Nurses Survive And Even Thrive In Tough Times A FORRESTER

Invest In Well-Being: Helping Nurses Survive And Even Thrive In Tough Times

1A FORRESTER CONSULTING THOUGHT LEADERSHIP PAPER COMMISSIONED BY CHAMBERLAIN UNIVERSITY, APRIL 2021

Table Of Contents

Executive Summary

Key Findings

The Pandemic Has Amplified The Importance Of Well-Being

Well-Being Assessment For Nurses: Methodology And Findings

It Takes A Village: The Case For A Comprehensive Support System

Societal Pressures Leave Nurses Feeling Helpless

Nurses Remain Passionate And Resilient

Key Recommendations

Appendix

3

4

5

7

10

13

15

17

19

ABOUT FORRESTER CONSULTING

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© Forrester Research, Inc. All rights reserved. Unauthorized reproduction is strictly prohibited. Information is based on the best available resources. Opinions reflect judgment at the time and are subject to change. Forrester®, Technographics®, Forrester Wave, RoleView, TechRadar, and Total Economic Impact are trademarks of Forrester Research, Inc. All other trademarks are the property of their respective companies. [E-49021]

Project Director: Mandy Polacek, Market Impact Consultant and Sean Galvin, Principal Analytics Consultant

Contributing Research: Forrester’s Employee Experience research group

INVEST IN WELL-BEING: HELPING NURSES SURVIVE AND EVEN THRIVE IN TOUGH TIMES 2

Executive Summary

On Wednesday, March 11, 2020, the World Health Organization declared the COVID-19 outbreak a global pandemic. Over a year later, and at the time of writing, the coronavirus pandemic has resulted in almost 150 million cases and over 3 million deaths worldwide.1 It has tested the physical, economic, and emotional resiliency of individuals, companies, and governments worldwide. And alongside the tragic loss of so many, the pandemic has compromised the mental health of frontline health workers, especially nurses, who have faced unique challenges in coping with increased burnout and stress.

To better understand the changes in nurses’ mental and physical well-being, Chamberlain University commissioned Forrester to create the Well-Being Assessment For Nurses. Over the course of seven months during the pandemic (from August 2020 through February 2021), Forrester conducted three waves of focus groups and surveys with more than 1,500 nurses of diverse demographics and areas of specialty; all surveyed nurses worked at facilities treating COVID-19 patients. And as expected, well-being scores decreased and increased relative to the rise and fall of COVID-19 cases regionally and nationally. Across all three waves, nurses cited a lack of bandwidth, time to prioritize self-care, and systemic support from leadership, professional associations, and the government. Despite work overload hampering their ability to prioritize themselves and their well-being, we found that nurses remained resilient and passionate about their work.

Key Findings


Key Findings

Nurses want more support. There is a disconnect between the support nurses say they need and the support they actually receive. More than one-quarter of nurses report they have not received the types of support included in our surveys (e.g., free access to mental health apps, hand cream/sanitizers that don’t dry out skin, empathetic personnel management, additional financial compensation, etc.).

Nurses prioritize patient care and forego self-care. At a time when self-care is more precious than ever, most nurses simply do not have the time or energy to focus on their own well-being.

Nurses find comfort in supporting each other. In all surveys and focus groups, we found that nurses consistently provide the highest levels of support to each other. In fact, nurses cited our focus groups as being “therapeutic,” and they took time during these sessions to ask each other questions to further understand and empathize with everyone’s unique situation.

Nurses remain resilient and passionate about their work, but some are looking to find new jobs. While 62% of nurses plan to stay with their current employers, 38% plan to actively look for new opportunities in the next 12 months.

4INVEST IN WELL-BEING: HELPING NURSES SURVIVE AND EVEN THRIVE IN TOUGH TIMES

“A lot of my staff have struggled with mental

health since this began.”

Wave 3 frontline nurse, working in Wisconsin

The Pandemic Has Amplified The Importance Of Well-Being

According to the CDC, there is no consensus around a single definition of well-being; however, at a minimum, well-being includes positive emotions and moods, satisfaction with life, fulfillment, and positive functioning.2 The pandemic has amplified already rising levels of employee stress, anxiety, and depression, highlighting the importance of investing more in improving nurses’ well-being.3 Healthcare leaders should heed this call because:

• So much depends on the well-being of healthcare workers, including both the public’s health and healthcare companies’ bottom lines. Before the pandemic, more than 200 million workdays were lost due to mental health conditions annually; this is the equivalent to losing $16.8 billion in employee productivity and engagement in the US. Lack of mental health support exacerbates existing chronic conditions, leading to higher medical spend — estimated at more than 300% higher costs per individual in the US when compared with an individual who had access to and leveraged available support. The good news? Research on mental health support points to a positive impact on productivity and medical spend if individuals can access care.4

• Alleviating nurse burnout is an ongoing challenge. Healthcare professionals are generally considered to have one of the highest risks of burnout. This is likely due to the emotional strain of providing care for and attending to sick and dying patients. According to the article, “Prevalence of and Factors Associated With Nurse Burnout in the US,” previous studies demonstrate that 35% to 54% of clinicians in the US experience burnout symptoms.5 Among the nurses who’ve reported leaving their jobs in recent years, a high proportion owe their departure to burnout.6 And while it’s easy to assume that burnout has stalked the nursing profession — to some extent — throughout its history, there is literature from previous epidemics (e.g., H1N1 influenza, severe acute respiratory syndrome, Ebola) that suggests nurses experience


significant stress, anxiety, and physical effects related to their work.7

• Nurses consistently self-report low levels of well-being. Nurses are acutely aware of the fact that their personal well-being has plummeted since the beginning of the pandemic. In each survey, we asked nurses to self-assess their well-being, taking into consideration their stress levels, the types of support they have received, and their ability to prioritize self-care. Less than one-third of nurses reported high levels of well-being at any time during the pandemic (see Figure 1).

Figure 1

Self-Reported Well-Being

“Keeping in mind both your stress level, different kinds of support you receive, and your ability to practice self-care to help yourself cope with stress, how would you estimate your general level of well-being at different times below?”(Showing top 3 on a 7-point scale from “Very low” to “Very high”)

General level of well-being before COVID-19

General level of well-being at the time of the biggest spike in the number of COVID-19 patients in your area

General level of well-being in the past month

Wave 1 Wave 2 Wave 3

Base: 523 respondents in Wave 3, 538 respondents in Wave 2, and 476 respondents in Wave 1Source: A commissioned study conducted by Forrester Consulting on behalf of Chamberlain University, 2021

71%

29%

43%

77%

32% 32%

76%

28%

44%


To fully measure and understand the trends in well-being relative to the physical and mental effects of the pandemic on nurses, Forrester created the Well-Being Assessment For Nurses. To create this assessment, Chamberlain University commissioned Forrester to explore the relationship between different aspects of well-being and nurses’ self-reported well-being scores. The three selected aspects of well-being were burnout, support, and self-care (see Figure 2 and Appendix A for definitions and a more detailed methodology). Forrester found that high well-being scores can be achieved when nurses experience empathy and are provided time to regularly recharge, as well as access to mental and physical health resources that best meet their individual needs. Healthcare leaders and their employees can use this assessment to gauge where well-being support is most needed at different times across facilities and teams. The creation of this model, as opposed to solely relying on self-reported data, enables more consistent comparisons and robust trending results across different segments of nurses.

Well-Being Assessment For Nurses: Methodology And Findings

Figure 2

Well-Being Assessment For Nurses: Methodology

Burnout

Self-care Support

These three aspects of well-being were weighted according to their relative impact of self-reported well-being scores.

The weighted score was then transformed into a value on a scale from 0 to 100.

0 to less than 20

See Appendix A for a more detailed methodology

Burned out Needs improvement Average Good Excellent

20 to less than 40 40 to less than 60 60 to less than 80 80 to 100



Analysis of the data and model uncovered the following:

Burnout and self-care are the biggest predicators of well-being. Self-care far outweighs burnout and support as the most significant predictor of well-being. In other words, the greater a nurse’s ability to prioritize self-care, the higher their well-being score will be. Nurses were asked to report on their level of self-care at the time of taking the survey, with examples including developing a healthy diet, exercising, sleeping regularly, practicing meditation, and taking regular breaks to “recharge.” Burnout is also a significant indicator. The more burned out a nurse feels, the lower their well-being score will be. And while support on its own is a less significant indicator, the type of support that their ecosystem provides directly impacts both burnout and nurses’ ability to prioritize self-care (see Figure 3).

As cases rise, well-being crumbles. Well-being scores shared an inverse relationship with the rise and fall of US COVID-19 cases. For example, when cases were the highest in Wave 2, only 27% of nurses experienced high well-being scores, i.e., the scores ranged from 60 to 100. In Wave 3, 38% of nurses experienced high well-being scores (see Figures 4 and 5).

Figure 3

Relative Impact Of Each Aspect As A Predictor Of Well-Being

Base: 1,537 nurses who worked at facilities that treated COVID-19 patientsSource: A commissioned study conducted by Forrester Consulting on behalf of Chamberlain University, 2021

63%

29%

8%

Burnout SupportSelf-care



Base: 523 respondents in Wave 3, 538 respondents in Wave 2, and 476 respondents in Wave 1Source: The COVID Tracking Project, US Daily Cases, 7-Day Average Line (https://covidtracking.com/data/charts/us-daily-positive)

Figure 4

Fieldwork Timing

Figure 5

Distribution Of Well-Being Score Categories

0 to less than 20 20 to less than 40 40 to less than 60 60 to less than 80 80 to 100

Wave 1 Wave 2 Wave 3

9%

19%

36%

22%

13%17%

25%31%

19%

8%11%

20%

33%

23%

15%

Wave 1 focus group

Wave 3 focus group

Wave 2 focus group

Wave 1 survey Wave 3

survey

Wave 2 survey

Burned out Needs improvement Average Good Excellent


Base: 1,537 nurses who worked at facilities that treated COVID-19 patients Source: A commissioned study conducted by Forrester Consulting on behalf of Chamberlain University, 2021

It Takes A Village: The Case For A Comprehensive Support System

There is no doubt that life as we know it has changed profoundly in the last year. In many areas of society, the pandemic has upturned norms, accelerated trends, and exacerbated already existing challenges. And the nursing profession did not escape these effects. Nurses in the US have long struggled with their challenging frontline role in healthcare, which is made evident by consistently heavy workloads and through the need to prioritize the management of their personal and professional well-being. This struggle is not one that can be taken alone; nurses critically rely on the support of their work ecosystem. Our survey respondents noted:

• Resources provided are often misaligned. More than one-quarter of surveyed nurses report they have not received the types of support included in our surveys (e.g., free access to mental health apps, hand cream/sanitizers that don’t dry out skin, empathetic personnel

Figure 6

Types Of Support Needed Vs. ReceivedNeeded Received

Additional financial compensation 20%92%

Flexibility in shift scheduling 21%83%

Empathetic personnel management 24%83%

Hand cream/sanitizers that don’t dry out skin or other types of cosmetics in restrooms at work 25%

72%

Food and/or supplements that boost immunity 13%69%

Free consultations with mental health experts 29%61%

Free fitness/yoga classes 7%57%

Help with childcare 13%53%

Free access to mental health apps 21%53%

Virtual meetings with other nurses 19%37%

Apps reminding about healthy habits 14%33%

Other 2%59%

of surveyed nurses report receiving none of these types of support.

27%



management, additional financial compensation, etc.). Those who have received support find that it is sometimes misaligned with what they need. For example, 83% say they need empathetic personnel management, something that only 24% have received. And with increased caseloads, 83% seek more flexibility in shift scheduling, but only 21% feel they have received such flexibility. One nurse from a focus group shared, “Trying to get the additional staff is next to impossible, and a lot of people are out sick or having to quarantine for a short period.” Another stated, “We do not have enough staff or providers, and it’s affecting our [nurse-to-patient] ratio.”

• Nurses lack the time for self-care. While 69% of nurses understand the importance of self-care, relative to their abilities to care for their patients, 67% report that they simply lack the time to focus on self-care — a sentiment shared across all focus groups (see Figure 7). A nurse in one of our focus groups shared: “I used to do yoga and meditation. I’m not doing them as frequently. I’m extremely exhausted and fogged out all the time so even on my few days off, I can’t get motivated to do any of that.”

Figure 7

“Which of the following do you think are the most important factors that set you up for success as a nurse?”

“I truly feel like we get the most support

from other nurses. I don’t think anyone

else knows what we’re going through.”

Wave 2 non-frontline nurse, working in Illinois

Quality clinical skills

Taking a good care of yourself in order to have enough physical and emotional resources to care for your patients

of surveyed nurses report they do not have time to self-care to cope with stress.

Finding a good mentor

Having the right personal traits

Caring for your colleagues

83%

69%

53%

51%

15%

67%


• Nurses find the most comfort in leaning on each other. Fellow nurses remain the number one support group for nurses during the pandemic, followed by their personal networks. Leadership, professional associations, and the government all significantly lag behind (see Figure 8). In our focus groups, nurses shared that signs of empathy such as simply being thanked for their efforts, remind them of the reasons why they are doing the work they do. One nurse from a focus group shared: “We have several new mothers on the floor. We set up volunteers so instead of them floating, we [those without children] would float for them, and they were really touched by it and very thankful.”

Figure 8

“How would you estimate the level of support you have been receiving from the groups below, related to the COVID-19 pandemic? Please think about your entire time working since the beginning of the first wave of COVID-19.”


Your colleagues

People outside your work (family, friends, neighbors, etc.)

Your management

Professional association/nonprofit organizations

Government

75%66%42%22%15%


As nurses lack the time and ability to self-care, the last bastion is often the support of their families and friends. However, as many nurses shared, they felt more isolated and alone as their families and communities failed to take the pandemic seriously.

• As masks go down, anxiety goes up. Eighty percent of nurses report that they feel frustrated when people do not wear masks in public (see Figure 9). This was a recurring theme in our focus groups. Several nurses shared the difficulty in treating critical COVID-19 patients and then seeing and hearing their friends and neighbors make light of the pandemic.

• Nurses are feeling helpless. Eighty-one percent of nurses feel distress over events like politics and natural disasters, while 83% feel distress over the uncertainty of life ever getting back to normal. And 71% feel helpless in not being able to help their patients more (see Figure 9). When asked during focus groups how they were feeling, nurses consistently echoed this feeling of helplessness, although they also shared a feeling of hope with the rollout of vaccines. Sentiments shared in our focus groups include: “There’s a lot of depression; there’s a lot of anxiety,” “We’re in a lot of grief,” and “I feel numb.”

Societal Pressures Leave Nurses Feeling Helpless


Figure 9

“How much do you agree or disagree with the following statements about the past month?”(Showing top 3 on a 7-point scale where 1 is “Strongly disagree” and 7 is “Strongly agree”)

I feel generally more stressed out by the uncertainty in different aspects of life and not knowing when things will get back to normal

I feel distressed from the political climate, natural disasters, and/or other events taking place this year

I feel frustrated when people do not wear masks in public settings

I feel anxious about the high risk of catching COVID-19 at work and having health complications as a result

I feel helpless from seeing my COVID-19 patients suffering and not being able to help more

I feel burnt out from not being able to take time off for a long time

I feel frustrated from dealing with patients who weren’t honest about their symptoms

I feel helpless from not being able to provide full support to my non-COVID patients as I normally would

I feel distressed from facing social inequalities reflected in the COVID-19 hospitalization and death rates

I feel upset by the unfair treatment from my management

The circumstances related to COVID-19 have a negative impact on my family relationships

I feel stressed from having to do things I haven’t been trained to do at work

I feel distressed by having to make hard decisions about which patients to save

83%

81%

80%

72%

71%

69%

68%

59%

54%

54%

51%

50%

40%



Despite all of these challenges, the majority of surveyed nurses remain passionate about their work, and they do not plan on abandoning nursing as a profession. Seventy-six percent of nurses report they remain enthusiastic about their work. In fact, a nurse in one of our focus groups stated: “You still have those aha moments where it’s like, ‘Oh yeah, this is the reason why I’m still doing this.’ I would not trade going into nursing because of the pandemic.” However, while 62% of nurses plan to stay with their current employer post-pandemic, 38% plan to actively look for new opportunities in the next 12 months (see Figure 10). There is an opportunity for employers to reverse this trend by investing the appropriate resources in the well-being of their nurses. In fact, the Forrester Analytics Business Technographics® Workforce Survey shows that 94% of the most engaged employees plan to stay with their employers for the next year, versus 41% for the least engaged.8

Nurses Remain Passionate And Resilient

Figure 10

“How likely are you to:”(Showing top 3 on a 7-point scale where 1 is “Not likely at all” and 7 is “Very likely”)

Stay at your current employer for next 12 months

“I am enthusiastic about my job.”

Recommend others to choose the same career path

Actively look for new opportunities outside of your workplace in the next 12 months

Change your profession in the next 12 months


12%

38%

42%

62%

76%


Key Recommendations

“I love nursing and would probably stay in this field, but after this pandemic, I would focus more on holistic and preventative needs. We are just crisis-managing, and [we’re] not [focused on] public health.”

Wave 3 frontline nurse, working in California


Key Recommendations Given the time and space to properly manage well-being, nurses can avoid burning out during highly stressful circumstances. Providing support for well-being is vital for a range of outcomes, including improved patient care, reduced nurse turnover, and lower employee healthcare costs. Leaders should keep in mind that this is a long game because employees will remember how their organizations treated them through a crisis, long after it passes. Short-term investments in the improved care and support of employees should be framed as a long-term investment in their engagement and commitment to your organization.

Forrester’s in-depth surveys and conversations with US nurses over the course of six months of the pandemic yielded several important recommendations:

Provide organizational support for well-being.

Organizational support for well-being means providing resources for both physical and mental health, i.e., allowing nurses the time and space to take advantage of the available options such as counseling and/or therapy. In addition to individual therapy, group sessions can provide a safe space for nurses to share their feelings and experiences with each other. On the more comprehensive end, providing organizational support for well-being also means creating a culture that reinforces these efforts; for instance, deliberately recognizing nurses uniquely for their hard work, accomplishments, and personal sacrifices at all levels of the organization.

Cultivate empathy in senior leadership.

The two largest gaps in support needed vs. support received were for additional compensation and more flexible shift scheduling — both things that require significant financial resources that many healthcare providers do not have. However, the third largest gap was a need for more empathetic management. In this context, empathy takes on the appearance of attentively listening with care and compassion to nurses’ struggles, worries,

17INVEST IN WELL-BEING: HELPING NURSES SURVIVE AND EVEN THRIVE IN TOUGH TIMES

and needs. Empathy and compassion are behaviors that can be cultivated at little or no cost. And in terms of the time invested, these behaviors are of great value to managers who are learning how to be good, caring listeners. Many noted that additional words of encouragement and support, or some extra recovery time, would have made the difference.

Use learnings from the pandemic to prepare for the future.

The pandemic has given organizations a chance to learn how to be more resilient for a seemingly tumultuous and unknown future. Putting programs and policies in place now to improve nurses’ well-being will not only ensure they keep from burning out, but it will also set them up success when we need them the most.

Leave room for individual needs.

Not all nurses need the same kind of support. Some have additional demands at home, such as childcare or elderly care, while others might have more established habits that keep them physically and emotionally healthier under stress. Support programs need to account for and prioritize these differences.

Use this Well-Being Assessment For Nurses to guide future efforts.

This assessment offers a valuable way to understand the differences in support needs, and it will allow organizations to set better priorities accordingly. Leaders can moderate burnout by enabling self-care, providing support for personal well-being, and actively recognizing nurses uniquely for their hard work and accomplishments.


In this study, Forrester conducted three waves of focus groups and surveyed more than 1,500 nurses to understand the state of nurses’ well-being and the impacting factors, namely burnout, self-care, and stress. Burnout was measured via individuals’ specific level of agreement with a series of statements that sought to understand exhaustion and engagement standards. Support was measured via the level of support nurses received from colleagues, management, family and friends, professional associations, and the government. Self-care was based on how well nurses reported being able to care for themselves at the time of taking the survey. Survey and focus group participants included frontline and non-frontline nurses representing diverse US regions and age groups. All nurses worked at facilities that treated COVID-19 patients. The study began in September 2020, and it was completed in February 2021 .

Appendix A: Methodology

PRIMARY WORK SETTING (SHOWING TOP 4)

Community public hospital 38%

Community private hospital 15%

Outpatient care facility/clinic 11%

Academic medical center 11%

AGE

18 to 34 33%

35 to 49 44%

+50 22%

ROLE

Registered nurse 82%

Advanced practice nurse 17%

Licensed practical or vocational nurse 1%

REGION

Northeast 20%

Midwest 31%

South 35%

West 14%

FRONTLINE/NON-FRONTLINE

Frontline 39%

Non-frontline 61%

GENDER

Female 91%

Male 9%

Appendix B: Demographics


Appendix C: Supplemental Material

RELATED FORRESTER RESEARCH

“Invest Now: Build A Resilient Workforce By Prioritizing Employee Mental Health,” Forrester Research, Inc., March 15, 2021.“Lack Of Mental Health Support Puts Sustained Post-Pandemic Business Continuity At Risk,” Forrester(https://www.forrester.com/fn/5MMQXXUXvTU0yXnO7gEDBw).

Forrester explored the relationship between different aspects of well-being and the surveyed nurses’ self-reported well-being scores in order to identify the core building blocks of the Well-Being Assessment For Nurses. • The benefit of using an index (i.e., a composite score) instead of a single variable (i.e., self-reported

well-being score) enables more consistent comparisons across different segments of nurses and more robust trending results.

Nurses’ self-reported well-being scores are based on the following question and a 7-point scale: “Keeping in mind both your stress level, different kinds of support you receive, and your ability to practice self-care to help yourself cope with stress, how would you estimate your general level of well-being in the past month?”The following three aspects of well-being were selected as primary candidates for the index development:

Well-Being Assessment For Nurses: Methodology

ASPECT OF WELL-BEING SURVEY QUESTIONS (BASED ON A 7-POINT SCALE)

Burnout(an arithmetic average of the eleven ratings (flipped to convey positive sentiment) was used for the burnout variable)

“How much do you agree or disagree with the following statements when thinking about your typical workday?”• I feel fatigued when I think about facing another workday at my job. • I tend to talk about my work in a negative way more often than in the past. • After most workdays, I feel worn out and tired. • Lately, I’ve been feeling less and less present at work. • I feel like I’m working too hard at my job.• When I think about my future at my job, it’s hard to feel excited. • Lately, I tend to think less at work and feel like I’m just going through the motions. • More and more, I find myself being easily distracted at work.• I feel frustrated by my work. • I am overwhelmed by my work. • I feel emotionally exhausted by my work.

Support(an arithmetic average of the five ratings was used for the support variable)

“How would you estimate the level of support you have been receiving from the groups below, related to the COVID-19 situation?”• Government• Professional associations/nonprofit organizations• Your management • Your colleagues• People outside your work (family, friends, neighbors, etc.)

Self-Care“How well do you feel you were able to do each of the following in the past month? Examples of self-care activities include developing a healthy diet, exercise/sleep routine, practicing meditation, taking regular breaks to ‘recharge,’ etc.”


Appendix D: Endnotes1 Source: “Coronavirus World Map: Tracking the Global Outbreak,” The New York Times, April 29, 2021 (https://www.nytimes.com/interactive/2020/world/coronavirus-maps.html).2 Source: “Well-Being Concepts,” Health-Related Quality of Life (HRQOL), Centers for Disease Control and Prevention, October 31, 2018 (https://www.cdc.gov/hrqol/wellbeing.htm).3 Source: “Invest Now: Build A Resilient Workforce By Prioritizing Employee Mental Health,” Forrester Research, Inc., March 15, 2021.4 Source: Arielle Trzcinski, Annalise Clayton, and Caleb Ewald, “Why Mental Health Needs To Be On Every Company’s 2020 Agenda,” Forrester Blogs, December 9, 2019 (https://go.forrester.com/blogs/mental-healththe-not-so-widely-talked-about-problem-that-needs-to-be-on-every-companys-agenda-in-2020/).5 Source: Ibid.6 Source: Shah M.K., Gandrakota, N., Cimiotti, J.P., Ghose, N., Moore, M., & Ali, M.K. (2021). Prevalence of and Factors Associated With Nurse Burnout in the US. JAMA network open, 4(2), e2036469. https://doi.org/10.1001/jamanetworkopen.2020.364697 Source: U.S. Department of Health and Human Services, Health Resources and Services Administration, National Center for Health Workforce Analysis. 2019. Brief Summary Results from the 2018 National Sample Survey of Registered Nurses, Rockville, Maryland. (https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/nssrn-summary-report.pdf).8 Source: Fernandez, R., Lord, H., Halcomb, E., Moxham, L., Middleton, R., Alananzeh, I., & Ellwood, L. (2020). Implications for COVID-19: A systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International journal of nursing studies, 111, 103637. https://doi.org/10.1016/j.ijnurstu.2020.1036379 Source: Forrester Analytics Business Technographics Workforce Survey, 2020. The base of this survey includes 10,749 global information workers who score either low, medium, or high on Forrester’s Employee Experience Index.


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Nurses Survive And Even Thrive In Tough Times A FORRESTER