Meanings of mourning for people who faced the death of a family member due to covid-19 / Significados do luto para pessoas que enfrentaram a morte de um familiar por covid-19 / Significados del luto para personas que enfrentaron la muerte de un familiar por covid-19

Objetivo: compreender os significados do luto para as pessoas que enfrentaram a morte de um familiar devido a COVID-19. Método: estudo qualitativo, do tipo ação-participante, fundamentado nos pressupostos de Paulo Freire. Participaram 16 familiares, residentes no litoral de Santa Catarina, Brasil. Realizou-se um Círculo de Cultura de modo virtual, seguindo as etapas do Itinerário Freireano. Resultados: os participantes significaram que a vivência do luto do familiar, devido a COVID-19, tirou-lhes a oportunidade de se despedir do ente querido. A pandemia também lhes tirou o emprego, as aulas presenciais dos filhos, encontros, casamentos, abraços e sorrisos. Mas também significaram que trouxe aprendizado, com fortalecimento da espiritualidade e família. Conclusão: o significado do luto permeou inúmeras perdas, restringindo a vivência das etapas do luto. Contudo, houve maior busca pela espiritualidade e religião, com valorização da família e da vida.

Objetivo: comprender los significados del luto para las personas que enfrentaron la muerte de un familiar debido a COVID-19. Método: estudio cualitativo, del tipo acción-participante, fundamentado en los presupuestos de Paulo Freire. Participaron 16 familiares, residentes en el litoral de Santa Catarina, Brasil. Se realizó un Círculo de Cultura de modo virtual, siguiendo las etapas del Itinerario Freireano. Resultados: los participantes significaron que la vivencia del luto del familiar, debido a COVID-19, les quitó la oportunidad de despedirse del ser querido. La pandemia también les quitó el empleo, las clases presenciales de los hijos, encuentros, matrimonios, abrazos y sonrisas. Pero también significaron que trajo aprendizaje, con fortalecimiento de la espiritualidad y familia. Conclusión: el significado del luto ha permeado numerosas pérdidas, restringiendo la vivencia de las etapas del luto. Sin embargo, hubo mayor búsqueda por la espiritualidad y religión, con valoración de la familia y de la vida.

Objective: to understand the meanings of mourning for people who faced the death of a family member due to COVID-19. Method: qualitative study, action-participant type, based on the assumptions of Paulo Freire. Participants were 16 family members living on the coast of Santa Catarina, Brazil. A Culture Circle was held in a virtual way, following the stages of the Freire's Itinerary. Results: the participants meant that the experience of mourning the family, due to COVID-19, took them the opportunity to say goodbye to their loved one. The pandemic also took away their jobs, their children's face-to-face classes, meetings, weddings, hugs and smiles. But it also meant that it brought learning, with strengthening of spirituality and family. Conclusion: the meaning of mourning permeated countless losses, restricting the experience of the stages of mourning. However, there was a greater search for spirituality and religion, with appreciation of family and life.

Nursing work environments during covid-19: contributions to develop a technological tool / Ambientes de trabalho de enfermagem durante a covid-19: contribuições para desenvolver uma ferramenta tecnológica / Ambientes de trabajo de enfermería durante covid-19: contribuciones para desarrollar una herramienta tecnológica

Objetivo: avaliar o impacto da COVID-19 nos ambientes de trabalho de enfermagem e desenvolver uma ferramenta tecnológica para avaliar sistematicamente a qualificação desses contextos. Método: pesquisa de método misto realizada em seis hospitais portugueses, com participação de 442 enfermeiros. Utilizou-se um questionário com caracterização sociodemográfica e profissional, a Scale for the Environments Evaluation of Professional Nursing Practice e questões abertas. Resultados: a COVID-19 teve impacto negativo nos componentes Estrutura (ƿ<0,001), Processo (ƿ<0,001) e Resultado (ƿ=0,009) dos ambientes de trabalho de enfermagem. A monitorização da qualidade dos ambientes de trabalho foi apontada como uma estratégia de melhoria. A ferramenta tecnológica desenvolvida permite identificar precocemente as dimensões mais fragilizadas e priorizar melhorias. Conclusão: a COVID-19 repercutiu negativamente nos ambientes de trabalho. A ferramenta tecnológica construída, que tornou mais dinâmica a avaliação dos ambientes de trabalho, além de garantir o envolvimento dos enfermeiros, constitui uma importante ferramenta de gestão.

Objetivo: evaluar el impacto de COVID-19 en los entornos de trabajo de enfermería y desarrollar una herramienta tecnológica para evaluar sistemáticamente la calificación de estos contextos. Método: investigación de método mixto realizada en seis hospitales portugueses, con participación de 442 enfermeros. Se utilizó un cuestionario con caracterización sociodemográfica y profesional, la Scale for the Environments Evaluation of Professional Nursing Practice y cuestiones abiertas. Resultados: La COVID-19 tuvo impacto negativo en los componentes Estructura (ƿ<0,001), Proceso (ƿ<0,001) y Resultado (ƿ=0,009) de los ambientes de trabajo de enfermería. La monitorización de la calidad de los entornos de trabajo fue apuntada como una estrategia de mejora. La herramienta tecnológica desarrollada permite identificar precozmente las dimensiones más fragilizadas y priorizar mejoras. Conclusión: COVID-19 tuvo un impacto negativo en los entornos de trabajo. La herramienta tecnológica construida, que hizo más dinámica la evaluación de los ambientes de trabajo, además de garantizar la participación de los enfermeros, constituye una importante herramienta de gestión.

Objective: to evaluate the impact of COVID-19 on nursing work environments and to develop a technological tool to assess systematically the qualification of these contexts. Method: mixed method research conducted in six Portuguese hospitals, with the participation of 442 nurses. The questionnaire used contained sociodemographic and professional characterization, which was the Scale for the Environments Evaluation of Professional Nursing Practice and open questions. Results: COVID-19 had a negative impact on the components Structure (ƿ<0,001), Process (ƿ<0,001) and Result (ƿ=0,009) of nursing work environments. The monitoring of the quality of the work environments was pointed out as an improvement strategy. The technological tool developed allows identifying the most fragile dimensions early and prioritizing improvements. Final considerations: COVID-19 had a negative impact on work environments. The technological tool built, which made the evaluation of work environments more dynamic, in addition to ensuring the involvement of nurses, is an important management tool.

Nursing teaching during the covid-19 pandemic / O ensino de enfermagem durante a pandemia de Covid-19 / La educación de enfermería durante la pandemia de Covid-19

O ano de 2020 ficou marcado como o ano dos desafios, devido aos inúmeros acontecimentos ocasionados pela COVID-19, desta forma objetiva-se quantificar e descrever as características da produção científica sobre o ensino de graduação em enfermagem no contexto da pandemia da COVID-19. Trata-se de um estudo quantitativo, descritivo e com enfoque teórico, ancorado em publicações nacionais, com a pesquisa realizada no mês de janeiro de 2021 nas bases de dados BDENF, LILACS e Medline. Os critérios de inclusão foram autores brasileiros, ano da publicação (2020), categorizado como artigo original, acesso ao texto completo e temática correlata ao processo de educação e formação de enfermeiros no nível de graduação. Foram encontrados 47 estudos, após a leitura dos resumos apenas 11 contemplavam os critérios de inclusão estabelecidos para leitura na íntegra que após a leitura minuciosa foram analisados conforme as sete categorias propostas. Fato marcante das onze publicações evidenciadas no estudo foi a condição de afastamento social imposta pelo contexto da pandemia, fazendo necessária a utilização de ferramentas da tecnologia da informação e comunicação, conhecidas anteriormente por meio dos cursos de educação a distância, além da preocupação com o atendimento aos requisitos que garantam a qualidade na formação em enfermagem. Os resultados desta pesquisa evidenciam que o tema pesquisado é emergente, o que sugere que há um grande campo de estudo para o desenvolvimento de pesquisas que correlacionem o ensino de graduação em enfermagem no contexto da pandemia da COVID-19 com a prática pedagógica por meio do ensino remoto.

The year 2020 was marked as the year of challenges, due to the countless events caused by COVID-19, thus aiming to quantify and describe the characteristics of scientific production on undergraduate nursing education in the context of the pandemic of COVID-19. This is a quantitative, descriptive study with a theoretical focus, anchored in national publications, with the research carried out in January 2021 in the databases BDENF, LILACS and Medline. The inclusion criteria were Brazilian authors, year of publication (2020), categorized as original article, access to the full text and thematic correlated to the education and training process of nurses at the undergraduate level. 47 studies were found, after reading the abstracts, only 11 contemplated the inclusion criteria established for reading in full, which after careful reading were analyzed according to the seven proposed categories. A striking fact of the eleven publications evidenced in the study was the condition of social isolation imposed by the context of the pandemic, making it necessary to use information and communication technology tools, previously known through distance education courses, in addition to the concern with service to the requirements that guarantee quality in nursing education. The results of this research show that the researched topic is emerging, which suggests that there is a large field of study for the development of research that correlates undergraduate nursing education in the context of the COVID-19 pandemic with pedagogical practice through the remote teaching.

El año 2020 fue marcado como el año de los desafíos, debido a los numerosos eventos provocados por el COVID-19, de esta manera se pretende cuantificar y describir las características de la producción científica sobre la formación de pregrado en enfermería en el contexto de la pandemia del COVID-19. Se trata de un estudio cuantitativo, descriptivo y con enfoque teórico, anclado en publicaciones nacionales, con la búsqueda realizada en enero de 2021 en las bases de datos BDENF, LILACS y Medline. Los criterios de inclusión fueron autores brasileños, año de publicación (2020), categorizado como artículo original, acceso al texto completo y tema correlacionado con el proceso de educación y formación de enfermeras a nivel de pregrado. Se encontraron 47 estudios, tras la lectura de los resúmenes, sólo 11 cumplían los criterios de inclusión establecidos para su lectura completa, que tras una lectura exhaustiva se analizaron según las siete categorías propuestas. Un hecho llamativo de las once publicaciones evidenciadas en el estudio fue la condición de retraimiento social impuesta por el contexto pandémico, haciendo necesario el uso de herramientas de tecnología de la información y la comunicación, antes conocidas a través de cursos de educación a distancia, además de la preocupación con el cumplimiento de los requisitos que garantizan la calidad en la educación de enfermería. Los resultados de esta investigación muestran que el tema investigado es emergente, lo que sugiere que existe un amplio campo de estudio para el desarrollo de investigaciones que correlacionen la educación de pregrado en enfermería en el contexto de la pandemia de COVID- 19 con la práctica pedagógica a través de la enseñanza a distancia.

The preparedness of disaster among nurses in community health centers in rural areas during the COVID-19 pandemic in Malang City.

Positive COVID-19 cases in Malang City, Indonesia continue to increase. Until 04 August 2021, the COVID-19 update shows 3301 positive cases with 7754 cured and 832 deaths. This study aims to identify nurses preparedness in rural area community health centers during the COVID-19 pandemic in Malang for self-control to implement health protocol. This study intends to provide insights on controlling COVID-19 spread in Malang, Indonesia. This research is a quantitative study with correlative analytic observational design and a cross-sectional approach involving 120 nurses from 16 primary health centers. The results of the bivariate analysis using gamma correlation test are: knowledge factors (p = 0.005; r = 0.35), attitude (p = 0.000; r = 0.46), means of infrastructure (p = 0.000; r = 0.54), and self-control (p = 0.000; r = 0.52) for the quarantined COVID-19 patients. Knowledge, attitude, infrastructure, and safe house factors can influence self-control for COVID-19. In rural areas, health education-as education and empowerment for patient self-control-is an effort to encourage them to obey health protocol during the pandemic. Nurse readiness and preparedness during the pandemic is crucial for strengthening the assertive behavior commitment through self-control. This ensures the community's awareness of the importance of complying with health protocols for the common good. Mental nursing intervention needs to be added as a part of psychosocial therapy for the community's social problems, primarily in reducing the pressure due to the social distancing enforcement to control and prevent COVID-19 spread.

What Do We Know Today about Long COVID? Nursing Care for a New Clinical Syndrome.

Persistent COVID, long COVID, long-effects, long-term effects or chronic COVID are all names of a new syndrome caused by a set of multi-organ symptoms that appear after having been infected with SARS-CoV-2 [...].

A Virtual World: New Graduate Education in the Era of COVID-19.

In this article, the authors share strategies of adult learning principles for successful transition to virtual learning for new graduate clinical nurses. Knowles' theory was used to redesign a simulation-based education approach to fulfill the diverse learning needs during the COVID-19 pandemic. The delivery of efficient, effective, and meaningful education was achieved by leveraging technology. This evidence-based strategy was delivered via a cost-effective virtual platform that offered improved accessibility and convenience of education without compromising the quality of the educational outcomes, participant engagement, or learner satisfaction. This virtual platform incorporating a variety of active learning strategies exhibited effective practices, engaging the new graduate clinical nurses and enhancing their acquiring, retaining, and applying knowledge in providing high-quality and safe patient care. It demonstrated the promise that virtual education holds for future programs to enhance professional development and build the nursing workforce. Nurse educators can be instrumental in advancing this virtual agenda. [J Contin Educ Nurs. 2022;53(7):307-311.].

Nursing care recommendation for pediatric COVID-19 patients in the hospital setting: A brief scoping review.

BACKGROUND: The hospitalization of children during the COVID-19 pandemic has affected their physical and mental health. Pediatric nurses have faced challenges in providing high-quality nursing care for children and their families. However, the pediatric nursing care recommendations for COVID-19 patients in the hospital setting remain unclear. The current scoping review provides recommendations for nursing interventions for pediatric COVID-19 patients in the hospital setting. METHODS AND FINDINGS: The selected articles containing management and nursing recommendations for COVID-19 that have occurred in pediatric patients ages 0-19 years old. A search strategy was developed and implemented in seven databases. We included peer-reviewed articles that reported observational or interventional studies, as well as policy papers, guides or guidelines, letters and editorials, and web articles. A total of 134 articles and other documents relevant to this review were included. We categorized the results based on The Nursing Intervention Classification (NIC) taxonomy which consists of six domains (e.g., Physiological: Basic); eleven classes (e.g., Nutrition Support); and eighteen intervention themes (e.g., Positioning, Family Presence Facilitation, Family Support, and Discharge Planning). CONCLUSION: Apart from the intervention of physical problems, there is a need to promote patient- and family-centered care, play therapy, and discharge planning to help children and families cope with their new situation.

Nursing Workflow Change in a COVID-19 Inpatient Unit Following the Deployment of Inpatient Telehealth: Observational Study Using a Real-Time Locating System.

BACKGROUND: The COVID-19 pandemic prompted widespread implementation of telehealth, including in the inpatient setting, with the goals to reduce potential pathogen exposure events and personal protective equipment (PPE) utilization. Nursing workflow adaptations in these novel environments are of particular interest given the association between nursing time at the bedside and patient safety. Understanding the frequency and duration of nurse-patient encounters following the introduction of a novel telehealth platform in the context of COVID-19 may therefore provide insight into downstream impacts on patient safety, pathogen exposure, and PPE utilization. OBJECTIVE: The aim of this study was to evaluate changes in nursing workflow relative to prepandemic levels using a real-time locating system (RTLS) following the deployment of inpatient telehealth on a COVID-19 unit. METHODS: In March 2020, telehealth was installed in patient rooms in a COVID-19 unit and on movable carts in 3 comparison units. The existing RTLS captured nurse movement during 1 pre- and 5 postpandemic stages (January-December 2020). Change in direct nurse-patient encounters, time spent in patient rooms per encounter, and total time spent with patients per shift relative to baseline were calculated. Generalized linear models assessed difference-in-differences in outcomes between COVID-19 and comparison units. Telehealth adoption was captured and reported at the unit level. RESULTS: Change in frequency of encounters and time spent per encounter from baseline differed between the COVID-19 and comparison units at all stages of the pandemic (all P<.001). Frequency of encounters decreased (difference-in-differences range -6.6 to -14.1 encounters) and duration of encounters increased (difference-in-differences range 1.8 to 6.2 minutes) from baseline to a greater extent in the COVID-19 units relative to the comparison units. At most stages of the pandemic, the change in total time nurses spent in patient rooms per patient per shift from baseline did not differ between the COVID-19 and comparison units (all P>.17). The primary COVID-19 unit quickly adopted telehealth technology during the observation period, initiating 15,088 encounters that averaged 6.6 minutes (SD 13.6) each. CONCLUSIONS: RTLS movement data suggest that total nursing time at the bedside remained unchanged following the deployment of inpatient telehealth in a COVID-19 unit. Compared to other units with shared mobile telehealth units, the frequency of nurse-patient in-person encounters decreased and the duration lengthened on a COVID-19 unit with in-room telehealth availability, indicating "batched" redistribution of work to maintain total time at bedside relative to prepandemic periods. The simultaneous adoption of telehealth suggests that virtual care was a complement to, rather than a replacement for, in-person care. However, study limitations preclude our ability to draw a causal link between nursing workflow change and telehealth adoption. Thus, further evaluation is needed to determine potential downstream implications on disease transmission, PPE utilization, and patient safety.

A multimodal sensor dataset for continuous stress detection of nurses in a hospital.

Advances in wearable technologies provide the opportunity to monitor many physiological variables continuously. Stress detection has gained increased attention in recent years, mainly because early stress detection can help individuals better manage health to minimize the negative impacts of long-term stress exposure. This paper provides a unique stress detection dataset created in a natural working environment in a hospital. This dataset is a collection of biometric data of nurses during the COVID-19 outbreak. Studying stress in a work environment is complex due to many social, cultural, and psychological factors in dealing with stressful conditions. Therefore, we captured both the physiological data and associated context pertaining to the stress events. We monitored specific physiological variables such as electrodermal activity, Heart Rate, and skin temperature of the nurse subjects. A periodic smartphone-administered survey also captured the contributing factors for the detected stress events. A database containing the signals, stress events, and survey responses is publicly available on Dryad.

Challenges faced by new nurses during the COVID-19 pandemic.

INTRODUCTION: COVID-19 can be considered a unique and complex form of trauma with potentially devastating consequences for nurses in general and new nurses specifically. Few studies have been published that explain how relatively new nurses were prepared for COVID-19 in terms of knowledge and skill and how these nurses fared physically and emotionally. DESIGN: A qualitative descriptive design utilizing purposive sampling to recruit a diverse group of nurses who were within 2 years post-graduation from nursing school. METHODS: In-depth interviews of 29 nurses were conducted using a semi-structured interview guide to elicit data, which was coded and analyzed using thematic analysis. RESULTS: Six main themes and multiple subthemes were identified in the data. The main themes were: "We were not prepared," "I was just thrown in," "Avoiding infection," "It was so sad," "We did the best we could," and "I learned so much." CONCLUSION: The nurses who participated in this study expressed fear, weariness, exhaustion, isolation, and distress, observations echoed by studies from other countries. Retention of new nurses in acute care settings has always been a concern. In the recent Current Population Survey, a 4% reduction in nurses under 35 years of age has been reported, imperiling the retention of an effective workforce for decades to come. CLINICAL RELEVANCE: A recent report suggests that a larger than expected number of young nurses have left the profession in the wake of the pandemic. Staff shortages threaten the ability of the remaining nurses to do their jobs. This is the time to listen to the needs of new nurses to retain them in the profession and to avoid an even greater shortage in the near future.

Reflections From the Middle: Exploring the Experience of Nurse Managers Across the United States During the COVID-19 Pandemic.

OBJECTIVE: The objective of this multisite study was to explore the professional and personal experiences of US nurse managers (NMs) during the COVID-19 pandemic. BACKGROUND: NMs are the most accessible and visible nurse leaders to the frontline staff during this pandemic. METHODS: Thirty-nine NMs from 5 health systems across the US participated in focus groups in this qualitative study. Data were analyzed using a constant comparative method. RESULTS: Three major themes were identified: challenges, feelings and emotions, and coping. Subthemes emerged within each major theme. CONCLUSION: NMs across the country accepted considerable responsibility at great professional and personal consequence during the pandemic. NMs experienced challenges, ethical dilemmas, and expressed negative emotions. As the usual coping strategies failed, NMs reported that they are considering alternative career choices. This work provided evidence to help senior leaders strategize about mechanisms for reducing managerial dissonance during times of stress.

Practical strategies and the need for psychological support: recommendations from nurses working in hospitals during the COVID-19 pandemic.

PURPOSE: Nurses working during the coronavirus disease 2019 (COVID-19) pandemic have reported elevated levels of anxiety, burnout and sleep disruption. Hospital administrators are in a unique position to mitigate or exacerbate stressful working conditions. The goal of this study was to capture the recommendations of nurses providing frontline care during the pandemic. DESIGN/METHODOLOGY/APPROACH: Semi-structured interviews were conducted during the first wave of the COVID-19 pandemic, with 36 nurses living in Canada and working in Canada or the United States. FINDINGS: The following recommendations were identified from reflexive thematic analysis of interview transcripts: (1) The nurses emphasized the need for a leadership style that embodied visibility, availability and careful planning. (2) Information overload contributed to stress, and participants appealed for clear, consistent and transparent communication. (3) A more resilient healthcare supply chain was required to safeguard the distribution of equipment, supplies and medications. (4) Clear communication of policies related to sick leave, pay equity and workload was necessary. (5) Equity should be considered, particularly with regard to redeployment. (6) Nurses wanted psychological support offered by trusted providers, managers and peers. PRACTICAL IMPLICATIONS: Over-reliance on employee assistance programmes and other individualized approaches to virtual care were not well-received. An integrative systems-based approach is needed to address the multifaceted mental health outcomes and reduce the deleterious impact of the COVID-19 pandemic on the nursing workforce. ORIGINALITY/VALUE: Results of this study capture the recommendations made by nurses during in-depth interviews conducted early in the COVID-19 pandemic.

In the Eye of the Storm: Leadership Lessons From the Front.

New York City (NYC) was in the eye of the COVID-19 pandemic storm in the spring of 2020. Since that time, the country has seen wave after wave of outbreaks and concurrent psychosocial crises. Clinical nurses and nurse leaders delivered extraordinary care with grit, innovation, agility, and resilience. When in the eye of the storm, staff have to feel safe and have a voice even in command-control, adaptive modes. Nurses and nurse leaders have been resilient, and organizations have to play their part in decreasing work burden and creating positive work environments. Non-value-added work as well as barriers to practice should be eliminated permanently. This article describes the many challenges including intensive care unit capacity, staffing, well-being, and lack of visitation, as well as leadership lessons such as the importance of presence, based on the NYC experience of a chief nursing officer in a large academic medical center. These lessons and their implications for our workforce, for public health, and for leadership development and competencies and have taught us how to lead into the future.

Pandemic Challenges: Keeping Nursing Research Alive.

Nursing has been pandemic-slammed. Although 2020 will be forever entangled with the COVID-19 pandemic, we, as nurse leaders, must continue to move forward and beyond this endemic challenge. We cannot lose focus on generating new knowledge to continue nursing excellence and move our profession forward.

The Top News Stories of 2021: Nursing: A Profession Reshaped by COVID-19.

The pandemic has brought new public awareness of nursing's role.

Original Research: Nurses' Experiences of Caring for Patients and Families During the COVID-19 Pandemic: Communication Challenges.

OBJECTIVE: The purpose of this study was to gain a better understanding of the perceptions and experiences of nurses caring for patients and families under the COVID-19 pandemic's socially restrictive practices and policies. BACKGROUND: The COVID-19 global pandemic has affected the delivery of health care to patients and their families, with many aspects altered because of the need for social distancing, social isolation, and visitation restriction policies. These policies have created communication challenges for interdisciplinary health care teams, patients, and families. As frontline caregivers, nurses have felt strongly the impact of these challenges. METHODS: A qualitative descriptive study was conducted among 17 RNs who were caring for patients during the COVID-19 pandemic and were recruited via social media posts on Facebook, Twitter, and LinkedIn. Watson's theory of human caring served as the conceptual framework for the study. RESULTS: Several themes emerged regarding nurses' experiences of communication with patients and families. These include communication challenges and barriers, prioritization, integration of group communication, nurse self-reflection, and acceptance of gratitude. CONCLUSIONS: The study findings underscore the importance of nurses' communication with patients and families under the pandemic's restricted conditions. They demonstrate the value of nurses' ability to innovate in fostering all parties' participation in the plan of care, and highlight the comfort nurses provide to patients who are isolated from loved ones. Strategies that fostered communication were identified, as were areas for further research.