Date of Award
5-2024
Degree Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
School
Leadership
Committee Chair
Dr. H. Quincy Brown
Committee Chair School
Leadership
Committee Member 2
Dr. Heather M. Annulis
Committee Member 2 School
Leadership
Committee Member 3
Dr. Casey Maugh Funderburk
Committee Member 3 School
Leadership
Committee Member 4
Dr. John J. Kmiec
Committee Member 4 School
Leadership
Committee Member 5
Dr. Dale L. Lunsford
Abstract
The COVID-19 pandemic’s effect on nurse recruitment and retention in the United States exacerbated the problem of nurse shortages, particularly for acute care nurses on the night shift. Long hours, heavy workloads, stressful work environments, high patient-nurse ratios, and dissatisfaction with administration are causing nurse burnout at an alarming rate. Burnout leads to low morale, exhaustion, intent to leave, and turnover. Moreover, exhausted night shift nurses compromise patient safety and care with unintentional medication errors or tasks left undone due to rigorous hours and little support or resources. Teambuilding, camaraderie, mentoring, and shared learning opportunities are scarce on night shift, leaving less experienced nurses and their patients vulnerable. Human resource development’s components of systems theory (chaos and futures theory), economic theory (human capital theory), and psychological theory (cognitive psychology, purposive behaviorism) frame this study’s goal of a performance improvement intervention. Through virtual interviews and an in-person focus group using semi-structured questions, 15 participants’ narratives recommend a collaborative strategy to reduce burnout, increase morale and engagement, and improve retention using a team nursing approach in the form of a rotational Resource Coach role. In the context of human capital development, this phenomenological action research study using NVIVO for thematic analysis results in a potential solution for acute care night shift nurses’ professional, physical, emotional, and psychological issues. Findings indicate this population experiences workplace crises and personal grievances. They are also limited in their capacity to provide safe and timely care for their patients when they have high acuity assignments coupled with high patient-nurse ratios. The Resource Coach role is a nurse exclusively allocated to nurses with the highest patient acuity to offer clinical assistance and support when needed. It is a shared role in which all unit staff nurses participate in a rotational cycle. This Resource Coach role’s shared governance and teamwork structure fosters clinical support, patient safety, and well-being for night shift acute care nurses. Recommendations include implementing the Resource Coach role, ROI evaluation utilizing an impact study, or other research methods investigating human capital development strategies to support other night shift populations for performance improvement and sustainability.
ORCID ID
0000-0002-2319-3381
Copyright
2024, Melissa Queen-Lomas
Recommended Citation
Queen-Lomas, Melissa, "Night Shift Acute Care Nurse Narratives: Exploring Collaborative Solutions to Reduce Burnout, Increase Morale and Engagement, and Improve Retention" (2024). Dissertations. 2231.
https://aquila.usm.edu/dissertations/2231