Dunning Alice, Hartley Hannah, Unsworth Kerrie, Simms-Ellis Ruth, Dunn Michael, Grange Angela, Murray Jenni, Marran Jayne, Lawton Rebecca
Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, University of Sheffield, Sheffield, S1 4DA UK.
Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK.
Int J Nurs Stud Adv. 2024 Sep 21;7:100244. doi: 10.1016/j.ijnsa.2024.100244. eCollection 2024 Dec.
During Covid-19 nurses were redeployed to new teams and specialties at a level never previously experienced. Little is known about how nurses made sense of and coped with this situation and what we can learn from this for future redeployment approaches.
We sought to understand how nurses made sense of ongoing redeployment during the COVID-19 pandemic and how this related to their psychological distress, burnout, turnover intentions, and perceived performance.
A longitudinal multi-method design. (ISRCTN: 18,172,749).
Three acute National Health Service (NHS) Trusts in England, selected for diversity in geographical location and ethnicity, with different COVID-19 contexts.
Sixty-two nurses (90 % female; 83 % white) who experienced different types of redeployment during the pandemic, with an average of 17 year's post-registration experience (mean age 41 years).
We gathered both interview and survey data from 62 nurses across two or three time points in 2020-2021 and sought to find commonalities and differences in patterns of experience using Pen Portrait analysis.
The pandemic redeployment process was life-changing for all nurses, personally and professionally The research uncovered an intertwined pattern of identity and sensemaking as nurses coped with COVID-19 redeployment. Three sensemaking 'journeys' were evident, involving professional identity as a nurse and identification with one's organisation. Nurses in journey one: 'Organisational Identification and Professional Identity Maintained' (n = 28) had the best outcomes for wellbeing, burnout, performance, and retention. Those experiencing the 'Devaluation of Organisational Identification But Maintenance of Professional Identity' journey (n = 24) maintained their professional identity, but their organisational identification deteriorated. Journey three nurses: 'Devaluation of both Organisational Identification and Professional Identity' (n = 10) had the worst outcomes for wellbeing, burnout, performance, and retention. A salient nurse identity triggered stoicism and resilient behaviours while external cues of control, support and contextual awareness affected organisational identification.
Nurses made sense of their experiences of redeployment during Covid-19 differently which, in turn affected their outcomes. Given the stark differences in how nurses perceived their psychological distress, burnout, turnover intentions and performance across the journeys, the importance of understanding the cues (e.g. having autonomy) associated with each journey is apparent. Thus, our research provides clear guidance for managers to help them support nurses during redeployment.
在新冠疫情期间，护士被重新调配到新的团队和专业领域，其规模前所未见。对于护士如何理解并应对这种情况，以及我们能从中学到什么以用于未来的调配方法，我们知之甚少。
我们试图了解护士如何理解新冠疫情期间持续的调配情况，以及这与他们的心理困扰、职业倦怠、离职意向和工作表现之间的关系。
纵向多方法设计。（国际标准随机对照试验编号：18,172,749）。
英格兰的三个急性国民保健服务（NHS）信托机构，因地理位置和种族的多样性以及不同的新冠疫情情况而被选中。
62名护士（90%为女性；83%为白人），她们在疫情期间经历了不同类型的调配，平均有17年的注册后工作经验（平均年龄41岁）。
我们在2020 - 2021年的两个或三个时间点收集了62名护士的访谈和调查数据，并试图通过人物特写分析找出经验模式中的共性和差异。
疫情期间的调配过程对所有护士的个人生活和职业生涯都产生了改变。研究发现，在护士应对新冠疫情调配时，身份认同和意义建构存在相互交织的模式。出现了三种意义建构“历程”，涉及护士的职业身份和对所在组织的认同。处于历程一“组织认同和职业身份得以维持”（n = 28）的护士在幸福感、职业倦怠、工作表现和留任意愿方面的结果最佳。经历“组织认同被贬低但职业身份得以维持”历程（n = 24）的护士保持了他们的职业身份，但组织认同有所恶化。处于历程三的护士“组织认同和职业身份均被贬低”（n = 10）在幸福感、职业倦怠、工作表现和留任意愿方面的结果最差。突出的护士身份引发了坚忍和适应力强的行为，而外部的控制、支持和情境意识线索则影响了组织认同。
护士对新冠疫情期间调配经历的理解各不相同，这反过来又影响了他们的结果。鉴于护士在不同历程中对心理困扰、职业倦怠、离职意向和工作表现的认知存在明显差异，理解与每个历程相关的线索（如拥有自主权）的重要性显而易见。因此，我们的研究为管理者在调配期间帮助支持护士提供了明确的指导。
