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32 NURSING SPOTLIGHT What chief nursing officers say contributes to moral distress: 5 notes By Erica Carbajal T he COVID-19 pandemic forced chief nursing officers to make tough decisions that led to moral distress, such as selecting nurses to work in COVID-19 units, according to a study published Aug. 31 in the Journal of Nursing Management. From October 2021 to January, researchers conducted virtual interviews with 13 chief and assistant chief nursing officers to explore the causes and effects of moral distress during the pandemic. Participants were required to have served as a chief/assistant nurse officer during the pandemic and to have been in their current position for at least one year. Five findings: 1. Decisions challenging fairness, such as selecting which nurses to assign to COVID-19 clinics or units, were among drivers of moral distress. 2. Exclusion from decision-making and failure to protect professional autonomy were also contributors to moral distress among CNOs. Decisions deemed invalid or overridden by senior management "caused CNOs to feel that they were not empowered with adequate professional autonomy in their current position," researchers said. 3. e inability to maintain continuity and quality of healthcare services was another driver of moral distress. Participants said they experienced this during COVID-19 peaks when hospitalizations increased and nurses became ill. 4. Chief nursing officers experienced emotional and physical effects stemming from moral distress. Emotional effects included feeling unhappy, hopeless and angry, and physical effects included sleep disturbances, palpitations and headaches. Some also considered quitting, the study found. 5. Staying up to date with the latest COVID-19 guidelines, effective communication and team collaboration were among factors that CNOs said mitigated their moral distress. n How Novant quickly increased its nurse workforce after an immediate jeopardy threat By Cailey Gleeson W ilmington, N.C.-based Novant Health New Hanover Regional Medical Center made significant progress in bolstering its nursing workforce this summer, adding more than 300 nurses. "What we've been able to do over the last two months has been extremely impactful, but we still have a ways to go," Amy Akers, BSN, RN, chief nurse executive at the hospital, said in an Aug. 31 statement. State inspectors visited the hospital in June and identified deficiencies regarding patient rights, nursing services, emergency services, quality assessment and performance improvement. Many of the care deficiencies at the hospital were related to its nursing shortages. CMS accepted Novant's correction plan Aug. 11, and the hospital regained compliance after a follow-up visit was performed. The hospital has brought on nurses through new graduates, a new residency program and traditional recruitment across the state. It has hired more than 100 travel nurses and 26 certified nursing assistants. More creative means of recruitment, such as allowing applicants to speak directly to recruiters, have also been embraced. "We're hearing from the team members that they feel the impact of the new team members coming in, so I think that's been really helpful," said Kirsti Smith, director of people and culture for Novant Health's coastal market. "We just want to continue to provide fantastic care and that's what we're going to do every day." n Beaumont- Spectrum system invests $20M to address nursing shortage By Mackenzie Bean B HSH System will invest more than $20 million over the next five years to increase Michigan's nursing workforce through a partnership with Oakland (Mich.) University. The health system, which comprises Grand Rapids, Mich.-based Spectrum Health and Southfield, Mich.-based Beaumont Health, will invest more than $10 million to fund scholarships for nursing students at Oakland University. After graduation, scholarship recipients must work at the health system for at least two years. Another $10 million will fund updates to the university's infrastructure, including lab and classroom spaces, to accommodate a larger volume of nursing students. n