Browsing by Person "Ramsay, Pam"

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The impact on redeployed nurses of working in critical care during the COVID-19 pandemic: a cross-sectional study
(Wiley, 2025-06-25) Mccallum, Louise; Dixon, Diane; Pollard, Beth; Miller, Jordan; Hull, Alastair; Scott, Teresa; Salisbury, Lisa; Ramsay, Pam; Rattray, Janice
Background Many nurses with little critical care experience were redeployed to critical care units during the COVID-19 pandemic to assist with the increased numbers of critically ill patients. The impact of this redeployment on nurses and their employing organization merits detailed assessment. Aims To (a) measure the impact on redeployed nurses of working in critical care during the COVID-19 pandemic and identify the predictors of that impact, (b) identify any differences between redeployed and critical care nurses and (c) measure the organizational impact. Study Design A cross-sectional study of redeployed (n = 200) and critical care nurses (n = 461) within the United Kingdom's National Health Service between January 2021 and March 2022. A survey measured components of the Job Demand-Resources Model of occupational stress. Free text questions enabled nurses to describe their experiences of being redeployed to critical care during the pandemic. Results Survey data indicated high levels of health impairment; 70% of redeployed nurses met the threshold for psychological distress, 52% for burnout and 35% had clinically significant symptoms of posttraumatic stress. When job demands (emotional load, mental load, pace and amount of work and role conflict) were high, health impairment was worse and when job resources (staffing, focus on well-being and learning opportunities) were low, work engagement was reduced. Free text comments illustrated both the stress and distress experienced by redeployed nurses. Conclusion Many redeployed nurses experienced significant negative consequences and potentially enduring sequelae of working in critical care during the pandemic. These may continue to affect individual and organizational outcomes. Relevance to Clinical Practice Nurses' well-being should be monitored, and appropriate services provided. Improvements in ongoing and meaningful communications with senior management alongside prioritization of ongoing professional development are required.
“Like fighting a fire with a water pistol”: A qualitative study of the work experiences of critical care nurses during the COVID ‐19 pandemic
(2023-07-28) Miller, Jordan; Young, Ben; Mccallum, Louise; Rattray, Janice; Ramsay, Pam; Salisbury, Lisa; Scott, Teresa; Hull, Alastair; Cole, Stephen; Pollard, Beth; Dixon, Diane
Aim: To understand the experience of critical care nurses during the COVID‐19 pandemic, through the application of the Job‐Demand‐Resource model of occupational stress. Design: Qualitative interview study. Methods: Twenty‐eight critical care nurses (CCN) working in ICU in the UK NHS during the COVID‐19 pandemic took part in semi‐structured interviews between May 2021 and May 2022. Interviews were guided by the constructs of the Job‐Demand Resource model. Data were analysed using framework analysis. Results: The most difficult job demands were the pace and amount, complexity, physical and emotional effort of their work. Prolonged high demands led to CCN experiencing emotional and physical exhaustion, burnout, post‐traumatic stress symptoms and impaired sleep. Support from colleagues and supervisors was a core job resource. Sustained demands and impaired physical and psychological well‐being had negative organizational consequences with CCN expressing increased intention to leave their role. Conclusions: The combination of high demands and reduced resources had negative impacts on the psychological well‐being of nurses which is translating into increased consideration of leaving their profession. Implications for the Profession and/or Patient Care: The full impacts of the pandemic on the mental health of CCN are unlikely to resolve without appropriate interventions. Impact: Managers of healthcare systems should use these findings to inform: (i) the structure and organization of critical care workplaces so that they support staff to be well, and (ii) supportive interventions for staff who are carrying significant psychological distress as a result of working during and after the pandemic. These changes are required to improve staff recruitment and retention. Reporting Method: We used the COREQ guidelines for reporting qualitative studies. Patient and Public Contribution: Six CCN provided input to survey content and interview schedule. Two authors and members of the study team (T.S. and S.C.) worked in critical care during the pandemic.
A model of occupational stress to assess impact of COVID-19 on critical care and redeployed nurses: a mixed-methods study
(NIHR Journals Library, 2024-12-18) Rattray, Janice; Miller, Jordan; Pollard, Beth; McCallum, Louise; Hull, Alastair; Ramsay, Pam; Salisbury, Lisa; Scott, Teresa; Cole, Stephen; Dixon, Diane
Objective: To use the job demands−resources model of occupational stress to quantify and explain the impact of working in critical care during the COVID-19 pandemic on nurses and their employing organisation. Design: Two-phase mixed methods: a cross-sectional survey (January 2021–March 2022), with comparator baseline data from April to October 2018 (critical care nurses only), and semistructured interviews. Participants: Critical care nurses (n = 461) and nurses redeployed to critical care (n = 200) who worked in the United Kingdom National Health Service (primarily Scotland) between January 2021 and March 2022. The 2018 survey was completed by 557 critical care nurses (Scotland only). Survey response rate in Scotland was 32% but could not be determined outside Scotland. Forty-four nurses were interviewed (critical care = 28, redeployed = 16). Methods: A survey measured job demands, job resources, health impairment, work engagement and organisational outcomes. Data were compared to 2018 data. Regression analyses identified predictors of health impairment, work engagement and organisational outcomes. Semistructured interviews were conducted remotely, audio-recorded and transcribed. Data were analysed deductively using framework analysis. Findings: Three-quarters of nurses reached threshold for psychological distress, approximately 50% reached threshold for burnout emotional exhaustion and a third clinically concerning post-traumatic stress symptoms. Compared to 2018, critical care nurses were at elevated risk of probable psychological distress, odds ratio 6.03 (95% CI 4.75 to 7.95); burnout emotional exhaustion, odds ratio 4.02 (3.07 to 5.26); burnout depersonalisation, odds ratio 3.18 (1.99 to 5.07); burnout accomplishment, odds ratio 1.53 (1.18 to 1.97). There were no differences between critical care and redeployed nurses on health impairment outcomes, suggesting elevated risk would apply to redeployed nurses. Job demands increased and resources decreased during the pandemic. Higher job demands predicted greater psychological distress. Job resources reduced the negative impact of job demands on psychological distress, but this moderating effect was not observed at higher levels of demand. All organisational outcomes worsened. Lack of resources predicted worse organisational outcomes. In interviews, staff described the pace and amount, complexity, physical and emotional effort of their work as the most difficult job demands. The sustained high-demand environment impacted physical and psychological well-being, with most interviewees experiencing emotional and physical exhaustion, burnout, and symptoms of post-traumatic stress disorder. Camaraderie and support from colleagues and supervisors were core job resources. The combination of sustained demands and their impact on staff well-being incurred negative organisational consequences, with increasing numbers considering leaving their specialty or nursing altogether. Dissemination events with a range of stakeholders, including study participants, identified staffing issues and lack of learning and development opportunities as problematic. Critical care nurses are concerned about the future delivery of high-quality critical care services. Positive aspects were identified, for example, reduced bureaucratic systems, increased local autonomy and decision-making, recognition of the critical care nurse skill set. Conclusions: The National Health Service needs to recognise the impact of COVID-19 on this staff group, prioritise the welfare of critical care nurses, implement workplace change/planning, and support them to recover from the pandemic. The National Health Service is struggling to retain critical care nurses and, unless staff welfare is improved, quality of care and patient safety will likely decline.
Work-related stress: The impact of COVID-19 on critical care and redeployed nurses: A mixed methods study
(BMJ, 2021-07-05) Rattray, Janice; McCallum, Louise; Hull, Alastair; Ramsay, Pam; Salisbury, Lisa; Scott, Teresa; Cole, Stephen; Miller, Jordan; Dixon, Diane
Introduction: We need to understand the impact of COVID-19 on Critical Care (CCNs) and redeployed nurses and NHS organisations. Methods and analysis: This is a mixed methods study (QUANT – QUAL), underpinned by a theoretical model of occupational stress, the Job-Demand Resources Model (JD-R). Participants are critical care and redeployed nurses from Scottish and three large English units. Phase one is a cross-sectional survey in part replicating a pre-COVID-19 study and results will be compared with this data. Linear and logistic regression analysis will examine the relationship between antecedent, demographic, and professional variables on health impairment (burnout syndrome, mental health, posttraumatic stress symptoms), motivation (work engagement, commitment), and organisational outcomes (intention to remain in critical care nursing and quality of care). We will also assess the usefulness of a range of resources provided by the NHS and professional organisations. To allow in-depth exploration of individual experiences, phase two will be one-to-one semi-structured interviews with 25 CCNs and 10 redeployed nurses. The JD-R model will provide the initial coding framework to which the interview data will be mapped. The remaining content will be analysed inductively to identify and chart content that is not captured by the model. In this way the adequacy of the JD-R model is examined robustly and its expression in this context will be detailed. Ethics and dissemination: Ethics approval was granted from the University of Aberdeen CERB2020101993. We plan to disseminate findings at stakeholder events, publish in peer reviewed journals and at present at national and international conferences.