The coronavirus disease (COVID-19) pandemic has exposed nurses to conditions that threaten their health, well-being, and ability to work. It is therefore critical to study nurses’ experiences and well-being during the current crisis in order to identify risk groups for ill health and potential sources of organizational intervention. The aim of this study was to explore perceptions of the most salient sources of stress in the early stages of the coronavirus pandemic in a sample of U.S. nurses. A cross-sectional online survey was conducted among a sample of 695 U.S. nurses in May 2020. Content analysis was conducted on nurses’ responses (n = 455) to an open-ended question on the most stressful situations they had experienced during the pandemic. Six distinct themes emerged from the analysis: exposure/infection-self; illness/death-others; workplace; personal protective equipment/supplies; unknowns; opinions/politics. Two sub-themes concerned restrictions associated with the pandemic and feelings of inadequacy/helplessness regarding patients and their treatment. More than half of all comments concerned stress related to problems in workplace response to the pandemic. Healthcare institutions should provide opportunities for nurses to discuss the stress they are experiencing, support one another, and make suggestions for workplace adaptations during this pandemic.

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Implementation and evaluation of a practical intervention programme for dealing with violence towards health care workers The aim of this study was to implement and evaluate a practical intervention programme designed to help staff in health care work-places to deal with patient violence towards staff. The programme was part of a controlled, prospective study that ran for 1 year. The study population was comprised of staff at 47 health care work-places, randomly assigned to either the intervention or control group. The Violent Incident Form (VIF), a checklist designed to simplify the registration of violent events, was introduced at all 47 work sites, where staff were instructed to register all types of violent and threatening incidents directed towards them during the 1-year study period. The intervention work-places also followed a structured feedback programme, where the circumstances concerning registered incidents were discussed on a regular basis with work-place staff. Baseline examination of the study groups revealed no statistically significant difference with regard to self-reported violence in the past year. At the conclusion of the 1-year period, the difference between groups was statistically significant (P < 0.05). Staff at the intervention work sites reported 50% more violent incidents than the control work sites during the year. Compared to the control group, intervention group staff reported better awareness: of risk situations for violence (P < 0.05); of how potentially dangerous situations could be avoided (P < 0.05); and of how to deal with aggressive patients (P < 0.05). Logistic regression analysis confirmed an increased risk for self-reported violence in the intervention group post-intervention (odds ratio 1.49; 95% confidence interval 1.07-2.06; P < 0.05). The structured feedback programme seems to have improved staff knowledge of risks for violence in the intervention group.

Future interventions should focus on counteracting work-related exhaustion and improving competence development to improve work satisfaction among older people care nursing staff in both care settings. Relevance to clinical practice. Work-related exhaustion and lack of competence development may have significant negative implications for work satisfaction among older people care nursing staff in both home care and nursing homes.

Objective: To determine the association between access to adequate personal protective equipment (PPE) and mental health outcomes among a sample of U.S. nurses. Methods: An online questionnaire was administered in May 2020 to Michigan nurses via three statewide nursing organizations (n = 695 respondents). Multivariable logistic regression analysis was used to identify factors associated with mental health symptoms. Results: Nurses lacking access to adequate PPE (24.9%, n = 163) were more likely to report symptoms of depression (OR 1.96, 95% CI 1.31, 2.94; P = 0.001), anxiety (OR 1.64, 95% CI 1.12, 2.40; P = 0.01) and post-traumatic stress disorder (OR 1.83, 95% CI 1.22, 2.74; P = 0.003). Conclusions: Healthcare organizations should be aware of the magnitude of mental health problems among nurses and vigilant in providing them with adequate PPE as the pandemic continues.