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1.
J Christ Nurs ; 38(3): E28-E31, 2021.
Article in English | MEDLINE | ID: covidwho-1532593

ABSTRACT

ABSTRACT: Nurses who provided care to patients with coronavirus (COVID-19) and supported patients in their transition from life to death in the absence of patients' families have been especially needful of spiritual self-care. A spiritual first aid kit can help nurses cope with these difficult times. Spiritual self-care is vital for all nurses to renew and preserve the psychological, spiritual, and physical self.


Subject(s)
COVID-19/psychology , Nurse-Patient Relations , Nursing Staff, Hospital/psychology , Self Care/psychology , Self Efficacy , Adaptation, Psychological , COVID-19/nursing , Critical Care/psychology , First Aid , Humans , Spirituality
10.
Neurology ; 96(20): e2558-e2560, 2021 05 18.
Article in English | MEDLINE | ID: covidwho-1232452

ABSTRACT

Patients with traumatic brain injury may be dependent on the decision-making of their families. Restrictive visitation policies implemented during the coronavirus disease 2019 (COVID-19) pandemic disproportionately affect these patients and their families. This narrative aims to illustrate this phenomenon and catalyze discussions regarding the need for careful evaluation of restrictive family visitation policies and exceptions that may be required for patients with brain injuries.


Subject(s)
Brain Injuries, Traumatic/therapy , COVID-19/prevention & control , Critical Care , Decision Making, Shared , Head Injuries, Penetrating/therapy , Visitors to Patients , Wounds, Gunshot/therapy , Adult , Critical Care/legislation & jurisprudence , Critical Care/psychology , Critical Care/standards , Glasgow Coma Scale , Humans , Internship and Residency , Male , Neurosurgeons , Palliative Care , Visitors to Patients/legislation & jurisprudence , Visitors to Patients/psychology
11.
Nurs Forum ; 56(3): 571-578, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1199709

ABSTRACT

AIM: This study sought to describe the experiences of critical care nurses caring for patients infected by coronavirus disease 2019 (COVID-19). DESIGN: A qualitative phenomenological design was used. METHODS: We enrolled 15 nurses who provided care for patients infected by COVID-19 purposively and through snowballing, using a phenomenological approach in critical care units of Iran's public hospitals between May and June 2020. The semi-structured interviews were carried out either via face-to-face or telephone and were analyzed using the 7-step method of Colaizzi. RESULTS: The experiences of nurses caring for patients infected with COVID-19 were categorized into four challenges, including psychological (eight subthemes), organizational (six subthemes), social (six subthemes), and professional (five subthemes). In general, based on the current classification, there seems to be a mixture of positive and negative effects on the psychological, social, and professional challenges and the negative effect only on the organizational challenges. CONCLUSIONS: Positive and negative emotions and experiences have coexisted for the critical care nurses since the COVID-19 outbreak. Emotional support and psychological counseling play an important role in maintaining nurses' optimal mental health during the COVID-19 crisis. Adequate protective equipment, financial and nonfinancial supports, effective communication, training and hiring of staff, and appropriate work shifts are also required to reduce nurses' negative experiences when providing care for the affected individuals.


Subject(s)
Adaptation, Physiological , Adaptation, Psychological , COVID-19/nursing , Critical Care/psychology , Nursing Staff, Hospital/psychology , Stress, Physiological , Stress, Psychological , Adult , Female , Humans , Iran , Male , Middle Aged , Qualitative Research
12.
AACN Adv Crit Care ; 32(2): 159-168, 2021 Jun 15.
Article in English | MEDLINE | ID: covidwho-1194731

ABSTRACT

OBJECTIVE: As intensive care unit bed capacity doubled because of COVID-19 cases, nursing leaders created a prone team to support labor-intensive prone positioning of patients with COVID-related acute respiratory distress syndrome. The goal of the prone team was to reduce workload on intensive care teams, standardize the proning process, mitigate pressure injuries and turning-related adverse events, and ensure prone team safety. METHODS: Staff were trained using a hybrid learning model focused on prone-positioning techniques, pressure injury prevention, and turning-related adverse events. RESULTS: No adverse events occurred to patients or members of the prone team. The prone team mitigated pressure injuries using prevention strategies. The prone team and intensive care unit staff were highly satisfied with their experience. CONCLUSION: The prone team provided support for critically ill patients, and team members reported feeling supported and empowered. Intensive care unit staff were highly satisfied with the prone team.


Subject(s)
COVID-19/psychology , COVID-19/therapy , Critical Care/standards , Health Personnel/psychology , Patient Positioning/standards , Prone Position , Respiratory Distress Syndrome/therapy , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Critical Care/psychology , Female , Humans , Male , Middle Aged , Patient Positioning/psychology , Practice Guidelines as Topic , SARS-CoV-2 , United States/epidemiology
13.
Am J Nurs ; 121(5): 38-45, 2021 May 01.
Article in English | MEDLINE | ID: covidwho-1191115

ABSTRACT

ABSTRACT: Care for the Caregiver is a peer-to-peer program that provides support and guidance to clinicians who have experienced an unexpected and emotionally distressing event. Its development was preceded by communication and resolution programs that were endorsed by the Joint Commission in 2001, subsequently introduced at several U.S. medical centers, and in 2009 were incorporated within demonstration projects funded by the Agency for Healthcare Research and Quality. In August 2014, the authors introduced the Care for the Caregiver program across the MedStar Health System, which includes seven hospitals in Maryland and three in the District of Columbia. Here, they describe how the program was initially conceived and structured-and how it evolved in response to the current pandemic.


Subject(s)
Caregiver Burden/prevention & control , Nurse's Role/psychology , Nursing Staff, Hospital/psychology , Self-Help Groups/organization & administration , Social Support , Adaptation, Psychological , COVID-19 , Caregivers , Critical Care/psychology , District of Columbia , Humans , Interprofessional Relations , Maryland
15.
Appl Nurs Res ; 59: 151418, 2021 06.
Article in English | MEDLINE | ID: covidwho-1146475

ABSTRACT

AIM: Due to a lack of literature about US critical care nurses caring for patients with coronavirus disease 2019 (COVID-19), the aim of this study was to examine their experiences caring for these patients. BACKGROUND: COVID-19 placed nurses at the forefront of battling this pandemic in the intensive care unit (ICU). Emerging international evidence suggests nurses experience psychological and physical symptoms as a result of caring for these patients. METHODS: A qualitative descriptive design was used. Using purposive sampling, 11 nurses from one ICU participated in semi-structured interviews. Interviews were recorded and coded; data were analyzed using content analysis. An audit trail was maintained and member checking was employed. RESULTS: The experiences among critical care nurses caring for patients diagnosed with COVID-19 were categorized into five themes and subthemes. Emotions experienced was subcategorized into anxiety/stress, fear, helplessness, worry, and empathy. Physical symptoms was subcategorized into sleep disturbances, headaches, discomfort, exhaustion, and breathlessness. Care environment challenges was subcategorized into nurse as surrogate, inability to provide human comforting connection, patients dying, personal protective equipment (PPE), isolation, care delay, changing practice guidelines, and language barrier. Social effects was subcategorized into stigma, divergent healthcare hero perception, additional responsibilities, strained interactions with others, and isolation/loneliness. Short term coping strategies was subcategorized into co-worker support, family support, distractions, mind/body wellness, and spiritualty/faith. CONCLUSION: ICU nurses are experiencing intense psychological and physical effects as a result of caring for patients diagnosed with COVID-19 in a challenging care environment. Outside of work, nurses faced pandemic-induced societal changes and divergent public perceptions of them.


Subject(s)
Adaptation, Psychological , Critical Care Nursing/methods , Critical Care/psychology , Empathy , Nursing Staff, Hospital/psychology , Stress, Physiological , Stress, Psychological , Adult , COVID-19 , Female , Humans , Male , Middle Aged , Pandemics , Qualitative Research , SARS-CoV-2 , United Arab Emirates , Young Adult
16.
Crit Care Med ; 49(7): 1068-1082, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1137999

ABSTRACT

OBJECTIVES: Eleven months into the coronavirus disease 2019 pandemic, the country faces accelerating rates of infections, hospitalizations, and deaths. Little is known about the experiences of critical care physicians caring for the sickest coronavirus disease 2019 patients. Our goal is to understand how high stress levels and shortages faced by these physicians during Spring 2020 have evolved. DESIGN: We surveyed (October 23, 2020 to November 16, 2020) U.S. critical care physicians treating coronavirus disease 2019 patients who participated in a National survey earlier in the pandemic (April 23, 2020 to May 3, 2020) regarding their stress and shortages they faced. SETTING: ICU. PATIENTS: Coronavirus disease 2019 patients. INTERVENTION: Irrelevant. MEASUREMENT: Physician emotional distress/physical exhaustion: low (not at all/not much), moderate, or high (a lot/extreme). Shortage indicators: insufficient ICU-trained staff and shortages in medication, equipment, or personal protective equipment requiring protocol changes. MAIN RESULTS: Of 2,375 U.S. critical care attending physicians who responded to the initial survey, we received responses from 1,356 (57.1% response rate), 97% of whom (1,278) recently treated coronavirus disease 2019 patients. Two thirds of physicians (67.6% [864]) reported moderate or high levels of emotional distress in the Spring versus 50.7% (763) in the Fall. Reports of staffing shortages persisted with 46.5% of Fall respondents (594) reporting a staff shortage versus 48.3% (617) in the Spring. Meaningful shortages of medication and equipment reported in the Spring were largely alleviated. Although personal protective equipment shortages declined by half, they remained substantial. CONCLUSIONS: Stress, staffing, and, to a lesser degree, personal protective equipment shortages faced by U.S. critical care physicians remain high. Stress levels were higher among women. Considering the persistence of these findings, rising levels of infection nationally raise concerns about the capacity of the U.S. critical care system to meet ongoing and future demands.


Subject(s)
COVID-19/psychology , Critical Care/psychology , Occupational Stress , Physicians/psychology , Psychological Distress , Adult , Disease Hotspot , Equipment and Supplies, Hospital/supply & distribution , Female , Humans , Male , Middle Aged , Personal Protective Equipment/supply & distribution , SARS-CoV-2 , Surveys and Questionnaires , United States/epidemiology , Workforce , Workplace
17.
Neurology ; 96(20): e2558-e2560, 2021 05 18.
Article in English | MEDLINE | ID: covidwho-1127739

ABSTRACT

Patients with traumatic brain injury may be dependent on the decision-making of their families. Restrictive visitation policies implemented during the coronavirus disease 2019 (COVID-19) pandemic disproportionately affect these patients and their families. This narrative aims to illustrate this phenomenon and catalyze discussions regarding the need for careful evaluation of restrictive family visitation policies and exceptions that may be required for patients with brain injuries.


Subject(s)
Brain Injuries, Traumatic/therapy , COVID-19/prevention & control , Critical Care , Decision Making, Shared , Head Injuries, Penetrating/therapy , Visitors to Patients , Wounds, Gunshot/therapy , Adult , Critical Care/legislation & jurisprudence , Critical Care/psychology , Critical Care/standards , Glasgow Coma Scale , Humans , Internship and Residency , Male , Neurosurgeons , Palliative Care , Visitors to Patients/legislation & jurisprudence , Visitors to Patients/psychology
20.
Ortop Traumatol Rehabil ; 22(5): 303-309, 2020 Oct 31.
Article in English | MEDLINE | ID: covidwho-1079801

ABSTRACT

BACKGROUND: Working during the coronavirus pandemic has had a significant impact on health care workers. A group of orthopaedic trainees at Royal Gwent Hospital, UK, were redeployed to intensive therapy unit for four weeks during COVID-19 pandemic. This study reviews our experience; focusing on causes of stress and anxiety, and how they were managed. The lessons learnt could be used as a framework for pre-emptive me-asures during future challenges. MATERIAL AND METHODS: Orthopaedic registrars were divided into two groups. Seven trainees (Redeployed group) moved to ITU for four weeks to support the critical care team. The other group (Retained group) of eight registrars continued to cover orthopaedic rota. A survey was done for anxiety levels comparing the two groups at three time points during these four weeks. RESULTS: Anxiety and stress in the ITU-redeployed group was comparatively less than the continuing group as time progressed during the redeployment. CONCLUSIONS: 1. The disruptive impact of the COVID-19 pandemic has been a source of massive stress and an-xiety for health care workers. 2. Our experience shows that stress is controllable with the correct strategies. 3. The main points are early identification of vulnerable groups, proper induction, active involvement, adequate explanation, appreciation, good communication, and available psychological support whenever needed. 4. These are essential to maintain a resilient workforce against upcoming waves of COVID-19.


Subject(s)
Anxiety Disorders/therapy , COVID-19/psychology , Critical Care/psychology , Depressive Disorder/therapy , Health Personnel/psychology , Orthopedic Nursing/organization & administration , Adult , Anxiety Disorders/etiology , COVID-19/epidemiology , Cohort Studies , Depressive Disorder/etiology , Female , Humans , Male , Middle Aged , Pandemics/prevention & control , SARS-CoV-2 , Surveys and Questionnaires , United Kingdom , Young Adult
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