Perceived effects of burnout on patients and its management among nurses in the Intensive Care Unit and Emergency Department of a Rwandan University Teaching Hospital

Background: The level of burnout among nurses working in the Intensive Care Unit (ICU) and Emergency Department (ED) is high, which adversely affects health and work-related outcomes for both nurses and patients. Little is known about burnout among ICU and ED nurses in Rwanda.Objective: To explore the perceived effects of burnout among nurses and its management at a referral hospital in Rwanda.Methods: A qualitative study design was carried out using focus groups. A purposive sample of six ICU and six ED nurses were recruited from the referral hospital in the capital city of Kigali. The discussions were audio-recorded in Kinyarwanda, transcribed verbatim into English and analysed inductively using thematic analysis.Results: Burnout among the 12 nurses was high and the five main themes namely, high burnout, the Variability of care, Incomplete care, Erratic care and Improving situation to prevent burnout.Conclusion: The results of this study indicated that burnout is high between the ICU and ED study population and nurses need to be taken care of too. A good working environment addressing adequate staffing, specialty training, operational materials, and social activities are needed to improve unit functioning, and patient satisfaction and safety.Keywords: Burnout, nurses, Intensive Care Unit, emergency department, patient car

Hemodialysis care by nurses: exploration of performance factors at four nephrology units in Rwanda

Background: Hemodialysis is the most standard method of Renal Replacement Therapy (RRT) used in Rwanda. Nephrology nursing is a new speciality, and little is known about the nurses’ work performance while caring for patients under going hemodialysis.Objective: To explore factors influencing nurse’s work performance in the care of hemodialysis patients in four nephrology units in Rwanda.Methods: A qualitative descriptive design used a purposive sampling strategy to recruit 12 registered nurses working on the hemodialysis unit. Data were collected through interviews using a semistructured guide. Data analysis used a thematic approach with six phases.Results: Two themes and eight subthemes were revealed. Facilitating factors to increase work performance included the nurses’ education and speciality training, good working environment, good interpersonal relationships among staff, and effective management and leadership. Barriers included, self-perceived knowledge and skills insufficiencies, moral distress, logistical concerns, and poor working conditions.Conclusion: The findings revealed specific facilitating factors and barriers to nurses’ work performance. Nurses at these study sites, in conjunction with faculty in the Master’s Nephrology Track at the University of Rwanda, could become change agents and begin to increase facilitating factors and decrease barriers. Continual improvement in facilitating factors is needed to keep nurses performing well.Keywords: Nephrology, hemodialysis, nurses, work performanc