How increased job demand affects nurses' task mastery and deviance in the pandemic era.

AIM: Although normative and ethical procedures are extremely critical for health care providers, during this unique time, when the pandemic suddenly increased job requirements and workloads, maintaining a morally appropriate working style became an increasingly difficult challenge for nurses. Few previous studies have examined whether these highly increased job demands influence nurses' resource condition, in turn affecting their deviance and task mastery. DESIGNS: In the current study, we proposed a theoretical model examining whether nurses' job demands (the predictor) will affect task mastery and deviance (the outcomes) by increasing resource depletion. METHODS: A multiwave field study of 172 nurses from two comprehensive hospitals was conducted to test the proposed theoretical model from April to August 2020. Descriptive statistics, confirmatory factor analyses, correlation coefficients and linear regressions were used to test the hypotheses. RESULTS: The results suggested that even though job demands may temporarily increase nurses' task mastery and decrease their organizational deviance, they ultimately have a negative influence since resource depletion acts as a side effect that suppresses the two direct effects. CONCLUSION: The theoretical contributions and practical implications of our findings were discussed. Specifically, we suggested that healthcare institutions should provide abundant support for nurses to supplement their resource reserves to avoid the risk of potential medical malpractice. IMPACT: Practically, this study tried to emphasize the important role of nurses' resource condition. Especially we aimed to remind managers and leaders cannot just improve nurses' job demand to deal with the public health crises. They also need to focus on their resource condition during pandemics.

Effect of ethical nurse leaders on subordinates during pandemics.

BACKGROUND: As caring in times of pandemics becomes extremely stressful, the volume and intensity of nursing work witness significant increase. Ethical practices are therefore even more important for nurses and nurse leaders during this special period. RESEARCH AIM: The aim was to explore the relationship between ethical nurse leaders and nurses' task mastery and ostracism, and to examine the mediating role of relational identification in this relationship during pandemics. RESEARCH DESIGN: Based on social exchange theory, this study tests a theoretical model proposing that ethical nurse leaders can increase nurses' task mastery and reduce their ostracism by improving their relational identification with leaders during pandemics. PARTICIPANTS AND RESEARCH CONTEXT: A multilevel and multi-wave field study using data from 172 nurses from 45 departments of two comprehensive hospitals was performed from April to August 2020 to test proposed hypotheses. ETHICAL CONSIDERATIONS: We received formal approvals from the ethical committee of the hospital where we conducted this study before the data collection. RESULTS: Ethical nurse leaders can indeed increase nurses' task mastery and reduce their ostracism during the pandemic period; furthermore, nurses' identification with their leaders mediates these relationships. We find that ethical leadership plays an even more important role in improving nurses' task mastery and reducing their ostracism that may be facilitated by pandemics this special time. Nurses will become more identified with their leaders when they are treated by ethical ways. DISCUSSION: The study tries to advance our understanding of the important role of ethical leadership in nurse management literature and provide useful suggestions for healthcare institutions, nurse leaders, and nurses during pandemics. CONCLUSION: Theoretical contributions and practical implications of our findings are discussed. Specifically, we suggest that healthcare institutions cultivate ethical nurse leaders to facilitate nurses' relational identification, which in turn will positively influence work outcomes.

Natural developing process of immunoglobulin G4-related sialadenitis after submandibular gland excision: a retrospective cohort study.

OBJECTIVE: This study aimed to evaluate the long-term outcome and quality of life of IgG4-related sialadenitis (IgG4-RS) patients after submandibular gland (SMG) excision without immunomediate therapy. MATERIALS AND METHODS: This retrospective review included patients with IgG4-RS who did not undergo further treatment following SMG excision. All patients diagnosed with IgG4-RS between January 1955 and December 2012 at the Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology, were enrolled. The main outcome measures included postoperative IgG4-RS progression rate and differences between patients with and without recurrent disease. The degree of subjective oral dryness was evaluated using the summated xerostomia inventory (SXI); the objective secretory function was assessed by whole saliva flow rate measurements. Serological findings were analyzed during the follow-up. RESULTS: SMG excision was adopted in all of the 83 patients. The median follow-up period was 108 (range 7-396) months. Clinical progression was observed in 54.2% of cases. Patients with other organ involvement (OOI) indicated higher progression rate to a significant extent (P = 0.015, HR = 2.108). The annual progression rate was 20.7% in the group with OOI and was 14.1% in the group without OOI. All cases showed higher levels of serum IgG4; the level was in positive correlation with follow-up time when no therapy was added. 82.4% of cases experienced xerostomia after the surgery, and the degree of dry mouth in patients underwent bilateral resection was significantly more severe than those in unilateral resection. CONCLUSIONS: Surgical excision of involved SMG cannot control the disease progression, which is not recommended for treatment of IgG4-RS. Differential diagnosis is crucial in order to prevent irreversible organ loss and relevant salivary gland dysfunction. Key Points • Surgical excision of involved SMG cannot control progression of IgG4-RS.