VIRTUAL GALLERY Navigating Nurse Wellness

Objective: This multi-site study was conducted to determine the current wellness levels of clinical registered nurses (RNs), advanced practice registered nurses (APRNs), and nurse leaders working in the Upper Midwest, including barriers to maintain wellness and recommended interventions to promote wellness. 
 
Background: Nurses experience more anxiety now than pre-pandemic. An extensive review of the literature revealed a gap in describing the nurses’ wellness and strategies to maintain their wellness in an Upper Midwest workforce. It is of upmost importance to gain a better understanding of the nurses’ experiences with holistic wellness specific to role and setting as well as recommended interventions that would positively impact nurses in their personal and professional lives.

Methods: A mixed methods approach with the Theory of Integrative Nurse Coaching (TINC) was utilized to holistically assess wellness. Phase 1 used survey questions from the Integrative Health and Wellness Assessment (IHWA) V2 2022 and open-ended questions to explore nurses’ wellness within the country’s largest rural health system. The IHWA V2 2022 measured participants’ wellness in eight dimensions. The Online Wellness Survey was deployed to 6,989 clinical RNs, APRNs, and nurse leaders. Following survey analysis, the longitudinal qualitative study, Phase 2, used 6 focus groups (FGs) to recommend the most important interventions to each nursing role that could be implemented across the healthcare system. Participants representing clinical nurses, nurse leaders, and APRNs from tertiary and rural settings, met in 2 different sessions over 5-6 months apart.

Results: The IHWA V2 2022 Phase 1 Online Wellness Survey mean score was 134.72 (range 86-180) for all participants. Significant findings revealed age, years of experience, and role of the more experienced nurses and APRNs had higher wellness scores. Insufficient time, work environment, and family responsibilities were identified barriers. Recommendations involved work environment, healthy boundaries, and stress management with proposed interventions to implement. Phase 2 FGs reinforced online findings and provided more context and detail to recommendations for promoting wellness in tertiary and rural settings.
Even though the FG sessions were not intended to be an intervention, the IHWA V2 2022 results demonstrated an increase in wellness scores from FG 1 to FG 2. In Phase 1 survey findings, work setting was not significant in relationship to participants’ wellness scores, barriers, or interventions. However, Phase 2 FGs participants not only identified interventions specific to their roles and settings, but stressed “one mold does not fit all” and each setting has its own unique challenges within the same healthcare system. 

Conclusions: Phases 1 and 2 findings can assist organizational leaders to implement interventions that positively impact nurse wellness in tertiary and rural settings. Interventions promoting wellness are essential for nurses to meet these same needs of their patients. Further research should focus on how specific interventions impact nurse wellness in diverse settings to improve patient outcomes. It is important to note the IHWA V2 2022 tool can be used to measure holistic wellness in various disciplines and interprofessional teams.