Medical and surgical nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards.

AIM: To explore general nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards. DESIGN: Qualitative action research was used working with nurses as co-researchers. METHODS: Pre-implementation focus groups were conducted in April 2022 to understand and explore the current strategies nurses utilized to avert, respond to or decrease violence. Following this, two Safewards interventions were modified by the nurses on the wards. Post-implementation focus groups were conducted in October 2022, to explore the nurses' experience of implementing Safewards interventions and the effect on their nursing practice. Data were analysed using Braun and Clarke's framework for thematic analysis. RESULTS: Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred: 'the space is hectic'; 'it can feel like a battlefield'; and 'the aftermath'. These themes encompass the nurses' experience of violence from patients and their visitors. Following the implementation of two modified Safewards interventions, the analysis of the focus groups reflected a change in nursing skills to avert or respond to violence: 'Safewards in action'; 'empathy and self-reflection'; and 'moving forward'. CONCLUSION: Safewards interventions can be successfully modified and used in general hospital wards and influence nursing practice to manage patient and visitor violence. IMPLICATIONS FOR THE PROFESSION: In the interests of safety, successful interventions to reduce violence towards general hospital nurses should be a priority for managers and healthcare organizations. Averting, mitigating and managing violence can decrease the negative professional and personal effect on nurses and ultimately improve well-being, job satisfaction and retention rates. Furthermore, decreasing violence or aggressive incidents leads to a safer patient experience and decreased number of nursing errors ultimately improving patient experiences and outcomes. Understanding nurses' experiences of violence and working with them to explore and develop contextually relevant solutions increases their capacity to respond to and avert violent incidents. Contextually modified Safewards interventions offer one such solution and potentially has wider implications for healthcare settings beyond the specific wards studied. IMPACT: This study addressed the implementation of modified Safewards strategies in medical and surgical wards to prevent violence. Three themes emerged from the analysis of the pre-implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred. Following the implementation of two modified Safewards interventions, the post-implementation focus groups reported positive changes to their practices using the modified resources to prevent violence from patients and their visitors. Mental health interventions, such as those used in the Safewards model can be modified and provide a tool kit of interventions that can be used by medical and surgical nurses. REPORTING METHOD: This paper has adhered to the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: This paper outlines and discusses the action research approach undertaken to work with general hospital nurses to modify mental health nurses' Safewards interventions into their clinical practice. This paper provides evidence of the 'real world' application of Safewards interventions by medical and surgical nurses in general hospital wards. This paper presents qualitative findings based on focus group methods to highlight the narratives of general nurses and their experiences of violence.

"I was just a shell": Mental health concerns for women in perimenopause and menopause.

Early detection of deteriorating mental health for women who are experiencing symptoms associated with perimenopause and menopause is critical to ensure the well-being of women. Unfortunately, many women during this phase of their lives find it difficult to access relevant and timely treatment. This concurrent mixed methods study using an online survey and qualitative interviews explored Australian women's knowledge and experiences of perimenopause and menopause and specifically reports on findings associated with women's mental health. Four hundred and eleven women completed the online survey in its entirety and 25 women participated in semi-structured interviews between April and July 2022. Survey data were analysed using SPSS and, in this article, data are presented as descriptive statistics. Qualitative interviews were analysed using thematic analysis guided by Braun and Clarke (2013; 2019). Quantitative and qualitative data specific to women's mental health were integrated into three themes: (1) increased anxiety and depression, (2) a negative impact on emotions and (3) a negative impact on self-worth. Findings from this study will help to inform clinical services for women as it highlights the need to improve education about perimenopause and menopause for healthcare providers and women.

A global exploration of palliative community care literature: An integrative review.

AIM: This review sought to discover how community nurses globally provide palliative care, with specific focus on how they manage the personal and professional stressors associated with caring for dying clients in the home. DESIGN: An integrative review methodology was used to gain insight into how community palliative care is delivered worldwide. BACKGROUND: The provision of home palliative care by community nurses gives clients the ability to spend their final days in familiar surroundings. Research has focussed on the provision of palliative care in the inpatient setting, with little known about the community setting. METHODS: Data were collected through a literature search, then a critical analysis approach was used to evaluate the strengths of palliative care literature by analysing recurrent themes to stimulate further research on the topic. DATA SOURCES: The following databases were used to conduct the literature search: CINAHL, Medline, Pubmed, Scopus, Ovid. RESULTS: The results highlighted the importance of building a skilled palliative community nursing workforce and the need to offer specialised palliative care training to nurses, particularly around difficult conversations and service coordination. CONCLUSION: The literature identified the challenges implicit within the community nursing role in delivering palliative care, but it did not identify the factors that enhance the nurses' ability to manage the stressors associated with this role. The input of nurses must be sought to understand the development of resilience. IMPLICATIONS FOR THE PROFESSION: Community palliative care nursing requires time spent with clients and family members who are suffering, therefore predisposing nurses to stress. Effort must be made to provide palliative care nurses with support to enhance professional resilience.

An exploration of women's knowledge and experience of perimenopause and menopause: An integrative literature review.

AIM: To explore the international literature related to women's knowledge and experience of perimenopause and menopause and to inform future directions for research and individualised healthcare delivery. BACKGROUND: Menopause is a normal physiological process experienced by most women. Despite this, care and support is fragmented and the implication on women's long-term health is not sufficiently understood. DESIGN: An integrative review of primary research on women's knowledge and experience of perimenopause and menopause. METHOD: CINAHL, Medline, Wiley Online Library, SCOPUS, PubMed and Google Scholar were searched from 2011 to 2021.Quantitative and qualitative studies written in English exploring women's knowledge and experience of menopause were included. The search strategy for the review complied with PRISMA guidelines. The mixed methods appraisal tool was used to assess quality. Thematic analysis was employed to present a narrative synthesis of the data. RESULTS: A total of 17 studies, comprising 10 quantitative, and seven qualitative studies met the inclusion criteria. The four themes regarding women's knowledge and experience of perimenopause and menopause identified in the literature were as follows: (1) Symptoms associated with perimenopause and menopause; (2) Strategies to manage symptoms; (3) Support and information (4) Attitudes, education and health literacy. CONCLUSION: This integrative review of the international literature highlights that women's knowledge of perimenopause and menopause varies significantly globally and within countries. The experience of perimenopause and menopause for women is heterogenous and influenced by deeply embedded sociocultural patterns. RELEVANCE FOR CLINICAL PRACTICE: This integrative review has shown that individualised support for women during perimenopause and menopause is critical to ensure the diverse needs of women are suitably addressed. NO PATIENT OR PUBLIC CONTRIBUTION: As this was a review of the literature, no patients, service users, caregivers or members of the public were involved in this review.

Factors contributing to high turnover rates of emergency nurses: A review of the literature.

OBJECTIVES: The objective of this study was to identify factors that contribute to high turnover rates of nurses working in emergency departments. REVIEW METHODS/DATA SOURCES: The search strategy for the review complied with Preferred Reporting Items for Systematics Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases, Medical Literature Analysis and Retrieval System Online (MEDLINE), Cummulative Index of Nursing and Allied Health Literature (CINAHL), and Google Scholar were systematically searched for literature studies published between 2006 and 2018. A predefined set of exclusion and inclusion criteria was used by two of the authors. Inclusion criteria included full-text articles available in English, original research that meets National Health and Medical Research Council (NHMRC) guidelines, peer-reviewed articles, and articles related to emergency departments (EDs) only. Data were analysed thematically using Braun and Clarke's six key phases of thematic analysis. RESULTS: A total of 20 articles, comprising 16 quantitative and four qualitative studies, met the inclusion criteria and identified factors that contribute to high turnover rates in EDs. This review identified three major themes: aggression and violence, critical incidents, and work environment. CONCLUSIONS: This review has identified that there are multiple challenges faced by nurses working in EDs. These challenges may result in high levels of occupational stress, burnout, compassion fatigue, and posttraumatic stress disorder or secondary traumatic stress, which further contributes to attrition rates.

Developing resilience: Stories from novice nurse academics.

BACKGROUND: It is acknowledged that novice nurse academics face many challenges on commencement of their new role. Most are recruited from the clinical arena, with little understanding of the academic triumvirate of teaching, research and service. They struggle with role expectation and experience feelings of isolation and anxiety. AIM: The aim of this paper is to report on an exploration of 14 new nurse academics from two major nursing education institutions as they utilised and developed resilience building strategies. METHOD: The paper is drawn from a qualitative study that sought to see the world through the eyes of the participants through storytelling. Data was collected using semi-structured, conversational style interviews. Interviews were audio recorded and revealed themes that captured resilience strategies. RESULTS: These themes were: Developing supportive collegial relationships; Embracing positivity; and Reflection and transformative growth. The first theme, developing supportive relationships, provides insight into the mentoring process and the relationships developed with peers and colleagues. The second theme, embracing positivity, describes the factors that assisted them to face the adversity and challenges in the new role. The final theme, reflection and transformative growth, demonstrated participants' reflecting on difficult situations and demonstrating the ability to learn from the experiences and move forward. CONCLUSIONS: The strategies utilised by the participants in this study were key factors in the development of resilience which assisted in the transition from clinical nurse to academic. These strategies were often tacit and it is imperative that in a time of acute nurse academic shortages where retention is paramount, that employing organisations support employees and contribute to resilience development. Education on resilience building strategies is fundamental for all new academics and is essential in the transition from clinical nurse to academic.

Conducting qualitative research in the context of pre-existing peer and collegial relationships.

AIM: To highlight issues and challenges faced in recruitment and interviewing during a study that sought to explore the transition of nurses into academic life and the associated ethical implications. BACKGROUND: This paper explores the challenges faced in conducting research where the potential participants are peers and workplace colleagues. There are advantages when conducting research with those among whom a pre-existing relationship is shared. However, difficulties can also arise. REVIEW METHODS: A methodological review was undertaken. Key database searches included CINAHL, MEDLINE, PubMed, Scopus and Google Scholar using the keywords as search terms. Studies were included if they described in detail issues surrounding qualitative interviewing of peers and colleagues. DISCUSSION: Management of the issues involved is discussed, with emphasis on boundaries, trust and rapport, the use of self-disclosure and maintaining confidentiality. CONCLUSION: Research involving peers and colleagues has received relatively little consideration in the literature. There are difficulties associated with interviewing participants with whom the researcher has a pre-existing and ongoing relationship in the same organisation. To ensure ethical conduct, strategies can be used to mitigate negative situations such as issues surrounding dual roles, practising reflexivity, trust and rapport, self-disclosure and confidentiality. IMPLICATIONS FOR RESEARCH/PRACTICE: It is imperative that dual roles are declared and acknowledged. Researchers need to be mindful of the difficulties that may occur and prioritise participants' confidentiality and privacy.

'I thought I was just going to teach': stories of new nurse academics on transitioning from sessional teaching to continuing academic positions.

Currently many nursing faculties and schools employ high numbers of sessional teachers to meet the demands of teaching. Sessional teachers are a source for future continuing academic staff; however, there is little exploration on the experiences of sessional teachers as they transition into the full-time nurse academic role. A qualitative study of 14 registered nurse participants used a story-telling approach to explore the experiences of sessional teachers as they transitioned into full-time and continuing academic roles. Findings revealed that participants had only a very limited understanding of the requirements of the academic role when appointed to it. Thematic analysis revealed two major themes. These were: 'Uncertainty: Dealing with role expectation' and 'Mitigating lack of confidence'. The implications of this paper contributes to and enhances knowledge of the transition experiences of sessional teachers and provides new evidence to suggest that adequate support processes are essential for sessional staff transitioning into permanent, full-time academic positions.

Factors contributing to the shortage of nurse faculty: a review of the literature.

There is an abundance of literature documenting the shortage of nurse faculty, both in Australia and internationally. This shortage has repercussions for the next generation of nurses, contributes to the overall nursing workforce shortage, and holds implications for the development of nursing research and continued practice development. The literature suggests a multitude of factors contributing to the shortage, including the ageing of current nurse faculty, and an undersupply of doctorally prepared nurses to take their place. To date, most nurse academics come from a clinical background with little preparation for the complex faculty role; despite this there is little exploration of their experiences transitioning to academia. The limited available evidence suggests that this new role may be accompanied by feelings of uncertainty, anxiety and isolation associated with changed responsibilities, an emphasis on scholarly activities and teaching, and the unique culture of the academic environment. The aim of this paper is to provide a critical review of the literature, identify issues relevant to the nurse faculty shortage and provide direction for further research.