Factors preceding occupational distress in emergency nurses: An integrative review.

AIMS AND OBJECTIVES: This integrative review aimed to synthesise current evidence on the factors that precede and contribute to the occupational distress of emergency nurses. BACKGROUND: Emergency nurses practice within an environment challenged by demand exceeding capacity, an inability of staffing to meet this demand in addition to limited resources which contribute to form a unique risk to clinician and patient safety. The risk of occupational distress, while demonstrated across specialties, is noted to be highest in emergency nurses with subsequent impacts for clinicians, organisations and patients being explored. While previous studies have examined singular outcomes or elements, a comprehensive review that considers the factors and components of the overarching occupational distress is not evident in the current published literature. DESIGN: Whittemore and Knafl's integrative review methodology enabled a structured format for synthesis and analysis of literature. METHODS: A review of CINAHL, MEDLINE, Psych INFO, Embase, Australian Digital Thesis Network, University Microfilm International and Google Scholar between 2014 and 2021 was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. Search terms explored the contributions of compassion fatigue, burnout, acute and post-traumatic stress disorder, and secondary traumatic stress/vicarious trauma to occupational distress. This search resulted in sixteen publications included for synthesis. RESULTS: Literature for inclusion was identified as quantitative (seven), qualitative (six) and mixed-methods (three) studies. Factors identified as contributing to the development of occupational distress arise from the characteristics and situations of individual nurses, local organisational governance and the inherent nature of the emergency nurse role. Consequentially, there are negative impacts on patients, clinicians and healthcare organisations. CONCLUSION: Emergency nurses experience exposure to several unique factors contributing to occupational distress which may originate from individual, organisational, occupational sources or a combination of these. Future research and strategies to address these factors could strengthen clinicians and organisations in the delivery of safe, holistic, high-quality nursing care. RELEVANCE TO CLINICAL PRACTICE: Emergency nurses practice in unique and challenging environments which place them at higher risk of occupational distress with subsequent negative impacts for the clinician, healthcare organisation and patients. Through the investigation and development of strategies such as the facilitation of knowledge of patient disposition, emergency nurses may experience an increase in their well-being, retention, job satisfaction and resiliency.

The Impact of COVID-19 Visitor Restrictions on Clinical Cancer Nurses.

OBJECTIVES: To explore the impact of visitor restrictions on clinical cancer nurses, their roles and duties, and the coping strategies used to address the impact. DATA SOURCES: Semistructured qualitative interviews were conducted through purposive sampling with nurses working in a clinical role within cancer services at the study site for at least 1 year. Interviews were recorded and transcribed. Textual data transcribed from interviews were analyzed for themes using NVivo version 12 software, following Braun and Clarke's six phases of thematic analysis. CONCLUSION: Visitor restrictions implemented due to COVID-19 had a significant impact on clinical cancer nurses. The study found evidence of moral injury and conflict-within the role of the nurse, the implementation of organizational policies, and nurses' professional identity and personal beliefs. Despite this adversity, nurses remained committed to their clinical practice. IMPLICATIONS FOR NURSING PRACTICE: Changes to nurses' roles and the practice environment have potentially significant impact on well-being and retention. To ensure that nurses can continue to provide high-quality nursing care in challenging environments, organizations must minimize this impact. Consistent communication and support activities, including recognizing and responding appropriately to situations, may be used in the reduction of potential moral injury and stress.

Impact of the Practice Environment on Oncology and Hematology Nurses: A Scoping Review.

BACKGROUND: Practice environments have a significant impact on nurses' practice and their retention within the oncology and hematology specialty. Understanding how specific elements of the practice environment impact nurse outcomes is important for creating supportive and safe practice environments. OBJECTIVE: To evaluate the impact of the practice environment on oncology and hematology nurses. METHODS: A scoping review was conducted according to the PRISMA-ScR Statement Guidelines. Electronic databases (MEDLINE, CINAHL, PsychINFO, Google Scholar, and Scopus) were searched using key terms. Articles were assessed according to the eligibility criteria. Data extraction was conducted with results explained through descriptive analysis. RESULTS: One thousand seventy-eight publications were screened with 32 publications meeting the inclusion criteria. The 6 elements of the practice environment (workload, leadership, collegial relations, participation, foundations, and resources) were found to significantly impact nurses' job satisfaction, psychological well-being, levels of burnout, and intention to leave. Negative practice environment elements were linked to increased levels of job dissatisfaction, higher levels of burnout, greater prevalence of psychological distress, and greater intention to leave both oncology and hematology nursing and the nursing profession. CONCLUSIONS: The practice environment has a significant impact on nurses, their job satisfaction, well-being, and intention to stay. This review will inform future research and forthcoming practice change to provide oncology and hematology nurses with practice environments that are safe and lead to positive nurse outcomes. IMPLICATIONS FOR PRACTICE: This review provides a foundation upon which to develop and implement tailored interventions that best support oncology and hematology nurses to remain in practice and provide high-quality care.