A concept analysis of psychological trauma in labour and delivery nurses.

AIM: To facilitate an understanding of the risk for psychological trauma in labour and delivery nurses. DESIGN: Concept analysis. METHODS: The Walker and Avant method of concept analysis was applied to 56 articles. The characteristics, antecedents, and consequences of psychological trauma in labour and delivery nurses were identified. DATA SOURCES: Peer-reviewed articles in English from CINAHL, PubMed and Google Scholar were reviewed on July 2023. RESULTS: The characteristics of psychological trauma in labour and delivery nurses are overwhelming distress, intrusive symptoms, avoidance and numbing behaviours, hypervigilance or hyperarousal, emotional dysregulation, cognitive distortions, and interpersonal challenges. The antecedents are exposure to one or more of the following nurse-specific traumas: natural or person-made disasters, historical role limitations, second victim situations, secondary trauma, system-mediated or over-medicalized care, insufficient resources, or workplace incivility. The consequences are disruptions in mental health, diminished physical health, alterations in relationships, and variable work performance. CONCLUSION: Labour and delivery nurses experience unique causes of psychological trauma due to their practice environment and patient population. The consequences of labour and delivery nurses' psychological trauma extend beyond individual health and impact the quality of patient care and organizational capacity. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Furthermore, research is needed to inform education, support and policy measures to mitigate harm effectively. WHAT PROBLEM DID THE STUDY ADDRESS?: Nurse-specific trauma theory has not been applied to the unique labour and delivery environment with a high incidence of patient trauma. WHAT WERE THE MAIN FINDINGS?: Multiple causes of trauma in the perinatal context have created a pervasive yet largely preventable issue. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: This research will impact labour and delivery nurses, their leadership, and their patients. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Effect of an Education Intervention on Nursing Students' Knowledge of and Attitudes Toward Caring for Transgender and Nonbinary People.

BACKGROUND: Transgender and nonbinary (TGNB) people experience inequities in health care access, quality, and outcomes. Health care professionals' lack of knowledge and biased attitudes toward gender minorities contribute to inequitable care. PURPOSE: This study examined the effect of TGNB health education on nursing students' knowledge and attitudes about caring for TGNB clients. METHODS: A quasi-experimental study using a one-group pretest/posttest design was conducted with 46 nursing students at 2 private baccalaureate nursing programs. RESULTS: A paired-samples t test found a significant increase in knowledge about caring for TGNB clients at posttest (P = .02). Attitudes toward caring for TGNB clients showed a significant improvement in the Sex and Gender Beliefs subscale at posttest (P = .014). CONCLUSIONS: The findings suggest that TGNB health education is effective for inclusion in nursing curricula to better prepare nurses to care for gender-diverse clients.

Experiences of new nurses in the United States during the acute phase of the COVID-19 pandemic.

AIM: This qualitative descriptive study describes the experiences of new nurses during the acute phase of the COVID-19 pandemic in the United States. BACKGROUND: New nurses faced the dual challenge of transitioning to practice while working during a global pandemic. Although multiple studies have described nurses' experiences during the COVID-19 pandemic, research is warranted to understand new nurses' experiences during the acute phase of the pandemic. METHODS: Registered nurses (n = 46) with less than two years of work experience, who participated in the COVID-19 Study and Registry of Healthcare and Support Personnel (CHAMPS), participated in this study. Thematic analysis was used to examine their responses. The COREQ guidelines were used in reporting this study. RESULTS: Five themes were extracted: feelings of increasing isolation, feelings of intense fear, personal health concerns, shattered and disrupted expectations, and living in a constant dilemma. DISCUSSION: New nurses described their distress and profound sense of isolation which was compounded by their status as new employees and being shunned by others. There was intense fear for their safety and health. They viewed their limited nursing experience with only COVID-19 patients as detrimental to their careers and encountered complex dilemmas and were obligated to make problematic choices. CONCLUSIONS: New nurses revealed unrelenting psychological and physical distress during the pandemic. Identification and implementation of strategies to address their distress and alleviate its negative consequences were needed but not provided. IMPLICATIONS FOR NURSING POLICY: The development and implementation of policies to address the challenges new nurses encounter are needed. Action strategies to promote professional socialization and job retention are required.

A thematic analysis of shared experiences of essential health and support personnel in the COVID-19 pandemic.

AIMS AND OBJECTIVES: Studies have shown that the COVID-19 pandemic has taken a toll on individuals who interact with patients with SARS-CoV-2 but focused largely on clinicians in acute care settings. This qualitative descriptive study aimed to understand the experiences and well-being of essential workers across settings during the pandemic. BACKGROUND: Multiple studies of the well-being of individuals who have cared for patients during the pandemic have included interviews of clinicians from acute care settings and revealed high levels of stress. However, other essential workers have not been included in most of those studies, yet they may also experience stress. METHODS: Individuals who participated in an online study of anxiety, depression, traumatic distress, and insomnia, were invited to provide a free-text comment if they had anything to add. A total of 2,762 essential workers (e.g., nurses, physicians, chaplains, respiratory therapists, emergency medical technicians, housekeeping, and food service staff, etc.) participated in the study with 1,079 (39%) providing text responses. Thematic analysis was used to analyze those responses. RESULTS: Four themes with eight sub-themes were: Facing hopelessness, yet looking for hope; Witnessing frequent death; Experiencing disillusionment and disruption within the healthcare system, and Escalating emotional and physical health problems. CONCLUSIONS: The study revealed major psychological and physical stress among essential workers. Understanding highly stressful experiences during the pandemic is essential to identify strategies that ameliorate stress and prevent its negative consequences. This study adds to the research on the psychological and physical impact of the pandemic on workers, including non-clinical support personnel often overlooked as experiencing major negative effects. RELEVANCE TO CLINICAL PRACTICE: The magnitude of stress among all levels of essential workers suggests the need to develop strategies to prevent or alleviate stress across disciplines and all categories of workers.

An uncertain time: Clinical nurses' first impressions during the COVID-19 pandemic.

The COVID-19 pandemic overwhelmed the US healthcare system and healthcare providers. Nurses, who comprise one of the most affected groups because they are the largest group of healthcare providers, were in a unique position to speak about their perspectives. As a result of the COVID-19 pandemic, nurses have experienced ongoing physical and psychological challenges while displaying strength and perseverance during uncertain times. In this study, we explored the perceptions and experiences of nurses in clinical practice caring for patients diagnosed with COVID-19 during the pandemic. Researchers conducted a qualitative descriptive study with 20 clinical nurses most of whom were enrolled in a graduate program while working in healthcare settings. Semi-structured interviews conducted through Zoom occurred between August 2020 and December 2020. Thematic analysis was used to analyze the transcripts. Five themes emerged: navigating uncertainty, managing death and loss, acknowledging emotional responses, learning opportunities, and facing community undercurrents. Lack of clinical practice guidelines, and inconsistent access to personal protective equipment when providing care to patients with COVID-19 caused emotional strain for nurses and highlighted future learning opportunities. Providing support to dying patients was devastating to nurses. Concern about community misunderstandings of the pandemic created challenges. Evolving teamwork provided invaluable support to study participants. Nurses shared essential information for revising and creating clinical practice guidelines. Nursing interventions and strategies were used to produce humane and positive patient outcomes and provide a foundation for nurse-driven care in possible future pandemics.

Vulnerability, loss, and coping experiences of health care workers and first responders during the covid-19 pandemic: a qualitative study.

INTRODUCTION: The ongoing COVID-19 pandemic substantially affects health care workers from multiple disciplines, including nurses, physicians, therapists, and first responders. The aims of this study were to 1) explore and describe the experiences of health care workers and first responders working with individuals with COVID-19 infection, and 2) identify the support and strategies that were helpful during their experience. METHODS: A qualitative descriptive study was conducted via online video interviews of 29 health care workers and first responders who agreed to be contacted for an interview. Thematic analysis resulted in three themes and corresponding subthemes. RESULTS: The three overriding themes were 1) experiencing vulnerability, 2) suffering loss and grief, and 3) coping with vulnerability. A sense of vulnerability and high levels of stress were described and affected participants during their professional work as health care workers and first responders as well as their roles in their homes and communities. DISCUSSION AND CONCLUSION: The findings indicate the need for effective measures to assist health care workers and first responders to minimize the negative consequences of persistent and severe stress and vulnerability as they care for individuals with COVID-19 and their families.

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.

Compassion satisfaction: A concept analysis in nursing.

BACKGROUND: Nurses experience an intrinsic sense of fulfillment derived from their work in caring for other people. There is a need to further investigate the concept of compassion satisfaction as it is experienced in the profession of nursing. AIM: The aim of this analysis is to provide clarity to the concept of compassion satisfaction in nursing. DESIGN/DATA SOURCE: A search of social work and nursing literature was completed. The search terms "compassion satisfaction," "nursing," "social workers," "teachers," and "educators" were entered in various combinations to the CINAHL, Journals@Ovid, ProQuest Nursing & Allied Health Source, ProQuest Psychology Journals, PsychINFO, ERIC, and Education Full Text databases. REVIEW METHODS: A comprehensive review of the literature was completed to identify features of compassion satisfaction. Utilizing the Walker and Avant method, assumptions, antecedents, characteristics, and consequences of compassion satisfaction were identified. RESULTS: A conceptual model of compassion satisfaction was developed encompassing 7 antecedents, 11 characteristics, and 8 consequences. Further, a theoretical definition of compassion satisfaction in nursing was derived. CONCLUSION: There is a need to focus on the positive effects of caring. This concept analysis provides the initial step to strengthening the science related to compassion satisfaction in nursing and other helping professions.

The lived experience of women in abusive relationships who sought spiritual guidance.

Women in abusive relationships have recognized the silence of religious institutions and clergy in addressing intimate partner violence. The old message, that women are to blame when family dysfunction occurs, remains evident in society. The objective of this qualitative study was to describe the experience of abused women attempting to decrease their spiritual distress and obtain spiritual guidance from their religious leaders. The findings revealed that clergy were not helpful in alleviating the women's spiritual distress or intervening in the violence. Four themes that epitomized the negative outcomes of the help-seeking behavior were spiritual suffering, devaluation, loss, and powerlessness.

Partner abuse in physically disabled women: a proposed model for understanding intimate partner violence.

PROBLEM: Physically disabled women are a population at significant risk for intimate partner violence. METHOD: This study used a qualitative research design to address the abuse experience of physically disabled women. FINDINGS: The participants identified multiple incidences of abuse, focusing on how the abuse began, proceeded, and terminated. A model was constructed to depict the abuse experience. The progression of abuse triggers, responses of the women, the abuse episode, the after-effects, and the slow return to usual routines were identified. CONCLUSIONS: A model, which is different from Walker's Cycle of Violence (Walker, 1979; 2000), was constructed to demonstrate the journey of women with disabilities through the abuse.