BEGIN:VCALENDAR VERSION:2.0 PRODID:Linklings LLC BEGIN:VTIMEZONE TZID:America/Chicago X-LIC-LOCATION:America/Chicago BEGIN:DAYLIGHT TZOFFSETFROM:-0600 TZOFFSETTO:-0500 TZNAME:CDT DTSTART:19700308T020000 RRULE:FREQ=YEARLY;BYMONTH=3;BYDAY=2SU END:DAYLIGHT BEGIN:STANDARD TZOFFSETFROM:-0500 TZOFFSETTO:-0600 TZNAME:CST DTSTART:19701101T020000 RRULE:FREQ=YEARLY;BYMONTH=11;BYDAY=1SU END:STANDARD END:VTIMEZONE BEGIN:VEVENT DTSTAMP:20240325T185834Z LOCATION:Salon A-1 DTSTART;TZID=America/Chicago:20240325T143000 DTEND;TZID=America/Chicago:20240325T145000 UID:HFESHCS_2024 International Symposium on Human Factors and Ergonomics i n Health Care_sess116_INDLEC144@linklings.com SUMMARY:“HeRoEs WoRk HeRe”: An Exploration of the Impact of Pandemic Virtu e Signaling on Nursing Culture DESCRIPTION:Oral Presentations\n\nGrace Babalola (SUNY Binghamton Universi ty, Human-Centered Mindful Technologies Lab); Jack Felag (SUNY Binghamton University, Thomas J Watson College of Engineering and Applied Sciences); Sumantra Sarkar (SUNY Binghamton University); Zeynep Ertem (SUNY Binghamto n University, Thomas J Watson College of Engineering and Applied Sciences) ; Shannon Walter (SUNY Downstate Health Sciences University, University Ho spital at Downstate (UHD)); Marie-Claire Rosenberg Roberts (SUNY Downstate Health Sciences University, College of Nursing); and Stephanie Tulk Jesso (SUNY Binghamton University, Human-Centered Mindful Technologies Lab)\n\n Background: The COVID-19 pandemic significantly impacted healthcare system s and increased risks of moral distress and burnout among nurses. Past res earch indicates organizational cultural elements like leadership, work ove rload, role conflict, and centralized decision-making are antecedents to n ursing burnout (Cimiotti et al., 2012; Jun et al., 2021; Nabizadeh-Ghargho zar et al., 2020). In the US, phrases such as “healthcare heroes” were use d ubiquitously to express thanks to nurses and other healthcare workers. W hile the original intention might have been to appreciate the herculean ef forts by nurses, it was commonly perceived as propagating a harmful narrat ive that these individuals were disposable (Mohammad et al., 2021; Rainbow et al., 2012). We argue that this phenomenon should be classified as a “v irtue signal” (Peters, 2015), and that such low-effort expressions of mora l support are used to justify a lack of real support to nurses through inc reased pay and improved working conditions, and that this itself can lead to burnout (Alipio et al., 2023). Overall, to recognize the full impact of the pandemic on nursing burnout, it is necessary to examine how support t o nurses by organizations and society at large, during the pandemic differ ed from pre and post-pandemic experiences, and the cumulative impact on th e personal and cultural experiences of nurses.\n\nPurpose: This study expl ores how the usage of the term “hero” grew to signify frustration over the conditions nurses faced over the course of the pandemic, and how it compa red to the usage of other signifiers over the same time period. We present the first step of a “netnographic” analysis of nursing culture by examini ng social media posts at the r/nursing subreddit website.\n\nDesign and Me thod: Archived Reddit posts and comments on the r/nursing subreddit (Baumg artner et al., 2020; r/Nursing, 2023) between January 2018 and December 20 22 were analyzed to track the monthly usage of terms that were associated with the lived experience of nurses over the pandemic. Seventeen terms wer e selected with our nursing collaborators, including “hero”, “essential wo rker”, “pizza party”, “work from home”, “salary”, “wage”, “pay”, “wage the ft”, “overtime”, “union”, “strike”, “burnout”, “quitting”, “unemployment”, “telehealth”, “turnover”, and “great resignation”. Posts and comments whi ch contained the keywords or common permutations of keywords (e.g., “pay”, “paid”, “paying”) were included. Memes and the natural language used with in comments and posts will be qualitatively analyzed to assess the emotion al effect associated with keywords, and other pertinent aspects of nursing culture. Data was separated into three time periods: pre-pandemic (Jan 20 18 – Dec 2019), early pandemic (Jan 2020 – June 2021, in which the number of new daily cases fell sharply, prior to the “Delta Variant” arriving in the US; CDC, 2022; Mathieu et al., 2023), and late pandemic (Oct 2021 – De c 2022, which is the last available archived post). The time series reflec ting the usage of each term were plotted, and Spearman’s correlation was u sed to analyze the relationship between time series.\n\nPreliminary Findin gs: Reddit users in r/nursing were very active over the four-year window, with a total of 11,497 posts containing any keywords, and 181,822 comments on these posts which also contained any keywords. Initial qualitative ana lysis shows that these posts often describe negative lived experiences rel ated to the usage of the virtue signal “hero”. The title of this paper: “H eRoEs WoRk HeRe”, is a direct quote from one user’s post, where the altern ating usage of capital and lowercase letters indicates sarcasm and mockery (https://www.urbandictionary.com/define.php?term=aLtErNaTiNg%20CaPs). “Pa y” is the most frequently occurring term across comments and posts. The ke ywords “hero”, “burnout”, “union”, and “quitting” were selected and compar ed due to high usage and relevance to the study. These preliminary results indicate a sharp increase in posts and comments containing the keywords i n April 2020, with "hero" being the second most frequent after pay (n=51 i n posts, n= 642 in comments), followed by “union” (n=27 in posts, n= 530). Around June 2022 (a turning point in the pandemic where new daily infecti ons reached a local minimum in the US), trends appear to shift again with sharp increases in usage of our four keywords, and further stratify into t he following months. Across the three pandemic time periods, Spearman’s ra nk correlation was computed for comment data to assess the relationship be tween “hero” and “union” due to their similar observed peak in April 2020, between “burnout” and “quitting” due to their observed overlap in the lat e pandemic period, and “burnout” and “hero” due to the importance of compa ring these two concepts. In the pre pandemic period, “hero” and “union” ha ve a small, but statistically significant negative correlation (R(60) = -. 51, p = 0.01), but the correlation becomes positive in the early pandemic (R(60) = .68, p = 0.002), and disappears in the late pandemic (R(60) = .46 , p = 0.056). For “burnout” and “quitting”, there are no statistically sig nificant correlations in the pre (R(60) = 0.03, p = 0.88), and early (R(60 ) = .23, p = 0.37) periods, but a strong correlation is seen in the late p andemic period (R(60) = .91, p < 0.001). For “hero” and “burnout”, there i s a weak but statistically significant negative correlation in the pre (R( 60) = -.46, p = 0.024), pandemic period, none in the early (R(60) = -0.06, p = 0.92) period, but a strong positive correlation is seen in the late p andemic period (R(60) = .77, p < 0.001).\n\nConclusions: Preliminary analy sis demonstrates some of the nuance in nursing culture that is expressed o n r/nursing, that there are observable relationships between culturally-re levant keywords that appear in nurses’ posts and comments, and that these relationships changed over the course of the pandemic. We believe this sho ws some evidence that nurses perceived “healthcare heroes” as a virtue sig nal in the later pandemic period, and this is at least a partial explanati on for why “hero” became more associated with terms that signify negative experiences and dissatisfaction. Future work will explore individual posts in further detail and attempt to describe causal relationships using sent iment analysis. It is our hope that these findings can inform strategies t o mitigate nurse burnout.\n\nReferences:\nCenters for Disease Control and Prevention. (2022). CDC museum COVID-19 timeline. 2022.\nCimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and health care-associated infection. American Journal of Infection Contro l, 40(6), 486-490.\nJ. Baumgartner, S. Zannettou, B. Keegan, M. Squire, J. Blackburn, The pushshift reddit dataset, in: Proceedings of the internati onal AAAI conference on web and social media, Vol. 14, 2020, pp. 830–839.\ nJun, J., Ojemeni, M. M., Kalamani, R., Tong, J., & Crecelius, M. L. (2021 ). Relationship between nurse burnout, patient and organizational outcomes : Systematic review. International journal of nursing studies, 119, 103933 .\nMohammed, S., Peter, E., Killackey, T., & Maciver, J. (2021). The “nurs e as hero” discourse in the COVID-19 pandemic: A poststructural discourse analysis. International Journal of Nursing Studies, 117. https://doi.org/1 0.1016/J.IJNURSTU.2021.103887\nNabizadeh-Gharghozar, Z., Adib-Hajbaghery, M., & Bolandianbafghi, S. (2020). Nurses’ job burnout: a hybrid concept an alysis. Journal of Caring Sciences, 9(3), 154.\nPeters, M. (2015). Virtue signaling and other inane platitudes. The Boston Globe, 24.\nPhillips, J., Alipio, J. K., Hoskins, J. L., & Cohen, M. Z. (2023). The Experience of F rontline Nurses during the COVID-19 Pandemic: A Phenomenological Study. We stern Journal of Nursing Research, 45(4), 327–334. https://doi.org/10.1177 /01939459221129944/SUPPL_FILE/SJ-PDF-1-WJN-10.1177_01939459221129944.PDF\n Rainbow, J., Littzen, C., & Bethel, C. (2021). Nurses don’t want to be hai led as “heroes” during a pandemic – they want more resources and support. The Conversation. https://theconversation.com/nurses-dont-want-to-be-haile d-as-heroes-during-a-pandemic-they-want-more-resources-and-support-167763\ nr/Nursing. Reddit, 18 September 2023, www.reddit.com/r/Nursing.\nRoser, M ., Ritchie, H., Ortiz-Ospina, E., & Hasell, J. (2023). United States: Coro navirus pandemic country profile. Our World in Data.\n\nTrack: Hospital En vironments\n\nSession Chair: Kristen Webster (Cincinnati Children's Hospit al Medical Center) END:VEVENT END:VCALENDAR