Please do Annotated Bibliography listed below and how is each article related to the topic:’  

Management of Work-Life Balance and Nursing Staff’s Work-Related Problems in Critical Care: Strategies for the Nurse Manager

RESEARCH ARTICLE

Critical care nurses’ communication

experiences with patients and families in an

intensive care unit: A qualitative study

Hye Jin Yoo
1
, Oak Bun Lim

1
, Jae Lan ShimID

2*

1 Department of Nursing, Asan Medical Center, Seoul, South Korea, 2 College of Medicine, Department of

Nursing, Dongguk University, Gyeongju, South Korea

* [email protected]

Abstract

This study evaluated the communication experiences of critical care nurses while caring for

patients in an intensive care unit setting. We have collected qualitative data from 16 critical

care nurses working in the intensive care unit of a tertiary hospital in Seoul, Korea, through

two focus-group discussions and four in-depth individual interviews. All interviews were

recorded and transcribed verbatim, and data were analyzed using the Colaizzi’s method.

Three themes of nurses’ communication experiences were identified: facing unexpected

communication difficulties, learning through trial and error, and recognizing communication

experiences as being essential for care. Nurses recognized that communication is essential

for quality care. Our findings indicate that critical care nurses should continuously aim to

improve their existing skills regarding communication with patients and their care givers and

acquire new communication skills to aid patient care.

Introduction

Critical care nurses working in intensive care units (ICUs) care for critically-ill patients, and

their work scope can include communicating with patients’ loved ones and care givers [1]. In

such settings, nurses must make timely judgments based on their expertise, and this requires a

high level of communication competency to comprehensively evaluate the needs of patients

and their families [2,3]. The objective of nurses’ communication is to optimize the care pro-

vided to patients [4]. Therapeutic communication, a fundamental component of nursing,

involves the use of specific strategies to encourage patients to express feelings and ideas and to

convey acceptance and respect. In building an effective therapeutic relationship, a focus on the

patient and a genuine display of empathy is required [5]. Empathy is the ability to understand

and share another person’s emotions. To convey empathy towards a patient, one must accu-

rately perceive the patient’s situation, communicate that perception to the patient, and act on

the perception to help the patient [6]. Effective communication based on empathy not only

contributes greatly to the patient’s recovery [3,5–7], but also has a positive eff

74

Resigning: How nurses work within constraints

Claire O’Donnell, University of Limerick

Tom Andrews, University College Cork

Abstract

This study explores and explains how nurses care for patients with stroke in the acute care setting
and how they process these challenges to enable delivery of care. Using a classic grounded theory
methodology, 32 nurses were interviewed who cared for patients with stroke and twenty hours of
observations were undertaken. Nurses’ main concern is how to work within constraints. In dealing
with this challenge, nurses engage in a process conceptualised as resigning and do so through
idealistic striving, resourcing and care accommodation. Resigning acts as an energy maintenance
and coping strategy, enabling nurses to continue working within constraints. This theory has the
potential to enhance nursing care while reducing burnout and making better use of resources,
while advocating for stroke care improvements.

Keywords: Care provision, constraints, classic grounded theory, nursing, resigning, stroke

Introduction

Quality and safety of patient care is a continued area of concern in healthcare services where
constraints on health expenditure prevail (Aiken et al., 2014; Kirwan et al., 2019). Work envi-
ronments influence patient outcomes where limited nursing staff and resources have a resultant
negative impact on patient care outcomes (Aiken et al., 2014; Griffiths et al., 2021; Jangland et
al. 2018; Rochefort & Clarke, 2010; Schubert et al., 2009). Stroke care in designated specialised
stroke units is associated with improved patient outcomes (Langhorne et al., 2020) however,
despite international consensus on optimum stroke care, wide variations in the delivery of stroke
care across Europe persist (Stroke Alliance for Europe, 2020). Such variations in the location of
stroke care adversely influence care delivery and patient mortality and morbidity (West et al.,
2013; Stroke Alliance for Europe, 2020).

Background

Constraints in the work environment such as reduced staff, lack of time and a lack of resources
are reasons for concern regarding their negative impact on patient care delivery (Chan et al. 2013;
Winsett et al., 2016; Blackman et al., 2018; Griffiths et al., 2021). Nurses caring for patients with
stroke are aware of what optimum stroke care entails however, they often provide a reduced level
of care due to the presence of constraints (Clarke & Holt, 2014; Seneviratne et al., 2009). One
constraint commonly reported as a barrier to optimal nursing is a lack of time (Blackman et al.,

The Grounded Theory Review (2021), Volume 20, Issue 1

75

2018; Chan et al., 2013; Clarke & Holt, 2014) and this includes the area of stroke care (Sen-
eviratne et al., 2009). Reduced nurse staffi

RESEARCH ARTICLE Open Access

Why so stressed? A comparative study on
stressors and stress between hospital and
non-hospital nurses
Rosnawati Muhamad Robat1†, Mohd Fadhli Mohd Fauzi2,3†, Nur Adibah Mat Saruan2,3, Hanizah Mohd Yusoff3* and
Abdul Aziz Harith4

Abstract

Background: Stress, which can be attributed to household and workplace stressors, is prevalent among nurses.
However, these stressors’ attribution may differ between hospital and non-hospital nurses. It is currently unknown
whether there are significant differences in the sociodemographic and occupational characteristics between
hospital and non-hospital nurses which may potentially influence the type and magnitude of stressors, and
subsequently the stress status. Therefore, this study aims to estimate the prevalence of stress and compare the roles
of sociodemograhic characteristics, occupational profiles, workplace stressors and household stressors in
determining the stress status between hospital and non-hospital female nurses in Malaysia.

Methods: This cross-sectional study was conducted among randomly-selected 715 female nurses in Malaysia using
pencil-and-paper self-reported questionnaires.

Results: The majority of participants were ever married (87.0%), having children (76.2%), and work in hospital
setting (64.8%). The level of household stressors was generally similar between hospital and non-hospital nurses.
However, hospital nurses significantly perceived higher level of workplace stressors. Shift work is significantly
associated with higher level of household and workplace stressors among nurses in both groups. The level of stress
was significantly higher among hospital nurses. Both household and workplace stressors explained about 40% of
stress status in both hospital and non-hospital nurses.

Conclusion: Hospital nurses are at higher risk of having stressors and stress as compared to non-hospital nurses,
probably due to higher proportion of them involved in shift work. Hospital nurses should be given high priority in
mitigating stress among nurses.

Keywords: Stress, Stressor, Workplace, Household, Nurse, Hospital, Shift work

© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,
which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give
appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if
changes were made. The images or other third party material in this article are included in the article’s Creative Commons
licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons
licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain
permission direc

International Journal of

Environmental Research

and Public Health

Article

Unplanned Absenteeism: The Role of Workplace and
Non-Workplace Stressors

Nur Adibah Mat Saruan 1,2,† , Hanizah Mohd Yusoff 1,*, Mohd Fadhli Mohd Fauzi 1,2,† ,
Sharifa Ezat Wan Puteh 1 and Rosnawati Muhamad Robat 3

1 Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre,
Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia;
[email protected] (N.A.M.S.); fadhli[email protected] (M.F.M.F.);
[email protected] (S.E.W.P.)

2 Ministry of Health Malaysia, Federal Government Administrative Centre, Putrajaya 62590, Malaysia
3 Occupational and Environmental Health Unit, Selangor State Health Department, No. 1 Wisma Sunway,

Jalan Tengku Ampuan Zabedah C 9/C, Seksyen 9, Shah Alam 40100, Malaysia; [email protected]
* Correspondence: [email protected]; Tel.: +60-3-9145-5904
† These authors contributed equally to this work.

Received: 14 July 2020; Accepted: 20 August 2020; Published: 24 August 2020
����������
�������

Abstract: Unplanned absenteeism (UA), which includes medically certified leave (MC) or emergency
leave (EL), among nurses may disturb the work performance of their team and disrupt the quality
of patient care. Currently, there is limited study in Malaysia that examines the role of stressors in
determining absenteeism among nurses. Therefore, apart from estimating the prevalence and the
reasons of UA among nurses in Malaysia, this study aims to determine its stressor-related determinants.
A cross-sectional study was conducted among 697 randomly sampled nurses working in Selangor,
Malaysia. Most of them were female (97.3%), married (83.4%), and working in shifts (64.4%) in
hospital settings (64.3%). In the past year, the prevalence of ever taking MC and EL were 49.1% and
48.4%, respectively. The mean frequency of MC and EL were 1.80 (SD = 1.593) and 1.92 (SD = 1.272)
times, respectively. Meanwhile, the mean duration of MC and EL were 4.24 (SD = 10.355) and
2.39 (SD = 1.966) days, respectively. The most common reason for MC and EL was unspecified
fever (39.2%) and child sickness (51.9%), respectively. The stressor-related determinants of durations
of MC were inadequate preparation at the




(
Contents

lists

available

at

ScienceDirect
Asian

Nursing

Research
journal

homepage:

www.asian-nursingresearch.com

)Asian Nursing Research 14 (2020) 178e187

Research Article

Developing Strategy: A Guide For Nurse Managers to Manage Nursing Staff’s Work-related Problems

Amal Refaat Gab Allah, Hayam Ahmed Elshrief, Marwa Hassan Ageiz*

Nursing Administration Department, Faculty of Nursing, Menoufia University, Menoufia Governorate, Egypt

a r t i c l e i n f o

Article history:

Received 20 November 2019 Received in revised form

25 June 2020

Accepted 14 July 2020

Keywords:

nursing staff occupational stress personnel turnover workplace

s u m m a r y

Purpose: The purpose of this study was to assess nursing staff’s work-related problems as perceived by their managers and thereafter develop strategies that would serve as a guide for nurse managers to manage these problems.

Methods: A descriptive research design was used. The participants included in the study consisted of the following two groups: Group 1da convenience sample of 150 first-line managers working at three different hospitals; and Group 2da panel of experts for the Delphi technique, selected using the Snowball sampling technique. Tools for data collection included the following: Tool 1dquestionnaire about nursing staff’s problems; Tool 2dDelphi technique to develop strategies for managing nursing staff’s problems; and Tool 3dopinionnaire format.

Results: The recruited first nurse managers were of the opinion that job stress, work overload, conflict, workplace violence, poor performance, staff turnover, demotivation, lack of empowerment, and staff absenteeism were among the common problems faced by staff nurses at work.

Conclusion: From the expert panelists’ perspectives, the newly developed strategy in this study was considered valid; the researchers recommend the strategy developed in this study to be universalized in different health care settings and used as a guide for nurse managers.

© 2020 Korean Society of Nursing Science. Published by Elsevier BV. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Introduction

Nursing is a h

RESEARCH ARTICLE

Critical care nurses’ communication

experiences with patients and families in an

intensive care unit: A qualitative study

Hye Jin Yoo
1
, Oak Bun Lim

1
, Jae Lan ShimID

2*

1 Department of Nursing, Asan Medical Center, Seoul, South Korea, 2 College of Medicine, Department of

Nursing, Dongguk University, Gyeongju, South Korea

* [email protected]

Abstract

This study evaluated the communication experiences of critical care nurses while caring for

patients in an intensive care unit setting. We have collected qualitative data from 16 critical

care nurses working in the intensive care unit of a tertiary hospital in Seoul, Korea, through

two focus-group discussions and four in-depth individual interviews. All interviews were

recorded and transcribed verbatim, and data were analyzed using the Colaizzi’s method.

Three themes of nurses’ communication experiences were identified: facing unexpected

communication difficulties, learning through trial and error, and recognizing communication

experiences as being essential for care. Nurses recognized that communication is essential

for quality care. Our findings indicate that critical care nurses should continuously aim to

improve their existing skills regarding communication with patients and their care givers and

acquire new communication skills to aid patient care.

Introduction

Critical care nurses working in intensive care units (ICUs) care for critically-ill patients, and

their work scope can include communicating with patients’ loved ones and care givers [1]. In

such settings, nurses must make timely judgments based on their expertise, and this requires a

high level of communication competency to comprehensively evaluate the needs of patients

and their families [2,3]. The objective of nurses’ communication is to optimize the care pro-

vided to patients [4]. Therapeutic communication, a fundamental component of nursing,

involves the use of specific strategies to encourage patients to express feelings and ideas and to

convey acceptance and respect. In building an effective therapeutic relationship, a focus on the

patient and a genuine display of empathy is required [5]. Empathy is the ability to understand

and share another person’s emotions. To convey empathy towards a patient, one must accu-

rately perceive the patient’s situation, communicate that perception to the patient, and act on

the perception to help the patient [6]. Effective communication based on empathy not only

contributes greatly to the patient’s recovery [3,5–7], but also has a positive eff

International Journal of

Environmental Research

and Public Health

Article

Unplanned Absenteeism: The Role of Workplace and
Non-Workplace Stressors

Nur Adibah Mat Saruan 1,2,† , Hanizah Mohd Yusoff 1,*, Mohd Fadhli Mohd Fauzi 1,2,† ,
Sharifa Ezat Wan Puteh 1 and Rosnawati Muhamad Robat 3

1 Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre,
Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia;
[email protected] (N.A.M.S.); fadhli[email protected] (M.F.M.F.);
[email protected] (S.E.W.P.)

2 Ministry of Health Malaysia, Federal Government Administrative Centre, Putrajaya 62590, Malaysia
3 Occupational and Environmental Health Unit, Selangor State Health Department, No. 1 Wisma Sunway,

Jalan Tengku Ampuan Zabedah C 9/C, Seksyen 9, Shah Alam 40100, Malaysia; [email protected]
* Correspondence: [email protected]; Tel.: +60-3-9145-5904
† These authors contributed equally to this work.

Received: 14 July 2020; Accepted: 20 August 2020; Published: 24 August 2020
����������
�������

Abstract: Unplanned absenteeism (UA), which includes medically certified leave (MC) or emergency
leave (EL), among nurses may disturb the work performance of their team and disrupt the quality
of patient care. Currently, there is limited study in Malaysia that examines the role of stressors in
determining absenteeism among nurses. Therefore, apart from estimating the prevalence and the
reasons of UA among nurses in Malaysia, this study aims to determine its stressor-related determinants.
A cross-sectional study was conducted among 697 randomly sampled nurses working in Selangor,
Malaysia. Most of them were female (97.3%), married (83.4%), and working in shifts (64.4%) in
hospital settings (64.3%). In the past year, the prevalence of ever taking MC and EL were 49.1% and
48.4%, respectively. The mean frequency of MC and EL were 1.80 (SD = 1.593) and 1.92 (SD = 1.272)
times, respectively. Meanwhile, the mean duration of MC and EL were 4.24 (SD = 10.355) and
2.39 (SD = 1.966) days, respectively. The most common reason for MC and EL was unspecified
fever (39.2%) and child sickness (51.9%), respectively. The stressor-related determinants of durations
of MC were inadequate preparation at the

nursingstandard.com3 0 / March 2020 / volume 35 number 3

nurses’ well-being /
feature

In 2019, a member of the nursing team working in the emergency department at Newham Hospital in London was stabbed multiple times with a pair of scissors.
Understandably, the incident prompted Barts Health

NHS Trust to review its security arrangements.
As a result, all emergency department (ED) staff at

Hostile environment – learning to
manage aggression at work

Employers have a duty to support nursing staff who come under attack, whether physical or verbal,
from patients, the public or colleagues

By Petra Kendall-Raynor

Newham Hospital will receive
training in the management of
actual or potential aggression.

The training, to be completed
by the end of August 2020,
teaches staff techniques to cope
with the escalation of aggressive
behaviour in a way that is
professional and safe.

‘Managing violence in the
workplace is an organisational
priority for Barts Health, which
we’re taking very seriously
with support from the board
all the way down through the
organisation,’ says trust associate
director of culture change
Geraldine Cunningham.

‘There is an increasing amount
of violence and aggression
across the NHS and we need to
keep our staff safe and secure
so they can continue providing
compassionate care.’

Identifying problem behaviour
Alongside the training, the trust
has developed a film for staff to
use to improve their understanding
of the issues, and has updated its
policy on managing abuse and
violence to help the workforce
identify behaviour that is
unacceptable, and feel confident to
manage potential risk and escalate
appropriately.

Psychological support following
an incident has also been increased
so staff feel valued and can ‘return
to work well’. There is growing
concern about the vulnerability
of healthcare staff to workplace
violence. A 2019 survey of 8,307
RCN members revealed that 29%
had experienced physical abuse in
their workplace.

In 2018, the Assaults on
Emergency Workers (Offences)
Bill came into effect in England
and Wales and provided
increased sentencing powers
for offences of common assault
and battery committed against
emergency workers.

On 6 January 2020 a joint
agreement between Her Majesty’s
Prison and Probation Service,
NHS England, the National Fire
Chiefs Council, the National
Police Chiefs Council and the
Crown Prosecution Service (CPS)
came into force.

It provides a broad framework
to ensure more effective
investigation and prosecution of
cases where emergency workers
are the victim of a crime, and sets
out the standards victims of these
crimes can expect.

Figures published by the CPS
show there were 20,000 offences
charged under the Assaults on
Emergency Workers (Offences)
Act in the year to Nove

Faghihi et al. BMC Women’s Health (2021) 21:209
https://doi.org/10.1186/s12905-021-01342-0

R E S E A R C H A R T I C L E

The components of workplace violence
against nurses from the perspective of women
working in a hospital in Tehran: a qualitative
study
Mitra Faghihi1, Aliasghar Farshad2, Maryam Biglari Abhari3, Nammamali Azadi4 and Morteza Mansourian5*

Abstract
Background: Based on the World Health Organization (WHO), workplace violence can affect events where employ-
ees are abused, attacked or threatened in their workplace, and it also has some consequences such as safety, wel-
fare, and health. Like other types of violence, workplace violence and aggression are an increasing phenomenon.
Moreover, workplace violence not only disrupts interpersonal and organizational relationships, but it also impairs the
persons self-esteem and affects their physical and mental health and well-being. Thus, this study aimed to explain the
components of workplace violence against nurses from the perspective of women working in a hospital in Tehran,
which was conducted through the qualitative method and content analysis.

Methods: In this study Purposive sampling included 21 female nurses who were working in different wards of the
hospital. Also, female nurses were selected with maximum diversity in terms of work experience, age, and the wards
they were working in. in this study the semi-structured interview was the main method of data collection. The inter-
view transcriptions were extracted and then divided into meaningful units. For strengthening and confirming the
results and accuracy of the research, the author used the data acceptability, credibility, accuracy, validity, believability,
verifiability, reliability, and transferability.

Results: During the data analysis process of this study, the first 15 classes with the same characteristics were put
together and then divided into 6 classes. Afterwards, based on the common features at a more abstract level, they
were converted into 2 themes. Based on the findings, violence against women in the workplace occurs at two levels,
that namely interpersonal violence and organizational coercion.

Conclusion: Therefore, it is necessary for managers to commit to lay the groundwork for reducing violence in the
hospital, as well as barriers to report these cases especially the hospital managers and officials should create aware-
ness on workplace among the staff, patient and visitors and must ensure stringent actions to prevent it.

Keywords: Violence, Healthy workplace, Women’s health, Nurse, Hospital

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which
permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the
original author(s) and the

RESEARCH ARTICLE Open Access

Relationships between nurse managers’
work activities, nurses’ job satisfaction,
patient satisfaction, and medication errors
at the unit level: a correlational study
Anu Nurmeksela1* , Santtu Mikkonen2, Juha Kinnunen3 and Tarja Kvist4

Abstract

Background: Nurse managers play a critical role in enhancing nursing and patient outcomes. The work of nurse
managers, who can be described as middle-managers at health care organizations, is complex and changes on a
daily basis. Only a few studies have clarified how nurse managers divide their time across various work activities.
This study aimed to describe the relationships between nurse managers’ work activities, nurses’ job satisfaction,
patient satisfaction, and medication errors at the hospital unit level.

Methods: A cross-sectional and correlational study design was used. The data were collected from nurse managers
(n = 29), nursing staff (n = 306), and patients (n = 651) from 28 units across three Finnish acute care hospitals
between April and November 2017. In addition, data concerning medication errors (n = 468) over one calendar year
(2017) were acquired from the hospitals’ incident reporting register. Analysis of covariance (ANCOVA) was used to
estimate relationships between data from subareas of Nurse Managers’ Work Content Questionnaire, Kuopio
University Hospital Job Satisfaction Scale, and Revised Humane Caring Scale, along with medication error reports. A
significance level of 95% was applied when estimating the covariances between variables. Unstandardized
regression coefficients (B) were used to explain the relationships between variables.

Results: Multiple relationships between nurse managers’ work activities, nurses’ job satisfaction, patient satisfaction,
and medication errors were identified. Nurse managers’ work activities had both positive and negative relationships
on the other studied variables. The Requiring factors of work (p < .001) subarea of nurses’ job satisfaction, total
patient satisfaction (p < .001), and medication errors (p < .001) were identified as the variables most significantly
affected by other factors.

Conclusions: The findings suggest that nurse managers should focus on improving nursing practices by managing
and organizing nurses’ work in a way that makes their employees feel supported, motivated and secure.
Furthermore, nurse managers should adopt a leadership style that emphasizes safe and patient-centered care. The
results also suggest that the administration of today’s health care organizations should actively evaluate nurse
managers’ share of work activities to ensure that their daily work is in line with the organizational goals.

Keywords: Job satisfaction, Medication errors, Nurses, Nurse manager, Patient satisfaction, Hospital

© The Author(s). 2021 Open Access This article is licensed under a Creative Commons

Received: 14 December 2020   |  Revised: 26 February 2021   |  Accepted: 2 March 2021
DOI: 10.1111/jonm.13301

O R I G I N A L A R T I C L E

Comparing nurse leader and manager perceptions of and
strategies for nurse engagement using a positive deviance
approach: A qualitative analysis

Amanda C. Blok PhD, MSN, RN, PHCNS- BC 1,2  | Ekaterina Anderson PhD 3,4  |
Lakshman Swamy MD, MBA 5  | David C. Mohr PhD 6,7

Published 2021. This article is a U.S. Government work and is in the public domain in the USA

1 Center for Clinical Management Research ,
Veterans Affairs (VA) Ann Arbor Healthcare
System, United States Department of
Veterans Affairs , Ann Arbor , MI , USA

2 Systems, Populations and Leadership
Department , School of Nursing , University
of Michigan , Ann Arbor , MI , USA

3 Center for Healthcare Organization and
Implementation Research , Veterans Affairs
(VA) Bedford Healthcare System , Bedford ,
MA , USA

4 Department of Population and Quantitative
Health Sciences , Division of Health
Informatics and Implementation Science ,
University of Massachusetts Medical School ,
Worcester , MA , USA

5 The Pulmonary Center , Boston University
School of Medicine , Boston , MA , USA

6 Center for Healthcare Organization and
Implementation Research , Veterans Affairs
(VA) Boston Healthcare System , Boston ,
MA , USA

7 Boston University School of Public Health ,
Boston , MA , USA

Correspondence
Amanda C. Blok, PhD, MSN, RN, PHCNS-
BC, Veterans Affairs (VA) Center for Clinical
Management Research, Veterans Affairs
(VA) Ann Arbor Healthcare System, United
States Department of Veterans Affairs, 2215
Fuller Road, Mail Stop 152, Ann A