"I Don't Want to Go to Work": A Mixed-Methods Analysis of Healthcare Worker Experiences from the Front- and Side-Lines of COVID-19.

During the COVID-19 pandemic, healthcare workers (HCW) were categorized as "essential" and "non-essential", creating a division where some were "locked-in" a system with little ability to prepare for or control the oncoming crisis. Others were "locked-out" regardless of whether their skills might be useful. The purpose of this study was to systematically gather data over the course of the COVID-19 pandemic from HCW through an interprofessional lens to examine experiences of locked-out HCW. This convergent parallel mixed-methods study captured perspectives representing nearly two dozen professions through a survey, administered via social media, and video blogs. Analysis included logistic regression models of differences in outcome measures by professional category and Rapid Identification of Themes from Audio recordings (RITA) of video blogs. We collected 1299 baseline responses from 15 April 2020 to 16 March 2021. Of those responses, 12.1% reported no signs of burnout, while 21.9% reported four or more signs. Qualitative analysis identified four themes: (1) professional identity, (2) intrinsic stressors, (3) extrinsic factors, and (4) coping strategies. There are some differences in the experiences of locked-in and locked-out HCW. This did not always lead to differing reports of moral distress and burnout, and both groups struggled to cope with the realities of the pandemic.

Neglecting physician desires to teach at an academic medical facility: A mixed method investigation of the consequences.

PURPOSE: Recent findings have suggested that physicians who spend more time participating in their most meaningful job activities (e.g. teaching) are less likely to experience burnout. The current study aimed to expound upon this finding, focusing specifically on the role of teaching in promoting meaning and preventing burnout. METHOD: A total of 428 physicians at a large academic healthcare institution completed an online survey that included measures of burnout and other relevant variables. In the second part of this study, 20 physicians participated in interviews with the aim of expounding upon and contextualizing the findings from Part 1. RESULTS: Results from Part 1 suggested that although meaningfulness derived from teaching was associated with reduced burnout, this association was only true for those who indicated that clinical teaching was among the most meaningful parts of being a physician. In addition, physicians were less likely to spend time working on their most meaningful job activity when it was teaching. Part 2 illustrated why teaching in the clinical environment can be so meaningful and protective against burnout. CONCLUSIONS: Many physicians are unable to teach due to the increasing demands of medical institutions, which may contribute to the increasing levels of burnout in healthcare providers.

Febrile Seizures: Risks, Evaluation, and Prognosis.

A febrile seizure is a seizure occurring in a child six months to five years of age that is accompanied by a fever (100.4°F or greater) without central nervous system infection. Febrile seizures are classified as simple or complex. A complex seizure lasts 15 minutes or more, is associated with focal neurologic findings, or recurs within 24 hours. The cause of febrile seizures is likely multifactorial. Viral illnesses, certain vaccinations, and genetic predisposition are common risk factors that may affect a vulnerable, developing nervous system under the stress of a fever. Children who have a simple febrile seizure and are well-appearing do not require routine diagnostic testing (laboratory tests, neuroimaging, or electroencephalography), except as indicated to discern the cause of the fever. For children with complex seizures, the neurologic examination should guide further evaluation. For seizures lasting more than five minutes, a benzodiazepine should be administered. Febrile seizures are not associated with increased long-term mortality or negative effects on future academic progress, intellect, or behavior. Children with febrile seizures are more likely to have recurrent febrile seizures. However, given the benign nature of febrile seizures, the routine use of antiepileptics is not indicated because of adverse effects of these medications. The use of antipyretics does not decrease the risk of febrile seizures, although rectal acetaminophen reduced the risk of short-term recurrence following a febrile seizure. Parents should be educated on the excellent prognosis of children with febrile seizures and provided with practical guidance on home management of seizures.