Occurrence and reasons for unfinished nursing care between COVID-19 and non-COVID-19 patients.

AIM: To compare the occurrence and the reasons for unfinished care among coronavirus disease (COVID-19) and non-COVID-19 patients as perceived by nurses. BACKGROUND: The recent pandemic has imposed tremendous changes in hospitals in all countries. INTRODUCTION: Investigating the occurrence of and the reasons for unfinished care as perceived by nurses working in COVID-19 and non-COVID-19 units might help to gain insights and to address future pandemics. METHODS: A comparative cross-sectional study based on the STROBE guideline has been conducted during November 2020-January 2021. The Unfinished Nursing Care Survey, comprising part A (elements) and part B (reasons), was administered online to all 479 nurses working in medical and surgical units converted progressively into COVID-19 and non-COVID-19 units. A total of 90 and 200 nurses participated, respectively. RESULTS: No differences in the unfinished care occurrence have emerged at the overall level between nurses caring for COVID (2.10 out of 5; 95% confidence interval [CI], 1.94-2.27) and non-COVID-19 patients (2.16; 95% CI, 2.06-2.26). Reasons for unfinished care reported significant higher averages among nurses caring for COVID (2.21; 95% CI, 2.10-2.31) as compared with those caring for non-COVID-19 patients (2.07; 95% CI, 2.01-2.14; p = 0.030). DISCUSSION: The overall occurrence of unfinished care was slightly higher compared with pre-pandemic data in all patients. CONCLUSIONS: Reasons triggering unfinished care were slightly different and were due to priority setting and human resources issues, which were perceived at higher significance among nurses working in COVID-19 compared with non-COVID-19 units. IMPLICATION FOR NURSING AND HEALTH POLICIES: A clear map of action has emerged that might be valid in the post-COVID-19 era as well as in the case of future pandemics.

[The covid-19 emergency in the words of the nurses]. / L'emergenza covid-19 nelle parole degli infermieri 1. Cosa è cambiato nel modo di lavorare 2. Essere preparati all'emergenza 3. Lavorare in team 4. La solitudine e l'isolamento dei pazienti 5. La solitudine degli infermieri 6. Le scelte difficili 7. L'organizzazione del lavoro e dei reparti 8. Cosa cambierà dopo il covid-19.

. The covid-19 emergency in the words of the nurses . This special issue of AIR is dedicated to the direct professional experiences and personal testimonies of a sample of the nursing personnel during the most dramatic phase of the covid-19 pandemia in the most severely affected regions of Northern Italy (Lombardy, Piedmont, Veneto, Friuli, Trentino, Emilia Romagna Regions). The decision to adopt a research strategy aimed to give visibility and voice to colleagues representing some of the key hospitals of the regions obliged to a radical reorganisation of their structures and organisation of care, was adopted to catch from inside the crisis scenarios the expected mix of intense emotions (from anxiety, to fatigue, to personal and professional uncertainty, to the burden of impotence), and of needed technical creativity and efficiency which were requested to face a totally unexpected situation where guidelines could hardly be of help. The interview/diaries/focus groups were carefully planned not so much in terms of the contents, but with attention to the acceptance of the interviewed to enter in a free dialogue, with no Q&A, to be recorded, and to last for the time felt to be by both sides appropriate. The texts which are reported in this dossier are fragments of the recordings (overall more then 30 hours), without adjustments. It has been agreed that while all the names of the participants are provided as 'authors', the individual contributions are anonymous (not out of privacy consideration!) as they are part of a collective narrative, which reflects the great variability of the languages and of the perceived-expressed experiences and memories. The material has been organised in sections which are conceived as 'verbal snapshots' taken from the networks of care settings, but at the same time of the places and houses where the colleagues were literally full-time living, to assure unaccountable overtime working hours, and the requested 'safety distances' and lockdowns. The titles of the 8 sections coincide somehow with the principal components of the chain of activities and challenges which had to be faced: The changes in everyday's care, How to be prepared to the emergency, The teamwork, The loneliness and the isolation of the patients, The loneliness of the nurses, The difficult choices, The organization of the work and of the wards, change after covid-19. The core of the dossier is framed by boxes which provide also a minimum background of the administrative and epidemiological data on the pandemia in the regions of interest (it is interesting to remind that the central-southern areas of Italy have been far less affected), and a brief concluding reflection on reflection on the post-pandemia from the nursing point of view.