended or dual roles is one promising element in a nurse leader tool kit for millennial nurse retention.

Equipping Nurses to Lead Evidence-Based Practice: An Opportunity for Professional Nursing Associations.

OBJECTIVE: The aim of this study was to describe the evidence-based practice (EBP) attributes among California nurse leaders who are members of a professional nursing organization. BACKGROUND: Nurse leaders are pivotal for successful EBP implementation. The Association of California Nurse Leaders' (ACNL) mission to equip nurses to lead self, others, and systems propelled them to conduct a study of members' EBP beliefs, knowledge, competencies, and implementation. METHODS: Evidence-based practice attributes of California nurse leaders were measured using valid and reliable scales via an anonymous, electronic survey. RESULTS: Although ahead in the subjective EBP scales, California nurse leaders' perceptions of organizational EBP culture were comparable with those of a similar national sample. Scores still indicated opportunities for improvement. CONCLUSIONS: Nurse leaders must be prepared to lead EBP in their organizations. Professional organizations such as ACNL have an opportunity to help leaders by conducting research and assessing and meeting their members' learning needs.

Joy and Meaning in Nurse Manager Practice: A Narrative Analysis.

Nurse managers are an integral part of the healthcare system and have powerful influence at the point of service. The experience of joy and meaning in the work of healthcare contributes to achievement of positive outcomes. This study aimed to learn how nurse managers described joy and meaning in their practice. Results included 5 themes: to mentor and be mentored, to focus on the patient, to create and cultivate environments, to be optimistic, and to be empowered by leaders. The themes are described and illustrated with participant quotes. Specific implications for organizations and leaders are discussed.

Feasibility of Online Mental Wellness Self-assessment and Feedback for Pediatric and Neonatal Critical Care Nurses.

PURPOSE: The primary goal of this study was to test the feasibility of an educational online self-assessment of burnout, resilience, trauma, depression, anxiety, and common workplace stressors among nurses working in a pediatric intensive care unit or neonatal intensive care unit setting. The secondary, exploratory objectives were to estimate the prevalence of psychiatric symptoms in this sample and to identify those variables that most strongly predict burnout. DESIGN AND METHODS: Data from optional and anonymous online measures were analyzed for 115 nurses (67.9% aged 25-44; 61.7% Caucasian) working in an urban children's hospital pediatric or neonatal ICU. Multiple linear regressions identified demographic variables and workplace stressors that significantly predicted each of three components of burnout. RESULTS: Most respondents found the educational assessment and feedback to be helpful. Choosing nursing as a second career was associated with better resilience. Having worked in ICU settings longer and being older were both linked to lower levels of anxiety. Predictors of burnout varied across the three burnout subscales. CONCLUSIONS: Implementation of an online self-assessment with immediate educational feedback is feasible in critical care settings. The variability of predictors across the three burnout subscales indicates the need for tailored interventions for those at risk. Future research may include follow-up of nurses to examine changes in scores over time and expansion of the tool for other medical personnel. PRACTICE IMPLICATIONS: An educational online self-assessment can be a helpful tool for pediatric critical care nurses experiencing varying degrees of burnout and distress.

A Narrative Analysis of Nurses' Experiences With Meaning and Joy in Nursing Practice.

Health care transformation is guided by the triple aim of improving health, enhancing the patient experience, and reducing costs. Experts have recommended the addition of a fourth aim, improving the experience of providing care. They advise that achievement of the triple aim will only be possible if we create the conditions where health care workers can find meaning and joy in their work. Nurses' experiences with meaning and joy in their practice have not been well described. In an effort to fill this knowledge gap, nurses across the nation recently participated in a qualitative study to share their experiences with meaning and joy in their nursing practice. The study utilized a narrative inquiry approach with a lens of appreciation to elicit and interpret nurses' stories. The stories, recorded and archived in StoryCorps, provided rich insight into meaning and joy in nursing practice. The study captured contemporary themes that crossed practice settings and generations across the United States. Four themes emerged from the analysis, including: fulfilling purpose-"I am a nurse"; meaningful connection; impact-the wow factor; and the practice environment. The practice environment theme included 3 subthemes: teams work, leaders model the way, and opportunities to learn and grow. The themes are described and illustrated with participant quotes. The study findings build on published evidence related to meaning in nursing practice and our conceptual understanding of joy. Results align with recommendations for defining and focusing on the fourth aim: To improve the practice experiences of nurses so they can more fully contribute to achieving both the triple aim in health care and their own well-being. Specific implications for leaders and supportive practice environments are discussed.

Education as a springboard for transformational leadership development: listening to the voices of nurses.

Nurses must assume a transformational leadership role in increasing the quality, safety, access, and value in the health care system. To lead effectively in this transformation process, nurses must be prepared for leadership roles. A strong leadership knowledge based acquired through education provides the springboard for nursing leadership competency development. This metasynthesis of 27 studies provided a broad understanding of the contribution and effectiveness of education for leadership competency from the perspective of nurses who have experienced it. Four overarching themes emerged: evidence-based relevant content, optimized learning strategies, benefits to the learner and others, and tensions and threats to the application of learning. This study affirms the value of a strong educational foundation for nursing leadership. With the support of a firm, yet flexible, educational platform, nurses will be positioned to more effectively lead and partner in health care transformation.

The Impact of Boost Methodology on Nurse Knowledge Retention: A Longitudinal, Quasi-Experimental Sepsis Simulation Pilot Study.

Boost methods for reinforcing educational content have been found to train the brain to designate information as important. A longitudinal, quasi-experimental study design evaluated the effect of an interprofessional simulated patient sepsis video with educational boosts on knowledge retention among acute care nurses at a large academic health system using linear mixed-effects modeling. Findings suggest that boost methods may impact nurse knowledge retention, potentially eliminating the need to repeat costly, traditional educational efforts.

Meaning, Joy, and Critical Care Nurse Well-Being: A Call to Action.

Healthy nurses are essential for optimizing population health, patient care experiences, and health care cost-efficiency. Critical care nurses are at increased risk of developing physical and psychological symptoms due to their high-stress work environment and exposure to traumatic events. There is growing recognition for the value of implementing nurse-centered, team-based, and organizational-wide levels of intervention designed to mitigate the impact of high work stress and trauma on health professionals. The central assertion of this article is that meaning and joy in nursing practice are contributors to professional well-being and part of the solution for achieving the quadruple aim.

Advocating for Patients: Honoring Professional Trust.

Perioperative nurse leaders create conditions for nurses in all health care settings that allow them to advocate for patients when they are unable to advocate for themselves; these conditions also enable nurses to enter into therapeutic relationships with patients and their families and establish trust. The nursing leadership practices that facilitate this advocacy include promoting continuity of care and patient relationships; helping to ensure practice environments support teamwork and collaboration; providing behavioral expectations for communication and conflict management; and supporting practices that promote self-care and ongoing professional development, flexibility, creativity, and innovation to meet patient care needs. A comprehensive professional practice model provides a framework for nurses to practice more fully and to skillfully care and successfully advocate for patients.

Dedicated Education Units: Partnerships for Building Leadership Competency.

BACKGROUND: To enable nurses to lead in health care transformation, nursing education must include opportunities for developing leadership, as well as clinical competencies. Dedicated education units (DEUs) provide supportive environments for competency development in undergraduate students. This study's aim was to explore the effects of a DEU experience on the leadership development of baccalaureate nursing students. METHOD: A mixed-methods design included a quantitative strand, using a quasi-experimental, pretest-posttest, multisite design with control groups and a qualitative strand using focus groups. RESULTS: Students in the DEUs demonstrated significant increases (p < 0.01) in leadership behaviors, as measured by the Student Leadership Practice Inventory. Focus group themes illuminate how the experiences of the students contributed to their leadership growth. CONCLUSION: Findings suggest that the DEU experience may promote enhanced undergraduate leadership competency development.

Cultivating nursing leadership for our envisioned future.

Nurses have been called upon to lead and partner in the transformation of health care. Leadership is a component of the scope of nursing practice; however, the optimal approach to development of leadership competency has not been established. A metasynthesis of qualitative studies on leadership development was conducted to enhance an understanding of conditions that nurses reported to support or hinder their development as leaders. Noblit and Hare's approach was used for the metasynthesis process. Three overarching themes emerged. Opportunity structure, the relationship factor, and organizational culture are essential factors contributing to the successful cultivation of leadership competencies in nurses.