This Was My Crimean War: COVID-19 Experiences of Nursing Home Leaders

Savage, Amber; Young, Sandra; Titley, Heather K.; Thorne, Trina; Spiers, Jude; Estabrooks, Carole A.

doi:10.1016/j.jamda.2022.08.001

Cited by 18 publications

(23 citation statements)

References 34 publications

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“…This study identifies how a lack of support and mental stress in the nursing home leaders over a long time period, lead to reduced motivation to take up future leader roles within nursing. This unanticipated end to a career due to heavy workloads and exhaustion is confirmed by others (Savage et al, 2022). Leaders in the present study expressed strong negative feelings.…”

Section: Nursing Home Leaders' Behaviour For Infection Controlsupporting

confidence: 86%

“…These attributes are crucial to promote patient safety, empower staff to respond to the situation, provide the ability to move from the here and now to a future state, and to instil loyalty and motivation in employees to change behaviours (Kim, 2021). The nurse leader's role and strategies for management during the COVID-19 crisis are also identified in other studies (Hand et al, 2021;Markey et al, 2021;Savage et al, 2022).…”

Section: Nursing Home Leaders' Behaviour For Infection Controlmentioning

confidence: 98%

“…Unresolved stress may result in burnout (Markey et al, 2021;van Dijk et al, 2022) and a crisis such as COVID-19 can lead to anxiety, depression, stress, and post-traumatic stress disorder (Brady et al, 2022;Kim, 2021;Savage et al, 2022;van Dijk et al, 2022).…”

Section: Nursing Home Leaders' Behaviour For Infection Controlmentioning

confidence: 99%

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Barriers and facilitators for leading nursing homes through the COVID‐19 pandemic: A focus group study in Norway

Samdal,

Alpers,

Sekse

et al. 2023

Nursing Open

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BackgroundDuring the COVID‐19 pandemic, nursing home leaders implemented infection control to protect residents and staff.AimTo understand the barriers and facilitators for leading nursing homes through the COVID‐19 pandemic.MethodsWe invited 34 nursing homes to participate, and 20 leaders (59%) attended focus group interviews. The COM‐B model and the theoretical domains framework were used in design and analysis of the study.ResultsThe barriers for infection control were organisational unpreparedness, high volumes of information, lack of clinical skills, protective equipment, and testing capacity, the nursing home's architectural design, health authorities' low priority of nursing homes, staff's fear, and mental pressure on the leaders over time. The facilitators were having a customised corona plan, change of routines, certification of new skills, access to the municipal quality system, the ability for crisis leadership, loyalty to the nursing home, and support from the environment. The number of part‐time positions and the opportunity to outsource parts of the services were also important determinants for infection control.ConclusionsThe results identify several barriers and facilitators for nursing home leaders' behaviour for infection control. The results confirm the importance of supporting the leaders' resilience and crisis leadership while working in the pressurised environment of a pandemic.Relevance to Clinical PracticeThe study provides important insights into barriers and facilitators for leading nursing homes through the COVID‐19 pandemic, which could help to inform future strategies for infection control.Patient or Public ContributionNo patient or public contribution.

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Section: Nursing Home Leaders' Behaviour For Infection Controlsupporting

confidence: 86%

Section: Nursing Home Leaders' Behaviour For Infection Controlmentioning

confidence: 98%

See 1 more Smart Citation

Barriers and facilitators for leading nursing homes through the COVID‐19 pandemic: A focus group study in Norway

Samdal,

Alpers,

Sekse

et al. 2023

Nursing Open

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“…In a different study, this research team assessed changes in health and well-being of the manager group (e.g., unit care managers, nursing home managers) sampled at the same time from the same Albertan nursing homes (Estabrooks et al, 2023; Savage et al, 2022). In the manager study, we observed statistically lower levels of job satisfaction and mental health and higher levels of cynicism and emotional exhaustion in December 2021 than pre-pandemic.…”

Section: Discussionmentioning

confidence: 99%

Changes in Health and Well-Being of Care Aides in Nursing Homes From a Pre-Pandemic Baseline in February 2020 to December 2021

Song,

Keefe,

Squires

et al. 2023

J Appl Gerontol

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Nursing homes were profoundly affected by the COVID-19 pandemic, influencing work outcomes of care aides who provide the most direct care. We compared care aides’ quality of work life by conducting a repeated cross-sectional analysis of data collected in February 2020 and December 2021 from a stratified random sample of urban nursing homes in two Canadian provinces. We used two-level random-intercept repeated-measures regression models, adjusting for demographics and nursing home characteristics. 2348 and 1116 care aides completed the survey in February 2020 and December 2021, respectively. The 2021 sample had higher odds of reporting worked short-staffed daily to weekly in the previous month than the 2020 sample. The 2021 sample also had a small but significant drop in professional efficacy and mental health. Despite the worsening changes, our findings suggest that this workforce may have withstood the pandemic better than might be expected.

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“…The context of timing is crucial to understanding the sustained impact of working during a period of a prolonged and ongoing crisis. Internationally, while timings of waves may have differed, many countries experienced similar issues within their care‐home systems, with care‐home workers, and RNs in particular, having to compromise on their care and be accountable for that to their professional bodies, with the concomitant effect on mental wellbeing as this impacted on their ethical belief systems (Calcaterra et al, 2022; Laher et al, 2022; Molterer et al, 2020; Savage et al, 2022), thus findings are likely transferable. Further value could have been added to this study if we were able to re‐interview participants at ongoing stages of the pandemic, including during the recovery period, to determine longer‐term impacts on well‐being and coping mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Care‐home Nurses' responses to the COVID‐19 pandemic: Managing ethical conundrums at personal cost: A qualitative study

Birt

Lane

Corner

et al. 2022

J of Nursing Scholarship

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Introduction:The COVID-19 pandemic had an unprecedented effect on those living and working in care-homes for older people, as residents were particularly vulnerable to contracting the SARS-CoV-2 virus, associated with high morbidity and mortality. Often undervalued, care-home nurses (RNs) are leaders, managing complex care while working in isolation from their professional peers. The pandemic made this more apparent, when care and treatments for COVID-19 were initially unknown, isolation increased due to withdrawal of many professional health services, accompanied by staff shortages. Objective: To explore RNs' experiences of working in older people's care-homes during the COVID-19 pandemic. Design: Qualitative interview study. Setting: Care-homes for older people in England and Scotland, UK. Methods: Recruitment via direct contact with care-homes, social media, and links provided by national partners, then purposive sampling for age, gender, type of carehome, and location. Data collected through one-to-one online interviews using topic guide developed collaboratively with care-home nurses, focusing on how COVID-19 impacted on nurses' resilience and mental wellbeing. Data analyzed thematically using Tronto's ethics of care framework to guide development of interpretative themes. Results: Eighteen nurses (16 female; 16 adult, and two mental health nurses) were interviewed March-June 2021; majority aged 46-55 years; mean time registered with Nursing and Midwifery Council: 19 years; 17 had nursed residents with COVID-19.RNs' experiences resonated with Tronto's five tenets of ethical care: attentiveness, responsibility, competence, responsiveness, and solidarity. All nurses described being attentive to needs of others, but were less attentive to their own needs, which came at personal cost. RNs were aware of their professional and leadership responsibilities, being as responsive as they could be to resident needs, processing and sharing rapidly changing guidance and implementing appropriate infection control measures, but felt

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This Was My Crimean War: COVID-19 Experiences of Nursing Home Leaders

Cited by 18 publications

References 34 publications

Barriers and facilitators for leading nursing homes through the COVID‐19 pandemic: A focus group study in Norway

Barriers and facilitators for leading nursing homes through the COVID‐19 pandemic: A focus group study in Norway

Changes in Health and Well-Being of Care Aides in Nursing Homes From a Pre-Pandemic Baseline in February 2020 to December 2021

Care‐home Nurses' responses to the COVID‐19 pandemic: Managing ethical conundrums at personal cost: A qualitative study

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