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"Appreciation motivates nurses in the pandemic"

How did the first wave of Covid-19 affect the workload of nurses? And what about stress?

Markus Arnold: Our survey of over 4,100 nurses at 19 Swiss hospitals clearly shows that the first Covid-19 wave increased the workload of nursing staff in all departments: The employees had to do more. The increase in the workload of nurses in emergency and intensive care departments was particularly strong. Here the workload increased by around 30% compared to the survey results from 2019.

Arthur Posch: The general stress caused by regular work has remained roughly the same compared to 2019. In contrast to workload, stress is understood to be the stress to which nursing staff are exposed due to experiences during their work - such as seeing a patient suffering or experiencing the death of a patient. However, during the first wave of the pandemic, the stress levels of the nursing staff increased. This is mainly due to the stress level specific to Covid-19: The nursing staff cited the risk of Covid-19 being transmitted to family members and the need for social distancing from their family as particularly stressful in the case of Covid-19-specific sources of stress.

What is the level of job satisfaction among nurses after the first wave of pandemics?

Markus Arnold: Interestingly, job satisfaction increased minimally during the first Covid-19 wave compared to 2019, although higher workload and stress usually lower job satisfaction. This is probably related to the fact that the nurses received a lot of media attention and public appreciation, which in turn has a positive effect on satisfaction.

However, satisfaction with the payment has decreased significantly ...

Arthur Posch: It turns out that the reduced satisfaction with the payment can be explained mainly by the fact that nurses were exposed to a significantly higher workload and stress during the first wave of the pandemic. Despite this higher burden, the pay of the nursing staff could not or only insufficiently be adjusted due to the cost pressure in hospitals.

Which Covid-19-specific measures were the nursing staff in the hospital confronted with?

Markus Arnold: Hospitals have placed particular emphasis on communicating clear guidelines for dealing with Covid-19 patients and on providing sufficient Covid-19 test capacities for nursing staff. To a lesser extent, hospitals have created additional childcare services and offered professional psychological support and training in dealing with Covid-19.

Arthur Posch: Nurses also state that during the first Covid-19 wave, managers relied more on rules and regulations, while they restricted the nurses' freedom to make decisions in the exercise of care activities compared to 2019. The nurses have accepted these changes well - they are even slightly more satisfied with their superiors than last year.

How many nurses received rewards for their work in the first wave of the pandemic?

Arthur Posch: Only 40 percent of the participating nurses received a reward for their work. The type of reward was very different, such as gift baskets, vouchers or other forms of recognition. Receiving a reward has had a very positive effect on overall job satisfaction. It is interesting that for satisfaction it is mainly relevant whether there was a hospital reward and not what monetary value it had.

Despite greater challenges, nurses stated that they are more motivated to work than in 2019. How do you explain this?

Markus Arnold: The appreciation of the population has a very positive effect on motivation. In addition, nurses are generally a very motivated professional group with a very high level of willingness to help patients. This gained additional importance during the first wave of the pandemic. The stronger cohesion between the nursing staff compared to 2019 also had a positive effect on motivation. The first wave of Covid-19 has led to a greater willingness to cooperate, more willingness to share knowledge and a better working atmosphere in the department among nurses.

Which factors influence the loyalty of nurses to their employer?

Arthur Posch: Whether or not a nurse wants to continue working for a hospital depends on many influencing factors. Job satisfaction and the satisfaction of nurses with the hospital's specific Covid-19 measures - for example, the provision of sufficient Covid-19 test capacities - have a positive influence on staying at the current job. Too much stress, on the other hand, has a negative effect on the likelihood of staying.

The shortage of nursing staff is increasing. In your opinion, what would have to change in the working environment in order to make the job more attractive again?

Markus Arnold: While the realization of better pay for nurses in hospitals appears to be very difficult in the short term, active personnel management can make the job more attractive. Constructive appraisal interviews or more freedom to make decisions in care activities that reflect trust in the work of the nursing staff can help make the job more attractive. Our research also shows that the offer of regular further training and the assumption of further training costs by the hospital increases the satisfaction of nursing staff. But one must not forget the workload and stress: It should be thought about how nursing staff can be relieved in the future. During the first wave of Covid-19, nurses still proved to be very robust. But this resilience will not last forever.

What results have amazed you personally?

Arthur Posch: I was impressed by the “resilience” of the nursing staff. We did not expect in advance that their motivation would even increase and that general job satisfaction would remain the same despite the pandemic. Our results also underline the high level of efficiency and willingness of the nursing staff. In a follow-up project, we are currently investigating how the resilience and motivation of the nursing staff stand in the much longer and more intensive second wave.

Markus Arnold: Nurses not only do immensely important work for our society, they are also a professional group that is of great interest for research in the healthcare sector. In order to promote further research in this area, we launched the Hospital Nursing Report Switzerland - a research program in which we regularly examine the work situation of nursing staff in close cooperation with Swiss hospitals.