The early career resilience experience of generation Z newly graduated registered nurses in standardized training in the emergency department: a qualitative study in Shanghai.

BACKGROUND: The period of standardized training is a transitional stage when Generation Z newly graduated registered nurses (Gen Z NGRNs) change their role from student to nurse. Affected by the COVID-19, they lack clinical practice and practicum experience in emergency departments in their university studies. At the beginning of career, they are under great pressure. Resilience is one of the factors that reduce their stress level and increases endurance. It is of interest to understand how this representative group of nurses gained and played the experience of resilience early in their careers. OBJECTIVE: To explore Gen Z NGRNs' experience and process of resilience, to provide a new perspective and theoretical basis for psychological rehabilitation or intervention of medical staff who experienced transition shock. METHODS: This study employed a qualitative design based on the phenomenological approach. 18 nurses from a third-level class-A hospital in Shanghai who participated in standardized training in emergency department were enrolled using purposive sampling. Data collection was through in-depth and semi-structured interviews and continued until reaching data saturation. RESULTS: The investigation uncovered three themes and ten subthemes. Pressure and challenge contained high workload and high risk coexist, death's stress response, more emergencies and high professional requirements. Coping and adaptation contained team help, psychological restructuring, peer support, transformational leadership. Reflection and planning contained enhance learning, appreciate life. CONCLUSIONS: Our study described the embodiment and coping experience of the physical and mental stress faced by Gen Z NGRNs during their standardized training in the emergency department. It is emphasized that nurse educators should pay attention to the character and actual needs of Gen Z NGRNs, explore and formulate strategies, so as to guide NGRNs to quickly adapt and grow in the new role. The ultimate goal is to increase nurse retention and improve the quality of nursing.

Newly graduated registered nurses' experiences of the pre-service safety training program: A qualitative study.

BACKGROUND: Patient safety is a top priority for the global healthcare system and a prerequisite for high-quality nursing care. In China, newly graduated registered nurses are required to receive two years of standardized training to ensure patient safety. The pre-service safety training program aims to provide safe, high-quality, and effective nursing care. However, perceptions and experiences of newly graduated registered nurses on pre-service safety training programs have not yet been explored. OBJECTIVES: To investigate newly graduated registered nurses' perceptions and experiences of the pre-service safety training program in a tertiary hospital in China. DESIGN: A phenomenological approach was used for this qualitative study. SETTINGS: Tertiary hospital in Shanghai, China. PARTICIPANTS: A total of 19 newly graduated registered nurses who participated in the pre-service safety training program. METHODS: Data were collected using semi-structured, face-to-face, in-depth interviews and analyzed using the Colaizzi seven-step framework. RESULTS: Three themes and nine sub-themes emerged: (1) satisfaction with the approaches and content of the training, (2) gaining benefits and growth, and (3) suggestions for the training. CONCLUSION: It is meaningful for newly graduated registered nurses to receive safety training before entering clinical practice and was praised by participants for helping them improve safety competence and change safety behaviors. Continuing safety training and optimizing the training modules and evaluation methods will maximize the effectiveness of safety training.

Post-traumatic growth among emergency nurses after COVID-19 in Shanghai, China: a qualitative study.

OBJECTIVES: This study aims to investigate the post-traumatic growth of emergency nurses (ENs) in Shanghai, China, in 2022 following the COVID-19 pandemic. DESIGN: A phenomenological qualitative research approach was employed, with 17 ENs being interviewed between July and August 2022. Data collection was conducted through semistructured, in-depth interviews, and data analysis was carried out using the Colaizzi's seven-step analysis method. SETTING: A third-level hospital in Shanghai. PARTICIPANTS: A total of 17 ENs were interviewed through face-to-face, semistructured, in-depth interviews. RESULTS: Three main themes and eight subthemes were extracted from the data: (a) stress, (b) restructuring and (c) growth. CONCLUSION: Significant stress was imposed on ENs by the Shanghai COVID-19 pandemic, but cognitive restructuring was successfully undergone by them, leading to the experience of growth. It is recommended that post-traumatic growth levels be enhanced through professional psychological counselling and tailored support measures for different stages.

Factors influencing the mental health status of support nurses and their workload during the COVID-19 epidemic.

OBJECTIVES: The authors used the National Aeronautics and Space Administration Task Load Index (NASA-TLX) and general health questionnaire to analyze the factors influencing the mental health status and the workload of support nurses during the COVID-19 epidemic. MATERIAL AND METHODS: The authors conducted a cross-sectional survey of 349 support nurses in April-October 2022. Using QuestionStar, a powerful online survey tool, the authors administered surveys to the participants, collected data on the mental health status and workload of support nurses, and analyzed the influencing factors based on the collected data. RESULTS: A total of 316 questionnaires were successfully collected, with an effective rate of 98.75%. The proportion of support nurses with mental health problems was 25% and the value of the NASA-TLX questionnaire was: M±SD 68.91±7.28 pts. Multi-factor analysis revealed that the number of children, family support, and nursing support location were the influencing factors of mental health status, while the multivariate analysis revealed that the presence of symptoms, nursing support location, support work type, and total 12-item General Health Questionnaire (GHQ-12) score were the influencing factors of the workload of support nurses. CONCLUSIONS: Compared to their counterparts in the plains, nurses working in isolated plateau regions who were caring for children and lacked family support, were more likely to have mental health issues. There was a positive correlation between the changes in GHQ-12 and NASA-TLX scores of the study participants. Compared to their counterparts in the plains and the tropical regions, nurses working in plateau regions had a heavier workload. As part of the follow-up measures to prevent and treat patients impacted by the COVID-19 epidemic, it is important to improve the mental health evaluation, consultation, and treatment of the support nurses to guarantee the high quality of the first-line support work. Int J Occup Med Environ Health. 2023;36(6)761-72.

Application of continuous nursing care based on hierarchical diagnosis and treatment mode in Stage II cardiac rehabilitation of patients after percutaneous coronary intervention.

Objective: To explore the effect of applying continuous nursing care based on hierarchical diagnosis and treatment in Stage II cardiac rehabilitation of patients after percutaneous coronary intervention (PCI) and provide a theoretical basis for clinical nursing intervention. Methods: Patients in PCI postoperative II cardiac rehabilitation were selected and randomly divided into the experimental group (community group), the experimental group (rehabilitation group), and the control group. Patients in the control group received the routine cardiac rehabilitation management scheme, while those in the experimental groups received continuous nursing protocol based on the hierarchical diagnosis and treatment mode. All patients were compared for the cardiac rehabilitation evaluation indexes at discharge and 6 months after discharge. Results: Compared with the control group, the left ventricular ejection fraction, 6-minute walking distance test, medication compliance, and quality of life were all improved in the two experimental groups, and the differences were statistically significant (P < 0.05). The improvement in the rehabilitation group was more significant than in the community group. There were more patients with high cardiac rehabilitation compliance in the rehabilitation group than in the community group, with the difference being statistically significant (P < 0.05). Conclusion: Continuous nursing care rehabilitation based on the hierarchical diagnosis and treatment mode can improve the cardiac function of patients after PCI, enhance their quality of life, and improve their rehabilitation and medication compliance, facilitating their cardiac rehabilitation.

A target-oriented algorithm for maintaining serum calcium stability automatically in regional citrate anticoagulation.

BACKGROUND: Regional citrate anticoagulation (RCA) for renal replacement therapy is widely practiced in critically ill patients. However, concern exists regarding its labor-intensiveness for monitoring and the associated hypocalcemia. In this study, we provided an algorithm for prescribing RCA and evaluated its safety in patients. METHODS: During 18 hemofiltration treatments with calcium-free replacement solution, participants were randomized to receive algorithm-based or trial-and-error RCA protocol. The effluent volume, post-filter and in vivo ionized calcium (iCa), and calcium in the sera and effluents were periodically measured at an interval of 1 to 2 h. RESULTS: For patients received algorithm-based RCA protocol, no one had a serum iCa less than 0.9 mmol/L, and none needed calcium supplement adjustment to maintain serum calcium stability. For patients accepted trial-and-error protocol, all patients had a serum iCa below 0.9 mmol/L, their serum iCa and calcium levels fluctuated dramatically, and all patients need additional calcium supplement adjustment during RCA. None of the participants showed a post-filter iCa > 0.4 mmol/L. CONCLUSION: We provided a safe algorithm for calculating calcium supplementation doses that could maintain serum calcium stability without additional adjustment during RCA.