Aims Because of the direct contact nurses have with patients, they are exposed to more stressful events during the outbreak of infectious diseases, which increases their turnover intention, highly impacting not only nurses, but also patients and organizations. The present study aimed to identify the predictors of turnover intention based on psychosocial factors in nurses of Ardabil pre‐hospital emergency and educational and medical centres during the COVID‐19 outbreak. Design The present descriptive‐analytical study was conducted in June, 2020. Methods A total of 479 nurses working in Ardabil pre‐hospital emergency and educational and medical centres to fight COVID‐19 were recruited for this study using the census method. Data were collected using the Demographic Information Questionnaire, Turnover Intention Questionnaire, Weiss & Marmar Impact of Event Scale‐Revised (IES‐R), General Health Questionnaire (12 C‐GHQ) and Job Content Questionnaire (JCQ). Data were analysed with SPSSv.22 software using correlation, t test, analysis of variance, multiple regression and descriptive tests. Results The mean turnover intention score of nurses was 41.73 with a standard deviation of 12.11. The results of correlation coefficient revealed a positive relationship between PTSD, general health, job demand and job strain with turnover intention ( p ≤ .01) and a positive and significant relationship between social support and turnover intention ( p ≤ .01). Multiple regression analysis showed that the variables of gender, marital status, work position, decision latitude, social support, job strain, general health and post‐traumatic stress disorder (PTSD) were predictors of turnover intention. Conclusion Job stressors during the COVID‐19 outbreak have led to an increase in nurses’ turnover intention. Identifying and managing the factors related to job stressors will make it possible to prevent nurses’ turnover intention in such critical situations.

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Emergency department (ED) nurses and emergency medical services (EMS) staff have been recently exposed to high levels of stress due to the new Coronavirus (COVID-19) pandemic. This increased stress level may influence the physical and mental health of ED nurses and EMS staff and the quality of caregiving to the patients. A spiritual coping approach is one of the most commonly used strategies to help healthcare workers manage stressful events or situations. This study explores the spiritual coping (positive or negative) among ED nurses and EMS staff during the COVID-19 pandemic. A descriptive cross-sectional study was performed on 494 ED/EMS nurses in Ardabil Province in the northwest of Iran, using a convenience sampling method. The spiritual coping questionnaire (SCQ) was used to assess spiritual coping in the subjects. The results of this study showed that ED nurses and EMS staff generally used positive spiritual coping methods to reduce stress during the COVID-19 pandemic. Multiple linear regression indicated that workplace ( β = 0.22, p < 0.001), service location ( β = 0.16, p < 0.001), and type of employment ( β = − 0.13, p = 0.012) were significant predictors of positive spiritual coping, and older age ( β = 0.13, p = 0.045), overtime work ( β = 0.12, p = 0.01), and marital status ( β = − 0.12, p = 0.021) were predictors of negative spiritual coping. Our findings indicated that positive religious behavior was the main spiritual coping strategy used by healthcare workers. The findings could help emergency nurse managers to propose future strategies to minimize stress based on the use of spiritual coping strategies and provide time and facilities to pray. Supplementary Information The online version contains supplementary material available at 10.1007/s10943-022-01523-7.

Aims This study aimed to assess predictors of patient safety competency among emergency nurses. Background The role of emergency nurses is to provide high-quality health care to patients and ensure their safety. The patient safety competency includes the absence of unnecessary or potential harm when providing health care to patients. In providing health care, effective teamwork can affect patient safety and outcomes. Psychological safety is essential to effective teamwork. Psychological safety allows health care workers to accept the interpersonal risks needed to perform effective teamwork and maintain patient safety. Methods This study was cross-sectional correlational research. Using convenience sampling methods, 254 emergency department nurses from five educational hospitals were enrolled in the study. Patient Safety in Nursing Education Questionnaire was used to measure the patient safety competency, the teamwork questionnaire to examine the teamwork, and Edmondson psychological safety questionnaire was used to measure psychological safety. Descriptive statistics, t-test, one-way analysis of variance (ANOVA), Pearson’s r correlation coefficient, and multivariate stepwise linear regression analysis were applied using SPSS 14.0. Results Participants’ mean patient safety competency score was 2.97 (1-4). Between 18 independent variables evaluated in the multiple regression analysis, seven had a significant effect on the patient safety competency of emergency nurses (R2: 0.39, p < .001). Conclusions The patient safety competency of emergency department nurses was primarily related to the structure and leadership of the team and secondary to psychological safety and experience in patient safety activity. The results demonstrated that policymakers and hospital managers should improve and enhance team structure and leadership via supervision and cooperation with the nursing staff. The development of training programs in patient safety activities, improvement, and increase of psychological safety at the levels of the nursing units is essential to increase patient safety competencies in the emergency nursing program.

The COVID-19 pandemic has considerably changed the workplace and social relationships of nurses. As potential factors, uncertainty, stigma, and exposure of nurses' families to risk have disturbed the process of providing healthcare services for patients infected by COVID-19. Accordingly, this study aimed at determining the impact of psychological factors on stigma among frontline nurses fighting COVID-19. The extant paper was carried out based on the descriptive-analytical method for April-June 2020. A total of 312 nurses working in educational-medical centers in Ardabil, Iran, were selected using the census method to participate in this research. To collect data, demographic features, stigma, mental health, perceived stress, and hardiness questionnaires were used. The collected data were analyzed using statistical correlation tests, multivariate regression, and descriptive tests through SPSS v.22 Software. The mean score of stigma in nurses equaled 28.36 ± 10.55. Results of the correlation coefficient showed a positive relationship between the mean score of stigma and stress (P ≤ 0.01) as well as the negative relationship between mental health and hardiness (P ≤ 0.01). Multivariate regression analysis indicated that mental health could be the predictor of stigma. Therefore, these factors should be identified and controlled to mitigate stigma under such critical circumstances.

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Purpose Many studies have shown that a disease outbreak causes high stress among healthcare workers. However, there is a scarcity of data on various patterns of work-related stress during such a critical situation in this group. The main purpose of the study was to identify latent profiles of healthcare workers with similar combinations of levels of various work-related stressors during the COVID-19 pandemic and to examine their predictors. Methods A paper-and-pencil survey was conducted among 297 ED nurses and 219 EMS staff members working in educational and medical centers in Ardabil province, Iran. Data were collected using the Health and Safety Executive Management Standards Indicator Tool for measuring work-related stress. Latent profile analysis (LPA) was used to analyze the data. Results Five work-related stress profiles were identified: “high stress with a good understanding of one’s job role” (11.1%), “moderate stress” (41.9%), “relatively high stress with average demands and a very low understanding of one’s job role” (23.8%), “low stress” (18.0%), and “generally low stress but with very high job demands and relational conflicts” (5.2%). Age, marital status, service location, workplace, and the number of overtime hours significantly predicted profile membership. Conclusion The results of the study suggest the importance of incorporating various sources of stress and using LPA to analyze them when studying the work-related stress of healthcare workers during disease outbreaks. A deeper and more complex understanding of particular patterns of work-related stressors in ED nurses and EMS staff may help prevent the specific area of work-related problems. Moreover, identifying sociodemographic and work-related predictors of profile membership may be useful for preparing interventions better suited to healthcare workers’ needs.