"Feeling Like an Island": Perceptions of Professional Isolation Among Emergency Nurses.

INTRODUCTION: Professional isolation, feelings of being isolated from one's professional peers and lacking mentoring and opportunities for professional interaction, collaboration, and development, is a challenge for workers across the labor market. The notion of professional isolation is particularly prevalent in low-resource health care settings and is common among emergency nurses. METHODS: This study explored the perceptions of professional isolation among emergency nurses working in a low-resource environment using individual interviews with 13 participants in 5 settings in Lesotho. RESULTS: The data were analyzed using qualitative content analysis and revealed an overarching theme of "feeling like an island" containing 3 categories, namely lack of interprofessional collaboration and consultation, skills mismatch, and enforced loneliness. DISCUSSION: This study suggests that lack of interprofessional collaboration and consultation, skills mismatch, and enforced loneliness have influenced feelings of professional isolation among emergency nurses working in low-resource environments. The findings of this research lend support to the idea that communities of practice may have a potential impact in addressing professional isolation.

Professional isolation and pandemic teleworkers' satisfaction and commitment: The role of perceived organizational and supervisor support.

Background: The COVID-19 pandemic has abruptly and profoundly changed the way people interact with their organization, their colleagues and their supervisor. Objective: This study assesses the effects of telework-induced professional isolation due to the pandemic. Drawing on organizational support theory, this study examines the relationship between professional isolation and satisfaction with the telework experience and affective organizational commitment during mandatory teleworking caused by the COVID-19 crisis. It does so by focusing on the moderating role of perceived organizational and supervisor support in these relations. Methods: Data was collected via self-reported survey questionnaires from 728 pandemic teleworkers from various industry sectors in Quebec during the COVID-19 crisis. The study's hypotheses were tested using structural equation modeling (SEM), and moderation effects were probed with the Johnson-Neyman technique. Results: The results reveal that professional isolation negatively affects satisfaction with the telework experience, but does not affect affective organizational commitment. The relationship between satisfaction with telework and professional isolation was moderated by perceived organizational support, and the relationship between affective organizational commitment and professional isolation was moderated by perceived supervisor support. Conclusion: This study expands the organizational support theory by examining perceived organizational and supervisor support during a crisis as a counterbalance to a challenging social and organizational climate that has led to professional isolation. The implications of the findings as well as future directions for research on professional isolation and telework are discussed.

Introduction: La pandémie de Covid-19 a brusquement et profondément changé la façon dont les individus interagissent avec leur organisation, leurs collègues et leur superviseur. Objectif: Cette étude examine les effets de l'isolement professionnel induit par le télétravail en raison de la pandémie. S'appuyant sur la théorie du soutien organisationnel, elle examine la relation entre l'isolement professionnel, la satisfaction de l'expérience de télétravail et l'engagement organisationnel affectif durant la période de télétravail obligatoire induit par la pandémie. Pour s'y faire, elle examine le rôle modérateur du soutien organisationnel perçu de l'organisation et du soutien perçu du superviseur dans ces relations. Méthodologie: Les données ont été recueillies auprès de 728 télétravailleurs québécois de divers secteurs d'activité à l'hiver 2021. Les hypothèses de l'étude ont été testées à l'aide d'analyse par équations structurelles et les effets de modération ont été examinés à partir de la méthode Johnson-Neyman. Résultats: Les résultats révèlent que l'isolement professionnel est négativement associé à la satisfaction à l'égard de l'expérience de télétravail, mais qu'il n'a pas d'effet sur l'engagement organisationnel affectif. La relation entre la satisfaction à l'égard du télétravail et l'isolement professionnel est modérée par le soutien organisationnel perçu, et la relation entre l'engagement organisationnel affectif et l'isolement professionnel est modérée par le soutien perçu du superviseur. Conclusion: Cette étude élargit la théorie du soutien organisationnel en examinant le soutien perçu de l'organisation et du superviseur pendant une crise comme un contrepoids à un climat social et organisationnel difficile qui a conduit à l'isolement professionnel. Les implications des résultats et les orientations futures de la recherche sur l'isolement professionnel et le télétravail sont discutées.

The hidden performance costs of professional isolation? A latent change score model of professional isolation during the early stage of COVID-19 pandemic.

Although past research has found that professional isolation can affect discernible work-related outcomes (e.g. job performance and turnover) and important job attitudes, researchers have not examined its impact on those less discernible but still costly work behaviours. Drawing on self-regulation theories, this study examined the effect of professional isolation on employees' cyberloafing and time theft through self-control capacity impairment. With longitudinal data collected from 343 U.S. employees across five consecutive weeks at the early stage of the pandemic (i.e. from mid-March to late April 2020), our results of latent change score modelling analyses found that professional isolation change was positively related with changes in cyberloafing and time theft via change in self-control capacity impairment. The results increase our understanding of the hidden performance cost of professional isolation. This research also shifts the research focus from a static, between-person perspective to dynamic, within-person changes in professional isolation and related outcomes. The findings shed light on the self-regulation perspective in understanding the harmful consequences of professional isolation. Implications for future research are discussed along with practical implications for organisations.

Does locally delivered small group continuing medical education (CME) meet the learning needs of rural general practitioners?

The World Health Organisation policy of improving retention of rural health care practitioners recommended that continuing medical education (CME) programmes addressing their needs should be accessible and delivered where they live and work. This cross-sectional study involved a self-administered anonymous questionnaire completed by GPs attending CME small groups (CME-SGL) in Ireland. All GPs attending CME-SGL in a one-month period were invited to complete the questionnaire which examined demographic details, distance to travel to educational meetings/nearest regional hospital, barriers to accessing continuing education, whether CME-SGL met their educational needs, morale and professional isolation. A total of 1,686 responses were collected, of which 332 (19.6%) were from rural GPs. Of these, 289 (87%) reported that their educational needs were fully or mostly met by attending CME-SGL. Compared to urban doctors, rural GPs had further to travel to CME-SGL meetings, were further from the nearest regional hospital, and reported increased barriers to accessing continuing education. Rural GPs reported lower morale and greater levels of professional isolation. Despite considerable barriers to accessing continuing education, rural GPs reported that CME-SGL meets their educational needs. Future research should focus on the potential positive impact this may have on professional isolation and morale.

The implications of isolation for remote industrial health workers.

INTRODUCTION: Recent literature has explored the health and social implications of industrial workers who are involved in a variety of long-distance commute (LDC) work arrangements including fly-in, fly-out; bus-in, bus-out; and drive-in, drive-out. However, the role of an industrial health worker in caring for this special population of workers is poorly understood and documented in current literature. In Australia, the health role has existed primarily to meet minimum standards of safety legislation and carry out compliance activities. The combination of low social risk tolerance, increasingly remote locations and changing health and safety legislation are driving changes to accountability for the health as well as the safety of remote industrial workers. Health staff are recruited from the ranks of registered nurses, paramedics and diploma-qualified medics. Often, they work in autonomous transdisciplinary roles with little connection to other health workers. The lack of a clear professional identity contributes to increased tension between the regulatory requirements of the role and organisations who don't always value input from a specialist health role. The aim of this study was to understand the experience of isolation for health workers in industrial settings to better inform industry and education providers. METHODS: A phenomenological methodology was chosen for this study owing to the paucity of qualitative literature that explored this role. This study utilised face-to-face or telephone interviews with nurses and paramedics working in remote offshore and onshore industrial health roles seeking to understand their experience of working in this context of health practice. RESULTS: Three thematically significant experiences of the role related to role dissonance, isolation, and gaining and maintaining skills. The second theme, isolation, will be presented to provide context for nurses' and paramedics' experiences of geographical, personal and professional isolation. CONCLUSIONS: Nurses and paramedics working in remote industrial roles are not prepared for the broad scope of practice of the role, and the physical and profession isolation presents barriers to obtaining skills and confidence necessary to meet the needs of the role. Limited resources in rural and remote areas combined with the isolation of many industrial sites pose challenges for industrial staff in accessing primary healthcare services, yet industrial organisations are resisting attempts to make them responsible for the health as well as the safety of their onsite workers, particularly in off-duty hours. Health workers in remote locations have to cope with their own experience of isolation but also have to treat and counsel other industrial workers experiencing chronic illness complications, separation from family and other consequences of the fly-in, fly-out 'workstyle'. In addition to the tyranny presented by distance and the emotional isolation common to all remote industrial workers, health workers are isolated from professional networks, access to education/professional development opportunities and other remote industrial peers. Their inclusion within a professional network and educational framework would help to mitigate these factors and provides opportunities for collaboration between industrial and rural health staff.

Isolated and Stressed? Examining the Effects of Management Communication in Alleviating Mental Health Symptoms during COVID-19.

The goal of this research was to assess the role of professional isolation on mental health symptoms via stress among employees working remotely due to COVID-19. Additionally, this research explored the interactive effect of management communication on the relationship between professional isolation and stress, and stress and mental health symptoms. In Study 1, behavior analysts who were working remotely as a result of the pandemic completed assessments of professional isolation, stress, and mental health symptoms at two points in time, separated by two weeks. Study 2 replicated and extended the findings from Study 1 in a sample of remote employees recruited from Amazon's Mechanical Turk using a three-wave design. Findings of both Study 1 and Study 2 suggested that stress mediated the relationship between professional isolation and mental health symptoms. Additionally, management communication buffered the association between stress and mental health symptoms in Study 2. Lastly, the indirect effect of professional isolation on mental health symptoms was stronger for those who received less communication from their management. The findings of these two studies expand our understanding of the mechanism and boundary condition through which professional isolation is related to mental health symptoms.

Negative Impact of Telework, Job Insecurity, and Work-Life Conflict on Employee Behaviour.

The COVID-19 pandemic imposed a large-scale adoption of teleworking in various fields, accepted by many employers as the ideal solution to protect their employees against the risk of contracting SARS-CoV-2. Working from home generated substantial savings for organisations and also contributed to alleviating employee stress. In addition to the potential positive effects, telework during COVID-19 favoured counterproductive behaviour, job insecurity, and intention to retire because of the negative outcomes generated by the growing conflict between personal life and working from home and professional and social isolation. The purpose of this research is to define and analyse a conceptual model capable of highlighting the way in which telework, job insecurity, and work-life conflict led to professional isolation and turnover intention, and finally, to the counterproductive behaviour of employees during the COVID-19 pandemic. This research was implemented using employees in Romania, an emerging European economy severely affected by the recent pandemic. The results have been analysed with the help of structural equations in SmartPLS, thus reflecting a significant influence of teleworking on work-life conflict, professional isolation, intentions, and insecurity during the pandemic. The insecurity of employees trained in teleworking contributes significantly to enhancing work-life conflict and professional isolation.

Understanding the impact of COVID-19 pandemic on teleworkers' experiences of perceived threat and professional isolation: The moderating role of friendship.

Drawing from conservation of resource theory and the social support resource theory, this study examines how the severity of an exogenous disruptive event - the COVID-19 pandemic - in one's community influences teleworkers' well-being outcomes indirectly through their perceptions of pandemic-related threat and experience of professional isolation, as well as the buffering effect of friendship on these relationships. Utilizing time-lagged data from participants of a two-wave survey panel (N = 351) and objective data of COVID-19 severity from counties around the United States, we found that perceived threat, but not professional isolation, mediated the negative effect of proportion of confirmed COVID-19 cases in the community on teleworkers' well-being outcomes. Further, consistent with our predictions, support from friends significantly weakened the negative effects of threat and professional isolation on well-being. Key theoretical and practical implications of this study are discussed.

What challenges and enablers elicit job satisfaction in rural and remote nursing in Australia: An Integrative review.

AIM: To explore challenges and stressors experienced by rural and remote area nurses and identify any interventions that aided in decreasing stress and increasing job satisfaction. BACKGROUND: Demand for a generalist nursing workforce in rural and remote locations exposes nurses to the same conditions as people residing there: higher mortality rates and higher incidence of chronic diseases and inadequacies in accessing health services. DESIGN: Christmals and Gross's integrative review framework was used with specified inclusion and exclusion criteria. Four databases were searched with no date limits. Only Australian studies were searched as international scope of practice differences for nurses could have distorted findings. FINDINGS: Eighteen studies identified three broad themes: access to education; isolation (geographical, professional and personal) and recognition of role. DISCUSSION: Interlinked themes showed positives and negatives from differing viewpoints. Ambivalence to education stemmed from inadequate exposure to learning and was linked with geographical isolation. Isolation was found to be less of a challenge to nurses who had an existing emotional connection with the community. CONCLUSION: The themes identified were recurrent and interconnecting. The benefits of working in small rural and remote communities are being used as a driver for recruitment. These benefits include higher wages, providing a sense of belonging and allowing nurses to work to their full scope and develop generalist nursing skills. The geographical isolation generates challenges through inequality in access to education and professional support, working outside their scope of practice, safety and vulnerability that comes with living remotely and adapting to extreme weather conditions. TWEETABLE ABSTRACT: What are the challenges and enablers of rural and remote working and living that influence job satisfaction for rural and remote area nurses in Australia?

Interventions for managing professional isolation among health professionals in low resource environments: A scoping review.

BACKGROUND: Professional isolation is viewed as a sense of isolation from ones professional peers and this has contributed to compromised quality of health service delivery as well as quality of life for health professionals in low resource environments. Professional isolation is a multidimensional concept which may be either geographic, social, and/or ideological. However, professional isolation in low resource environments remains poorly defined with a limited body of research focusing on health professionals. AIM: To map and examine available literature on interventions for managing professional isolation among health professionals in low resource environments. METHODS: We conducted a scoping review of the published and grey literature to examine the extent, range and nature of existing research studies relevant to professional isolation in health professionals. RESULTS: Of the 10 articles retrieved, 70% were conducted in high income countries where the context may be different if applied to other low-income settings such as in Africa. Only 20% of the studies focused specifically on nurses or the nursing profession and only 10% were conducted on the African continent. CONCLUSION: There is insufficient research on the definition and origins of professional isolation among health professionals including the interventions that can be employed. Rural, remote and/or isolated settings significantly predispose health professionals to professional isolation but remain poorly defined. Additional research is recommended to explore and determine the interventions for managing professional isolation among health professionals in low resource environments.