Bergman Alanna J, Hanson Ginger C, Jenkins Christian, Nelson Katie E, Boyce Danielle, Rushton Cynda H
School of Nursing, University of Virginia, Charlottesville, VA, USA.
Johns Hopkins Center for Infectious Disease and Nursing Innovation, 525 N. Wolfe Street, Suite 511, Baltimore, MD, 21205, USA.
BMC Nurs. 2025 Aug 22;24(1):1100. doi: 10.1186/s12912-025-03744-z.
While nurse leaders have a voice in some organizational decisions, their moral resilience and moral injury can be affected by organizational structures and processes during a public health emergency such as the COVID-19 pandemic.
The purpose of this exploratory descriptive analysis was to characterize the differences and commonalities between types of nurse leaders and their experiences of perceived organizational effectiveness, moral injury, and moral resilience during the COVID-19 pandemic.
This was a quantitative study conducted via an online, national, cross-sectional survey. The survey included sociodemographic and professional practice questions, validated instruments measuring organizational effectiveness, moral injury, and moral resilience. Open-ended questions allowed participants to expand on topics of particular interest. Quantitative data were analyzed using ANCOVA models, qualitative data accompanies the quantitative results for descriptive elaboration.
In total, 763 nurse leaders were included in the analysis. Executives scored higher on overall organizational effectiveness than other leaders but not nurse managers. Examining the differences in specific facets of organizational effectiveness revealed that nurse managers rated several aspects of staffing lower than executives. One-third of respondents met the threshold for clinically significant levels of moral injury (score ≥ 36). No significant differences were found between nurse leader roles on moral injury. ANCOVAs indicated that nurse executives had higher total moral resilience than either nurse managers (p = 0.030) or other leaders (p < 0.001). In the open-ended questions, nurse leaders discussed two additional facets of organizational effectiveness that affected moral injury and moral resilience: (1) inequity between healthcare workers in different roles, and (2) an imbalance between organizational finances and patient safety.
Organizations can promote retention and moral resilience among nurse leaders by cultivating trustworthy behaviors. This may be achieved through authentic communication and transparency, and by promoting the values reflected in the nursing code of ethics.
Not applicable.
虽然护士领导者在一些组织决策中拥有发言权，但在诸如新冠疫情这样的突发公共卫生事件期间，他们的道德复原力和道德伤害可能会受到组织结构和流程的影响。
本探索性描述性分析的目的是描述不同类型护士领导者之间的差异和共性，以及他们在新冠疫情期间对组织有效性、道德伤害和道德复原力的感知体验。
这是一项通过全国性在线横断面调查开展的定量研究。该调查包括社会人口统计学和专业实践问题，以及用于测量组织有效性、道德伤害和道德复原力的经过验证的工具。开放式问题让参与者能够详细阐述特别感兴趣的话题。定量数据使用协方差分析模型进行分析，定性数据则伴随定量结果用于描述性阐述。
总计763名护士领导者纳入分析。行政管理人员在整体组织有效性方面的得分高于其他领导者，但高于护士管理者。对组织有效性具体方面的差异进行考察发现，护士管理者对人员配置的几个方面的评分低于行政管理人员。三分之一的受访者达到了临床上道德伤害显著水平的阈值（得分≥36）。在道德伤害方面，护士领导者角色之间未发现显著差异。协方差分析表明，护士行政管理人员的总体道德复原力高于护士管理者（p = 0.030）或其他领导者（p < 0.001）。在开放式问题中，护士领导者讨论了影响道德伤害和道德复原力的组织有效性的另外两个方面：（1）不同角色医护人员之间的不公平，以及（2）组织财务与患者安全之间的不平衡。
组织可以通过培养可信赖的行为来促进护士领导者的留任和道德复原力。这可以通过真诚沟通和透明度来实现，并通过弘扬护理伦理准则中所体现的价值观来实现。
不适用。
