An Abundance Mindset Approach to Support Nurse Well-Being: The Feasibility of Peer Support.

This article describes the process of building a system-wide, interprofessional peer support program at the onset of the COVID-19 pandemic. With limited resources, but with a dedicated team driven by the desire to provide psychological first aid, nurse leaders from a large academic medical center developed a peer support program, inclusive of 16 hours of peer supporter training and quarterly continuing education. To date, this program has 130 trained peer supporters who offer peer support, active listening, and close partnerships with the health care system and university employee assistance programs. This case study shares lessons learned and considerations on how leaders can initiate their own local peer support programs.

Changes in Posttraumatic Growth After a Virtual Contemplative Intervention During the COVID-19 Pandemic.

OBJECTIVE: The aim of this study was to describe the effects of an intervention called "Compassion & Growth Workshops" on reported posttraumatic growth (PTG) using the Posttraumatic Growth Inventory-Expanded (PTGI-X). BACKGROUND: Few studies measure the impact of interventions, such as contemplative practices, on nurse PTG. METHODS: We delivered a series of three 2-hour microretreats to nurses and advanced practice nurses and measured their impact on PTG scores. Using multivariate logistic regression, we identified cofactors predictive of 25% overall improvement on the PTGI-X. RESULTS: Overall PTG increased among participants, with the greatest improvement in relating to others, new possibilities, and personal strength. Posttraumatic growth improved as workshop attendance increased; nurses providing direct patient care also benefitted the most. CONCLUSIONS: Contemplative interventions can substantively improve PTG. This may be particularly relevant for coping with COVID pandemic stress among nurses on the frontlines and for healthcare leaders seeking to strengthen psychological support within their teams and reform the workplace environment.

Incidence of COVID-19 in patients treated with infliximab compared with patients treated with rituximab.

OBJECTIVE: To determine whether patients with inflammatory autoimmune diseases treated with rituximab (RTX) have more severe forms of COVID-19 compared with patients treated with anticytokine therapies, such as Tumour Necrosis Factor (TNF) inhibitors. METHODS: We included all patients who were on either RTX or infliximab (IFX) in two Swiss cantons during the first wave of the COVID-19 pandemic. We collected self-reported symptoms compatible with COVID-19, PCR-confirmed diagnoses of COVID-19 and the evolution of COVID-19 infections. We computed the raw and propensity score-adjusted incidence of COVID-19 by treatment group. RESULTS: 190 patients were enrolled, of whom 121 (64%) were in the RTX group and 69 (36%) were in the IFX group. Twenty-one patients (11%) reported symptoms compatible with COVID-19 (RTX: 10, IFX: 11, p=0.14). Among patients with COVID-19 symptoms, four developed severe forms of the disease, with life-threatening pulmonary manifestations requiring intensive mechanical ventilation (RTX: 4 of 10, IFX: 0 of 11, Fisher's exact test p=0.04). The incidence rate of COVID-19 symptoms was 0.73 (95% CI 0.39 to 1.37) cases per 1000 patient-days on RTX vs 1.52 (95% CI 0.82 to 2.85) cases per 1000 patient-days on IFX (crude p=0.10, adjusted p=0.07). The incidence rate of severe COVID-19 was 0.28 (95% CI 0.08 to 0.7.2) cases per 1000 patient-days on RTX compared with null on IFX (95% CI 0.0 to 0.44) (p=0.13). A replication in an independent validation cohort confirmed these findings, with consistent results in the Swiss Clinical Quality Management registry. CONCLUSION: While the incidence of symptoms compatible with COVID-19 was overall similar in patients receiving RTX or IFX, the incidence of severe COVID-19 tended to be higher in the RTX group.

Posttraumatic Growth as a Model to Measure and Guide Implementation of COVID-19 Recovery and Resiliency.

The COVID-19 pandemic has forced leaders to reconsider the various factors that attribute to work-life balance, a healthy work environment, and resilience among nurses. Posttraumatic growth (PTG) provides a lens through which clinicians and leaders can measure, articulate, and espouse resilient recovery through unprecedented times. This article suggests the use of PTG as a framework, measured by the Posttraumatic Growth Inventory to guide leaders as they implement job-specific resiliency interventions for professional nurses. This article also suggests 3 science-based interventions intended to increase PTG. Published data support the efficacy of these interventions: resilience retreats, resilience rounds, and "The Pause," while longitudinal impacts of PTG following these interventions remain currently unknown.

Innovation Amid Pandemic: Construction of a COVID-19 Intensive Care Unit Surge Care Delivery Model.

This article details a shared leadership structure and decision-making processes used to construct an innovative and evidence-based care delivery model for safety and optimal outcomes in the intensive care unit during the novel coronavirus (COVID-19) pandemic. Insights into ways professional development practitioners can facilitate changes in care delivery models, support nurses in their professional roles, and contribute to improved patient care outcomes during the COVID-19 pandemic are provided.

Nurse Leaders Employ Contemplative Practices to Promote Healthcare Professional Well-being and Decrease Anxiety.

OBJECTIVE: The purpose of this study was to test the effectiveness of a daylong resilience retreat on healthcare professionals' anxiety levels, intention to engage in mindfulness practices, and self-efficacy around mindfulness. BACKGROUND: Caregiver burnout is a concern that needs to be addressed at the organizational level so that professionals can reduce their risk of psychological injury while providing high-quality care. The COVID-19 (novel coronavirus) pandemic has exacerbated symptoms of burnout among nurses nationally. METHODS: Ten sessions of daylong resilience retreats were delivered to independent groups of nurses, nurse practitioners, and other healthcare professionals. Preretreat and postretreat assessments were completed using a 19-item survey developed by the research team to assess state anxiety, intention to engage in mindfulness practices, and self-efficacy around mindfulness. RESULTS: One hundred six healthcare professionals completed the resilience retreats. There was a statistically significant decrease in state anxiety scores following the retreat. The majority of the participants reported high intentions to engage in mindfulness practices and felt confident about incorporating mindfulness in their lives. CONCLUSIONS: Brief resilience retreats endorsed by nurse leadership can reduce perceived anxiety and facilitate engagement in contemplative practices, which are associated with a decrease in the risk of burnout.