Advanced Practice Nurses’ Experiences in Sustaining Practice During a Prolonged Global Crisis
Bibliographic record
Abstract
Abstract Aim: To understand advanced practice nurses’ experiences during the COVID-19 pandemic and identify strategies that may support their coping and wellbeing while sustaining clinical practice. Background: Advanced practice nurses are registered nurses with graduate level education who provide essential care to individuals, families and communities across the globe. Nurse practitioners, clinical nurse specialists and other designations are part of the broader Advanced Practice Nurse population. The COVID-19 pandemic provided a unique opportunity to study their coping, wellbeing and practice sustainability. Methods: Qualitative description was used to analyze narrative responses to questions administered within a survey circulated at two points of time within the COVID-19 pandemic. Findings: Supports and opportunities provided by practice settings and employers were found to be helpful in the early months of the pandemic. However, beyond six months of global crisis response advanced practice nurses began to identify more closely with supports external to the work team and practice setting. These included time with others, meditation, mindfulness, hiking, yoga and time off. Some maladaptive behaviours, including increased alcohol use, were also identified during phase two (late pandemic) data collection. Experiences of support from employers and colleagues were variable and may have been linked to pre-existing conditions in the employee/workplace relationship. Conclusion: Advanced practice nurse coping, wellbeing and clinical practice benefitted from in-workplace supports such as information sharing, team activities, relationships with colleagues and feeling supported by employers in the early phases of a system crisis. In later phases external supports and time away from the practice setting were described as being more helpful. This work suggests there is a tipping point where approaches to supporting advanced practice nursing professionals in a prolonged crisis should move from workplace initiatives to activities external to the practice setting.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.006 | 0.006 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.001 | 0.007 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".