Strategies to promote nurses’ health: A qualitative study with student nurses

Developing strategies to support student nurses' health is a global priority for healthcare organisations and governments. This is because emerging international evidence indicates that improvements in student nurses' health are required to increase the longevity of careers and reduce the loss of time, skill and financial cost of sickness absence and workforce exit. However, we do not know what intervention strategies student nurses think would support their health. The study aim was to explore student nurses' views on factors that influence health-related behaviours and strategies that could improve health. Data were collected through participatory activities during focus groups with student nurses in Scotland. Analysis was theoretically informed and involved mapping to the Behaviour Change Wheel framework. Students identified several factors that influenced health-related behaviours. Four were ranked most important: knowledge, culture, time constraints, and stress. Strategies student nurses thought should be prioritised to improve nurses' health-related behaviours were: stimulating a health-promoting environment by reviewing shift work, improving workplace support, increasing staffing levels, subsidising and role-modelling of healthy food and exercise; and creating applied health-promoting curricula by integrating time and stress management training and lifestyle advice into nursing education. Educational and environmental interventions are needed to support student nurses’ health.     

Pediatric emergency nurses’ workplace violence experiences: A qualitative study

IntroductionWorkplace violence is a crucial problem experienced by health workers who serve at the emergency service. The identification of emergency nurses’ workplace experiences is of importance to the prevention of violence and the development of solutions.PurposeThis study was performed to identify the workplace violence experiences of the nurses working for the pediatric emergency units.MethodA total of 20 nurses who experienced violence at the emergency service participated in the study that was conducted as qualitative research. The data were collected with the semi-structured interview form and were evaluated by using thematic analysis.ResultsFive themes, namely, “the characteristics of violence”, “the causes of violence”, “the approach during/after the violence”, “the consequences of the violence for the person”, and the “consequences of the violence for the profession”, were identified. Nurses stated that they often experienced verbal violence due to patient relatives’ unmet expectations, the failure of patient relatives to understand treatments and practices, and the heavy workload, they endeavored to eliminate violence by trying to communicate with perpetrators of the violence, calling the security staff, and reporting the violence to their managers, and they were individually and professionally affected by the violence.ConclusionNurses are negatively affected by workplace violence. Pediatric emergency nurses should be supported with training programs and policies to be developed for the prevention and solution of violence.     

Communicative barriers and resources in nursing homes from the enrolled nurses’ perspective: A qualitative interview study

Background and objectivesManaging communicative disability is a pervasive issue in long-term care facilities. The aim of this study was to explore how enrolled nurses experience their everyday interactions with residents in nursing homes, particularly focusing on interactions with residents with communicative disability.DesignA qualitative exploratory design including content analysis was used.Participants and settingEight individuals working at six nursing homes in western Sweden were interviewed.MethodThe interviews were semi-structured with questions about the participants’ experiences in communicating with residents, feelings associated with interactions involving residents with communicative disability, meaning ascribed to interactions, and factors influencing interactions. The interviews were analysed using content analysis.ResultsA dynamic interplay between interpersonal relations, daily interactions and the managing of communicative disability was revealed. The enrolled nurses had good knowledge of supportive strategies and an awareness of the importance of the development of personal relationships with residents in order to facilitate interaction. However, factors in the environment presented barriers to communication.Conclusions/implicationsThe organisation and physical environment of nursing homes prevent the enrolled nurses from taking full advantage of the communicative resources they have in interaction with residents with communicative disability, hence affecting staff–resident relationships and the delivery of person-centred care.     

Perioperative nurses’ experiences of communication in a multicultural operating theatre: A qualitative study

AimTo explore the lived experiences of perioperative nurses in a multicultural operating theatre in Melbourne, Australia.BackgroundMulticulturalism has become the norm in the health workforce of several developed countries due mostly to immigration. Within an operating theatre setting where good communication is paramount, the presence of nurses and doctors from multiple cultures and different training backgrounds could pose a major challenge.MethodUsing a qualitative research methodology underpinned by phenomenology, we interviewed fourteen nurses from different sections of an operating theatre.ResultsFrom the lived experiences of the participants, difficulties in communication emerged as the major theme. Difficulties in communication affected patient care and the working atmosphere. In addition, social integration appeared to improve communication.ConclusionsAddressing the needs of patients from culturally and linguistically diverse backgrounds in the operating theatre continues to be challenging. However, developing a sense of camaraderie and fostering good relationships between staff through regular social gatherings can improve communication and the working atmosphere.     

Novice nurses’ experiences from teamwork in the emergency department: A qualitative content analysis

Background and aimTeamwork is assumed crucial in nursing. Nevertheless, nursing shortages in medical centers have thus far compelled nurse managers to use novice nurses. The present study aimd to explaining the challenges and experiences of novice nurses regarding teamwork in emergency departments.Materials and methodsUsing qualitative content analysis, 11 novice nurses working at emergency department, participated in this study. Data were collected with semi structured interview and analyzed by Graneheim and Lundman.ResultsThe data analysis led to the emergence of four themes of “essential teamwork skills development”, “contradictory relationships between team members”, “unpleasant feelings and experiences”, and, “personal growth and maturation during teamwork”.ConclusionFostering different personal aspects as prerequisites for teamwork, novice nurses will be able to deal with unpleasant feelings and experiences as well as contradictory relationships between team members in an effective manner. This challenging experience will thus give rise to personal growth and maturation during teamwork among them in emergency department.     

Barriers to adequate pain and symptom relief at the end of life: A qualitative study capturing nurses’ perspectives

BackgroundSymptom management remains a critical challenge at the end of life. Barriers to symptom relief predominantly focus on perspectives of physicians, patients or care systems but rarely acknowledge the views of nurses.AimExamine nurses’ perceptions of barriers to adequate end-of-life symptom relief.MethodsSemi-structured interviews with 25 nurses across different settings who routinely prescribed and/or administered symptom relief to patients near the end of life in Queensland and New South Wales, Australia. Data were analysed using a six-stage hybrid thematic analysis technique.FindingsNurses identified five barriers to adequate symptom management. Firstly, fears concerning symptom relief such as hastening death, causing addiction, loss of consciousness, and legal/professional repercussions affected clinical practice. Secondly, lack of knowledge, experience and training hindered symptom management. Nurses discussed knowledge gaps regarding medication and palliative care, symptom assessments, recognition of dying and relevant laws. Thirdly, personal, cultural and religious beliefs influenced staff's willingness to offer pain relief, and patients’ and families’ willingness to accept it. Lack of communication between medical teams, patients and families further challenged symptom management. Lastly, institutional barriers played a considerable role as time constraints, insufficient staff support and difficulties accessing resources prevented end-of-life symptom management.DiscussionThe identified barriers highlight a substantial need for targeted interventions. Setting-specific challenges such as limited access to medication, staff and palliative care services must be addressed.ConclusionsTo provide better end-of-life care, services should acknowledge nurses’ unique insights. Particular attention should be on supporting nurses in aged care facilities, community settings and remote areas.     

Nurses’ perspectives regarding the disclosure of errors to patients: A qualitative study

BackgroundThere is often a mismatch between patients’ desire to be informed about errors and clinical reality. In closing the “disclosure gap” an understanding of the views of all members of the healthcare team regarding errors and their disclosure to patients is needed. However, international research on nurses’ views regarding this issue is currently limited.ObjectivesExplore nurses’ attitudes and experiences concerning disclosing errors to patients and perceived barriers to disclosure.DesignInductive, exploratory study employing semi-structured interviews with participants, followed by conventional content analysis in which investigators read and discussed transcribed data to identify important themes.SettingsNursing departments from hospitals in two German-speaking cantons in Switzerland.ParticipantsPurposive sample of 18 nurses from a range of fields, positions in organisational hierarchy, work experience, hospitals, and religious perspectives.MethodsData were collected via individual, face-to-face interviews using a researcher–developed semi-structured interview guide. Interviews were transcribed in German and analysed using the qualitative data analysis software package Atlas-Ti (Berlin) and conventional content analysis. The most illustrative quotes were translated into English.ResultsNurses generally thought that patients should be informed about every error, but only a very few nurses actually reported disclosing errors in practice. Indeed, many nurses reported that most errors are not disclosed to the patient. Nurses identified a number of barriers to error disclosure that have already been reported in the literature among all clinicians, such as legal consequences and the fear of losing patients’ trust. However, nurses in this study more frequently reported personal characteristics and a lack of guidance from the organisation as barriers to disclosure. Both issues suggest the need for a systematic institutional approach to error disclosure in which the decision to inform the patient stems from within the organisation and is not shouldered by individual nurses alone.ConclusionsOur study suggests that hospitals need to do more to support and train nurses in relation to error disclosure. Such measures as hospitals establishing a disclosure support system, providing background disclosure education, ensuring that disclosure coaching is available at all times, and providing emotional support for all parties involved, would likely go a long way to address the barriers identified by nurses.     

Novice nurses’ transition to the clinical setting in the COVID‐19 pandemic: A phenomenological hermeneutic study

BackgroundThe COVID-19 pandemic both exposed and increased weaknesses in the healthcare system, so that novice nurses have become a more vulnerable group during this context.AimThis study sought to illuminate experience of novice nurses in providing care during the COVID-19 pandemic.MethodIt consists of a qualitative study conducted with data collected by means of semistructured interviews, audio recorded, transcribed, anonymised, and analysed in the light of the phenomenological hermeneutic approach. Fourteen registered novice nurses from two health areas in northwest of Spain, being twelve women and two men, who experienced the COVID-19 pandemic within their first five years of professional experience, were selected through a non-statistical snowball sampling.ResultsAfter analysing the narratives, we identified four main themes: “Transitioning to a hostile, unknown and uncertain clinical setting from inexperience,” “Invisible wounds because of being on the front line,” and “Healing to return to the front line.”DiscussionThe uncertainty of an unknown illness and the lack of support during the COVID-19 pandemic has been affecting novice nurses, impacting their health conditions. At the same time, this context created opportunities for professional development. According to the interviewees, self-care and social support were elements to cope with exhaustion.ConclusionOur study investigates the experiences of a group barely approached in the literature, highlighting the reality and difficulties of these nurses in transitioning to the clinical setting and providing insights to managerial leaders and educators.