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A study recently published in “The Journal of Advanced Nursing” could help emergency nurses with personal and professional sustainability while giving policymakers a guide to build supportive work environments and enhance nurse wellbeing, according to the authors.
Going beyond “traditional themes” of retention and stress in the emergency department, the authors of “The social processes that emergency nurses use to achieve sustainability: A constructivist grounded theory” conducted interviews with, and observed, 29 emergency nurses in Indonesia between February 2018 and January 2019.
They found four main approaches nurses take to navigate their role in the emergency department and suggested how leadership can use those when establishing (or improving) a team structure.
Pillars of a basic social process for emergency departments include:
Intrinsic, extrinsic, and religious motivation were named as significant factors in retention under the driving forces category.
“I’ve always felt a strong desire to help people, which is why I decided to become a nurse and stick with working in emergency care,” Wenwen, an interview subject, told the authors. “Because there’s honestly nothing more fulfilling than being right there on the frontline, providing crucial support when people need it the most.”
Financial and nonfinancial rewards also emerged as “important drivers” because, as Dedi, another interview subject, said, “the rewards are higher than those in the regular hospital ward.”
Creating armories — tools and approaches for work in the emergency environment — is “crucial” to enhance resilience and effectiveness, the authors found, noting five key elements:
Integrating religion was a “novel finding,” according to the authors, highlighting how nurses use their beliefs to sustain themselves in their work.
One nurse, Lili, told the authors her religion teaches to prioritize the wellbeing of her patients.
“These principles are what guide me in providing nursing care and help me thrive in my current job,” she said.
Using regional dialects or languages with patients can help build rapport and increase communication with patients, the authors stated.
Other nurses reported using the following tactics to maintain work-life balance:
In the final approach, nurses shared that an effective emergency team took on the following attributes:
Establishing and fostering a healthy work environment is “essential” for personal and professional sustainability, the authors said.
“Nurse managers should prioritize accessible resources, rest breaks, supportive leadership, and peer relationships. Additionally, fostering spirituality, effective interpersonal relationships, teamwork, and addressing motivational needs are crucial factors highlighted as important to this study’s findings,” they stated. “In addition, adequate staffing, resources, and equipment have been repeatedly identified as necessary for sustaining effective nursing practice.”
Nursing CE Central Author Cheryl Newmark, MSN, RN, previously shared how the emergency department she worked in developed a “social and morale team” that ultimately helped to unite the department through surprise gifts, donating to charity, and other activities.
Nearly 100 hospitals that are making strides in quality and safety of emergency nursing also were acknowledged through the Emergency Nurses Association’s Lantern Award. Orlando Health Dr. P. Phillips Hospital, among the honorees for 2024, uses a “multidisciplinary approach” that focuses not only on patients, but staff.
“While clinical teams care for the community, the hospital’s spiritual care team cares for its team members,” a news release stated. “‘Tea for the Soul’ is a monthly event that provides a relaxing environment for teams to decompress and put their mental and spiritual health first, which supports their ability to give their best at a patient’s bedside.”
Adequate staffing, resources, and equipment were mentioned often in relation to personal and professional sustainability, they said.
“Policymakers should recognize factors affecting emergency nursing sustainability and support workplace practices that enhance nurse well-being,” the authors stated. “Strategies for sustaining the emergency nursing workforce must be developed and implemented to ensure the availability of high-quality emergency care. Prioritizing these measures benefits both nurses and patients.”
Nurse educators Gilny Rantung, Debra Griffiths, and Cheryle Moss developed a theory to show how emergency nurses maintain or foster sustainability in their work environment. Their research, published in “The Journal of Advanced Nursing,” detailed four overarching principles that guide the “basic social process” of achieving sustainability on both a personal and professional level. Some organizations already put this theory into motion through providing morale boosting events or offering mental health support.
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