The coronavirus disease (COVID-19) pandemic has exposed nurses to conditions that threaten their health, well-being, and ability to work. It is therefore critical to study nurses’ experiences and well-being during the current crisis in order to identify risk groups for ill health and potential sources of organizational intervention. The aim of this study was to explore perceptions of the most salient sources of stress in the early stages of the coronavirus pandemic in a sample of U.S. nurses. A cross-sectional online survey was conducted among a sample of 695 U.S. nurses in May 2020. Content analysis was conducted on nurses’ responses (n = 455) to an open-ended question on the most stressful situations they had experienced during the pandemic. Six distinct themes emerged from the analysis: exposure/infection-self; illness/death-others; workplace; personal protective equipment/supplies; unknowns; opinions/politics. Two sub-themes concerned restrictions associated with the pandemic and feelings of inadequacy/helplessness regarding patients and their treatment. More than half of all comments concerned stress related to problems in workplace response to the pandemic. Healthcare institutions should provide opportunities for nurses to discuss the stress they are experiencing, support one another, and make suggestions for workplace adaptations during this pandemic.

Objective: To evaluate the effects of a randomized controlled intervention on the incidence of patient-to-worker (Type II) violence and related injury in hospitals. Methods: Forty-one units across seven hospitals were randomized into intervention (n = 21) and control (n = 20) groups. Intervention units received unit-level violence data to facilitate development of an action plan for violence prevention; no data were presented to control units. Main outcomes were rates of violent events and injuries across study groups over time. Results: Six months post-intervention, incident rate ratios of violent events were significantly lower on intervention units compared with controls (incident rate ratio [IRR] 0.48, 95% confidence interval [CI] 0.29 to 0.80). At 24 months, the risk for violence-related injury was lower on intervention units, compared with controls (IRR 0.37, 95% CI 0.17 to 0.83). Conclusions: This data-driven, worksite-based intervention was effective in decreasing risks of patient-to-worker violence and related injury.

Objective: To identify organizational factors contributing to workplace violence in hospitals. Methods: A questionnaire survey was conducted in 2013 among employees in a Midwestern hospital system (n = 446 respondents). Questions concerned employees’ experiences of violence at work in the previous year and perceptions of the organizational safety climate. Logistic regressions examined staff interaction and safety climate factors associated with verbal and physical violence, respectively. Results: Interpersonal conflict was a risk factor for verbal violence (OR 1.49, 95% CI 1.04 to 2.12, P < 0.05) and low work efficiency was a risk factor for physical violence (OR .98, 0.97 to 0.99). A poor violence prevention climate was a risk factor for verbal (OR 0.48, 0.36 to 0.65, P < .001) and physical (OR 0.60, 0.45 to 0.82, P < .05) violence. Conclusions: Interventions should aim at improving coworker relationships, work efficiency, and management promotion of the hospital violence prevention climate.

Background. Shared decision-making implies that patients and healthcare professionals make decisions together about clinical exams, available treatments, choice of options, and the benefit or downside of every choice. Patients involved in the shared decision-making process are more compliant with treatments and have a reduced risk of complications related to the pathology. In Italy, patient involvement in caring processes is still barely investigated. Aim. To investigate patients’ perceptions about shared decision-making with physicians and nurses, respectively, and to examine the relationship between shared decision-making and patient satisfaction and perceived quality of care/treatment. Methods. The study was performed between March and June 2019 in two wards of one Italian hospital. A questionnaire was administered to inpatients at the time of admission and again at discharge, including demographic information and measurement scales regarding patient involvement in shared decision-making, patient satisfaction, and perceived quality of treatment/care. Results. A total of 151 out of 301 patients completed questionnaires at both admission and discharge. Patients’ scores for shared decision-making (information, patient needs, treatment planning) were significantly different for physicians and nurses. At both admission and discharge, patients rated shared decision-making significantly higher for physicians compared to nurses, while there were no differences in their satisfaction ratings. Patient ratings of physicians did not change from admission (information: mean (M) = 3.50, standard deviation (SD) = 0.81; patient need: M = 3.05, SD = 1.05; treatment planning: M = 2.75, SD = 1.23) to discharge (information: M = 3.50, SD = 0.79; patient need: M = 3.17, SD = 1.02; treatment planning: M = 2.66, SD = 1.23) (p = 0.924, p = 0.098, p = 0.293, respectively), but patients’ ratings of nurses’ behavior increased significantly from admission (information: M = 2.44, SD = 1.23; patient need: M = 2.27, SD = 1.17; treatment planning: M = 2.12, SD = 1.19) to discharge (information: M = 2.62, SD = 1.22; patient need: M = 2.53, SD = 1.24; treatment planning: M = 2.35, SD = 1.21) (p = 0.019, p = 0.001, p = 0.003, respectively). Attention to patients’ needs was the key determinant of both satisfaction with nurses (OR = 3.65, 95% CI = 1.31–10.14, p = 0.013) and perceived quality of care (OR = 3.97, 95% CI = 1.49–10.55, p = 0.006). Providing appropriate information about disease progress and treatments was a key determinant of both satisfaction with physicians (OR = 19.75, 95% CI = 7.29–53.55, p < 0.001) and perceived quality of treatment (OR = 8.03, 95% CI = 3.25–19.81, p < 0.001). Discussion. Nurses should be sensitized to involving patients in the decision-making process, especially upon hospital admission. Specific training about effective communication techniques can be implemented to manage relationships with patients in different caring situations. Practical implications and future directions are discussed.

Aim: To examine the relationships between nurses' exposure to workplace violence and self‐reports of workplace cognitive failure.Design: A cross‐sectional study.Methods: An online questionnaire was administered in April 2023 to nurses in Michigan, US. Structural equation modelling was used to examine effects of physical and non‐physical workplace violence (occupational stressors) and work efficiency and competence development (occupational protective factors) on workplace cognitive failure.Results: Physical violence was a significant predictor of the action subscale of cognitive failure. There were no direct effects of non‐physical violence, workplace efficiency, or competence development on any of the workplace cognitive failure dimensions. Both types of violence and efficiency had significant indirect effects on workplace cognitive failure via work‐related exhaustion. Work‐related exhaustion predicted significantly higher scores for workplace cognitive failure.Conclusion: Workplace violence and work efficiency exhibited primarily indirect effects on workplace cognitive failure among nurses via work‐related exhaustion.Implications for the Profession and/or Patient Care: Nurses experiencing workplace violence may be at increased risk for workplace cognitive failure, especially if they are also experiencing work‐related exhaustion. Workplaces that nurses perceive as more efficient can help to mitigate the effects of violence on nurses' cognitive failure.Impact: This study addressed the possible effects of workplace violence as well as work efficiency and competence development on nurses' cognitive failure at work. Analyses revealed primarily indirect effects of workplace violence, and indirect protective effects of work efficiency, on nurses' cognitive failure via work‐related exhaustion. This research has implications for healthcare organizations and suggests that efforts made by healthcare workplaces to prevent violence and work‐related exhaustion, and to enhance work efficiency, may help to mitigate workplace cognitive failure among nurses.Reporting Method: We have followed the STROBE checklist in reporting this study.Patient or Public Contribution: No Patient or public contribution.