Background The subject of emotional exhaustion organisations has become important because of the emerging trends in employment and its associated challenges. Unhealthy practice environment is a major threat in the incidence of emotional exhaustion among nurses; and any organisational culture that do not support its personnel has huge burnout costs. The study aimed at assessing rate of emotional exhaustion; determining factors that accounts for it and also ascertaining the coping strategies used by nurses to overcome it in the Ghanaian health care setting. Methods A cross-sectional study with a proportionate stratified sampling was used to draw a sample from five health facilities. A standardized questionnaire of Professional Practice Environment Scale of Nursing Work Index, Maslach Burnout Inventory and Coping Scale were used to assess variables under study. The STROBE guidelines were followed in reporting this study. Results Out of the 232 registered nurses studied, 91.1% of them reported experiencing moderate to high rate of emotional exhaustion. The practice environment of the nurses explained 39.6% of the variance in emotional exhaustion. Emotion-focused and problem-focused approaches were identified to be used by registered nurses to cope with emotional exhaustion. Conclusion When appropriate and effective intervention are employed, emotional exhaustion will be reduce and this will enrich the effectiveness of quality care delivery to patients.

Background: The subject of emotional exhaustion in an organisation has become important because of the emerging trends in employment and its related problems. Unhealthy practice environment is a major threat in the incidence of emotional exhaustion among nurses; and organisational cultures that do not support its personnel has huge burnout costs. The study aimed at assessing rate of emotional exhaustion; determined factors that accounts for it and also ascertained the coping strategies used by nurses to overcome it in the Ghanaian health care setting. Methods: A cross-sectional study with a proportionate stratified sampling was used to draw a sample from five health facilities. A standardized questionnaire of Professional Practice Environment Scale of Nursing Work Index, Maslach Burnout Inventory and Coping Scale were used assess variables under study. The STROBE guidelines were followed in reporting this study.Results: Out of the 232 registered nurses studied, 91.1% of them reported experiencing moderate to high rate of emotional exhaustion. The practice environment of the nurses explained 39.6% of the variance in emotional exhaustion. Emotion-focused and problem-focused approaches were identified to be used by registered nurses to cope with emotional exhaustion. Conclusion: When appropriate and effective intervention are employed, emotional exhaustion will be reduce and this will enrich the effectiveness of quality care delivery to patients.

Aim This study aimed at assessing the nature and effect of toxic leadership of nurse managers on the perceived job satisfaction and productivity of the nursing workforce. Background Nursing job outcomes such as job satisfaction and productivity are influenced by various factors in the nursing practice environment including leadership. Due to rising health care expenses and depleting material resources, the productivity of nurses that is expected to improve the efficiency of health care organizations is mostly low. Managers' toxic behaviour towards nurses affects their job satisfaction and subsequently low productivity. Method A multi‐centre, cross‐sectional descriptive design was used. Validated tools were used to collect data from participants, and data were analysed using descriptive, correlation, and hierarchical linear regressions. Results Registered nurses appraised the leadership behaviour of nurse managers to be toxic, with most managers exhibiting narcissistic leadership behaviour. Though all the components of toxic leadership behaviour of manager and job satisfaction were associated with the perceived productivity of the nurses; only intemperate leadership behaviour of the managers (β = −.301, p < .005), and job satisfaction (β = .296, p < .001) significantly predicted perceived productivity among nurses (R2 = .238, F(7, 922) = 41.088, p < .001). Conclusion Nurse managers' leadership behaviours were toxic. Nurses' job satisfaction and all components of managers' toxic leadership behaviour influenced productivity. Implications for Nursing Management There should be a policy developed to guide the creation and maintenance of efficient nursing leadership to enhance job satisfaction and productivity among nurses.

Background. The nursing practice environment supports excellence and decent work and has the influence to entice and retain the quality nursing workforce. Appreciating the dynamics that affect the turnover intention of RNs offer reasonable solutions to the challenges of the nursing shortage, which directly influence the quality of nursing care. There is a paucity of information on the impacts of these concepts among RNs in Sub-Saharan African. The study therefore aimed at determining the impacts of work environment and burnout on turnover intentions among RNs in Ghana. Methods. A descriptive cross-sectional design using a simple random and proportionate stratified sampling with a sample of 232 RNs from Municipal and Regional Hospitals, Sunyani, West-Central part of Ghana completed validated instruments measuring work environment, burnout, and turnover intentions. Descriptive analysis was done to find out RNs’ perceptions of their work environment and turnover intentions. Mediation analysis by Baron and Kenny’s approach was used to determine the mediating effect of burnout on the relationship between the domains of PPE and the turnover intention of RNs. STROBE checklist was used as the reporting tool. Results. While most RNs had a positive perception about their work environment, greater number of them had turnover intentions. There were significant associations between some nursing work environment facets and turnover intention. The results also showed a statistically significant relationship between nurse-physician relation (β = .353, t = 5.476, p  ≤ .001), nurse manager leadership (β = −0.485, t = −8.192, p  ≤ .001), nursing foundation for quality care (β = .400, t = 7.059, p  ≤ .001), staffing and resource adequacy on (β = 0.485, t = 8.183, p  ≤ .001), and turnover intention as mediated by burnout. Conclusion. Burnout resulting from an unsafe work environment impact RNs’ turnover intention. This phenomenon can potentially affect the human resource management and quality of nursing care. Policy strategies aimed at ensuring a professional practice environment and decreased burnout can therefore improve retention of RNs at their workplace.

Objective Care in the emergency department focuses significantly on delivering lifesaving/ life-sustaining clinical actions, often with limited attention to health-related suffering even at the end-of-life. How healthcare staff experience and navigate through the end-of-life phase remains minimally explored. Thus, this study aimed to uncover the lived experiences of emergency department staff at the end-of-life. Methods van Manen’s hermeneutic phenomenological approach was used. Nineteen healthcare staff were purposively recruited and interviewed. Interviews were audio-taped, transcribed verbatim, and thematic categories formulated. The existential lifeworld themes (corporeality, relationality, spatiality, and temporality) were used as heuristic guides for reflecting and organizing the lived experiences of participants. Results The overarching category, ‘ resuscitate and push’, was captured as corporeality (resisting death and dying); relationality (connectedness to the body of the patient; and lacking support for family and self); spatiality (navigating through a liminal space and lack of privacy for patients); and temporality (having limited to no time for end-of-life care and grieving). The end-of-life space was unpleasant. Although participants experienced helplessness and feelings of failure, support systems to help them to navigate through these emotions were lacking. Grief was experienced covertly and concealed by the entry of a new patient. Conclusion End-of-life in the emergency department is poorly defined. In addition to shifting from the traditional emergency care model to support the streamlining of palliative care in the department, staff will require support with navigating through the liminal space, managing their grief, and developing a better working relationship with patients/ families.

Introduction Attrition of the Nursing Workforce from low-and middle-income countries to high-resourced settings is a reality that has escalated in the current Coronavirus pandemic due to varied reasons. With increased job stress resulting from the pandemic, the Quality of Work-Life of the Nursing Workforce is affected, with its effect on poor quality care to the client. This study sought to assess the perception of the Nursing Workforce about the Quality of Work-Life, and the factors that predict turnover intention among nurses in the Kumasi Metropolis, Ghana. Methods A cross-sectional, descriptive design involving multiple centres was used. The participants were made up of 348 Registered Nurses working in primary, secondary, and tertiary healthcare in five (5) hospitals in the Kumasi Metropolis. Data collection was done using questionnaires adapted from the Work-Related Quality of Life Scale and the Turnover Intention Scale and analyzed using frequencies, mean, standard deviation, Pearson’s Product Moment Correlation, and Multiple Regression. Results The Registered Nurses perceived Quality of Work-Life as low; with close to half of them having a turnover intention. All the domains of Quality of Work-Life of the Nursing Workforce significantly correlated with Turnover intentions. Regression analysis showed that the number of years in a healthcare setting, general well-being, job control and satisfaction, and working condition of the Registered Nurse significantly predicted their turnover intentions at the p-value of 0.05. Conclusion The findings of the study have provided an understanding of the Quality of Work-Life, and factors that contribute to increased turnover intentions among the Nursing Workforce amid the COVID-19 pandemic. Healthcare systems must enrol in requisite programmes that provide psychological and social support through counselling to promote the Quality of Work-Life of nurses.

Introduction Recognizing the values and norms significant to healthcare organizations (Safety Culture) are the prerequisites for safety and quality care. Understanding the safety culture is essential for improving undesirable workforce attitudes and behaviours such as lack of adverse event reporting. The study assessed the frequency of adverse event reporting, the patient safety culture determinants of the adverse event reporting, and the implications for Ghanaian healthcare facilities. Methods The study employed a multi-centre cross-sectional survey on 1651 health professionals in 13 healthcare facilities in Ghana using the Survey on Patient Safety (SOPS) Culture, Hospital Survey questionnaire. Analyses included descriptive, Spearman Rho correlation, one-way ANOVA, and a Binary logistic regression model. Results The majority of health professionals had at least reported adverse events in the past 12 months across all 13 healthcare facilities. Teamwork (Mean: 4.18, SD: 0.566) and response to errors (Mean: 3.40, SD: 0.742) were the satisfactory patient safety culture. The patient safety culture dimensions were statistically significant (χ2 (9, N = 1642) = 69.28, p < .001) in distinguishing between participants who frequently reported adverse events and otherwise. Conclusion Promoting an effective patient safety culture is the ultimate way to overcome the challenges of adverse event reporting, and this can effectively be dealt with by developing policies to regulate the incidence and reporting of adverse events. The quality of healthcare and patient safety can also be enhanced when healthcare managers dedicate adequate support and resources to ensure teamwork, effective communication, and blame-free culture.

Background Professional practice environment supports excellence and decent work and has the influence to entice and retain quality-nursing workforce. In high-resourced settings, significant number of studies exist to prove that professional practice environment with low levels of burnout play important role in enhancing patients’ and staff job outcomes. Appreciating the dynamics that affect turnover intention of nurses offer reasonable solutions to the challenges of nursing shortage, which directly influence quality of nursing care. Few studies undertaken on the subject in Ghana, however focused on miners, workers in the hotel industry, and worker telecommunication. There is evidently paucity of information on the impacts of nursing practice environment on turnover intentions among nurses in Sub-Saharan African. The study therefore aimed at determining the predictors of turnover intentions among nurses in Ghana. Methods A cross-sectional approach using a simple random and proportionate stratified sampling with a sample of 232 nurses completed validated instruments measuring work environment, burnout and turnover intentions. Descriptive and regression analysis were done on the various variables. Results While most nurses had positive perception about their work environment, greater number of them had turnover intentions. There was also significant associations between nursing work environment facets and turnover intention. The age of the nurse, years in nursing and the personal accomplishment of the nurse were significant predictors of turnover intentions of the nurse. Conclusion Burnout in any dimension results from unhealthy workplace; and unduly influences nurses’ turnover intention. This phenomenon can potentially affect the human resource management and the consequentially poor quality of nursing care provided to patients. Ensuring positive work setting and reduced burnout can therefore improves retention of nurses at their workplace.