Developing an intervention to manage professional isolation among emergency nurses working in Lesotho: an action research approach.

Abstract

Introduction: Professional isolation is described as a deficiency in one’s network of social relations at work and is associated with compromised health service delivery and quality of life among health professionals, particularly those working in low-resource environments. Aim: to develop an intervention for managing professional isolation among emergency nurses working in Lesotho. Method: A mutually collaborative action research study, with an exploratory-descriptive qualitative design, was conducted in the emergency departments of five selected hospitals in Lesotho, with 25 purposively sampled registered nurses. A needs assessment was conducted through a scoping review and focus group discussions, followed by the establishment of a three-member research team (Cycle One). Thereafter, 13 individual interviews were conducted to explore the perceptions of professional isolation among emergency nurses (Cycle Two). The intervention, a Digital Community of Practice, was developed (Cycle Three) and facilitated through WhatsApp platform, then was implemented and evaluated in Cycle Four. Results: The scoping review highlighted there is limited literature on professional isolation among health professionals and the focus group discussions revealed that participants acknowledged that there was a need for such a study. Qualitative interviews exploring professional isolation resulted in an overarching theme of ‘feeling like an island’ and three categories; lack of interprofessional collaboration and consultation, skills mismatch, and enforced loneliness. Following consultation with the research team, a digital community of practice was developed for emergency nurses using the WhatsApp platform and then implemented. Conclusion This study revealed that emergency nurses in Lesotho do experience professional isolation and a digital community of practice developed using social media, such as WhatsApp, as a communication tool, could be considered as an intervention strategy for managing professional isolation among emergency nurses working in low-resource environments. However, it is recommended that a larger-scale study be undertaken to encourage the motivation for developing contextual interventions for addressing professional isolation in emergency care settings.