Mental health nurses' experience of resilience during COVID-19: A qualitative inquiry.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Source:
      Publisher: Blackwell Pub Country of Publication: Australia NLM ID: 101140527 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1447-0349 (Electronic) Linking ISSN: 14458330 NLM ISO Abbreviation: Int J Ment Health Nurs
    • Publication Information:
      Publication: Carlton, Vic. : Wiley-Blackwell : Blackwell Pub.
      Original Publication: Carlton, Vic. : Blackwell Pub., c2002-
    • Subject Terms:
    • Abstract:
      The COVID-19 pandemic created unprecedented demands and additional stress for nurses in mental health settings. There is no prior evidence on nurses' experience of building and maintaining resilience in the context of work during COVID-19. The aim of this study was to explore the experience and impacts of the COVID-19 pandemic on the resilience of nurses in mental health settings. Data from semi-structured interviews with 20 nurses from an Australian mental health service were analysed using reflexive thematic analysis. Four main themes were generated: experiencing significant disruptions; making sense of shared chaos; having professional commitment; and growing through the challenges. Nurses' practice and teamwork were disrupted by COVID-19 related changes to care models and infection prevention policies. They successfully adjusted by having awareness of self and others' emotions, using mental and emotional self-regulatory strategies, engaging in self-care, using 'bricolage' to create different ways to provide care, and having mutually supportive relationships. Nurses connected to their sense of purpose and professional commitment to fuel their therapeutic work and sustain care delivery. They experienced personal and professional growth with an increased understanding of their strengths and resilience. In the post-pandemic period, although the challenges presented by the pandemic have lessened, there are ongoing negative impacts on nurses' wellbeing. To maintain and strengthen their wellbeing and practice, the findings indicate the importance of professional development in emotional regulation skills, and strategies to strengthen self-care and build collegial relationships in teams. Resilience education can be implemented to support nurses' resilient practice skills.
      (© 2023 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)
    • References:
      Abbas, M.J., Kronenberg, G., McBride, M., Chari, D., Alam, F., Mukaetova-Ladinska, E. et al. (2021) The early impact of the COVID-19 pandemic on acute care mental health services. Psychiatric Services (Washington, D.C.), 72(3), 242-246. Available from: https://doi.org/10.1176/appi.ps.202000467.
      Australian Government Department of Health and Aged Care. (2023) About nurses and midwives. Australia: Australian Government Department of Health and Aged Care. Available from: https://www.health.gov.au/topics/nurses-and-midwives/about.
      Braun, V. & Clarke, V. (2022) Thematic analysis: a practical guide to understanding and doing, 1st edition. Los Angeles: SAGE Publications Ltd.
      Bui, M.V., McInnes, E., Ennis, G. & Foster, K. (2022) Protocol for a mixed methods process evaluation of the promoting resilience in nurses (PRiN) trial. International Journal of Mental Health Nursing, 31(3), 687-696. Available from: https://doi.org/10.1111/inm.12989.
      Bui, M.V., McInnes, E., Ennis, G. & Foster, K. (2023) Resilience and mental health nursing: an integrative review of updated evidence. International Journal of Mental Health Nursing, 00, 1-17. Available from: https://doi.org/10.1111/inm.13132.
      Cho, G.-J. & Kang, J. (2017) Type D personality and post-traumatic stress disorder symptoms among intensive care unit nurses: the mediating effect of resilience. PLoS One, 12(4), e0175067. Available from: https://doi.org/10.1371/journal.pone.0175067.
      Cooper, A.L., Brown, J.A. & Leslie, G.D. (2021) Nurse resilience for clinical practice: an integrative review. Journal of Advanced Nursing, 77(6), 2623-2640. Available from: https://doi.org/10.1111/jan.14763.
      Cranage, K. & Foster, K. (2022) Mental health nurses' experience of challenging workplace situations: a qualitative descriptive study. International Journal of Mental Health Nursing, 31(3), 665-676. Available from: https://doi.org/10.1111/inm.12986.
      Dahan, S., Levi, G. & Segev, R. (2022) Shared trauma during the COVID-19 pandemic: psychological effects on Israeli mental health nurses. International Journal of Mental Health Nursing, 31(3), 722-730. Available from: https://doi.org/10.1111/inm.12996.
      Delgado, C., Evans, A., Roche, M. & Foster, K. (2022) Mental health nurses' resilience in the context of emotional labour: an interpretive qualitative study. International Journal of Mental Health Nursing, 31(5), 1260-1275. Available from: https://doi.org/10.1111/inm.13037.
      Fahy, G. & Moran, L. (2018) Who supports the psychiatric nurse? A qualitative study of the social supports that affect how psychiatric nurses cope with workplace risks and stressors. Irish Journal of Sociology, 26(3), 244-266. Available from: https://doi.org/10.1177/0791603518792366.
      Farrington, A., King, M., Donohue, G. & McCann, E. (2023) The experiences of mental health nurses working through COVID-19: an analysis of long-term support needs. British Journal of Mental Health Nursing, 12(1), 1-11. Available from: https://doi.org/10.12968/bjmh.2021.0045.
      Foster, K., Cuzzillo, C. & Furness, T. (2018) Strengthening mental health nurses' resilience through a workplace resilience programme: a qualitative inquiry. Journal of Psychiatric and Mental Health Nursing, 25(5-6), 338-348. Available from: https://doi.org/10.1111/jpm.12467.
      Foster, K., Evans, A. & Alexander, L. (2023) Grace under pressure: mental health nurses' stories of resilience in practice. International Journal of Mental Health Nursing, 32, 866-874. Available from: https://doi.org/10.1111/inm.13130.
      Foster, K., Marks, P., O'Brien, A. & Raeburn, T. (2020) Mental health in nursing: theory and practice for clinical settings, Fifth edition. Australia: Elsevier.
      Foster, K., Roche, M., Delgado, C., Cuzzillo, C., Giandinoto, J.A. & Furness, T. (2019) Resilience and mental health nursing: an integrative review of international literature. International Journal of Mental Health Nursing, 28(1), 71-85. Available from: https://doi.org/10.1111/inm.12548.
      Foster, K., Roche, M., Giandinoto, J. & Furness, T. (2020) Workplace stressors, psychological well-being, resilience, and caring behaviours of mental health nurses: a descriptive correlational study. International Journal of Mental Health Nursing, 29(1), 56-68. Available from: https://doi.org/10.1111/inm.12610.
      Foster, K., Shochet, I., Wurfl, A., Roche, M., Maybery, D., Shakespeare-Finch, J. et al. (2018) On PAR: a feasibility study of the promoting adult resilience programme with mental health nurses. International Journal of Mental Health Nursing, 27(5), 1470-1480.
      Foye, U., Dalton-Locke, C., Harju-Seppänen, J., Lane, R., Beames, L., Vera San Juan, N. et al. (2021) How has COVID-19 affected mental health nurses and the delivery of mental health nursing care in the UK? Results of a mixed-methods study. Journal of Psychiatric and Mental Health Nursing, 28(2), 126-137. Available from: https://doi.org/10.1111/jpm.12745.
      Gao, T., Ding, X., Chai, J., Zhang, Z., Zhang, H., Kong, Y. et al. (2017) The influence of resilience on mental health: the role of general well-being. International Journal of Nursing Practice, 23(3), e12535. Available from: https://doi.org/10.1111/ijn.12535.
      Gao, Z. & Tan, F.P.L. (2021) Nurses' experiences in response to COVID-19 in a psychiatric ward in Singapore. International Nursing Review, 68(2), 196-201. Available from: https://doi.org/10.1111/inr.12680.
      Gillespie, B.M., Chaboyer, W. & Wallis, M. (2007) Development of a theoretically derived model of resilience through concept analysis. Contemporary Nurse: A Journal for the Australian Nursing Profession, 25(1-2), 124-135. Available from: https://doi.org/10.5172/conu.2007.25.1-2.124.
      Huang, F., Lin, M., Sun, W., Zhang, L., Lu, H. & Chen, W. (2021) Resilience of frontline nurses during the COVID pandemic in China: a qualitative study. Nursing & Health Sciences, 23(3), 639-645. Available from: https://doi.org/10.1111/nhs.12859.
      Jiang, J., Liu, Y., Han, P., Zhang, P., Shao, H., Peng, H. et al. (2022) Psychological resilience of emergency nurses during COVID-19 epidemic in Shanghai: a qualitative study. Frontiers in Public Health, 10, 1001615. Available from: https://doi.org/10.3389/fpubh.2022.1001615.
      Johnson, S., Dalton-Locke, C., Vera San Juan, N., Foye, U., Oram, S., Papamichail, A. et al. (2021) Impact on mental health care and on mental health service users of the COVID-19 pandemic: a mixed methods survey of UK mental health care staff. Social Psychiatry and Psychiatric Epidemiology, 56(1), 25-37. Available from: https://doi.org/10.1007/s00127-020-01927-4.
      King, M., Farrington, A., Donohue, G. & McCann, E. (2022) Psychological impact of the COVID-19 pandemic on mental health nurses. Issues in Mental Health Nursing, 43(4), 300-307. Available from: https://doi.org/10.1080/01612840.2021.1978598.
      Lepore, S.J. & Revenson, T.A. (2006) Resilience and posttraumatic growth: recovery, resistance, and reconfiguration. In: Calhoun, L.G. & Tedeschi, R.G. (Eds.) Handbook of posttraumatic growth: research & practice. Mahwah, New Jersey: Lawrence Erlbaum Associates, Inc., pp. 24-46.
      Levers, M.-J.D. (2013) Philosophical paradigms, grounded theory, and perspectives on emergence. SAGE Open, 3(4), 215824401351724. Available from: https://doi.org/10.1177/2158244013517243.
      Mallak, L.A. (1998) Measuring resilience in health care provider organizations. Health Manpower Management, 24(4), 148-152. Available from: https://doi.org/10.1108/09552069810215755.
      Mallak, L.A. & Yildiz, M. (2016) Developing a workplace resilience instrument. Work (Reading, Mass.), 54(2), 241-253. Available from: https://doi.org/10.3233/WOR-162297.
      Marie, M., Hannigan, B. & Jones, A. (2017) Resilience of nurses who work in community mental health workplaces in Palestine: resilience of mental health nurses in Palestine. International Journal of Mental Health Nursing, 26(4), 344-354. Available from: https://doi.org/10.1111/inm.12229.
      McLarnon, M.J.W. & Rothstein, M.G. (2013) Development and initial validation of the workplace resilience inventory. Journal of Personnel Psychology, 12(2), 63-73. Available from: https://doi.org/10.1027/1866-5888/a000084.
      Merriam, S.B. & Grenier, R.S. (2019) Qualitative research in practice: examples for discussion and analysis, 2nd edition. San Francisco, CA: Jossey-Bass.
      Murphy, L., Markey, K., O' Donnell, C., Moloney, M. & Doody, O. (2021) The impact of the COVID-19 pandemic and its related restrictions on people with pre-existent mental health conditions: a scoping review. Archives of Psychiatric Nursing, 35(4), 375-394. Available from: https://doi.org/10.1016/j.apnu.2021.05.002.
      Palmer, B.R., Gignac, G., Ekermans, G. & Stough, C. (2008) A comprehensive framework for emotional intelligence. In: Emotional intelligence: theoretical and cultural perspectives. New York: Nova Science Publishers Inc., pp. 17-38.
      Prosser, S.J., Metzger, M. & Gulbransen, K. (2017) Don't just survive, thrive: understanding how acute psychiatric nurses develop resilience. Archives of Psychiatric Nursing, 31(2), 171-176. Available from: https://doi.org/10.1016/j.apnu.2016.09.010.
      QSR International Pty Ltd. (2018) NVivo (Version 12) [Computer software]. Available from: https://www.qsrinternational.com/nvivo-qualitative-data-analysis-software/home.
      Suresh, K., Thomas, S. & Suresh, G. (2011) Design, data analysis and sampling techniques for clinical research. Annals of the Indian Academy of Neurology, 14(4), 287-290. Available from: https://doi.org/10.4103/0972-2327.91951.
      Ward-Miller, S., Farley, E.M., Espinosa, L., Brous, M.E., Giorgi-Cipriano, J. & Ferguson, J. (2021) Psychiatric mental health nursing in the international year of the nurse and COVID-19: one hospital's perspective on resilience and innovation - past, present and future. Archives of Psychiatric Nursing, 35(3), 303-310. Available from: https://doi.org/10.1016/j.apnu.2020.11.002.
      Warelow, P. & Edward, K. (2007) Caring as a resilient practice in mental health nursing. International Journal of Mental Health Nursing, 16(2), 132-135. Available from: https://doi.org/10.1111/j.1447-0349.2007.00456.x.
      Yalçın, M., Baş, A., Bilici, R., Özdemir, Y.Ö., Beştepe, E.E., Kurnaz, S. et al. (2021) Psychiatric emergency visit trends and characteristics in a mental health epicenter in Istanbul during COVID-19 lockdown. Social Psychiatry and Psychiatric Epidemiology, 1-12, 2299-2310. Available from: https://doi.org/10.1007/s00127-021-02171-0.
      Zugai, J.S., Stein-Parbury, J. & Roche, M. (2015) Therapeutic alliance in mental health nursing: an evolutionary concept analysis. Issues in Mental Health Nursing, 36(4), 249-257. Available from: https://doi.org/10.3109/01612840.2014.969795.
    • Grant Information:
      Australian Research Council
    • Contributed Indexing:
      Keywords: COVID-19; mental health nurses; mental health nursing practice; qualitative; resilience
    • Publication Date:
      Date Created: 20230822 Date Completed: 20231127 Latest Revision: 20231127
    • Publication Date:
      20231127
    • Accession Number:
      10.1111/inm.13213
    • Accession Number:
      37605316