Collective strategies to cope with work related stress among nurses in resource constrained settings: An ethnography of neonatal nursing in Kenyaby Jacob McKnighta, Jacinta Nzingab, Joyline Jepkosgeib, Mike English
Nursing is central to the provision of hospital-based care and is particularly so in the treatment of newborns. Continuous, effective provision of a basic set of interventions can have a highly positive impact on neonatal mortality, and most of these key interventions are delivered by nurses. Unfortunately, neonatal wards in low income settings are typified by a high ratio of sick infants to nurses, which makes it difficult to deliver even basic care and limits the level of quality that is achievable. In the context of neonatal nursing in low-income countries, nursing stress is of particular concern because workloads are higher and the demands on individuals are greater. While a great deal of research has been directed towards nursing stress, the study of how stress affects nursing practice at the ward level has not been a priority, particularly in LMIC settings. Instead, the study of nursing over-work, burnout and resilience has largely been focused on individuals and their personal, psychological characteristics. In the course of this study, the authors found that theories of individualised burnout and resilience did not help to explain the practices that seemed most important in reducing nurses' exposure to stress. Their research question asks instead how nurses collectively cope with workload and stress and how this affects nursing practice.
Sustaining safe and quality care in the SARS-CoV-2 pandemic hinges on the health and mental wellbeing of frontline healthcare workers. Medical staff face exhaustion, difficult triage decisions, separation from families, stigma and the pain of losing patients and colleagues, in addition to their own risks of infection. In this literature review, the authors describe the infection risks and mental health challenges that healthcare workers face in the COVID-19 pandemic and propose interventions to counter these in Africa. Lessons from previous disease-control efforts on the continent are highlighted and draw on experiences with SARS-CoV-2 in other parts of the world.