Stimpfel Amy Witkoski, Goldsamt Lloyd, Liang Eva, Costa Deena K
is an Assistant Professor, Rory Meyers College of Nursing, New York University, New York.
is a Senior Research Scientist, Rory Meyers College of Nursing, New York University.
J Nurs Regul. 2022 Oct;13(3):4-12. doi: 10.1016/S2155-8256(22)00085-0. Epub 2022 Oct 19.
The COVID-19 pandemic put extreme stress on an already strained healthcare workforce. Suboptimal work organization, exacerbated by the pandemic, is associated with poor worker, patient, and organizational outcomes. However, there are limited qualitative studies exploring how the interconnections of work organization factors related to shift work, sleep, and work stress influence registered nurses and their work performance in the United States.
We sought to understand how nurses perceive work organization factors that impact their performance. Knowledge in this area could direct efforts to implement policies and design tailored interventions to support nurses in the post-pandemic period.
We used a qualitative descriptive design with the framework as an overarching guide to understand the interconnectedness of work organization factors, work stress, and outcomes. Participants were randomly assigned to one of two anonymous, asynchronous virtual focus groups (i.e., threaded discussion boards) in 2019. Registered nurses ( = 23) working across the United States were recruited and engaged until data saturation was achieved. Directed content analysis was used to analyze the data.
Findings aligned with the framework and revealed three themes: (1) "Our Voice Should Matter" (nurses' desire to have their voices heard in staffing policies); (2) "Tired But Wired" (the harmful cycle of work stress, rumination, and poor sleep); and (3) "We're Only Human" (nurses' physical, emotional, and mental exhaustion linked to critical performance impairments).
These findings underscore that high work stress and poor sleep were present before the pandemic and impacted nurses' perceptions of their performance. As leaders look forward to recovery and work redesign efforts, these findings can guide decision-making and resource allocation for optimal nurse, patient, and organization outcomes.
新冠疫情给本就紧张的医护人员队伍带来了极大压力。疫情加剧了工作组织的不合理，这与员工、患者和组织的不良后果相关。然而，在美国，探索与轮班工作、睡眠和工作压力相关的工作组织因素之间的相互联系如何影响注册护士及其工作表现的定性研究有限。
我们试图了解护士如何看待影响其工作表现的工作组织因素。这方面的知识可以指导实施政策和设计针对性干预措施，以在疫情后时期支持护士。
我们采用定性描述性设计，以该框架作为总体指南，来理解工作组织因素、工作压力和结果之间的相互联系。2019年，参与者被随机分配到两个匿名的、异步的虚拟焦点小组（即主题讨论板）之一。招募了在美国各地工作的注册护士（n = 23），并让他们参与讨论，直到达到数据饱和。采用定向内容分析法对数据进行分析。
研究结果与该框架一致，揭示了三个主题：（1）“我们的声音应该被重视”（护士希望在人员配置政策中表达自己的意见）；（2）“疲惫但紧张”（工作压力、反复思考和睡眠不佳的有害循环）；（3）“我们只是普通人”（护士的身体、情感和精神疲惫与关键绩效受损有关）。
这些发现强调，在疫情之前就存在高工作压力和睡眠不佳的情况，并且影响了护士对其工作表现的认知。当领导者展望复苏和工作重新设计的努力时，这些发现可以指导决策和资源分配，以实现护士、患者和组织的最佳结果。
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