Towards the idea of ‘clinical capital’: A longitudinal study exploring nurses' dispositions and workplace manifestations in an Australian intensive care unit

Abstract

Objective To explore the concept of ‘capital’ through the study of successive interventions and outcomes (patient and staff) in a quaternity intensive care unit (ICU) across a 5‐year time frame. Design A longitudinal intrinsic single site, a survey study was designed. The concept of ‘capital’ was explored through an adopted interpretive approach that involved understanding meanings from different sources, for example, discussions at compassion cafés, follow‐up from staff‐initiated activities, informal responses to organizational imperatives external to the unit (i.e. staff reductions and resource constraints), alongside empirical data about workplace climate and patient incidents. Setting A single ICU employing approximately 220 registered nurses at a quaternary hospital in Queensland, Australia. Participants All nurses employed in the ICU at the time of compassion cafes participated in providing feedback to inform successive activities. All nurses in the unit had equal opportunity to complete surveys, participate in subsequent unit‐based sessions, take‐up options; and all nurses had a responsibility to complete incident data. Results Survey and incident data from 2015 to 2019 identify the complexity of workplace environments. Between 35% and 45% of nurses consistently completed the survey. Activities based on staff requests initially improved incident data but did not impact the work environment; negative perceptions of the work environment at the endpoint (2019) were associated with external factors. Conclusion Quality care environments are labile; sensitive to both unit activity and external organization directives (namely staff reductions). Quality care can be sustained in adverse situations with increased nurse engagement in patient care dynamics in the short term. Impact This study articulates a previously unidentified concept, ‘clinical capital’. Activities facilitating nurse engagement in broad care dynamics gave rise to a more robust climate than just focusing on social and psychological well‐being activities for nurses. Participation in issues of concern about patient care can promote resilience to short term fluctuations.

Effect of the Postoperative Pain Management Model on the Psychological Status and Quality of Life of Patients in the Advanced Intensive Care Unit

“…In addition, establishing good communication with patients was conducive to the development of auxiliary care. Medical staff should guide patients to carry out relevant pain rehabilitation activities to let patients understand the methods to reduce pain [42][43][44][45]. A small number of patients have prejudice toward the use of analgesics, and they should have good communication so that they can understand the use of analgesics and their disadvantages, illustrating the importance of analgesic measures in perioperative care.…”

Assessing the impact of creating virtual windows on the incidence of delirium in a surgical intensive care unit: a before and after study

“…Critical care nurses can engage in self-care practices to improve resilience, promote healing, and enhance compassion for self and others as a preventative measure and intervention (Gee et al, 2022;McAdam & Erikson, 2020;Salmon & Morehead, 2019). They can also advocate for accessible areas of rest, opportunities for mindfulness, reflection, and physical activity at work, strong interprofessional support and collaboration, development of social networks, and an increased sense of community (Gee et al, 2022;Herron et al, 2022;Jarden et al, 2019a;Henderson et al, 2022;Rheaume et al, 2022). Individuals can foster wellness within their environment by prioritizing personal and team wellbeing.…”