Keeping connected: Family therapists' experiences of working online during the COVID‐19 pandemic

For this qualitative study, eight family therapists were interviewed about their experiences of practising online during the pandemic. Findings are organised using a framework of problems, possibilities, resources and restraints (PPRR, Neden & Burnham, 2007). Despite variation in therapist confidence in online practice, all participants found new possibilities in this way of working, including connecting family members across distance, increased co‐construction within therapeutic relationships and engaging clients who would not usually attend appointments. Therapeutic alliance was generally possible to establish online, though felt more challenging with whole families than individuals. Problems and restraints included therapist fatigue, risk and safety management, and attuning to nuanced expression of emotion. Implications for practice and future research are proposed. It is suggested that systemic practice has unique qualities to offer the field of online psychotherapy.

The impact of COVID-19 on relationships between family/friend caregivers and care staff in continuing care facilities: a qualitative descriptive analysis.

BACKGROUND: The COVID-19 pandemic and related public health measures added a new dynamic to the relationship between caregivers and care staff in congregate care settings. While both caregivers and staff play an important role in resident quality of life and care, it is common for conflict to exist between them. These issues were amplified by pandemic restrictions, impacting not only caregivers and care staff, but also residents. While research has explored the relationship between caregivers and care staff in long-term care and assisted living homes, much of the research has focused on the caregiver perspective. Our objective was to explore the impact of COVID-19-related public health measures on caregiver-staff relationships from the perspective of staff in long-term care and assisted living homes. METHODS: We conducted 9 focus groups and 2 semi-structured interviews via videoconference. RESULTS: We identified four themes related to caregiver-staff relationships: (1) pressure from caregivers, (2) caregiver-staff conflict, (3) support from caregivers, and (4) staff supporting caregivers. CONCLUSIONS: The COVID-19 pandemic disrupted long-standing relationships between caregivers and care staff, negatively impacting care staff, caregivers, and residents. However, staff also reported encouraging examples of successful collaboration and support from caregivers. Learning from these promising practices will be critical to improving preparedness for future public health crises, as well as quality of resident care and life in general.

Child vaccination schedule: new risks and tackling hesitancy: Uptake of childhood vaccines shows a worrying fall due to several factors, but nurses can answer parents' questions and allay vaccination fears

New data show vaccination coverage for young children fell in 2021-22 for virtually all programmes. Uptake was falling before the pandemic, and COVID-19 is likely to have had a further effect on parents having their children vaccinated.

Reflecting on professional self-disclosure and supportive relationships with foster carers during the COVID-19 pandemic

Why you should read this article: • To enhance your knowledge of professional self-disclosure • To understand how mental health nurses can appropriately use professional self-disclosure in their work with foster carers • To learn about how approaches to self-disclosure changed during the shift to remote working during the COVID-19 pandemic Professional self-disclosure can be defined as a clinician revealing personal information about themselves to the person they are caring for. This article provides reflections from clinicians working in child and adolescent mental health services (CAMHS) and their navigation of professional self-disclosure during the coronavirus disease 2019 pandemic. The reflections focus on the use of self-disclosure in supportive relationships with foster carers. Drawing on the authors' practice experiences as clinicians in specialist CAMHS settings, the article considers changes in the way that self-disclosure was approached following the shift to remote care delivery during the pandemic. The authors suggest that remote working involves a potentially increased scope for inappropriate use of self-disclosure and outline the implications for mental health nurses working with foster carers.

Family Presence on Rounds in Adult Critical Care: A Scoping Review.

Family presence on rounds involves allowing family members to participate in daily healthcare team rounds and is recommended by critical care professional societies. Yet, family presence on rounds is not performed in many institutions. There is a need to synthesize the current evidence base for this practice to inform healthcare providers of the potential benefits and challenges of this approach. The main objective of this study was to explore the impact of family presence on adult ICU rounds on family and healthcare providers. DATA SOURCES: Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and PubMed databases were last searched on January 28, 2022. Studies published during the COVID-19 pandemic were included. STUDY SELECTION: Studies involving family presence during rounds that included family or healthcare provider perspectives or outcomes were selected. There were no limitations on study design. DATA EXTRACTION: Qualitative and quantitative family and provider perspectives, barriers and challenges to family presence, and study outcomes were extracted from studies. The JBI Manual for Evidence Synthesis published guidelines were followed. DATA SYNTHESIS: There were 16 studies included. Family reported family presence on rounds as a means of information transfer and an opportunity to ask care-related questions. Family presence on rounds was associated with increased family satisfaction with care, physician comfort, and improved physician-family relationship. Healthcare providers reported a positive perception of family presence on rounds but were concerned about patient confidentiality and perceived efficacy of rounds. Family presence was found to increase rounding time and was felt to negatively impact teaching and opportunities for academic discussions. CONCLUSIONS: Family presence on rounds has potential advantages for family and healthcare providers, but important challenges exist. Further studies are needed to understand how to best implement family presence on adult ICU rounds.

Neuroscience nurses' comprehension of collaborating with and involvement of relatives: A qualitative interview study

Within the field of neurological disease, it seems that involvement of relatives is of utmost importance since the patients often are affected in several areas (physical, cognitive, and emotional) which impair their ability to participate in decision-making about their treatment and care. This study aimed to illuminate neuroscience nurses' comprehension of collaborating with and involvement of relatives. Semi-structured interviews were conducted with 19 neuroscience registered nurses. The qualitative data were analyzed utilizing inductive thematic analysis. The COREQ checklist was applied. The analysis identified how collaboration with, and involvement of relatives are perceived as a focus for nursing care and a resource for both patients and registered nurses. Registered nurses having personal experience as a relative find it easier to establish a relationship with relatives. This study emphasizes the importance of the establishment of a trusting relationship between registered nurses and relatives for a positive collaboration and thus involvement of relatives.

Communication and visiting policies in Italian intensive care units during the first COVID-19 pandemic wave and lockdown: a nationwide survey.

BACKGROUND: During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions. METHODS: A national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave. RESULTS: Two hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICUs, 60% were dedicated to COVID-19 patients, 21% were dedicated to patients without COVID-19 and 19% were dedicated to both categories (Mixed). A total of 11,102 adult patients were admitted to the participating ICUs during the study period and only approximately 6% of patients received at least one visit. Communication with family members was guaranteed daily through an increased use of electronic devices and was preferentially addressed to the same family member. Compared to the prepandemic period, clinical psychologists supported physicians more often regarding communication with family members. Fewer patients received at least one visit from family members in COVID and mixed-ICUs than in non-COVID ICUs, l (0 [0-6]%, 0 [0-4]% and 11 [2-25]%, respectively, p < 0.001). Habits of pediatric ICUs were less affected by the pandemic. CONCLUSIONS: Visiting policies of Italian ICUs dedicated to adult patients were markedly altered during the first COVID-19 wave. Remote communication was widely adopted as a surrogate for family meetings. New strategies to favor a family-centered approach during the current and future pandemics are warranted.

A Year into the Pandemic: An Update on Women in Science, Technology, Engineering, Math, and Medicine.

The coronavirus pandemic revealed long-standing, unaddressed fissures in our systems, including dramatic gender inequities in science, technology, engineering, mathematics, and medicine (STEMM) fields. Women have disproportionately carried the burden of childcare and other caregiving responsibilities during the pandemic, and there are strong indications that the pandemic will likely exacerbate preexisting disparities in the pipeline of women in STEMM and in leadership positions. Based on a literature review, our own experiences, and the experiences of our colleagues, we review promising strategies that have been implemented by funding bodies, journals, professional societies, and colleges/universities as well as additional strategies that might be helpful for these entities to implement to move forward with policies in place that address gender inequities and rebuild our institutional systems better. At this moment in time, institutions should collect data on metrics such as recruitment, retention, tenure/promotion, funding, professional society membership, awards/honors, and scientific publishing. These data will be essential in determining the impact of policies on women in STEMM to ensure they are having the intended effect as well as what future actions might be necessary in an iterative process.

Telephone communication with relatives of hospitalised COVID-19 patients by a specialised family support team: lessons learned.

During March and April 2020, the number of hospital admissions and deaths due to the first wave of COVID-19 peaked. The objective of this study was to analyse the experiences of a team of health professionals in charge of breaking bad news over the telephone to the relatives of patients admitted to the respiratory ward of a large hospital in Barcelona. This was a qualitative research based on semi-structured individual interviews with all the members of the team and a group interview. The interviews were analysed using Condensation of Meaning techniques. Three central themes emerged after analysing the interviews: (1) the call itself, (2) the need for good organisational support both before and during a crisis, and (3) the care that the professionals themselves need. To set up a large-scale operation to break bad news over the phone, some organisational aspects must be considered that go beyond the call itself. All these aspects are interrelated to a large extent, and due attention should be given to proper communication and adequate care practices for both relatives and health workers.

Clinical Pearls

The article presents some evidence-based best practices of medical care. Among them are the use of cumulative stress debriefings (CSD) to reduce compassion fatigue and improve job satisfaction of pediatric intensive care unit (PICU) nurses and other professionals, the use of proactive interprofessional family meetings to educate and support patients' families, and the use of informant-based screening tool for post-intensive care syndrome (PICS).

Why and how to open intensive care units to family visits during the pandemic.

Since the lockdown because of the pandemic, family members have been prohibited from visiting their loved ones in hospital. While it is clearly complicated to implement protocols for the admission of family members, we believe precise strategic goals are essential and operational guidance is needed on how to achieve them. Even during the pandemic, we consider it a priority to share strategies adapted to every local setting to allow family members to enter intensive care units and all the other hospital wards.