ABSTRACT
[...]the relationship between exercise volume during a pandemic and COVID-19 disease severity was examined to inform the nursing community and others who educate patients on a healthy lifestyle. Researchers have concluded exercise may play an important role in countering respiratory symptoms associated with COViD-19 (Mohamed & Alawna, 2020). [...]the current authors sought to determine if exercise volume was related to symptoms and hospitalization from COVID-19. Use of four exercise volume groups would provide 80% power to detect correlations in excess of 0.16 with outcome measures, and effect size differences of 0.5 or higher based on a sample of 400 respondents. Comorbidities and risk factors were obtained from the COVID-19 registry, including smoking, chronic obstructive pulmonary disease (COPD), asthma, diabetes, hypertension, coronary artery disease, heart failure, cancer (type), transplant, multiple sclerosis, connective tissue disease, inflammatory bowel disease, HIV, other immunosuppressive disease, other heart disease, other lung disease, pregnancy, and epilepsy.
ABSTRACT
AIMS: To identify and understand ethical challenges arising during COVID-19 in intensive care and nurses' perceptions of how they made "good" decisions and provided "good" care when faced with ethical challenges and use of moral resilience. BACKGROUND: Little is known about the ethical challenges that nurses faced during the COVID-19 pandemic and ways they responded. DESIGN: Qualitative, descriptive free-text surveys and semi-structured interviews, underpinned by appreciative inquiry. METHODS: Nurses working in intensive care in one academic quaternary care centre and three community hospitals in Midwest United States were invited to participate. In total, 49 participants completed free-text surveys, and seven participants completed interviews. Data were analysed using content analysis. RESULTS: Five themes captured ethical challenges: implementation of the visitation policy; patients dying alone; surrogate decision-making; diminished safety and quality of care; and imbalance and injustice between professionals. Four themes captured nurses' responses: personal strength and values, problem-solving, teamwork and peer support and resources. CONCLUSIONS: Ethical challenges were not novel but were amplified due to repeated occurrence and duration. Some nurses' demonstrated capacities for moral resilience, but none described drawing on all four capacities. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers would benefit from greater ethics training to support their nursing teams.
Subject(s)
COVID-19 , Nurses , Humans , COVID-19/epidemiology , Pandemics , Qualitative Research , Morals , Critical CareABSTRACT
BACKGROUND: The clinical work of nurses across the United States was profoundly impacted by the Coronavirus (COVID-19) pandemic. Nurses in both hospital and outpatient settings had to adapt quickly to the continuously changing healthcare environment. OBJECTIVE: To describe nurses' responses to open-ended questions of their clinical work adaption during the COVID-19 pandemic. METHODS: A descriptive, cross-sectional survey with four open-ended questions was completed by practicing HF nurses. Content analysis was used to analyze the written data. RESULTS: The 127 nurses who provided one to four narrative responses, 55.1% were clinical registered nurses and 44.9% were advance practice nurses. Four categories emerged: changing paths exemplifies work challenges, developing technical skills and resources, asking better questions while listening, and showing resilience through new paths to optimize work. CONCLUSION: Understanding perceptions of nurses' adaptions to clinical work made during the pandemic provides insight into the challenges and opportunities for development in the future.