The Wounded Healer: A Phenomenological Study on Hospital Nurses Who Contracted COVID-19.

Since the pandemic began nurses were at the forefront of the crisis, assisting countless COVID-19 patients, facing unpreparedness, social and family isolation, and lack of protective equipment. Of all health professionals, nurses were those most frequently infected. Research on healthcare professionals' experience of the pandemic and how it may have influenced their life and work is sparse. No study has focused on the experiences of nurses who contracted COVID-19 and afterwards returned to caring for patients with COVID-19. The purpose of this study was therefore to explore the lived personal and professional experiences of such nurses, and to describe the impact it had on their ways of approaching patients, caring for them, and practicing their profession. A phenomenological study was conducted with 54 nurses, through 20 individual interviews and 4 focus groups. The main finding is that the nurses who contracted COVID-19 became "wounded healers": they survived and recovered, but remained "wounded" by the experience, and returned to caring for patients as "healers," with increased compassion and attention to basic needs. Through this life-changing experience they strengthened their ability to build therapeutic relationships with patients and re-discovered fundamental values of nursing. These are some of the ways in which nurses can express most profoundly the ethics of work done well.

A mixed methods study of an organization's approach to the COVID-19 health care crisis.

BACKGROUND: Healthcare emergency can increase work-related stress and reduce nurses' job satisfaction and quality of life. Managerial decisions and proactive interventions implemented to react to the emergency ensure the best patient outcomes. PURPOSE: The purpose of this study was to verify whether a proactive organizational approach can limit nurses' work-related stress and help preserve their job satisfaction and quality of life during a health emergency. METHODS: A longitudinal mixed methods study was conducted. Data were collected before and after the transformation into a SARS-CoV-2 Hospital and the implementation of organizational interventions. Focus groups were conducted to investigate quantitative data. FINDINGS: After the implementation of interventions and as the pandemic progressed, work-related stress decreased and job satisfaction and quality of life increased. DISCUSSION: Through proactive organization, even during an emergency, nurses are prepared for working, and work-related stress due to changes is reduced. Nurses are motivated and satisfied with their organization and management, and quality of life increases.

[Mental health in the hospital. Analysis of conditions of risk by department, age and gender, for the creation of best practices for the health of nurses]. / Salute mentale in ospedale. Analisi delle condizioni di rischio per reparto, età e genere orientata alla costruzione di buone pratiche per la salute delle infermiere.

BACKGROUND: Nurses mental health is still a major and unachieved goal in many public hospital settings. Hospital work organization analysis shows differences in health professions, hospital units, age and gender. OBJECTIVES: To analyse work organisation and its effects on nurses mental health in three high risks hospital units (Oncoematology, First Aid, General Medicine) in order to improve good practices for nurses health. METHODS: The Method of Organizational Congruences (72 hours of observation) has been used to detect organizational constraints and their possible effects on nurses' mental health. General Health Questionnaire (Goldberg D., 12 items) and the Check up Surveys for burnout (Leiter MP and Maslach C.) have been used to evaluate the mental health status of the 80 nurses employed (78% women). RESULTS: High emotional work load in oncoematology Unit, high monotony and repetitiveness with lower emotional load in first Aid Unit, High mental and physical workload in General Medicine Unit. Burnout was significantly higher in General Medicine Unit, followed by First Aid Unit and oncoematology Unit. Female nurses reported more chronic diseases than males. The GHQ showed high frequency of minor psychiatric disorders (58%) in all units, higher in General Medicine Unit (78%). CONCLUSION: The overall results show how organizational constraints and mental health conditions differ per hospital units, age groups and gender. Good nursing practices, to prevent mental health problems, should therefore be developed specifically in each hospital unit according to these results.

[In-depth assessment of work-related stress in a major company undergoing restructuring]. / La valvutazione approfondita dello stress lavoro correlate in una grande azienda in cambiamento.

BACKGROUND: An in-depth assessment of work-related stress was conducted in a major national telecommunications company undergoing major changes. The assessment was made on three homogeneous groups of workers and covered a large representative sample of the corresponding populations. OBJECTIVES: To identify the main sources of stress for the three populations of workers, stimulate a discussion on the possible corrective actions, and assess the impact of the on-going organizational changes on workers' health. METHODS: The assessment started with an analysis of the objective stress indicators listed in the INAIL (National Insurance Institute for Occupational Diseases and Accidents) Checklist. This was followed by a combination of qualitative and quantitative investigations on work context and tasks and on the subjective perceptions of workers, which were carried out by using: semi-structured interviews with management, field observations of work tasks, focus groups and questionnaires (GHQ-12, HSE Indicator Tool, ad-hoc questionnaire). RESULTS: The assessment allowed identification of the critical areas to be addressed with specific interventions: relationship with the company, work performance, work organization, and equipment. CONCLUSIONS: the investigation allowed to identification of specific practical actions (improvement of technological tools; professional development through training courses) as well as strategic actions ( re-establish relationship of trust with the company) so as to mitigate the workers' level of stress. Analysis of the results also showed that the three targeted populations differed in the degree of acceptance and understanding of the organizational changes.

Women's working conditions in hospital cleaning: a case study.

Hospital cleaning work, as health care work, is mainly performed by women all over Europe. Hospital cleaning activities represent a poorly studied sector although very important also for patient's health. We applied the Method of Organizational Congruencies to study cleaning work in three typical hospital units (Emergency Room, Haematology, General Medicine) of a roman University hospital where 198 women cleaners work. We analyzed the 731 technical actions performed in the three shifts and the related Organizational Constraints (OC). Working outsourcing, no occupational risks training, washing personal equipment at home, standing, long walking, early morning and night shift in emergency room, high monotony (>10 actions per hour) contact with biological and chemicals materials, risk conditions of accidents, artificial lights, hot microclimate and working in a cure setting represent the main Organizational Constraints. Differences among the three Units are discussed together with the importance of considering cleaning hospital as a preventive action towards hospital clinical risk.

Gender and ergonomics: a case study on the 'non-formal' work of women nurses.

Women's work activities are often characterised by 'non-formal actions' (such as giving support). Gender differences in ergonomics may be due to this peculiarity. We applied the method of organisational congruencies (MOC) to ascertain the 'non-formal' work portion of nurses employed in three hospital units (haematology, emergency room and general medicine) during the three work shifts in a major University Hospital in Rome, Italy. We recorded a total of 802 technical actions performed by nine nurses in 72 h of work. Twenty-six percent of the actions in direct patient's care were communicative actions (mainly giving psychological support) while providing physical care. These 'double actions' are often not considered to be a formal part of the job by hospital management. In our case study, the 'non-formal' work of nurses (psychological support) is mainly represented by double actions while taking physical care of the patients. The dual task paradigm in gender oriented research is discussed in terms of its implications in prevention in occupational health. PRACTITIONER SUMMARY: The main purpose of the study was to assess all the formal and non-formal activities of women in the nursing work setting. Offering psychological support to patients is often not considered to be a formal part of the job. Our case study found that nurses receive no explicit guidelines on this activity and no time is assigned to perform it. In measuring the burden of providing psychological support to patients, we found that this is often done while nurses are performing tasks of physical care for the patients (double actions). The article discusses the significance of non-formal psychological work load of women nurses through double actions from the ergonomic point view.