RESUMO
ABSTRACT: The COVID-19 pandemic has been exceptionally disruptive to healthcare delivery, exposing the strengths and weaknesses of our healthcare system. Though systems will continue to improvise in the short term to provide essential patient care, thoughtful consideration should be given to a long-term approach to improve healthcare delivery. Policy makers, legislators, and healthcare system leaders have the opportunity to reflect on lessons learned during this time and update outdated and detrimental restrictions affecting healthcare providers who have been vital to the pandemic response. This article focuses on lessons learned about the use of physician assistants and NPs, who have been readily deployed during this time.
Assuntos
COVID-19/terapia , Mão de Obra em Saúde/estatística & dados numéricos , Profissionais de Enfermagem/estatística & dados numéricos , Assistentes Médicos/estatística & dados numéricos , COVID-19/epidemiologia , Humanos , Atenção Primária à Saúde/organização & administração , Recursos Humanos/estatística & dados numéricosRESUMO
Immunocompromised patients account for about 3% of the US population. Complications arising from infection are common in these patients and can present diagnostic and therapeutic challenges. This article describes the pathophysiology of immunosuppression in five common immunocompromised states-asplenia, HIV infection, solid organ transplant, biologic use, and cancer-as well as specific infectious risks and considerations for affected patients and how to manage them.
Assuntos
Doenças Transmissíveis/etiologia , Doenças Transmissíveis/imunologia , Hospedeiro Imunocomprometido/imunologia , Doenças Autoimunes , Fatores Biológicos , Infecções por HIV , Síndrome de Heterotaxia , Tolerância Imunológica , Neoplasias , Risco , Transplantes , VacinaçãoRESUMO
This study explored registered psychiatric nurses' (RPNs') interactions and level of empathy towards service users with a diagnosis of borderline personality disorder (BPD). A qualitative approach was used, and 17 RPNs were interviewed using a semistructured interview schedule incorporating the "staff-patient interaction response scale" (SPIRS). Four themes emerged following data analysis: "challenging and difficult," "manipulative, destructive and threatening behaviour," "preying on the vulnerable resulting in splitting staff and other service users," and "boundaries and structure." Additionally, low levels of empathy were evident in the majority of participants' responses to the SPIRS. The findings provide further insight on nurses' empathy responses and views on caring for service users with BPD and further evidence for the need for training and education for nurses in the care of service users diagnosed with BPD.
