Two Sue & Bill Gross School of Nursing faculty and a nursing PhD student have been awarded research grants to study how school nurses ensured the health and safety of their communities during the pandemic and the impact of moral injury on nurses amid COVID-19.
The grants are from the Institute for Clinical and Translational Research (ICTS) as part of its Campus-Community Research Incubator (CCRI) Program.
The impact of school nurses
Assistant Professor Nakia Best is principal investigator of an interdisciplinary team that is examining the impact of COVID-19 on school nurses and school health services.
School nurses are vital for supporting students’ emotional, behavioral, physical and social health. As California went into lockdown in March 2020, their role shifted to COVID-19-related functions to ensure the safety of the students and school community.
The study, a collaboration between UCI and the School Nurses of California Foundation (SNOCF), seeks to answer several questions:
· How have school nurses mitigated the impact of COVID-19 on students, teachers and other school staff, and families?
· What are their unique skills that no other employee can perform?
· What is their involvement in COVID mitigation, before, during and after the pandemic?
· How are they coping with their own health and safety?
The study will uncover the differences between the core responsibilities of the school nurse before COVID and their additional COVID functions.
Most importantly, this study will also establish the infrastructure for joint school nurse research, which will be critical for future studies with SNOCF.
In addition to Best, the research team includes:
· Eden Donahue, DNP, RN, Officer-at-Large, School Nurses of California Foundation
· Kirsten Munk, DNP, MSN, RN, Board Member, School Nurses of California Foundation
· Phyllis Agran, MD, Professor Emeritus, Department of Pediatrics, UCI School of Medicine
· John Billimek, PhD, Associate Professor and Vice Chair for Academic Affairs, UCI Department of Family Medicine
Nurses and ‘moral injury’
Assistant Professor Candace Burton, nursing PhD student Danisha Jenkins and Alyson Zalta, assistant professor in the UCI Department of Psychological Science are exploring the impact of moral challenges nurses are facing under the COVID pandemic and their potential contribution to professional turnover.
The pandemic has taken a tremendous toll on frontline nurses, and many are directly involved in caring for COVID patients. Issues of insufficient supplies, illness among staff, and increased acuity in patient populations have all taken their toll.
Since approximately 33% of registered nurses leave the profession in their first five years, anything that may prompt nurses to exit the profession has the potential to create shortages.
In fact, the U.S. Bureau of Labor Statistics projects that the country will be short 1 million nurses by 2026. That statistic was released before the pandemic and has likely worsened.
While the role of burnout in nurse turnover has been well-studied, this study seeks to add the dimension of moral injury to what is known about nurse burnout.
Moral injury is the psychological reactions that occur after perpetrating, failing to prevent or witnessing events that transgress one’s deeply held moral beliefs and expectations. Events that can lead to moral injury occur in high-stakes situations in which other factors, such as chaos or power and rank, affect in-the-moment decisionmaking.
The COVID-19 pandemic has created fertile ground for such injury to occur among frontline nurses, especially in under-resourced areas.
The study, a collaboration with the American Nurses Association of California and HealthImpact, will seek to establish:
· What experiences contribute to moral injury
· The environmental and psychological conditions that increase risk for morally injurious workplace events
· How morally injurious workplace events affect psychological and occupational outcomes
This project will lay the groundwork for the development of a novel intervention to reduce or prevent moral injury among frontline nurses.
About the Campus-Community Research Incubator Program
The CCRI is a small grant fund that fosters collaborative, research-oriented projects between university researchers and community organizations.
Only teams that comprise campus researchers and community organization representatives are eligible to receive grants. This includes community organizations, faculty, healthcare providers, post-doctoral researchers, graduate students, senior researchers and others.
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