Nurse Burnout in Hospice and Palliative Care: A Scoping Review

Burnout in hospice and palliative care nurses is a growing issue, especially in light of the COVID-19 pandemic. However, few studies have focused specifically on burnout in this population. A scoping review was undertaken to identify what is known about burnout among hospice and palliative care nurses, and to unify disparate findings. Analysis of eight articles revealed three overarching categories: personal factors, organizational/workplace factors, and nursing professional development factors. Each category was then divided into three cross-cutting subcategories: contributory and noncontributory factors, mitigating factors, and workplace issues. Recommendations for individuals include self-care as well as self-awareness of intrinsic characteristics that can predispose one to burnout. Within the workplace, leaders are challenged to support evidence-based practice and ongoing education. Role modeling positive communication skills, effective conflict mitigation, responsiveness, promotion of equity, and workplace commitment also help to create a culture of wellness. Nursing professional development may aid in resilience-building, and promotion of self-efficacy, self-confidence, and assertiveness. Although all identified recommendations were derived from the literature, no interventional studies have been conducted to test the effects of suggested interventions. Future research should include interventional studies as well as qualitative research to capture nuanced experiences of burnout in hospice and palliative care nurses.

Change starts with me: an impact evaluation of a multiprofessional leadership programme to support primary care networks in the South East of England

PurposeThis paper aims to present the impact evaluation findings from a multiprofessional leadership programme commissioned in the South East of England to support primary care networks (PCNs) to lead system improvement together. It identifies programme impact at micro and meso system levels; a leadership impact continuum that can be used by individuals and teams to evidence impact of improvements in PCN practices; the learning and development strategies that were effective and proposes implications for other networks. Design/methodology/approachMixed methods underpinned by practice development methodology were used to explore the impact of the programme on two practitioner cohorts across 16 PCNs. Data were collected at the start, mid-point and end of the eight-month programme. FindingsResults illustrate an innovative approach to collective leadership development. A continuum of impact created with participants offers insight into the journey of transformation, recognising that “change starts with me”. The impact framework identifies enablers, attributes and consequences for measuring and leading change at micro, meso and macro levels of the health-care system. Participants learned how to facilitate change and collaboratively solve problems through peer consulting which created a safe space for individuals to discuss workplace issues and receive multiprofessional views through action learning. These activities enabled teams to present innovative projects to commissioners for service redesign, enabling their PCN to be more effective in meeting population health needs. The authors believe that this programme may provide a model for other PCNs England and other place-based care systems internationally. Originality/valueThis study offers insight into how to enable a journey of transformation for individuals and PCN teams to enhance team effectiveness and collective leadership for system-wide transformation required by the National Health Service Long Term Plan (2019). Contribution to Impact

The role of human environment in making a workplace congenial: a case of university libraries

Purpose Organizations ought to provide a congenial workplace for employees, particularly females, to get optimum performance. This study aims to investigate the congeniality of libraries’ human environment for female library and information science professionals (LIPs). Regarding the human environment, the manager’s support, relationship with colleagues and informal communication have been studied. Design/methodology/approach For this quantitative study, the researchers use a survey research method based on a self-constructed questionnaire. The questionnaire consisted of closed-ended questions, which were used to collect the data; however, the open-ended question entitled comments was also added to take the opinion of respondents. The sampling includes the female LIPs working in the university libraries of Punjab, Pakistan. Findings The results highlight that female LIPs were satisfied with the human environment at their workplaces. Participants not only appreciated the role and support of their immediate managers in terms of respect, feedback, task allocation and approachability but also recognized the role of colleagues and informal communication (social interaction) in making their workplace congenial and comfortable to work by establishing a positive relationship with supervisors, colleagues or subordinates at the workplace. However, some open-ended comments reveal that females face leg-pulling, favoritism, male colleagues’ indecent behavior and managers’ critical behavior at the workplace. Research limitations/implications Because of the sensitivity of the topic and limitedness of an instrument, the respondents might have been hesitant to give real opinions. This study was limited in terms of participants as data was collected only from one province of Pakistan. Practical implications Workplaces for females in a male-dominated society like Pakistan impede their commitment to giving their best. Despite an increased number of females in the profession, it is surprising that so little empirical research has been conducted on the topic. Therefore, this study is an excellent addition to the dearth of literature on the subject. The findings may help in sensitizing the management and authorities to control the human environment at workplaces as this study will also bring into light the prevailing working environment for females. Originality/value Libraries as a workplace have been studied internationally (Farler and Broady-Preston, 2012; Ocholla, 2002; Oud, 2008). From the local perspective, the only study concerning the workplace issues of libraries is by Yousaf et al. (2013), which was limited to the managerial problems faced by female librarians working at the University of the Punjab. Hence, to the best of the authors’ knowledge, this study will be one of its nature.

Preparing Graduates for Interprofessional Practice in South Africa: The Dissonance Between Learning and Practice

With South Africa's tumultuous history and resulting burden of disease and disability persisting post-democracy in 1994, a proposed decentralization of heath care with an urgent focus on disease prevention strategies ensued in 2010. Subsequently a nationwide call by students to adapt teaching and learning to an African context spoke to the need for responsive health professions training. Institutions of higher education are therefore encouraged to commit to person-centered comprehensive primary health care (PHC) education which equates to distributed training along the continuum of care. To cope with the complexity of patient care and health care systems, interprofessional education and collaborative practice has been recommended in undergraduate clinical training. Stellenbosch University, South Africa, introduced interprofessional home visits as part of the students' contextual PHC exposure in a rural community in 2012. This interprofessional approach to patient assessment and management in an under-resourced setting challenges students to collaboratively find local solutions to the complex problems identified. This paper reports on an explorative pilot study investigating students' and graduates' perceived value of their interprofessional home visit exposure in preparing them for working in South Africa. Qualitative semi-structured individual and focus group interviews with students and graduates from five different health sciences programmes were conducted. Primary and secondary data sources were analyzed using an inductive approach. Thematic analysis was conducted independently by two researchers and revealed insights into effective patient management requiring an interprofessional team approach. Understanding social determinants of health, other professions' roles, as well as scope and limitations of practice in a resource constrained environment can act as a precursor for collaborative patient care. The continuity of an interprofessional approach to patient care after graduation was perceived to be largely dependent on relationships and professional hierarchy in the workplace. Issues of hierarchy, which are often systemic, affect a sense of professional value, efficacy in patient management and job satisfaction. Limitations to using secondary data for analysis are discussed, noting the need for a larger more comprehensive study. Recommendations for rural training pathways include interprofessional teamwork and health care worker advocacy to facilitate collaborative care in practice.

Speaking up at work: personality’s influence on employee voice behavior

Purpose To boost efficiency and productivity, organizations are increasingly depending upon employees to speak up about workplace concerns and disagreements. This change-oriented bottom-up communication, termed employee voice behavior, brings attention to workplace issues that could otherwise go undetected by management. This study examined the relationships between personality characteristics, job attitudes, and employee voice behavior, and investigated the moderating role of extraversion on the relationships between job attitudes (i.e., job satisfaction and turnover intentions) and voice. Design/methodology/approach A cross-sectional study design was used, with data collected through an online survey from a sample of 284 individuals working in the US. Hypotheses were tested using correlation, regression and moderation analyzes. Findings Job satisfaction and turnover intentions were found to be positively and negatively-related, respectively, to employee voice behavior. Extraversion was found to be predictive of employee voice behavior and moderate the relationships between job attitudes and voice behavior. Interestingly, results suggest that the job attitudes of individuals high in extraversion do not influence their likelihood of speaking up. Rather, voice behaviors of only those with low or moderate levels of extraversion are impacted by their job attitudes. Originality/value This study builds upon prior research identifying the importance of extraversion in predicting voice behavior by testing its incremental validity and relative weight, compared to the other Big Five personality characteristics. Furthermore, this research contributes to the theoretical understanding of instances in which employee voice behavior occurs by examining the moderating effect of extraversion on the relationship between job attitudes and employee voice behavior.

Workers’ Protection in the Covid-19 Era in Nigeria

Against the backdrop of measures adopted sequel to the outbreak of the pandemic, this research focuses on the impact of Covid-19 on the workplace. It highlights and interrogates the utility of responsive measures and also articulates recondite labour issues relating to changing work patterns, pay cuts, job losses culminating in growing unemployment rate, and occupational safety and health concerns within the context of extant labour standards. It also extends focus to the impact of Covid-19 on existing challenges revolving around working poverty, decent work deficit, unfair labour practices, and ineffective labour regimes. This research finds, inter alia, that impact of the Covid-19 pandemic on the workplace is colossal, disruptive, and unprecedented, and that extant labour standards, having proved mute on a wide range of contingent workplace issues, can only provide some sort of protection in a detached manner. The research concludes with an array of far-reaching recommendations on the adoption of protective and remedial legal norms that are transient, flexible, and proactive enough to accommodate diverse situations capable of undermining the prospects for labour laws, regulations, and policies in the Covid-19 era.