BACKGROUND: Every two years, the National Council of State Boards of Nursing (NCSBN) and the National Forum of State Nursing Workforce Centers (Forum) conduct the only national-level survey focused on the entire U.S. nursing workforce. The survey generates data on the supply of registered nurses (RNs) and licensed practical nurses/licensed vocational nurses (LPNs/LVNs). These data are especially crucial in providing information on emerging nursing issues, which in 2022, was the impact of the (COVID-19) pandemic on the nursing workforce. PURPOSE: To provide data critical to planning for enough adequately prepared nurses and ensuring a safe, diverse, and effective healthcare system. METHODS: This study used a mixed-mode approach, involving mailing a national, randomized sample survey to licensed RNs and LPNs/LVNs in most jurisdictions, supplemented by a national, randomized sample survey emailed to licensed RNs and LPNs/LVNs in four jurisdictions and data from the e-Notify nurse licensure notification system for five jurisdictions. Data from RN and LPN/LVN respondents were collected between April 11, 2022, and September 30, 2022. Data included nurse demographics, educational attainment, employment, practice characteristics, and trends. RESULTS: The total number of active RN and LPN/LVN licenses in the United States were 5,239,499 and 973,788, respectively. The median age of RNs was 46 years and 47years for LPNs/LVNs, which reflects a decrease of 6 years for each cohort from the 2020 data. This decline was associated with estimated losses to the workforce of at least 200,000 experienced RNs and 60,000 experienced LPNs/LVNs. An average of 89% of all nurses who maintain licensure are employed in nursing with roughly 70% working full-time. Hospitals and nursing/extended care facilities continue to be the primary practice setting for RNs and LPNs, respectively. Increased proportions of male and Hispanic/Latino nurses have introduced greater racial diversity in the nursing workforce. The nursing workforce is becoming increasingly more educated with more than 70% of RNs holding a baccalaureate degree or higher. More than one-quarter of all nurses report that they plan to leave nursing or retire over the next 5 years. Increased demand from the COVID-19 pandemic and inflation led nursing incomes to rise significantly across the country. Nurses were also specifically asked how the COVID-19 pandemic impacted them, and more than 60% of all nurses reported an increase in their workload because of the pandemic. CONCLUSION: In the wake of the COVID-19 pandemic, the nursing workforce has undergone a dramatic shift with the loss of hundreds of thousands of experienced RNs and LPNs/LVNs. The nursing workforce has become younger and more diverse with increases reflected for Hispanic/Latino and male nurses. An increasing proportion of the RN workforce holds a baccalaureate degree or higher, moving closer to goals established by the National Academy of Medicine. Salaries have notably increased for nurses, likely due to inflation and increased demand for nursing services. With a quarter of the population contemplating leaving the profession, the impact of the pandemic may still be felt in the future.
The 2022 National Nursing Workforce Survey
BACKGROUND: Korean immigrants are among the fastest-growing ethnic minority groups and make up the fifth-largest Asian group in the United States. A better understanding of the work environment factors and its impact on Korean American nurse and primary care provider (PCP) burnout may guide the development of targeted strategies to help mitigate burnout and workplace stressors, which is critical for the retention of Korean American nurses and PCPs to promote better alignment of national demographic trends and meet patients’ preference for cultural congruence with their health care providers (HCPs). Although there is a growing number of studies on HCP burnout, a limited number of studies specifically focus on the experience of ethnic minority HCPs, particularly during the COVID-19 pandemic. Objective: In light of these gaps in literature, the aim of this study was to assess burnout among Korean American HCPs and to identify work conditions during a pandemic that may be associated with Korean American nurse and PCP burnout. METHODS: A total of 184 Korean American HCPs (registered nurses [RNs]: n=97; PCPs: n=87) practicing in Southern California responded to a web-based survey between February and April 2021. The Maslach Burnout Inventory, Areas of Worklife Survey, and Pandemic Experience & Perceptions Survey were used to measure burnout and work environment factors during the pandemic. A multivariate linear regression analysis was used to assess work environment factors associated with the 3 subcategories of burnout. RESULTS: No significant differences were found in the level of burnout experienced by Korean American nurses and PCPs. For RNs, greater workload (P<.001), lower resource availability (P=.04), and higher risk perception (P=.02) were associated with higher emotional exhaustion. Greater workload was also associated with higher depersonalization (P=.003), whereas a greater (professional) community (P=.03) and higher risk perception (P=.006) were associated with higher personal accomplishment. For PCPs, greater workload and poor work-life balance were associated with higher emotional exhaustion (workload: P<.001; worklife: P=.005) and depersonalization (workload: P=.01; worklife: P<.001), whereas only reward was associated with personal accomplishment (P=.006). CONCLUSIONS: Findings from this study underscore the importance of strategies to promote a healthy work environment across multiple levels that recognize demographic variation among Korean American RNs and PCPs, potentially influencing their burnout mitigation needs. A growing recognition of identity-informed burnout experiences across frontline Korean American RNs and PCPs argues for future explorations that capture nuance both across and within this and other ethnic minority nurse and PCP groups. By recognizing and capturing these variations, we may better support the creation of targeted, burnout-mitigating strategies for all.
The Association Between Korean American Nurse and Primary Care Provider Burnout, Areas of Worklife, and Perceptions of Pandemic Experience: Cross-sectional Study
BACKGROUND: Burnout has risen across healthcare workers during the pandemic, contributing to workforce turnover. While prior literature has largely focused on physicians and nurses, there is a need to better characterize and identify actionable predictors of burnout and work intentions across healthcare role types. OBJECTIVE: To characterize the association of work overload with rates of burnout and intent to leave (ITL) the job in a large national sample of healthcare workers. Design: Cross-sectional survey study conducted between April and December 2020.SettingA total of 206 large healthcare organizations. PARTICIPANTS: Physicians, nurses, other clinical staff, and non-clinical staff. MEASURES: Work overload, burnout, and ITL. Results: The sample of 43,026 respondents (mean response rate 44%) was comprised of 35.2% physicians, 25.7% nurses, 13.3% other clinical staff, and 25.8% non-clinical staff. The overall burnout rate was 49.9% (56.0% in nursing, 54.1% in other clinical staff, 47.3% in physicians, and 45.6% in non-clinical staff; p < 0.001 for difference). ITL was reported by 28.7% of healthcare workers, with nurses most likely to report ITL (41.0%), followed by non-clinical staff (32.6%), other clinical staff (32.1%), and physicians (24.3%) (p < 0.001 for difference). The prevalence of perceived work overload ranged from 37.1% among physicians to 47.4% in other clinical staff. In propensity-weighted models, work overload was significantly associated with burnout (adjusted risk ratio (ARR) 2.21 to 2.90) and intent to leave (ARR 1.73 to 2.10) across role types. LIMITATIONS: Organizations’ participation in the survey was voluntary. CONCLUSIONS: There are high rates of burnout and intent to leave the job across healthcare roles. Proactively addressing work overload across multiple role types may help with concerning trends across the healthcare workforce. This will require a more granular understanding of sources of work overload across different role types, and a commitment to matching work demands to capacity for all healthcare workers.
The Association of Work Overload with Burnout and Intent to Leave the Job Across the Healthcare Workforce During COVID-19
The COVID-19 pandemic disrupted the world of leadership. Every healthcare professional—front-line staff and leaders alike—adapted their work to confront this virus. The contributions of clinical leaders during the COVID-19 pandemic are unique and important. Experiences of clinical leadership reinforce the critical nature of leadership strategy, quality improvement principles, and commitment to integrated, whole-system quality. Clinical leaders, possessing the dual responsibility of front-line care and system-level leadership, hold critical insights regarding change in healthcare organizations as a whole. In their pandemic response, clinical leaders demonstrated key leadership characteristics that required individual growth and facilitated team cohesion: communicating with consistency and humanity; being the first to try; attending to burnout and moral injury; and building bridges to strengthen the overall response. John Kotter’s landmark book, Leading Change, provides an anchoring framework for examining the experiences and strategies of clinical leaders during the COVID-19 pandemic.
The Balancing Act of Clinical Leadership: Lessons Learned from the COVID-19 Pandemic
In 2019, the National Academy of Sciences, Engineering, and Medicine identified clinician burnout as a major problem that required immediate action because of its threat to both health care worker safety and patient safety. Unfortunately, the rise of COVID-19 in 2020 with no signs of a clear ending (as of the summer of 2022) has compounded this problem. Consequently, much focus has been placed by many to address clinician burnout and help alleviate this major threat to safety. Unfortunately, compared with clinician burnout, articles and resources to address frontline leader (FL) burnout are fewer. FLs are key to supporting teams and are integral to their success. They also execute and operationalize organizational strategic plans to ensure patient safety at the point of care. The burnout issue with bedside clinicians is a big issue, a fractured fault line in our health care system. However, without addressing the well-being of FLs, this fault line becomes a chasm. The column shares background from the American Organization for Nursling Leadership longitudinal studies and other pertinent research. It also provides examples of practices across the nation of how nurse executives are supporting their teams and promoting leader support and well-being.
This resource is found in our Actionable Strategies for Health Organizations: Strengthening Leadership.
The Business Case for Addressing Burnout in Frontline Leaders: A Toolkit of Interventions From Nurse Executives Around the United States
Although surgical training programs have nearly reached gender parity, pregnancy and parenthood remain challenging for female surgeons, with obstetric risks related to occupational demands, stigma, inconsistent and brief parental leaves, a paucity of postpartum support for lactation and childcare, and little mentorship on work-family integration. This work environment causes many to postpone starting a family, which leads to higher risks of infertility among female surgeons compared to their male peers. Perception of work-family incompatibility jeopardizes recruitment and retention of our surgical workforce, as it deters medical students from the profession, increases risk of resident attrition, and leads to burnout and career dissatisfaction. The challenges of parenthood for female surgeons was the focus of a Hot Topics session during the 2022 Academic Surgical Congress, the discussion of which is presented herein with recommendations for policy change to better support maternal-fetal health and the needs of surgeons with young children.
The Challenges of Parenthood for Female Surgeons: The Current Landscape and Future Directions
BACKGROUND: Nursing professionals experienced greater levels of stress and burnout during the COVID-19 pandemic. Studies examining stress and burnout have found a relationship between compensation and burnout. However, further studies are needed to examine the relationship between the mediating effects of supervisor and community support and coping strategies and the effects of burnout on compensation. OBJECTIVE: The purpose of this study is to build on previous burnout research by examining the mediation effects of supervisor and community support and coping strategies on the relationship between sources of stress and burnout on feelings of compensation inadequacy, or the desire for more compensation. METHODS: Using Qualtrics survey responses from 232 nurses, this study used correlation testing and mediation analyses of indirect, direct, and total effects to explore the relationships between critical factors influencing stress, burnout, nurses’ use of coping skills, and the perception of supervisor and community support on perceived compensation inadequacy. RESULTS: This study found that the support domain has a significant and positive direct effect on compensation, with supervisor support increasing the desire for additional compensation. Support was also found to have a significant and positive indirect effect and a significant and positive total effect on the desire for additional compensation. This study’s results also found that coping strategies had a significant, direct positive effect on the desire for additional compensation. While problem solving and avoidance increased the desire for additional compensation, transference had no significant relationship. CONCLUSION: This study found evidence of the mediation effect of coping strategies on the relationship between burnout and compensation.
The Cost of Frontline Nursing: Investigating Perception of Compensation Inadequacy During the COVID-19 Pandemic
[This is an excerpt.] In this study, 17 key informant experts shared their perspectives on how the emergency medical services (EMS) and community paramedicine (CP) workforces responded to COVID-19 during the first year of the pandemic, 2020. Experts also described how the pandemic has affected EMS and CP. EMS responders provide 9-1-1 emergency services, while community paramedics (CPs), typically drawn from EMS personnel, provide non- emergent public health services and augment primary care services to patients in the community. [To read more, click View Resource.]
The EMS and Community Paramedic Workforces Respond to COVID-19 – UW CHWS
OBJECTIVE: To describe the impact of the COVID-19 pandemic on intensive care nurses personal and professional well-being. RESEARCH METHODOLOGY/DESIGN: A descriptive, qualitative design was used. Two nurse researchers conducted one-on-one interviews via Zoom or TEAMS using a semi-structured interview guide. Setting: Thirteen nurses who were working in an intensive care unit in the United States participated in the study. A convenience sample of nurses who completed a survey in the larger parent study provided an email and were contacted by the research team to participate in interviews to discuss their experiences. MAIN OUTCOME MEASURES: An inductive approach to content analysis was used to develop categories. FINDINGS: Five major categories emerged from the interviews: (1) We are not heroes, (2) inadequate support, (3) helplessness, (4) exhaustion, and (5) Nurses the second victim. CONCLUSION: The COVID-19 pandemic has taken a physical and mental health toll on intensive care nurses. The impact of the pandemic on personal and professional well-being has serious implications for retaining and expanding the nursing workforce. IMPLICATIONS FOR CLINICAL PRACTICE: This work highlights the importance for bedside nurses to advocate for systemic change to improve the work environment. It is imperative for nurses to have effective training including evidence-based practice and clinical skills. There needs to be systems in place to monitor and support nurses’ mental health and encourage bedside nurses to use self-care methods and practices to prevent anxiety, depression, post-traumatic stress disorder and burnout.
The Early Impact of COVID-19 on Intensive Care Nurses’ Personal and Professional Well-Being: A Qualitative Study
PURPOSE: Although intimate partner violence is a type of violence that women are frequently exposed to, its victims are adversely affected by violence at various levels, bio-psycho-socially. This study was conducted to determine the relationship between exposure to spousal violence, communication skills and burnout levels in female nurses. MATERIALS AND METHODS: The study was carried out in a descriptive and cross-sectional research design. The study was conducted in a university hospital in the Black Sea region of Turkey in September 2021. Sample selection was not made in the study, and female nurses who agreed to participate in the study were included in the study. The study's sample size is 165 female nurses. A personal Information Form, Intimate Partner Violence Scale, Communication Skills Scale, and Burnout Scale were used to collect data. FINDINGS: It was concluded that the exposure of female nurses to spouse violence significantly affects their communication skills and there is a significant relationship between nurses' communication skills and burnout levels (P = 0.001). PRACTICAL IMPLICATIONS: The attitudes and behaviors of nurses who are strong in the caregiving process are very important. Personal characteristics, communication styles and body language of nurses who are exposed to partner violence are reflected in nursing care practices and affect the caregiving process. In this context, prevention and intervention approaches for intimate partner violence of female nurses should be known.
The Effect of Exposure to Intimate Partner Violence of Female Nurses on Communication Skills and Burnout Levels
BACKGROUND: Evidence suggests that mindfulness training using a phone application (app) may support neonatal intensive care unit (NICU) nurses in their high stress work. If effective, phone apps could improve nurses' professional quality of life (QOL) defined as compassion satisfaction (CS) and compassion fatigue (CF) that includes burnout (BO) and secondary traumatic stress (STS).Purpose: To test the hypothesis that use of a mindfulness phone app will increase NICU nurses' professional QOL. METHODS: Using a single-group, pre/posttest design, investigators invited a convenience sample of 54 NICU nurses from a 377-bed Magnet-recognized, nonprofit hospital to complete a demographic sheet and 2 established scales: the Professional Quality of Life scale, version 5 (ProQOL5), and the Mindfulness Attention Awareness Scale (MAAS). The intervention was nurses' using the mindfulness phone app, Premium Moodfit, for 3 weeks. RESULTS: Response rate was 41% (N = 22). A paired t test for the 9 nurses who returned both pre- and posttest questionnaires showed that their STS fell from moderate to low (P = .003), while their low BO scores (P = .12) and moderate CS scores (P = .4) remained stable. Wilcoxon tests confirmed results: only STS decreased (P =.01). The hypothesis was partly supported. IMPLICATIONS FOR PRACTICE AND RESEARCH: Using the Premium Moodfit mindfulness phone app may improve or maintain NICU nurses' professional QOL even under heightened stress. Individual nurses may independently access Moodfit and the free ProQOL5. Replication studies are warranted to confirm results and establish trends.
The Effect of a Mindfulness Phone Application on NICU Nurses' Professional Quality of Life
IMPORTANCE: There is an abundance of research demonstrating the growing challenge of burnout in healthcare professionals. This has been further exacerbated by the COVID-19 pandemic. The use of meditation using various techniques has shown promising results in the reduction of stress and its sequelae. OBJECTIVE: To determine the efficacy of a mantra-based meditation protocol developed by the American Meditation Institute to reduce caregiver stress by evaluating changes in burnout and secondary traumatic stress (components of compassion fatigue) and compassion satisfaction with the application of the meditation protocol. DESIGN, SETTING, AND PARTICIPATION: This pre–post cohort analysis was conducted on prospective enrollees of the Continuing Medical Education (CME)-accredited American Meditation Institute's annual Heart and Science of Yoga® Conference, a comprehensive training in Yoga Science as Holistic Mind/Body Medicine for physicians and other healthcare providers held in October in Lenox, Massachusetts. Enrollees were trained in mantra-based AMI Meditation at the conference and monitored during the 6-month period following the conference. INTERVENTIONS: The mantra-based AMI Meditation intervention included a 5-day in-person training, a daily practice of a guided mantra-based AMI Meditation using a 20-min CD or MP3 recording, and receipt of a monthly motivational letter. Study participants completed the Professional Quality of Life (ProQOL) Measure (a survey) and a demographic survey at baseline, and the ProQOL Measure and an informational survey at 3 and 6 months. MAIN OUTCOMES AND MEASURES: The primary outcome was a change from baseline in participants’ level of burnout using the ProQOL assessed at baseline and 3 and 6 months. Secondary outcomes included change from baseline in participants’ level of secondary traumatic stress and compassion satisfaction assessed at 3 and 6 months using the ProQOL Measure. Qualitative data were also collected from participant feedback, via the informational surveys, at 3 months and after completion of the program at 6 months. RESULTS: Of the 54 participants who enrolled and completed a baseline survey, 30 completed the follow-up at 3 months and 21 participants completed the follow-up at 6 months. From baseline to 6 months, there were statistically significant improvements in the scores for all three ProQOL scales. Using paired t-test, burnout scores were reduced by 23.2% (p < 0.0001), secondary traumatic stress scores were reduced by 19.9% (p = 0.001), and compassion satisfaction scores improved by 11.2% (p < 0.0001). For secondary traumatic stress and compassion satisfaction scores, most improvements were seen at 3 months. For burnout, the improvements were constant across the 3- and 6-month follow-ups. CONCLUSIONS: In this small cohort of healthcare professionals, the mantra-based AMI Meditation program significantly improved all three domains of caregiver stress with improvements in burnout and secondary traumatic stress as well as improvements in feelings of compassion. This adds to a rapidly growing body of research supporting the critical importance of these tools and skills in the mitigation of caregiver stress.
The Effects of Mantra-Based AMI Meditation on Burnout, Secondary Traumatic Stress, and Compassion Satisfaction Levels in Healthcare Providers
BACKGROUND: The COVID-19 pandemic demanded exceptional physical and mental effort from healthcare workers worldwide. Since healthcare workers often refrain from seeking professional psychological support, internet-delivered interventions could serve as a viable alternative option. OBJECTIVE: We aimed to investigate the effects of a therapist-guided six-week CBT-based internet-delivered stress recovery intervention among medical nurses using a randomized controlled trial design. We also aimed to assess program usability. METHODS: 168 nurses working in a healthcare setting (Mage = 42.12, SDage = 11.38; 97 % female) were included in the study. The intervention group included 77 participants, and the waiting list control group had 91 participants. Self-report data were collected online at three timepoints: pre-test, post-test, and three-month follow-up. The primary outcome was stress recovery. Secondary outcomes included measures of perceived stress, anxiety and depression symptoms, psychological well-being, posttraumatic stress and complex posttraumatic stress symptoms, and moral injury. RESULTS: We found that the stress recovery intervention FOREST improved stress recovery, including psychological detachment (d = 0.83 [0.52; 1.15]), relaxation (d = 0.93 [0.61, 1.25]), mastery (d = 0.64 [0.33; 0.95]), and control (d = 0.46 [0.15; 0.76]). The effects on psychological detachment, relaxation, and mastery remained stable at the three month follow-up. The intervention was also effective in reducing its users' stress (d = − 0.49 [− 0.80; − 0.18]), anxiety symptoms (d = − 0.31 [− 0.62; − 0.01]), depression symptoms (d = − 0.49 [− 0.80; − 0.18]) and increasing psychological well-being (d = 0.53 [0.23; 0.84]) with the effects on perceived stress, depression symptoms, and well-being remaining stable at the three-month follow-up. High user satisfaction and good usability of the intervention were also reported. CONCLUSIONS: The present study demonstrated that an internet-based intervention for healthcare staff could increase stress recovery skills, promote psychological well-being, and reduce stress, anxiety, and depression symptoms, with most of the effects being stable over three months.
The Efficacy of the Internet-Based Stress Recovery Intervention FOREST for Nurses Amid the COVID-19 Pandemic: A Randomized Controlled Trial
PURPOSE: This project specifically aims to examine (1) the individual impact of coronavirus disease 2019 (COVID-19) on first responders, (2) the organizational impact of COVID-19 on first response agencies and (3) policy and organizational response and support efforts to mitigate potentially harmful effects of the pandemic. DESIGN/METHODOLOGY/APPROACH: The authors' conducted a mixed-methods analysis, including a review of secondary sources (e.g. government documents, organizational policies and news pieces), state-level policies, encompassing surveys, in-depth semi-structured interviews and PhotoVoice focus groups. FINDINGS: COVID-19 compounded many of the inherent risks facing first responders and added new stressors. First responders assumed added responsibilities during the pandemic which increased workloads, job-related stress, burnout, distance from the community and first responders' feelings of frustration. Even with personal protective equipment (PPE), first responders faced greater exposure to individuals with COVID-19 and were primarily concerned with transmitting the virus to family members, or other members of the first responders' support networks. State-level COVID-19 policies that were geared toward first responders aimed to improve the first responders' personal lives outside of work and mitigate burnout within the profession. First response agencies adapted to the pandemic by implementing a wide range of measures. PRACTICAL IMPLICATIONS: First responders also identified several weaknesses in the first responders' agencies' approach to the pandemic. To prepare for the next public health emergency, first response agencies should proactively train employees, build up the first responders' supplies of equipment and PPE, implement policies to strengthen their workforce (e.g. increase hiring for understaffed positions, reduce turnover and mitigate role abandonment), allow for greater employee autonomy, improve communication between leaders and employees and prioritize employees' mental health, as well as other factors relating to departments' informal culture. ORIGINALITY/VALUE: This is one of the largest studies conducted on three types of first responders (police officers, fire firefighters, emergency medical technicians (EMTs) and paramedics) across the United States of America during a public health crisis.
The Impact of COVID-19 on First Responders in the United States of America
The COVID-19 pandemic disrupted conventional medical education for surgical trainees with respect to clinical training, didactics, and research. While the effects of the COVID-19 pandemic on surgical trainees were variable, some common themes are identifiable. As hordes of COVID-19 patients entered hospitals, many surgical trainees stepped away from their curricula and were redeployed to other hospital units to care for COVID-19 patients. Moreover, the need for social distancing limited traditional educational activities. Regarding clinical training, some trainees demonstrated reduced case logs and decreased surgical confidence. For residents, fellows, and medical students alike, most didactic education transitioned to virtual platforms, leading to an increase in remote educational resources and an increased emphasis on surgical simulation. Resident research productivity initially declined, although the onset of virtual conferences provided new opportunities for trainees to present their work. Finally, the pandemic was associated with increased anxiety, depression, and substance use for some trainees. Ultimately, we are still growing our understanding of how the COVID-19 pandemic has redefined surgical training and how to best implement the lessons we have learned.
The Impact of COVID-19 on Surgical Training and Education
Health care providers caring for patients at the end of life (EOL) are faced with a multitude of emotions such as guilt, anger, sadness, and helplessness. Because of the negative impact of initiating EOL care (EOLC) to the pediatric population, organizations must be proactive in instituting education and resources on EOLC. They must also provide advanced skills to nurses who take care of patients at their EOL. Understanding the consequences of providing EOL care to patients in the pediatric intensive care unit allows for better allocation of resources and support services for nurses. This improves patient outcomes and nurse retention.
The Impact of End-of-Life Care Among nurses Working in the Pediatric Intensive Care Unit
Burnout is an internationally recognized occupational phenomenon that negatively impacts the healthcare workforce and its recipients. The aim of this pilot study was to test whether positive reinforcement and integrating a language of support among co-workers can enhance resiliency, facilitate psychological wellness, and encourage hope. This embedded mixed methods prospective, behavioral, interventional study evaluated the effects of positive feedback on wellness among intensive care unit clinicians during the COVID-19 pandemic in a single center, quaternary care medical center. The deliberate positive feedback paradigm has the potential to augment resiliency and improve attitudes toward a teamwork climate. The routine use of deliberate positivity may represent a scalable, low-cost initiative to enhance wellness in a healthcare organization.
The Impact of Positive Reinforcement on Teamwork Climate, Resiliency, and Burnout During the COVID-19 Pandemic: The TEAM-ICU (Transforming Employee Attitudes via Messaging Strengthens Interconnection, Communication, and Unity) Pilot Study
This study seeks participation from patrol-level officers with at least two years’ experience in the New Castle County Police Department in Delaware (n=134) and requests that they respond to two questionnaires measuring resilience and job burnout: the 25-item Resilience Scale and the Maslach Burnout Inventory. Additionally, participants are asked to self-report their pre-hire fitness scores. Police officers are repeatedly exposed to trauma, which has negative mental and physical consequences, often leading to extreme stress, fatigue, and emotional imbalance. Repeated trauma also impacts physical fitness, which is critical for not only physical and mental health but also work performance, especially for police officers. Two related concepts are used to investigate the relationship between physical and mental health: resilience, which describes an individual’s capacity to recover quickly from difficulties, and burnout, a state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress. The data generated by the aforementioned scales are compared to pre-hire physical fitness scores to observe the relationship between pre-hire fitness and current levels of burnout and resilience. This study aims to improve the hiring practices of police organizations by identifying characteristics that enable candidates to manage repeated exposure to trauma. Failing to hire resilient police officers can produce physically and mentally exhausted police populations that cannot provide the public with safe and effective policing. The study hypothesizes that pre-hire physical fitness scores influence measures of resilience and burnout in patrol-level police officer populations.
The Impact of Pre-Hire Fitness Scores on Resilience and Burnout Among New Castle County Patrol-Level Police Officers
BACKGROUND: Job Crafting is a strategy undertaken by highly motivated individuals to modify their own work. Educating individuals about the benefits of this approach has recently been explored in other professions as a wellbeing intervention. OBJECTIVE: We aimed to demonstrate that a Job Crafting intervention for health care leaders would result in improved wellbeing, lower burnout, and enhanced job resources. METHODS: Fourteen health care leaders across 6 departments at one academic medical center participated in a two-part workshop on Job Crafting between January 1, 2019 and December 31, 2020. Participants completed electronic surveys before and 4-6 weeks after the sessions. Pre- and post-intervention scores were compared using Wilcoxon signed rank sum tests. RESULTS: Eighty-six percent of participants stated the sessions were useful and applicable to their jobs, with 93% stating they were a valuable use of time and would recommend sessions to others. Participant Job Crafting behaviors increased following the intervention, with 46% increasing structural and social resources (P = .03) and 85% decreasing Hindrance Demands (P = .02). Increased meaning in work was identified by 38% post-intervention (P = .04). No statistically significant differences were identified in Distress Scores at high risk for burnout pre- and post-intervention (86% for both), but 30% of participants had an absolute improvement (decrease) in their Distress Score. CONCLUSIONS: A Job Crafting intervention was associated with high rates of satisfaction among participants and was successful in increasing Job Crafting behaviors and perceptions of meaningful work, but did not result in a change in risk for burnout in the short follow-up period.
The Impact of a Job Crafting Intervention on Wellbeing in Health Care Leaders
BACKGROUND: Burnout and other psychological comorbidities were evident prior to the COVID-19 pandemic for critical care healthcare professionals (HCPs) who have been at the forefront of the health response. Current research suggests an escalation or worsening of these impacts as a result of the COVID-19 pandemic. OBJECTIVES: The objective of this study was to undertake an in-depth exploration of the impact of the evolving COVID-19 pandemic on the wellbeing of HCPs working in critical care. METHODS: This was a qualitative study using online focus groups (n ¼ 5) with critical care HCPs (n ¼ 31, 7 medical doctors and 24 nurses) in 2021: one with United Kingdom-based participants (n ¼ 11) and four with Australia-based participants (n ¼ 20). Thematic analysis of qualitative data from focus groups was performed using Gibbs framework. FINDINGS: Five themes were synthesised: transformation of anxiety and fear throughout the pandemic, the burden of responsibility, moral distress, COVID-19 intruding into all aspects of life, and strategies and factors that sustained wellbeing during the pandemic. Moral distress was a dominant feature, and intrusiveness of the pandemic into all aspects of life was a novel finding. CONCLUSIONS: The COVID-19 pandemic has adversely impacted critical care HCPs and their work experience and wellbeing. The intrusiveness of the pandemic into all aspects of life was a novel finding. Moral distress was a predominate feature of their experience. Leaders of healthcare organisations should ensure that interventions to improve and maintain the wellbeing of HCPs are implemented.


