Christine T Kovner

Abstract

The COVID-19 pandemic has been difficult for registered nurses. Media reports, most of them anecdotal, have reported upticks in nurse resignations, and plans to resign and/or leave nursing due to COVID-19. This article reports findings from an online anonymous 95-item survey completed by about 1,600 nurses from a New York City metropolitan area health system's (HS) four hospitals and ambulatory care centers about their COVID-19 experience in the spring of 2020, their intent to stay at the HS, and their intent to stay working as a nurse. Conducted early in the pandemic, this survey addresses a major gap in the literature, as there was no timely evaluation of nurses’ intent to leave during the “Great Attrition” wave or to stay during the “Great Attraction” trend. Among those nurses completing the survey, 85.7% reported that they planned to work as a nurse one year later and 77.9% reported that they planned to work at the HS one year later. Those nurses who obtained a master’s or doctoral degree as their first professional degree in nursing, or had a high level of mastery, were less likely to report an intent to stay at the HS. Those with no children, those who thought the HS was more supportive, and those who thought that registered nurse–medical doctor relations were higher were more likely to intend to stay at the HS. Those nurses who reported worse communication with their nurse manager were less likely to report an intent to stay in nursing. Those who reported lower stress, who were unmarried and had no children were more likely to intend to work as nurses. Our findings on nurses’ intent to leave their organization and their intent to leave nursing are much lower than reports in the popular press. Our data were collected early in the pandemic and it may not reflect the accumulated stress nurses experienced from witnessing the death of so many patients.

Abstract

There are concerns that the future balance between the supply and demand for nurses will result in major nursing shortages around the world. Some think that nurses are leaving nursing because of the COVID-19 pandemic. In the United States, nurses may be leaving their jobs, but not nursing. Enrollments in nursing programs have increased. Nurse migration to the United States has decreased. This paper, using examples from the United States mainly, aims to explore the issue of supply of nurses and argues that it is not clear that we will have a worldwide nursing shortage going forward.

Abstract

Background: Infectious disease pandemics, such as COVID-19, have dramatically increased in the last several decades. Purpose: To investigate the personal and contextual factors associated with the psychological functioning of nurses responding to COVID in the New York City area. Method: Cross sectional data collected via a 95-item internet-based survey sent to an email list of the 7,219 nurses employed at four hospitals. Findings: 2,495 nurses responded (RR 35%). The more that nurses cared for COVID patients as well as experienced home-work conflict and work-home conflict the higher the nurses' depression and anxiety. When asked what has helped the nurses to carry out their care of patients the most common responses were support from and to co-workers, training in proper PPE, and support from family/friends. Discussion: Understanding the potential triggers and vulnerability factors can inform the development of institutional resources that would help minimize their impact, reducing the risk of psychological morbidity.

Abstract

Infectious disease pandemics, such as COVID-19, have dramatically increased in the last several decades.

Abstract

Frontline workers are at great risk of significant mental health challenges as a result of responding to large-scale disasters. We conducted a mixed-methods study to identify the challenges experienced and the resources nurses drew upon during this first phase of the COVID-19 pandemic in the spring of 2020 in New York City (NYC). The qualitative data presented here are on 591 nurse participants in the qualitative arm of the study. Responses to qualitative questions were reviewed by one of the investigators to identify emerging themes. Two qualitative researchers used both deductive (guided by the Resilience Theory) and inductive approaches to analysis. Challenges identi fied by nurses included concerns about well-being and health risk; mental health symptoms such as depres sion, anxiety, and difficulty sleeping; fears about the ability to care for patients with severe life-threatening symptoms; and home-work challenges such as risk to family and friends; and lack of availability of institutional resources, particularly, personal protec tive equipment (PPE). Facilitators of resilience were institutional resources and support available; social support from coworkers, friends, and family; and positive professional identity. Recommendations for promoting resilience in future disaster/pandemic responses included clarification of disaster-related professional responsibilities, integration of disaster preparedness into professional education, and engage ment of nurses/frontline workers in preparation plan ning for disasters.

Abstract

Lack of staff engagement in quality improvement (QI) is a persistent challenge in improving quality in health care. In this study, we examined variables associated with nurse-reported participation in QI using data from over 500 registered nurses employed in US hospitals. Of the 16 studied variables, based on the adjusted multivariate regression analysis, the following were positively associated (p < 0.05) with nurse-reported participation in QI: working in advanced practice nursing and manager roles versus staff nurse role, working a full-time work schedule versus a part-time work schedule, and reporting higher levels of procedural justice, quantitative workload, and work motivation.