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Rev. gaúch. enferm ; 42(spe): e20200339, 2021. graf
Article in English | LILACS (Americas) | ID: covidwho-1280681


ABSTRACT Objective To trigger a reflection on the current working conditions of Nursing professionals in coping with the Covid-19 pandemic. Method A theoretical-reflective study supported by studies from the Marxist perspective, national and international scientific articles, and official documents from the World Health Organization and the Federal Nursing Council. Results The daily work of Nursing professionals in the face of the Covid-19 pandemic presents unfavorable working conditions in Brazil and worldwide, with emphasis on the deficit of professionals, overload of activities, low pay, and personal protective equipment, often insufficient and inadequate, conditions that can lead to exhaustion, illness and death. Conclusion This study can contribute to raising discussions about the need for improvements in the working conditions of Nursing professionals, especially in pandemic times and the impact on the health of these professionals.

RESUMEN Objetivo Elaborar una reflexión sobre las condiciones laborales actuales de los profesionales de enfermería frente a la pandemia del Covid-19. Método Análisis teórico-reflexivo sustentado en estudios desde la perspectiva marxista, artículos científicos nacionales e internacionales y documentos oficiales de la Organización Mundial de la Salud y el Consejo Federal de Enfermería. Resultados El trabajo diario de los profesionales de enfermería ante la pandemia de Covid-19 presenta condiciones desfavorables en Brasil y en todo el mundo, con énfasis en el déficit de profesionales, sobrecarga de actividades, salarios bajos y equipos de protección personal a menudo insuficientes e inadecuados, condiciones que pueden conducir al agotamiento, la enfermedad y la muerte. Conclusión Este estudio puede contribuir a generar discusiones sobre la necesidad de mejorar las condiciones de trabajo de los profesionales de enfermería, especialmente en tiempos de pandemia y el impacto en la salud de estos profesionales.

RESUMO Objetivo Desencadear uma reflexão sobre as atuais condições de trabalho dos profissionais de enfermagem no enfrentamento da pandemia da Covid-19. Método Estudo teórico-reflexivo sustentado por estudos da vertente marxista, artigos científicos nacionais e internacionais e por documentos oficiais da Organização Mundial da Saúde e do Conselho Federal de Enfermagem. Resultados O cotidiano laboral dos profissionais de enfermagem diante da pandemia da Covid-19 apresenta condições de trabalho desfavoráveis no Brasil e no mundo todo, com destaque para o déficit de profissionais, sobrecarga de atividades, baixa remuneração e equipamentos de proteção individual, muitas vezes, insuficientes e inadequados, condições essas que podem levar à exaustão, ao adoecimento e à morte. Conclusão Este estudo pode contribuir para suscitar discussões sobre a necessidade de melhorias nas condições de trabalho dos profissionais de enfermagem, especialmente, em tempos de pandemia e o impacto na saúde destes profissionais.

Working Conditions , Adaptation, Psychological , Pandemics , COVID-19 , Nurse Practitioners/psychology , Salaries and Fringe Benefits , Burnout, Professional , Psychosocial Impact
J Nurses Prof Dev ; 37(3): E5-E9, 2021.
Article in English | MEDLINE | ID: covidwho-1219254


The nursing professional development practitioner's call to action at a large, acute care academic facility during the novel coronavirus pandemic required adaptability and resiliency. When rapid, unprecedented challenges altered nursing professional development workflow, a department of 16 practitioners split into three teams. The teams achieved goals by meeting the demand for education and training of frontline staff during the surge in novel coronavirus patients.

COVID-19/nursing , Nurse Practitioners/psychology , Nursing Staff, Hospital/education , COVID-19/epidemiology , Hospitals, Teaching , Humans , Interprofessional Relations , New Jersey/epidemiology , Nursing Evaluation Research
Adv Emerg Nurs J ; 43(2): 89-101, 2021.
Article in English | MEDLINE | ID: covidwho-1207366


The Research to Practice column presents an analysis of current and controversial research findings with implications for practice change relevant to emergency care settings. This review critiques Johnson et al.'s (2016) investigation, titled "The Impact of Cognitive Stressors in the Emergency Department on Physician Implicit Racial Bias," that examined emergency department characteristics and stressors and their effects on physician racial bias and decision making. Their findings suggest that unconscious biases can affect clinical decisions when providers experience increased cognitive stress. The implications are significant for emergency providers as resources are especially strained during the COVID-19 pandemic and as the adverse effects of unconscious bias on health disparities and patient outcomes have become clearly apparent. Implicit bias training (IBT) is recommended for emergency providers and has significant implications for medical and nurse educators in executing and evaluating IBT outcomes.

Emergency Service, Hospital , Nurse Practitioners/psychology , Personnel, Hospital/psychology , Racism/psychology , Adult , Awareness , Female , Humans , Pregnancy , Prejudice
Nurse Pract ; 46(5): 34-43, 2021 05 01.
Article in English | MEDLINE | ID: covidwho-1197021


ABSTRACT: In this second article of a three-part series, we explore how stakeholders can be educated on the use of telehealth technology and telemedicine. We address the need for staff and patient support for the transition to telehealth and offer suggestions to NPs for appropriate presentation and interaction with interdisciplinary teams and patients regarding telehealth.

COVID-19 , Nurse Practitioners/psychology , Telemedicine/organization & administration , Health Personnel/education , Humans , Interprofessional Relations , Nurse-Patient Relations , Patient Education as Topic , Stakeholder Participation
CMAJ Open ; 9(2): E400-E405, 2021.
Article in English | MEDLINE | ID: covidwho-1190636


BACKGROUND: In March 2020, all levels of government introduced various strategies to reduce the impact of the COVID-19 pandemic. The purpose of this study was to document how the experience of providing medical assistance in dying (MAiD) changed during the COVID-19 pandemic. METHODS: We conducted a qualitative study using semistructured interviews with key informants in Canada who provided or coordinated MAiD before and during the COVID-19 pandemic. We interviewed participants from April to June 2020 by telephone or email. We collected and analyzed data in an iterative manner and reached theme saturation. Our team reached consensus on the major themes and subthemes. RESULTS: We interviewed 1 MAiD coordinator and 15 providers, including 14 physicians and 1 nurse practitioner. We identified 4 main themes. The most important theme was the perception that the pandemic increased the suffering of patients receiving MAiD by isolating them from loved ones and reducing available services. Providers were distressed by the difficulty of establishing rapport and closeness at the end of life, given the requirements for physical distancing and personal protective equipment. They were concerned about the spread of SARS-CoV-2, and found it difficult to enforce rules about distancing and the number of people present. Logistics and access to MAiD became more difficult because of the new restrictions, but there were many adaptations to solve these problems. INTERPRETATION: Providers and coordinators had many challenges in providing MAiD during the COVID-19 pandemic, including their perception that the suffering of their patients increased. Some changes in how MAiD is provided that have occurred during the pandemic, including more telemedicine assessments and virtual witnessing, are likely to remain after the pandemic and may improve service.

COVID-19/psychology , Health Services Accessibility/statistics & numerical data , Medical Assistance/statistics & numerical data , Perception/physiology , Adult , Aged , Aged, 80 and over , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Canada/epidemiology , Death , Female , Humans , Interviews as Topic , Male , Medical Assistance/trends , Middle Aged , Nurse Practitioners/psychology , Patient Isolation/psychology , Personal Protective Equipment/adverse effects , Physicians/psychology , Qualitative Research , SARS-CoV-2/genetics
Hosp Pract (1995) ; 49(4): 245-251, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1171276


Background: Hospitalists, comprised of nurse practitioners and physician assistants (collectively, advanced practice providers [APPs]) and physicians, have opportunities to counsel patients and reduce SARS-CoV-2 related coronavirus disease 2019 (COVID-19) vaccine hesitancy. However, hospitalist perspectives on the COVID-19 vaccine and potential differences between APPs and physicians are unknown. Understanding hospitalist perspectives could help to address vaccine hesitancy among patients.Methods: We conducted an online survey of hospitalists at Mayo Clinic sites in Arizona, Florida, Minnesota, and Wisconsin from 14 December 2020 through 4 January 2021. We collected demographic information and assessed perspectives on the COVID-19 vaccine and, for comparison, on the influenza vaccine. Descriptive statistics were used to compare responses between APPs and physicians.Results: The overall response rate was 42.7% (n = 128/300) and comprised of 53.9% women (n = 69/128) and 41.4% APPs (n = 53/128). Most hospitalists reported receiving or planning to receive vaccination against COVID-19 (93.7%; n = 119/128) and influenza (97.7%; n = 125/128). Most hospitalists reported they would advise 100% of patients to receive the COVID-19 vaccine (66% for APPs; 74.7% for physicians) and influenza vaccine (83% for APPs; 80% for physicians). Barriers to recommending the COVID-19 vaccine included patient health status and vaccine safety profile. Hospitalists reported that patients and coworkers receiving the COVID-19 vaccine would reduce their anxiety (~80% of hospitalists), social isolation (~64% of hospitalists), and improve their emotional support (~40% of hospitalists). APP and physician responses were similar. The possible reduction in social isolation was associated with higher odds of hospitalists advising all patients to receive the COVID-19 vaccine (adjusted odds ratio 2.95 [95% confidence interval, 1.32-6.59]; P< .008), whereas hospitalist age, gender, and profession showed no association.Conclusion: Most hospitalists would reportedly advise patients to receive the COVID-19 vaccine. Barriers to this recommendation included patient health status and vaccine safety. Hospitalists are an important resource to provide patient education and reduce COVID-19 vaccine hesitancy.

COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Hospitalists/psychology , Influenza Vaccines/administration & dosage , Influenza, Human/prevention & control , Adult , COVID-19 Vaccines/adverse effects , Female , Health Status , Humans , Influenza Vaccines/adverse effects , Male , Middle Aged , Nurse Practitioners/psychology , Physician Assistants/psychology , Physicians/psychology , SARS-CoV-2 , Social Isolation , Socioeconomic Factors
Rev. gaúch. enferm ; 42(spe): e20200225, 2021.
Article in English | LILACS (Americas) | ID: covidwho-1076313


ABSTRACT Objective: To reflect about the work context of nursing professionals in the COVID-19 pandemic and the repercussions for these professionals' mental health. Method: This is a theoretical reflective study with two thematic axes: i) Pandemic by COVID-19: epidemiological condition, manifestations, and preventive measures; ii) Precariousness of work in times of pandemic and impacts on the worker's mental health. Results: The COVID-19 pandemic made explicit the reflects of precariousness in the health sector. For example, the psychological suffering of nursing workers was evidenced due to the scarcity of personal protective equipment, the weakness in the description of the protocols and the flows for the effective control of infections, the long working hours, the inadequate professional training for crisis scenario and uncertainty in relation to therapeutic measures. Conclusion: The present article brings to light the aggravation of a scenario that raises the potential for negative impact on the mental health of nursing workers.

RESUMEN Objetivo: Reflexionar sobre el contexto de trabajo de los profesionales de enfermería en la pandemia de COVID-19 y las repercusiones para la salud mental de estos profesionales. Método: Se trata de un estudio teórico reflexivo con dos ejes temáticos: i) Pandemia de COVID-19: cuadro epidemiológico, manifestaciones y medidas preventivas; ii) Trabajo precario en tiempos de pandemia e impactos en la salud mental del trabajador. Resultados: La pandemia de COVID-19 explicitó los reflejos de precariedad en el sector de la salud, por ejemplo, el sufrimiento psicológico de los trabajadores de enfermería debido a la escasez de equipos de protección individual, la fragilidad en la descripción de los protocolos y los flujos al hospital. control efectivo de infecciones, horas de trabajo prolongadas, capacitación profesional inadecuada para el escenario de crisis e incertidumbres en relación con las medidas terapéuticas. Conclusión: El presente artículo saca a la luz el agravamiento de un escenario que aumenta el potencial de impacto negativo en la salud mental de los trabajadores de enfermería.

RESUMO Objetivo: Refletir sobre o contexto de trabalho dos profissionais de enfermagem na pandemia da Covid-19 e as repercussões para saúde mental desses profissionais. Método: Trata-se de um estudo teórico reflexivo com dois eixos temáticos: i) Pandemia pela Covid-19: quadro epidemiológico, manifestações e medidas preventivas; ii) Precarização laboral em tempos de pandemia e impactos na saúde mental do trabalhador. Resultados: A pandemia da Covid-19 explicitou os reflexos da precarização no setor saúde. Por exemplo, evidenciou-se o sofrimento psíquico dos trabalhadores de enfermagem decorrente da escassez de equipamento de proteção individual, da fragilidade na descrição dos protocolos e dos fluxos para o controle efetivo de infecções, das prolongadas horas de trabalho, da formação profissional inadequada para o cenário de crise e das incertezas em relações as medidas terapêuticas. Conclusão: O presente artigo traz à tona a agudização de um cenário que eleva o potencial de impacto negativo na saúde mental dos trabalhadores de enfermagem.

Humans , Mental Health , Occupational Health , Pandemics , Psychological Distress , COVID-19/epidemiology , Nurse Practitioners/psychology , Work Hours , COVID-19/prevention & control
J Am Assoc Nurse Pract ; 33(1): 2-4, 2021 Jan 01.
Article in English | MEDLINE | ID: covidwho-1039764


ABSTRACT: JAANP Fellow Dr. Leslie-Faith Morritt Taub, NYU Adult-Gerontology Primary Care Program Director, describes the emotional, political, and social impact of COVID-19 on one graduating cohort of nurse practitioner (NP) students at New York University and one incoming cohort of students. Through the lens of a seasoned professor she describes the changes to her teaching methods because she leads these students through the course work and clinical work required to take on the role of the NP in the midst of a global pandemic in the heart of New York City.

COVID-19/psychology , Nurse Practitioners/education , Nurse Practitioners/psychology , Students, Nursing/psychology , COVID-19/nursing , Humans , New York , United States
Rev. gaúch. enferm ; 42(spe): e20200140, 2021.
Article in English | LILACS (Americas) | ID: covidwho-883755


ABSTRACT Objective: To reflect on the mental health of Nursing professionals in the context of the coronavirus pandemic. Method: This is a theoretical-reflective study based on the discursive formulation on the theme and supported by the national and international scientific literature and by the authors' critical analysis. Results: The analyzed studies, along with the care practice, showed that Nursing professionals are susceptible to the exacerbation of symptoms such as depression, anxiety, insomnia, anguish, and stress in the midst of the coronavirus pandemic, in view of their exhaustive work shifts, patients' deaths, risk of infecting themselves and their families, and social isolation. Final considerations: The mental health of Nursing professionals needs to be listed as one of the priorities for health managers, guaranteeing strategies and public policies that ensure sanity for those who are in the front line of the fight against the pandemic.

RESUMEN Objetivo: Reflexiones sobre la salud mental de los profesionales de Enfermería en el contexto de la pandemia de coronavirus. Método: Estudio teórico-reflexivo basado en la formulación discursiva sobre el tema respaldada por literatura científica nacional e internacional y por el análisis crítico de los autores. Resultados: Los estudios analizados, sumados a la práctica asistencial, demuestran que los profesionales de Enfermería son susceptibles a la exacerbación de síntomas como depresión, ansiedad, insomnio, angustia y estrés en medio de la pandemia de coronavirus, en vista de los exhaustivos turnos de trabajo, la muerte de los pacientes, el riesgo de autocontaminación y de contagio de sus familias y el aislamiento social. Consideraciones finales: La salud mental de los profesionales de Enfermería debe figurar como una de las prioridades para los gerentes de salud, garantizando estrategias y políticas públicas que aseguren la salud de quienes están en la primera línea de lucha contra la pandemia.

RESUMO Objetivo: Refletir sobre a saúde mental dos profissionais de enfermagem no contexto na pandemia de coronavírus. Método: Estudo teórico-reflexivo baseado na formulação discursiva acerca da temática, sustentado pela literatura científica nacional e internacional e análise crítica dos autores. Resultados: Os estudos analisados, somados à prática assistencial, têm evidenciado que os profissionais de enfermagem são suscetíveis à exacerbação de sintomas como depressão, ansiedade, insônia, angústia, estresse, em meio à pandemia de coronavírus, tendo em vista os turnos exaustivos de trabalho, a morte de pacientes, risco de autocontaminação e de seus familiares e isolamento social. Considerações finais: A saúde mental dos profissionais de enfermagem necessita ser elencada como uma das prioridades para os gestores de saúde, garantindo estratégias e políticas públicas que assegurem a sanidade para estes que estão na linha de enfrentamento da pandemia.

Humans , Male , Female , Adaptation, Psychological , Mental Health , Health Strategies , COVID-19 , Nurse Practitioners/psychology , Anxiety , Public Policy , Social Isolation , Depression
West J Emerg Med ; 21(6): 88-92, 2020 Sep 25.
Article in English | MEDLINE | ID: covidwho-869241


INTRODUCTION: Emergency clinicians on the frontline of the coronavirus pandemic experience a range of emotions including anxiety, fear, and grief. Debriefing can help clinicians process these emotions, but the coronavirus pandemic makes it difficult to create a physically and psychologically safe space in the emergency department (ED) to perform this intervention. In response, we piloted a video-based debriefing program to support emergency clinician well-being. We report the details of our program and results of our evaluation of its acceptability and perceived value to emergency clinicians during the pandemic. METHODS: ED attending physicians, resident physicians, and non-physician practitioners (NPP) at our quaternary-care academic medical center were invited to participate in role-based, weekly one-hour facilitated debriefings using Zoom. ED attendings with experience in debriefing led each session and used an explorative approach that focused on empathy and normalizing reactions. At the end of the pilot, we distributed to participants an anonymous 10-point survey that included multiple-answer questions and visual analogue scales. RESULTS: We completed 18 debriefings with 68 unique participants (29 attending physicians, 6 resident physicians, and 33 NPPs. A total of 76% of participants responded to our survey and 77% of respondents participated in at least two debriefings. Emergency clinicians reported that the most common reasons to participate in the debriefings were "to enhance my sense of community and connection" (81%) followed by "to support colleagues" (75%). Debriefing with members of the same role group (92%) and the Zoom platform (81%) were considered to be helpful aspects of the debriefing structure. Although emergency clinicians found these sessions to be useful (78.8 +/- 17.6) interquartile range: 73-89), NPPs were less comfortable speaking up (58.5 +/- 23.6) than attending physicians (77.8 +/- 25.0) (p = < 0.008). CONCLUSION: Emergency clinicians participating in a video-based debriefing program during the coronavirus pandemic found it to be an acceptable and useful approach to support emotional well-being. Our program provided participants with a platform to support each other and maintain a sense of community and connection. Other EDs should consider implementing a debriefing program to safeguard the emotional well-being of their emergency clinician workforce.

COVID-19/epidemiology , Emergency Service, Hospital , Feedback , Nurse Practitioners/psychology , Occupational Stress/therapy , Physicians/psychology , Videoconferencing , Attitude of Health Personnel , Burnout, Professional/prevention & control , Health Promotion/methods , Humans , Occupational Stress/psychology , Resilience, Psychological , SARS-CoV-2 , Surveys and Questionnaires