The perceived and experienced role of the nurse unit manager in supporting the wellbeing of intensive care unit nurses: An integrative literature review

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Abstract

The number of patients requiring admission into intensive care units (ICUs) is increasing worldwide. Concurrently, recruitment and retention of the ICU nursing workforce is becoming a major challenge due to the high intensity environment, heavy workloads, and decreasing nurse wellbeing. Nurse unit managers play a vital role in promoting and supporting ICU nurse wellbeing, yet little is known about perceptions and experiences of this role. To examine the perceived and experienced role of the nurse unit manager in supporting the wellbeing of ICU nurses. A comprehensive review of the literature was undertaken using Whittemore and Knafl’s five stage approach: (i) problem identification, (ii) literature search, (iii) quality appraisal, (iv) data analysis, and (v) presentation of findings. The following databases were searched for literature published between January 2007 and December 2017: Cumulative Index to Nursing and Allied Health Literature, Cochrane, Informit, Joanna Briggs Institute Library of Systematic Review, ProQuest, PubMed, Scopus, and Wiley online library digital databases. Variations and synonyms of key words included: nurse unit manager, ICU, compassion fatigue, burnout, stress, job satisfaction, bullying, wellbeing, and work environment. Rigour and trustworthiness of the included studies were assessed using the Critical Appraisal Skills Program qualitative research checklist, a modified Critical Appraisal Skills Program Cohort study checklist for quantitative research, and the Mixed Methods Appraisal Tool for mixed-method studies. The critical review guidelines by Shenton and Polit and Beck were also used to make judgements about the worth of the evidence. All of the 11 qualitative studies provided moderate to strong evidence. The overall quality of the quantitative studies was lower, with three of seven studies providing only adequate evidence. The majority of the 19 included studies represented the voices of ICU nurses. Three major themes emerged from the analysis; ‘1) building professional relationships’, ‘2) leading the way’ and ‘3) satisfying the needs of ICU nurses’. Nurse unit manager behaviours clearly affect the wellbeing of ICU nurses. However, the role of supporting ICU nurses is complex and challenging. More research is needed to investigate the needs of ICU nurses and the facilitators and barriers nurse unit managers face when supporting the wellbeing of nurses in their unit.

Citation

Relevant Evidence Summaries

The evidence was reviewed and included in the following summaries: 

What works to reduce burnout and vicarious trauma among refugee service providers?

There is strong evidence for a variety of strategies to reduce vicarious trauma, secondary traumatic stress, compassion fatigue, and burnout among helping professionals. A strong body of evidence has developed in the past twenty years on reducing stress reactions among a variety of professional helpers in a wide range of settings and professions. Strategies to…

About this study

AGE: Adults

DIRECTION OF EVIDENCE: Positive impact

FULL TEXT AVAILABILITY: Paid

HOST COUNTRY: Multiple countries

HOST COUNTRY INCOME: High

INTERVENTION DURATION: Varies

INTERVENTION: Organizational strategies

OUTCOME AREA: Reduction of compassion fatigue, burnout, and secondary trauma

STRENGTH OF EVIDENCE: Strong

TYPE OF STUDY: Systematic review

YEAR PUBLISHED: 2019

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