Conceptual model for intensive care nurse work well‐being: A qualitative secondary analysis

Abstract

Background There had been little focus on the well‐being of intensive care nurses until a recent programme of research found work well‐being to be best described as a collection of elements, a multifaceted construct. Strengtheners of intensive care nurses' work well‐being were found to extend across individual, relational, and organizational resources. Actions such as simplifying their lives, giving and receiving team support, and accessing employee assistance programmes were just a few of the intensive care nurses' identified strengtheners. Aims and objectives To synthesize intensive care nurse perceptions of work well‐being characteristics and strengtheners to identify opportunities for job crafting and redesign. Design This was a qualitative secondary analysis. Methods Intensive care nurse work well‐being characteristics and strengtheners were explored using applied thematic analysis and pre‐design, open card‐sort technique. Results Five facets were identified in the analysis: (a) healthy, (b) authentic, (c) meaningful, (d) connected, and (e) innovative. These five facets were described from a theoretical perspective and illustrated as a conceptual model for intensive care nurse job crafting and redesign. Conclusions The proposed conceptual model contributes new knowledge to be explored in meaningful discussions about intensive care nurse work well‐being and empirically investigated in terms of construct validity and theory development. Furthermore, the model provides practical opportunities to explore individual and collaborative ways to enhance intensive care nurse work well‐being across a range of levels. Relevance to clinical practice Opportunities for job crafting and redesign were identified and presented in a conceptual model of intensive care nurse work well‐being. This model provides individual nurses, intensive care teams, health care organizations, and workers' well‐being programme and policy developers practical opportunities to explore individual and collaborative ways to enhance intensive care nurse work well‐being.

A well‐being champion and the role of self‐reflective practice for ICU nurses during COVID‐19 and beyond

“…It is apparent that ICU nursing staff are exposed to high levels of stress prior to COVID‐19; additionally, evidence suggests, over 80% are at high risk of burnout, 3 compassion fatigue, and emotional exhaustion 4 . These risks could be even higher during the COVID‐19 pandemic, further challenging the ICU nurse's well‐being and resilience 1 .…”

“…Furthermore, such moral distress could lead to long‐lasting mental distress including post‐traumatic stress disorder and depression 1 . Mentally distressed care staff will have limited capacity to support and offer compassionate care to patients 4 . It is evident that these well‐being risk factors are intensified for ICU nurses during the prolonged COVID‐19 pandemic; consequently, the ability to support, normalize psychological response and offer psychological first aid 9 can be challenged.…”

“…Nurses may be reluctant to speak openly with managers, 10 a well‐being champion provides approachable peer to peer support, encourages individual well‐being and signposts nurses towards professional help within the organization. Staff well‐being requires (a) an organizational “us,” (b) a team/unit “we” and (c) an individual “me” approach 4 for supportive workplace well‐being. In our ICU, a well‐being champion was identified from within the nursing team.…”

“…Mindfulness can develop the ability to self‐sooth and reframe negative thoughts positively, improving compassion for self and others, which are essential for well‐being 15 . It is suggested self‐care is inadequately recognized by nurses 4 but nurses cannot care for others without caring for themselves. While critical care nurses are normally frequently highly resilient, 12 the majority were ill‐prepared for the prolonged working challenges of COVID‐19.…”

What's in this Special Issue

“…Jarden and colleagues present a conceptual model for well‐being characteristics and facilitators in intensive care nursing, based on a qualitative secondary analysis of two studies the same authors had published in Nursing in Critical Care : a prototype analysis of nurses’ conceptions of well‐being and an exploratory study about factors enhancing ICU nurses’ well‐being . Through their analysis, five aspects of ICU nurse well‐being emerged, namely healthy , authentic , meaningful , connected , and innovative .…”