Paving new pathways for happier, healthier nurses 

18 August 2021

Article from July 2021 edition of INPractice

How Dr Rebecca Jarden went from culinary catering for Xena: Warrior Princess to a career focused on the wellbeing of nurses.

Prior to her distinguished career as a nursing lecturer Rebecca Jarden used to cater to the wellbeing needs of such international screen stars as Lucy Lawless and Kevin Sorbo.

Having just graduated with a uni degree in anthropology and psychology, a young "what am I going to do now?" Rebecca managed to score a novel job as a cook on the sets of Xena: Warrior Princess and Hercules, two very popular American TV series filmed in her native New Zealand.

Years later, Dr Jarden is now a lecturer in nursing at the University of Melbourne. With an interprofessional team including clinicians, researchers and health care organisations such as the Nursing and Midwifery Program - Victoria, they have embarked on a major piece of research on nurse wellbeing, aimed at improving the working lives of nurses and to make the profession of nursing an attractive proposition for future generations.

Their research project, Supporting graduate nurse wellbeing, work wellbeing and mental health, secured a $47,000 grant from the Rosemary Bryant Foundation, which is based at the ANMF (SA Branch)'s Ridleyton headquarters. The Foundation aims to support the wonderful work" of Australia's 360,000 nurses and midwives by raising funds to improve health outcomes through nursing and midwifery-led research.

Named after Rosemary Bryant AO, Australia first Commonwealth Chief Nurse and Midwifery Officer, Emerita Director of Nursing at the RAH and honorary life member of the ANMF (SA Branch), the Foundation seeks applications for high­-quality research projects which have a strong focus on being able to be translated into practice.

Dr Jarden's study fits the bill. The first aim was to determine the prevalence and predictors of nurse wellbeing, work wellbeing and mental health.

Based on the findings of Dr Jarden and the team's analysis, effective nurse leadership, support, and resourcing were essential for nurses work wellbeing.

The second aim was to explore nurses' perceptions of barriers and enablers of their wellbeing, work wellbeing and mental health.

"The importance nurses attributed to enablers such as work/life balance, social connection, psychological wellbeing and physical health provides key areas to focus both longitudinal work wellbeing  assessments and future workforce interventions," she says.

Dr Jarden says research to date has developed a contextualised understanding of the enablers of nurses wellbeing, extending from the individual to the team and to the organisation.

"Examples from the nurses included having a sense of workllife balance, their social connections, feeling respected and valued, experiencing safe and supportive work environments, having a really strong team-focused leader or leaders and then experiencing adequate breaks, fair rostering practice, and having sufficient leave," she says.

"Some or this came down to individuals engaging in self-care such as exercise, hobbies, getting good sleep and practising mindfulness and meditation. However, more broadly at a team and organisational level the nurses wanted to be able to create work/hie balance, so getting as much autonomy as possible in terms of their rostering was seen as an important enabler. From a phys,cal and psychological health perspective it was really about being able to access support when they needed it and in a way that enabled 'connection', and in a way that enabled connection'.

"It can now be hypothesized that those nurses who report feeling connected, valued, respected and supported, with work-life balance and adequate workloads work-life balance and adequate workloads will report experiencing higher levels of psychological wellbeing (e.g., flourishing, work satisfaction) and lower mental illbeing symptoms (e.g. depressed mood, distress), symptoms (e.g., depressed mood, distress).

"With this greater understanding of what these nurses feel enables their wellbeing, the next step is to think about the different domains that they've identified and really start unpacking these domains with the nurses and health care organisations to determine the next steps," determine the next steps."

Given the predicted large numbers of nurses and midwives leaving the profession in the next 10 years due to retirement and illbeing, Dr Jarden believes such research is critical.

"This work is going to inform targeted wellbeing initiatives that will not just address factors contributing to the predicted shortage of nurses, but also enhancing the working lives of nurses," she says.

"We can now leverage this research to advise educational and organisational practice changes in the ways student and new graduate nurses are educated and supported in relation to their mental health and psychological wellbeing. Secondly, this contextualised understanding informs the development and implementation of nurses' mental health and wellbeing interventions and programs. Thirdly, the dissemination of these findings now informs policy in future-proofing the nursing workforce, supporting both enhanced recruitment and retention."

The daughter of a practice nurse (who is still nursing in New Zealand), Dr Jarden is a Registered Nurse and Masters of Nursing graduate from the Victoria University of Wellington, and has worked in various nursing guises, including intensive care, in London, Auckland and Australia.

She has primarily nursed in cardiothoracics and tertiary critical care across a range of roles including flight retrieval and associate charge nurse manager - mainly at the Wellington Regional Hospital ICU. In 2014 she took on a formal teaching role at the Auckland University of Technology as a nurse lecturer, later moving to the University of Melbourne.

"I maintain a passion for critical care nursing, leadership and management, quality improvement in health care, and creating positive workplaces," she says.

Dr Jarden says the COVID-19 pandemic had brought about many challenges for nurses, with mask wearing and physical distancing impacting on the sense of social connectedness. Institutions like the Rosemary Bryant, Foundation were, absolutely essential, crucial". "I'm just so incredibly grateful, on behalf of nurses everywhere, for investing in this project," she says.

"It's nurses caring about nurses and an organisation and government that's willing to invest in that and think about what creates a great day for nurses out there that make all the difference.

"It's a highly important initiative because investing in nurses' wellbeing influences not just the recruitment and retention of nurses, but also patient safety."

Harping back to the wellbeing of Xena and Hercules?

"We would head out to the filming location at the crack of dawn on a truck which was all set up as a kitchen Dr Jarden says.

"The film crew would go and do their filming and we would be whipping up some fabulous brekkie, lunch and arvo tea. it was pretty gourmet food.

From memory, Kevin Sorbo loved his tinned tuna with pasta - couldn't go too wrong there. Lucy seemed to enjoy whatever we were cooking."

Click here to read the July 2021 edition of INPractice