Leadership, professional quality of life and moral distress during COVID‐19: A mixed‐methods approach

Ness, Michelle; Saylor, Jennifer; DiFusco, Leigh Ann; Evans, K. F.

doi:10.1111/jonm.13421

Cited by 42 publications

(53 citation statements)

References 40 publications

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“…Respondents described that their managers did not have enough knowledge of how to lead in a crisis and considered whether managers had too limited a degree of knowledge or they were too inexperienced to handle the situation. This is consistent with earlier studies showing that managers need to have better training in disaster management, and that managers need more organisational support to minimize their own challenges during and beyond the pandemic (Ness et al, 2021 ). It is therefore essential that there is a clear approach to crisis management, and that lessons and experiences are used for future pandemic situations.…”

Section: Discussionsupporting

confidence: 91%

“…Furthermore, it is of utmost importance that staff are encouraged to express their feelings and sources of distress and to openly discuss their experiences and challenges in their care of COVID‐19 patients (Bianchi et al, 2021 ; Labrague, 2021 ). Consequently, when managers prioritize staff's well‐being, their trust in management will increase (Jackson & Nowell, 2021 ; Ness et al, 2021 ; Vázquez‐Calatayud et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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The importance of management in promoting hospital staff's mental well‐being during the COVID‐19 pandemic—A survey

Peltokoski

Kaunonen

Helminen

et al. 2022

J Nursing Management

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Aim To describe hospital staff's experiences of management actions to promote their mental well‐being during the COVID‐19 pandemic. Mental well‐being was examined on the basis of four entities: level of anxiety, support and encouragement from the manager, and the opportunity to discuss concerns about COVID‐19 with the manager. Background The workload of COVID‐19 affects the mental well‐being of staff. However, there is limited data on managers' actions to promote their mental well‐being during the pandemic. Methods A cross‐sectional study was used to collect survey data ( n = 1995) among staff working in two specialized medical care hospitals. To gain deeper understanding related issues, the survey included open questions, which were answered by 178 participants. Results The results indicate that those staff who felt they had received support, encouragement, and the opportunity to discuss of COVID‐19 worries with a manager experienced less anxiety. Conclusions The study provides an insight into managers' actions to promote staff's mental well‐being during the COVID‐19 pandemic. Implications for Nursing Management The manager's actions have a significant effect on the anxiety levels of staff. During the pandemic, the well‐being of staff is a priority that should be visible to both hospital administrators and policymakers.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The importance of management in promoting hospital staff's mental well‐being during the COVID‐19 pandemic—A survey

Peltokoski

Kaunonen

Helminen

et al. 2022

J Nursing Management

View full text Add to dashboard Cite

show abstract

“…Moral distress has been a prominent theme for healthcare workers during the pandemic. [134][135][136][137] In a study in the Netherlands, two sources of moral distress that increased in COVID-19 (scarcity of resources and the perception of colleagues acting unsafely) were significant predictors of burnout. 103 In a Toronto hospital, moral distress was strongly related to emotional exhaustion and accounted for most of the difference in burnout between roles (nurses vs. other health professionals vs. other staff with regular patient contact; Hunter J, personal communication).…”

Section: Moral Distressmentioning

confidence: 99%

Burnout in Hospital-Based Healthcare Workers during COVID-19

Maunder¹,

Heeney²,

Strudwick³

et al. 2021

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About Us: The Ontario COVID-19 Science Advisory Table is a group of scientific experts and health system leaders who evaluate and report on emerging evidence relevant to the COVID-19 pandemic, to inform Ontario's response. Our mandate is to provide weekly summaries of relevant scientific evidence for the COVID-19 Health Coordination Table of the Province of Ontario, integrating information from existing scientific tables, Ontario's universities and agencies, and the best global evidence. The Science Table summarizes its findings for the Health Coordination Table and the public in Science Briefs. The Mental Health Working Group comprises scientific experts and public health leaders with specific expertise in mental health. Their expertise spans mental health of children and youth, adults and geriatric populations, mental health of health care providers, women's health, mental health among LGBTQ persons, mental health among Black, Indigenous, and other racialized populations, and COVID-19. The Working Group evaluates emerging scientific evidence related to maintaining mental health during COVID-19, the mental health burden of disease and public health interventions on individuals across the lifespan, including children and adolescents, and the older adult population, as well as the need for assessment and recommendations

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“… 41 This study is about staff, but, nota bene, the very presence of first-line managers in care is crucial for giving emotional support to coworkers and to ensure the concern of patients and families as a relational inclusion, that is, ethics of care. Ness et al , 42 for instance, showed that lack of support during COVID-19 increased moral distress. The frustration caused by the pandemic might risk the exacerbating of an already unhelpful narrowing of identification of belonging, in order to emotionally endure these stressing circumstances.…”

Section: Discussionmentioning

confidence: 99%

Moral and exhausting distress working in the frontline of COVID-19: a Swedish survey during the first wave in four healthcare settings

et al. 2022

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ObjectivesTo describe the prevalence and sources of experienced moral stress and anxiety by Swedish frontline healthcare staff in the early phase of COVID-19.DesignCross-sectional survey, quantitative and qualitative.Participants and setting1074 healthcare professionals (75% nurses) in intensive, ward-based, primary and municipal care in one Swedish county.MeasuresA study-specific closed-ended and an open-ended questionnaire about moral stress and the Generalised Anxiety Disorder 7-item scale measuring anxiety, followed by an open question about anxiety.FindingsMoral stress was experienced by 52% of respondents and anxiety by 40%. Moral stress in concern for others attributed to institutional constraints comprised experiences of being deprived of possibilities to respond to humane and professional responsibility. Staff experienced being restricted in fulfilling patients’ and families’ need for closeness and security as well as being compelled to provide substandard and inhumane care. Uncertainty about right and good, without blame, was also described. However, a burdensome guilt also emerged as a moral distress, blaming oneself. This comprised feeling complicit in the spread of COVID-19, inadequacy in care and carrying patients’ suffering. Staff also experienced an exhausting distress as a self-concern in an uncontrollable work situation. This comprised a taxing insecurity by being in limbo, being alone and fear of failing, despair of being deprived control by not being heard; unable to influence; distrusting management; as well as an excessive workload.ConclusionsWe have not only contributed with knowledge about experiences of being in the frontline of COVID-19, but also with an understanding of a demarcation between moral stress/distress as a concern for patients and family, and exhausting distress in work situation as self-concern. A lesson for management is that ethics support should first include acknowledgement of self-concern and mitigation of guilt before any structured ethical reflection. Preventive measures for major events should focus on connectedness between all parties concerned, preventing inhumane care and burn-out.

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Leadership, professional quality of life and moral distress during COVID‐19: A mixed‐methods approach

Cited by 42 publications

References 40 publications

The importance of management in promoting hospital staff's mental well‐being during the COVID‐19 pandemic—A survey

The importance of management in promoting hospital staff's mental well‐being during the COVID‐19 pandemic—A survey

Burnout in Hospital-Based Healthcare Workers during COVID-19

Moral and exhausting distress working in the frontline of COVID-19: a Swedish survey during the first wave in four healthcare settings

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