Abstract
The paper analyzes different issues affecting the nursing workforce through a systematic review. The study also focuses on factors that cause stress in the workplace and resilience among the Australian nursing workforce. Workplace burnout acts as part of the major problem affecting performance among nurses. The study, therefore, aimed to investigate practices that facilitate resilience among nurses and identify organizational interventions implemented to address the issue. Evaluation of methodology and data extraction focused on finding the relationship between resilience and work-related stress.
Qualitative and quantitative studies were used to seek extensive data regarding the problem. The work further focused on empirical data as a primary source of information regarding the problem. The result analysis also demonstrated a close impact of resilience to the problems. The studies focused on the Australian nursing workforce in selecting participants for the study. Besides, female participants were prioritized, and this could have contributed to risks associated with bias.
Systematic Review
Workplace burnout is one of the crises among Australian nurses. The review will analyze evidence of workplace stress faced by the nursing workforce in Australia. Workplace stress mediates cases of resilience. Resilience is a mental burnout response that moderates work stress. Most instances of resilience-building activities are considered to be time-consuming and complex. According to Badu et al. (2020), nurses work under demanding and more stressful conditions than before and have less optimal working conditions, affecting psychological functioning.
The reason for focusing on the topic and reviews related to the topic is due to high cases of workplace stress among the nursing workforce. Recent studies have attempted to find the reasons for nurses’ workplace stress and resilience (Badu et al., 2020). According to Badu et al. (2020), burnout, anxiety, and secondary traumatic stress are common workplace stressors experienced by nurses.
According to Badu et al. (2020), studies have consistently reported high rates of stress-related conditions in the workplace. Secondary traumatic stress occurs in the form of compassion fatigue. The stress results from negative aspects of professional quality of life. Secondary traumas can also result from sleep difficulties and avoidance of reminders of traumatic experiences. Intrusive procedures can also act as a source of secondary trauma.
Badu et al. (2020) noted that studies have focused on different areas related to this topic. The concept of mental wellness and stress disorders among nurses has threatened the quality of care delivered to patients (Badu et al., 2020). Therefore, investigating the source of the problems is vital in identifying the psychological functioning; however, it can vary depending on workplace stress management strategies. Most workplaces have not focused on addressing mental disorders as part of the crises affecting their workforce. On the other hand, those with stress management strategies in place have fewer negative outcomes in work-related burnout.
Some of the individual attributes noted include work-life balance and emotional intelligence. Most of the nurses demonstrated the ability to positively take the workplace stress through positive thinking and self-efficacy mechanism.
Methods
Most of the studies focused on workplace interventions for workplace stress. Therefore, the review recommended that workplace management focuses on educational intervention as a core strategy for achieving sustainable improvements and improving the well-being of the nurses. Protocol registration is an important aspect of studying populations. The review protocol for the study exists, and it includes a methodology where both inclusion and exclusion criteria are employed. Search strategy has also been outlined through an integrated method and procedure for finding the right data (Badu et al., 2020). Furthermore, search terms and Boolean operators and the selection process have also been highlighted in the article. The protocol used several stages to ensure that appropriate data were collected and the right articles were collected.
Data management and extraction were conducted based on search results, screening, and review of articles. Besides, the removal of duplicate references was also considered to avoid repetition in terms of data analysis. Study details, year of publication, authors, and contact details stud population and subject area determined the choice of articles to use for data extraction. The concept of resilience antecedent and impact of resilience on nurses’ workplace further determined the type of data to collect from the sources selected for review. Moreover, the study aimed to analyze existing interventions on workplace burnout and stress and management intervention from the management. Therefore, the data extraction process further relied on the existing interventions and outcomes and additional information on resilience.
Eligibility criteria focused on the research strategy, language, and terms used to identify the right topic. Inclusion criteria focused on papers that used qualitative and mixed-method approaches. It targeted studies that utilized quantitative randomized controlled trials. Qualitative papers provided data based on grounded theory and phenomenological studies (Badu et al., 2020). Besides, narrative ethnography and participatory methodologies also played a significant role in examining the effects of resilience in mitigating workplace stress. However, all the articles were limited to the ones with studies that focused on Australian nurses. The review, therefore, excluded papers that failed to address resilience topics in nursing.
Report characteristics also focused on resilience to workplace stress as a core aspect for consideration among Australian nurses. The authors of the articles selected were independently screened and approved after meeting the selection criteria. The authors reviewed the abstracts and full text to confirm that the articles represented the desired eligibility characteristics in terms of populated targeted and outcomes of the studies (Badu et al., 2020). Most papers used cross-sectional study designs. Moreover, mixed methods were also used for collecting quantitative data. Therefore, the selection process adheres red to the required standards in terms of data collection approaches and targeted groups.
The methodology focused on collecting reliable data from the participants; the integrative review was found to offer an appropriate strategy for achieving the goals designed for this section. It is an approach that allows the simultaneous inclusion of different methodologies. Therefore, varied theoretical models are used to understand the topic of concern. Integrative methods play an important role in proving a reliable model for analyzing data based on the problem presented. It aims to use diverse data sources to create a holistic understanding of resilience in nursing. Problem identification and literature search were prioritized as part of the core methodologies in analyzing these stages. Data evaluation, analysis, and presentation were also considered part of the primary aspects of the methodology process.
Data synthesis is an important stage of data analysis since it describes components of variables used in the study. The use of mixed methods was vital for credibility since the authors displayed matrices by using coded ideas assigned to each variable under investigation. Theoretical constructs were also identified in regard to resilience in the workplace (Badu et al., 2020). For example, personal characteristics and organizational factors were prioritized in analyzing the factors that facilitate resilience to workplace stress. Furthermore, the authors considered background information as a vital component for analyzing emerging codes.
Results
The result section aimed to analyze different papers collected from the database. The section shows that the search strategy identified 406 papers and 83 duplicates (Badu et al., 2020). Most of the papers reported the study designs that were used in conducting the studies. Besides, more than a third of the papers sued for the study aimed to find a quantitative aspect of resilience at the workplace and approaches used to manage stress. The study population involved both female and male participants. The other bias noted was based on the primary responses developed by the organization since most of the paper failed to target male participants.
A simple summary of data was provided through datable, the calculations of theoretical data were done effectively, and this was featured from the author’s summary and presentation of data through a simple method. Most of the data were recorded based on estimated results, and this was accounted for in determining error limits. Moreover, estimates and confidence intervals were also considered as part of the primary factors to determine the outcomes of resilience levels among the participants.
Discussion
Results analysis was done efficiently since the aims of the study focused on identifying the levels of mental stress. The section also evaluated evidence on the individual attributes, and organizational interventions sued to build resilience. Evidence from studies showed that levels of stress and impact on workplace nurses and individual attributes determined resilience intervention adopted by the organization. Moreover, the evidence extracted from the results showed that Australian nurses experience different rates of stress levels that are majorly associated with workplace bullying. Increasing workplace adversity affects nurses with low resilience, and this was shown to contribute to low to moderate levels of depression and anxiety. Environmental and individual factors cause increased stress levels associated with the outcomes. Furthermore, increasing levels of psychological stress had a significant influence on the rates of burnout.
The risk of bias was noted in the review. For example, most of the participants enrolled in the studies were females. This can raise concerns regarding the representation of resilience rates among male nurses. Moreover, the estimation of data could pose a major threat to the accuracy and validity of the results. Assessment of bias across studies was also attributed to the methods applied in analyzing additional data collected from other sources. Moreover, the data collection method also posed a major bias risk to the study since most of the work focused on workplace and nurse attributes. Furthermore, the study area acts as one of the sources of bias since it fails to consider other aspects, such as healthcare policies and health systems regarding management and provision of appropriate workplace conditions.
The additional analysis focused on the previous exposure of nurses to stressful events. Family, education, and health issues were also considered to contribute to significant stress, depression, and anxiety disorders among the groups. Measures of consistency rates also reflected different factors that contribute to workplace burnout. However, additional analysis was not conducted in the study.
Findings
Evidence from the studies showed that Australian nurses encounter different levels of workplace stress. Results collected from participants were categorized based on moderate to high levels of stress. Most of the nurses were shown to experience moderate levels of stress, which was significantly associated with workplace bullying. Therefore, several interventions were shown to improve resilience. Maintaining work-life balance, self-efficacy, and seeking support services were shown to have an outstanding effect on the management of stress. The organization resources used to build resilience included role modeling and leadership. Interventions such as mindfulness also proved to promote adult resilience in many participants.
Badu et al. (2020) noted that the existing evidence largely uses qualitative-quantitative methods, with few using mixed approaches. Relatively few studies cannot provide adequate information in terms of interventions and the most reliable method to use in developing interventions required to address workplace stress. Empirical studies focused on individual and organizational attributes. However, the study could further identify other ways of analyzing data from external sources. Relying on one method could pose a challenge in identifying the outcomes of the studies.
Reference
Badu, E., O’Brien, A.P., Mitchell, R., Rubin, M., James, C., McNeil, K., Nguyen, K. and Giles, M., (2020). Workplace stress and resilience in the Australian nursing workforce: A comprehensive integrative review. International Journal of Mental Health Nursing, 29(1), 5-34.