If Schools Are Closed, Who Will Watch Our Kids? Family Caregiving and Other Sources of Role Conflict among Nurses during Large-Scale Outbreaks

Abstract

Objectives:The global impact of severe acute respiratory syndrome (SARS) brought attention to the role of healthcare professionals as “first receivers” during infectious disease outbreaks, a collateral aspect to their role as responders. This article records and reports concerns expressed by Canadian emergency and critical care nurses in terms of organizational and social supports required during infectious disease outbreaks. The nature of work-family and family-work conflict perceived and experienced by nurses during infectious disease outbreaks, as well as the supports needed to enable them to balance their social roles during this type of heightened stress, are explored.Methods:Five focus groups consisting of 100 nurses were conducted using a Structured Interview Matrix facilitation technique.Results:Four emergent themes included: (1) substantial personal/professional dilemmas; (2) assistance with child, elder, and/or pet care; (3) adequate resources and vaccinations to protect families; and (4) appropriate mechanisms to enable two-way communication between employees and their families under conditions of quarantine or long work hours.Conclusions:Social and organizational supports are critical to help buffer the effects of stress for nurses and assist them in managing difficult role conflicts during infectious disease outbreaks. These supports are necessary to improve response capacity for bio-disasters.

Unraveling the complexities of disaster management: A framework for critical social infrastructure to promote population health and resilience

“…The intersection between health and social services systems is a good example of how community crises naturally cross system boundaries. In Canada, and worldwide, the transboundary nature of the 2003 outbreak of Severe Acute Respiratory Syndrome (SARS) and the 2009 pandemic of influenza A highlighted the complexity of interdependencies among different systems and how emergency plans are implemented at the community level (O'Sullivan et al, 2009;O'Sullivan & Bourgoin, 2010;The Campbell Commission, 2006). These examples underscore the need to consider how the impact of massive demands on the acute health care system radiate into other parts of the health sector where service delivery is provided, including public health and home care, as well as occupational health and safety, employee assistance programs, and other sectors which ultimately influence population health.…”

“…The asset/need assessments involved nine focus group consultations across five communities, using the Structured Interview Matrix (SIM) facilitation technique (O'Sullivan et al, 2009). We planned two focus groups per community (one evening and one daytime session), to ensure broad representation, however, in one community we canceled the evening session due to low recruitment.…”

“…The SIM design has been used in previous studies to address common pitfalls in traditional focus groups (O'Sullivan et al, 2009). It is designed for larger groups (10e40 people), yet enables voices of all participants to be heard, and provides a structure to reduce power differentials within the group.…”

Promoting Resilience Using an Asset-Based Approach to Business Continuity Planning

“…All of these features of the SIM method align with principles of a CBPR approach (Israel, Eng, Schulz, & Parker, 2013). Some of its applications have included consultations with nurses about support mechanisms needed during large-scale outbreaks (O'Sullivan, 2009), community engagement to support emergency preparedness among high-risk populations (O'Sullivan et al, 2015), social media use in public health (Khan & Tracey, 2017), and development of an emergency preparedness framework for public health (Khan, Nayani, & Schwartz, 2017).…”

Exploring staff willingness to attend work during a disaster: A study of nurses employed in four Australian emergency departments

“…10,20,21 Communication with family was a particular concern during periods of quarantine or extended shifts. 10,21 Communication with family members is a strong theme expressed by Australian paramedics who suggest that creating predetermined communication channels and strategies for contacting loved ones would enhance willingness to attend work. 10…”