Tarnished Silver Linings.

The SARS-CoV-2 pandemic may have many of us feeling distraught, but there are still reasons to be hopeful about the future of health care.

COVID-19 pneumonia: What APRNs should know.

ABSTRACT: COVID-19-associated pneumonia is a complex acute care diagnosis that requires careful evaluation and management. This article includes pertinent recommendations for management of acutely ill patients with COVID-19 pneumonia.

Protect the nurse, protect the practice: Effective communication is the foundation for keeping nurses safe.

Every year around Nurses Week, Dr. Rhonda Collins, DNP, RN, FAAN, Chief Nursing Officer for Vocera Communications, publishes a report examining important issues that impact the nursing profession worldwide. Her 2021 CNO report examines how the COVID-19 pandemic put a spotlight on the realities of the nursing profession and how the lack of resources, infrastructure, and policies impact nurses' work and lives. Dr. Collins addresses the toll of mental, emotional, and physical fatigue and outlines steps to help leaders create environments that protect the well-being of nurses and their patients. Dr. Collins closes the report by asking nurses to participate in a study to measure the mental, emotional, and physical burden nurses experience during communication. The study will use the NASA Task Load Index, a tool that has been used to measure the task load of workers in high-intensity jobs, such as pilots and air traffic controllers. The objective is to gain insight and a body of knowledge toward reducing nurses' cognitive burden going forward.

Exhausted and Burned Out: COVID-19 Emerging Impacts Threaten the Health of the Pediatric Advanced Practice Registered Nursing Workforce.

INTRODUCTION: The purpose of this study was to describe the holistic impacts of COVID-19 on pediatric advanced practice registered nurses (APRNs). METHOD: AA convenience sample of APRNs affiliated with the National Association of Pediatric Nurse Practitioners participated in this cross-sectional descriptive study. An investigator-developed survey explored multifocal, holistic impacts of COVID-19. RESULTS: A total of 886 participants were provided the survey, with 796 (90%) completing the entire survey. Respondents indicated adverse impacts across personal, clinical, educational, and research foci. Among the most alarming findings, 34% indicated moderate or extreme concern for feeling professionally burned out, 25% feeling nervous or anxious, and 15% feeling depressed or hopeless. DISCUSSION: The pediatricAPRN workforce pipeline is at significant risk for provider burnout and compromised mental health. Acknowledgment of pandemic-related trauma on families, children and APRNs is essential. Sustained intentional efforts to cultivate holistic wellness are critically emergent.

World Health Organization Chief Nursing Officer Elizabeth Iro in interview: the COVID-19 pandemic, and nursing and midwifery challenges and qualities.

In an interview, World Health Organization Chief Nursing Officer Elizabeth Iro reflected on nursing during the COVID-19 pandemic and how nurses have risen to the challenges they have faced. Despite the cancellation of virtually all the activities planned to mark 2020 as the International Year of the Nurse and Midwife, she believes that nurses' leadership, courage, compassion, commitment and expertise have been revealed to the world like never before. However, it is critical to nurture and support the next generation of nurses so that they can help to bring about the necessary reforms for health systems around the world.

COVID-19: Looking to the future of nursing: innovations & policy recommendations.

The impressive work of nurses, midwives and other health and emergency workers is far from over in the COVID-19 pandemic. But opportunities to learn from adversity are being explored and enacted in many settings and locations. Many ideas, opinions, research findings, innovations in practice, and policy recommendations are described in this Special Issue of International Nursing Review, The Official Journal of the International Council of Nurses in Switzerland. The contents will help inform educators, policymakers, health reformers, researchers, governments, leaders and practitioners about nursing's future. On International Nurses Day 2021, we dedicate this issue to the memory of the yet unknown number of nurses and midwives around the world who have died during this pandemic.

The International Council of Nurses in the time of the COVID-19 pandemic.

International Council of Nurses President Annette Kennedy reviews the organization's contribution to nursing during the COVID-19 pandemic. She describes the Council's efforts to support nurses around the world and bring its National Nursing Associations together to share their experiences and best practices, and the lessons learned with other nations who are at different stages of the pandemic.

COVID-19 impact on nurses in Spain: a considered opinion survey.

AIM: To survey nurses' opinions about their work conditions at the onset of the COVID-19 pandemic in Spain. BACKGROUND: For the Spanish General Council of Nursing (the Consejo General de Enfermería de España), it was essential to have information on nursing workforce conditions and nurses' preparedness to wear protective measures at the pandemic's onset. The coronavirus outbreak was believed to have started in China and rapidly spread as a global pandemic requiring policies and actions for planning emergency healthcare delivery. METHODS: A cross-sectional survey was conducted online. Data were collected during April 2020 and covered social demography, working conditions, training, availability of personal protective equipment, and nurses' health conditions, including the impact of COVID-19. FINDINGS: From all national territories in Spain, 11 560 registered nurses from different services completed the questionnaire. Findings indicated that the lack of personal protective equipment was a crucial issue, as well as service planning and organization, and 80.2% reported high or very high psychological impact of COVID-19. Alarmingly, 29.5% of the nurses reported COVID-19 symptoms. Of these 23.3% had been tested, and 30.2% were confirmed as being positive to the virus. The nurses deemed proper preparedness for emergencies and disasters as a significant concern. CONCLUSION: Nurses' responses showed evidence of health services deficiencies as a source of damage to their capacity to provide safe patient care and protect themselves and their families' health. The working conditions of the nurses are at critical levels and are unacceptable. The study results provide evidence regarding the necessity of suitable planning and actions being taken to enable safe patient care and safety for nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Our survey gathered nurses' views at the pandemic's onset. The evidence gathered is being used to advise policymakers and nursing organizations to take actions to control public health risks to populations. It is necessary that more investment in growing nursing workforce expertise and health infrastructure for pandemic and epidemic emergencies is provided.

[Nursing Experience of Caring for a Patient With COVID-19 During Isolation].

The ongoing coronavirus disease-2019 (COVID-19) epidemic continues to have a global impact. This article describes the author's experience providing nursing care to a female patient who was diagnosed with COVID-19 after returning to Taiwan from overseas. During the patient's period of isolation (February 5th to February 29th, 2020), the author used Roy's adaptation model to perform first-level holistic physical, psychological, and social nursing assessments and collected health-problem information using face-to-face interviews, telephone interviews, and observations via a remote monitoring system. A second level of assessment confirmed that the problems faced by the patient included (1) existing infections related to COVID-19 and (2) anxiety related to uncertainties about disease prognosis, forgiveness from the family, and potential violations of personal privacy by the media. Due to the special nature of the isolation ward, the author used a remote physiological monitoring system to monitor the vital signs, fever, and shortness of breath status of the patient to quickly decrease her physical discomfort and to improve her self-care ability during hospitalization. Environmental cleanliness was strictly maintained to reduce the risk of cross-infection and ensure patient safety. To alleviate patient anxiety, the author established a good therapeutic interpersonal relationship with the patient by making 10-60 minutes of caring calls to her each day, by providing individual care measures, and by using the Internet to play audio and video to teach mindfulness meditation. Caring for COVID-19 cases is a completely new experience. The author hopes that this experience may be used as a reference for caregivers.

Nurses' experiences in response to COVID-19 in a psychiatric ward in Singapore.

AIM: To understand nurses' responses to COVID-19 and identify their uptake of changes in the procedure required for the management of COVID-19 in an inpatient psychiatric ward. BACKGROUND: The infection risk for COVID-19 in an enclosed inpatient psychiatric ward is high due to living arrangements in the ward and the nature of the infectious disease. INTRODUCTION: This paper describes inpatient nurses' experiences, challenges and strategies deployed at the institutional and national levels to contain the spread of infection. METHODS: Written feedback was collected to understand nurses' responses and identify their uptake of changes in procedure following the COVID-19 outbreak in the ward. FINDINGS: Nurses felt shocked, worried, isolated, expressed a lack of confidence, and experienced physical exhaustion. COVID-19 specific challenges were highlighted in the delivery of safe and quality nursing care. Nurses were satisfied with the hospital policy and strategies implemented during the outbreak, acknowledging the importance of support from nursing leaders. DISCUSSION: Practical support and strong nursing leadership have been imperative in the battle against the COVID-19 outbreak in the psychiatric hospital. Psychiatric nursing care was maintained with a modified management and treatment approach. IMPLICATIONS FOR NURSING PRACTICE: Nurses' willingness to adjust to the reconfiguration of operations to accommodate changes has been crucial for the healthcare system to run effectively. Good practices and policies established during this crisis should be developed and established permanently in nursing practice. IMPLICATIONS FOR HEALTH POLICY: Prompt and effective contingency planning and policymaking at the national and institutional level, targeting human resource management and infection control, can introduce changes and alternative options for nursing care in a pandemic. CONCLUSION: With support from influential nursing leaders, strategies and policies are imperative in ensuring the successful management of COVID situations in an inpatient psychiatric setting.

Factors affecting frontline Korean nurses' mental health during the COVID-19 pandemic.

AIM: To identify the factors affecting fear, anxiety and depressive symptoms among frontline nurses working with COVID-19 patients or are in charge of COVID-19 screening in Korea. BACKGROUND: Nurses are at a higher risk of COVID-19 infection because they are in closer, longer-duration contact with patients. These situations can negatively affect the mental health of nurses. METHODS: This study analysed data from COVID-19 module in the Korean Nurses' Health Study. Data from 906 participants were analysed. To identify the factors influencing mental health, descriptive statistics, Pearson's correlation and hierarchical multiple regression analyses were performed. RESULTS: Caring for patients who are COVID-19-positive increased levels of fear, anxiety and depressive symptoms of nurses. The hospital safety climate influenced mental well-being among nurses. CONCLUSION: Caring for patients with COVID-19 had a negative impact on fear, anxiety and depressive symptoms. However, the higher was the perceived hospital safety climate, the lower were the nurses' psychological symptoms. Further research on the mental health of nurses is warranted. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Institutions should manage human resources to enable periodic rotation of nurses' work and working periods related to COVID-19. In addition, hospital managers should provide sufficient personal protective equipment, related education, and safety climate.

[The advanced practice nurse in post-COViD-19 respiratory follow up]. / L'IPA dans le suivi respiratoire post-Covid-19.

The setting up of an advanced practice nursing activity to monitor patients with severe or very severe pneumonia associated with Severe Acute Respiratory Syndrome Coronavirus 2, is a reponse to the population's new health care needs and a massive influx of patients. The skills of the advanced practice nurse are mobilised in this context in order to carry out prevention missions and screening for potential sequelae which could lead to chronic respiratory failure.

Professional Identity During the COVID-19 Pandemic: A Cross-Sectional Survey of Nurses in China.

BACKGROUND: Emergency and intensive care unit nurses are the main workforce fighting against COVID-19. Their professional identity may affect whether they can actively participate and be competent in care tasks during the pandemic. OBJECTIVE: To examine the level of and changes in professional identity of Chinese emergency and intensive care unit nurses as the COVID-19 pandemic builds. METHODS: A cross-sectional survey composed of the Professional Identity Scale for Nurses plus 2 open-ended questions was administered to Chinese emergency and intensive care unit nurses through an online questionnaire. RESULTS: Emergency and intensive care unit nurses had a medium level of professional identity. Participants' total and item mean scores in 5 professional identity dimensions were higher than the professional identity norm established by Liu (P < .001). The greatest mean item score difference was in the dimension of professional identity evaluation (3.57 vs 2.88, P < .001). When asked about their feelings witnessing the COVID-19 situation and their feelings about participating in frontline work, 68.9% and 83.9%, respectively, reported positive changes in their professional identity. CONCLUSIONS: The professional identity of emergency and intensive care unit nurses greatly improved during the early stages of the COVID-19 pandemic. This finding may be attributed to more public attention and recognition of nurses' value, nurses' professional fulfillment, and nurses' feelings of being supported, motivated, respected, and valued.

Nurses as new heroes of modern times.

BACKGROUND: Difficult times of epidemics, wars and an ageing population have made humanity aware of the important role to be played by those who, at the risk of their own health and lives, help and care for others, are the new superheroes of modern reality. Nurses are the foundation of any healthcare system. Today, many of them are on the front line in the fight against COVID-19. Without nurses and other health professionals, the world will not win the fight against epidemics or pandemics or achieve the health potential of populations. AIM: The main purpose of this article is to draw attention to the heroic work of nurses and the role they have to fulfil in society. Their daily work, hardship and courage can be called heroism, especially when in times of epidemics or pandemics they risk their own lives to care for and support those most in need. CONCLUSION: The greatest heroes of today are health professionals, among whom nurses play a key role. The new superheroes can be a symbol of hope, tenacity, courage and persistence of humanity, no matter how difficult a challenge fate presents. Implications for nursing, and Social Policy.

Italian Nurses' experiences during the COVID-19 pandemic: a qualitative analysis of internet posts.

AIM: To investigate the experience of Italian nurses during the first wave of the COVID-19 outbreak by analysing professional social media posts. BACKGROUND: The COVID-19 outbreak has overwhelmed health care institutions; as a consequence, nurses' lives and psycho-physical health have been affected. INTRODUCTION: The COVID-19 pandemic forced nurses to work in physically and psychologically stressful conditions impacting on their life. METHODS: A qualitative descriptive study. All narratives (texts and videos) posted by nurses from the 23rd of February 2020 to the 3rd of May (from the start of the outbreak to the end of the first lockdown) were analysed and published on the five most popular Italian professional social media platforms. The Consolidated Criteria for Reporting Qualitative research guidelines were followed. RESULTS: Five themes emerged from the 380 narratives explored: 'Sharing what is happening within myself'; 'Experiencing unprecedented working conditions'; 'Experiencing a deep change'; 'Failing to rehabilitate the image of nurses in society'; and 'Do not abandon us'. Even though nurses appreciated the recognition of their communities, they still felt devalued and not recognized as professionals. DISCUSSION: Several psychological, physical, social and professional implications emerged from nurses working during the COVID-19 pandemic. Despite being highly praised, nurses perceived they had failed in rehabilitating the image of nurses in society. CONCLUSION: The experience of working during the COVID-19 pandemic represented a traumatic event for nurses but it offered them personal and professional growth opportunities. IMPLICATIONS FOR NURSING PRACTICE, NURSING POLICY AND HEALTH POLICY: Supporting nurses' mental health is highly recommended, together with a cultural investment on nurses' role recognition, and a zero-tolerance policy towards violence and aggression towards nurses.

Nurses' Mental Health During the Covid-19 Outbreak: A Cross-Sectional Study.

OBJECTIVE: To describe nurses' mental health status during the Covid-19 outbreak and to explore the factors that might accentuate the negative consequences on their mental health. METHODS: We conducted an online survey to evaluate demographic variables, working conditions, family dynamics, and mental health variables in nurses working in healthcare settings, in Portugal, during the Covid-19 outbreak. RESULTS: Portuguese nurses presented higher depression, anxiety and stress levels, when compared to the Portuguese general population, during the outbreak. Overall, nurses who did not consider the quantity and quality of personal protective equipment as adequate presented significantly higher levels of depression, anxiety, and stress. CONCLUSIONS: Our results suggest that nurses' mental health status seems to be particularly affected by the Covid-19 outbreak and that some modifiable elements might accentuate the impacts on their mental health.

The Impact of COVID-19 on the Global Nursing Workforce.

Skilled nurses are critically important to an effective pandemic response.