Table 6 Qualitative findings summarized from the open survey questions and semi-structured interviews.

Helpful aspects

Interpersonal exchange

The exchange and interaction with colleagues created a sense of cohesion and mutual understanding; it gave the opportunity for discussion, and expressing one´s own opinion

“I found the discussions in the group very helpful for exchanging ideas and getting rid of things.”

Self-reflection

Continuously self-reflecting and becoming aware of one´s own thoughts, feelings and reactions helped to identify areas of control

“Worthwhile and very special to have this opportunity for personal reflection.”

“I can change myself and my point of view, not the others.”

Feeling of appreciation

Feeling valued and seen as a person

“Being brought to realize how important you are was very helpful for me.”

Gaining relevant knowledge

Being shown different ideas, possibilities and options to act

“…interesting new thought-provoking ideas and breathing exercises that are easy to use”

Moment of inner peace

Sessions offered the opportunity to find a moment of inner peace and mindful breathing, to treat oneself with something nice

“…to find a moment of inner peace, to breathe consciously”

Low-threshold to participate

Sessions held at study sites, no additional time required to get there

“The easy access of the offer was helpful.”

Regular appointments

Fixed appointments created a sense of commitment

“Regular appointments created a sense of commitment.”

Barriers

Session duration

Sessions too short, especially for group exchange exercises; on the other hand, some participants estimated the time required for the program as difficult to reconcile with the ward routine

“There was not enough time for exercises and exchange.”

“The course times are not compatible with everyday working life.”

Lack of support by leaders

Assumed lack of support and understanding from leaders

“Other employees were interested, but e.g. physicians argued: ´they [bosses] won’t give me time off for that.´ They don’t dare to ask.”

Role conflict

One participant in the role of a nurse director took part with a nurse from the same team

Perceived effects

Growing awareness and self-reflection

Becoming aware of the importance of one´s own health; reflecting oneself, behavior and thought patterns, which helps to choose different reaction patterns

“It was an enrichment for everyday life to deal differently with myself and my colleagues.”

“It increased the awareness of your own situation, recognition of stress, opportunities to act.”

Application to practice

Applying some exercises and techniques from the program within ward teams

“We self-organized the ´dyad concept´ in the team - after the Monday meeting, 2.5 min. I’ve been thinking about doing that in private too.”

Empowerment

Participants experienced the program as motivating for change

“The program was positively encouraging and motivating to change things.”

Patient perspective

Experiencing the exercises oneself helped to take patients´ perspectives

“It was a great experience for me because I accompany patients in the day clinic. Now I’ve experienced first-hand what’s easy and what’s hard, and now I realize for myself why it’s sometimes not that easy.”

Sense of connectedness

A feeling of common humanity, not being alone with one´s problems

“It’s often reassuring to hear that things are stressful elsewhere too. And that you’re not alone. I always thought it was just me!”

Sense of calmness

Sense of calmness through reflection where to put in energy and where not

“I have become calmer.”

“I don’t let stress get to me.”

Influence by/on work fellows

Support by leaders

Contradictory experience, some indicated to experience their leaders as supportive and committed, others described their leaders as skeptical about the program and criticized their lack of interest

“The ward manager was totally committed and made a big effort.”

“My boss was skeptical about it.”

“It was waved through by the clinic and nurse management, but they never asked how things were going"

Influence on colleagues

Colleagues were inspired to deal with the topics themselves

“For some, it has given impulses as to how things could run better.”

Proposed adjustments

Session duration

Suggested session length to be at least two hours; more time for exchange and practical exercises

“The course time should be extended to 10–12 sessions with the individual lessons being 2 hours long.”

“Please make sure that the times for mutual exchange are extended.”

Session content

More practice rather than theory and repetition of the learned concepts, providing the rationale for some exercises

“More practice and repetition would be useful”

“I would like to know the background to some of the exercises. What it is good for”

Hybrid-format

In-person sessions were preferred due to a better group dynamic, although online sessions were described as feasible and working well

“Contact was relatively good in the online sessions, but in-person was much better.”

Further ideas

Exchange platform

Possibility for exchange with colleagues and staying in touch beyond the scope of the program was desired; proposals were to offer a platform for participants to keep in touch

“A blackboard in the hospital would be cool for activities, e.g. on Mondays we meet up for a walk, have coffee… where we can simply get together as nursing staff and exchange ideas. An opportunity to maintain social contacts and get to know the teams better”

Feedback platform

Establishing a platform for feedback, points of improvement and solutions

“A structure, being able to write what is not good and finding solutions for it, would be useful”

Leader involvement

A desire for more leader involvement and appreciation

“…to get the management on board and show how important their appreciation is for the quality of life at work. There is a longing to be seen. Sometimes it can’t be satisfied, but it would be good if it came up a little.”