Nursing in the COVID-19 pandemic and beyond: protecting, saving, supporting and honouring nurses

A Global Overview of Missed Nursing Care During the COVID-19 Pandemic: A Systematic Review

The coronavirus disease 2019 (COVID-19) pandemic has placed unparalleled pressure on many countries' healthcare systems, impacting the delivery of health and nursing care services. Despite the growing number of missed care studies during the pandemic, a broader perspective is essential when designing theory-driven strategies to improve nursing care delivery. This review aimed to synthesize evidence of missed nursing care during the COVID-19 pandemic in acute care settings through a systematic review and narrative synthesis. An electronic search of articles published since the emergence of the pandemic was conducted using 5 databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO). A total of 470 articles were identified during the initial search, and 10 articles were included in the review. The sample sizes of the studies ranged from 37 to 536 nurses. Results of the content analysis were grouped into 5 categories: (1) prevalence of missed care, (2) frequency of missed care, (3) reasons for missed care, (4) nurses' and organizational variables contributing to missed care, and (5) work environment elements contributing to missed care. The review's findings revealed a shift in the nature of missed nursing care during the pandemic, with an emphasis on nursing care tasks vital for the recovery of patients with COVID-19. Despite the unique circumstances brought about by the pandemic, an inadequate nursing workforce continued to be identified as the primary reason for missed care, consistent with the pre-pandemic period.

Development and evaluation of extracorporeal membrane oxygenation nursing education program for nursing students using virtual reality

BACKGROUND

This study aims to improve nursing students' ability to care for critically ill patients through education in extracorporeal membrane oxygenation (ECMO) nursing.

METHODS

This study developed a virtual reality (VR) simulation program for the five-step ECMO nursing of the Analysis, Design, Development, Implement, and Evaluation (ADDIE) model and used an equivalent control group pre-test and post-test no-synchronized design to verify the effect. The participants of this study were fourth-year nursing students enrolled in nursing departments at three universities in Seoul, Gangwon, and Gyeonggi in South Korea; it included 66 participants, 33 in each of the experimental and control groups. The program consisted of pre-training, orientation, VR simulation, and debriefing.

RESULTS

The interaction effect of the intervention and control groups with time points using the ECMO nursing VR simulation program was rejected due to no statistically significant difference in knowledge (F = 1.41, p = .251), confidence (F = 1.97, p = .144), and clinical reasoning capacity (F = 2.85, p = .061). However, learning immersion (t = 3.97, p < .001) and learning satisfaction (t = 4.25, p < .001) were statistically significantly higher in the experimental group than in the control group.

CONCLUSION

VR simulation program for ECMO nursing developed in this study is a potential educational method that positively affects the learning immersion and learning satisfaction of nursing students.

A Qualitative Study on Frontline Nurses' Experiences and Challenges in Providing Care for COVID-19 Patients in the Volta Region of Ghana: Implications for Nursing Management and Nursing Workforce Retention

Since the outbreak of COVID-19, studies related to the COVID-19 pandemic have been published widely. However, there are limited qualitative studies in Ghana that explored and shed light on frontline nurses' experiences and challenges in caring for patients diagnosed with COVID-19. This study aimed to explore frontline nurses' experiences and challenges of providing care for COVID-19 patients in the Volta Region of Ghana. This study adopted a descriptive qualitative research design to collect data. We conducted the study among frontline nurses who provided nursing care for COVID-19 patients in the Treatment Centre for COVID-19 cases in the Volta Region of Ghana. A purposive sampling method was used to select fifteen (15) participants for this study. We collected data through individual in-depth interviews facilitated by a semi-structured interview guide. The content analysis approach was used to analyse the data. The results showed: frontline nurses received inadequate information and training during the initial stages of the pandemic; stress and burnout because of inadequate staffing; logistical challenges; stigmatisation by family members and friends; frontline nurses displeased with the decision to exclude other nurses as frontline workers; participants made some recommendations towards supporting frontline nurses for effective management of patients during pandemics. This study revealed an in-depth understanding of the experiences of frontline nurses who provided nursing care to COVID-19 patients during the pandemic. Our study concludes that the frontline nurses experienced both physical and psychological problems while caring for COVID-19 patients at the treatment centre. Some challenges frontline nurses encountered were inadequate information on COVID-19 prevention and management in the early stages of the pandemic, logistical inadequacies, and stigmatisation in providing care for COVID-19 patients during the pandemic, all of which affected the quality of nursing care, work productivity, and efficiency. Therefore, nurse managers need to provide support to frontline nurses providing care for patients with COVID-19.

The experience of nurses participating in peer group supervision: a qualitative systematic review

AIM

This systematic review will identify, appraise, and synthesise the best available qualitative studies exploring nurses' experiences of peer group supervision. The review purpose draws from the synthesised evidence recommendations to enhance policy and implementation of peer group supervision in practice.

BACKGROUND

Clinical Supervision is increasing in acceptance as a means of professional and best practice support in nursing. Peer group supervision is a non-hierarchical, leaderless model of clinical supervision delivery and is an option for implementation by nursing management when prioritising staff support with limited resources. This systematic review will provide a synthesis of the qualitative literature regarding the nursing peer group supervision experience. Understanding the experience of peer group supervision from those participating may provide constructive insights regarding implementation of this practice to benefit both nurse and patient driven outcomes.

DESIGN

Included are peer reviewed journals focused on nurses' experiences of participating in peer group supervision. Participants are registered nurses of any designation. Qualitative articles, written in English and relating to any area of nursing practice and/or speciality are included. The standards of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Statement were used to guide the review. Two investigators independently screened titles, abstracts and selected full text studies describing the experience of peer group supervision. Pre-designed data extraction tools were utilised, and the review followed the Joanna Briggs Institute qualitative meta-aggregation approach with a hermeneutic interpretive analysis.

RESULTS

Results identified seven studies that met the inclusion criteria. A total of 52 findings that described the experiences of nursing peer group supervision are synthesised into eight categories. Four overarching synthesised findings resulted: 1. facilitating professional growth 2. trusting the group 3. professional learning experience and 4. shared experiences. Benefits such as sharing of experiences whilst receiving feedback and support were identified. Challenges identified related to group processes.

CONCLUSIONS

The paucity of international research into nursing peer group supervision poses challenges for nurse decision makers. Significantly, this review provides insight into the value of peer group supervision for nurses regardless of clinical context and setting. The ability to share and reflect with nursing peers enhances both personal and professional aspects of practice. The worth of the peer group supervision model varied across studies however the outcomes provided important insights into facilitating professional growth, enabling a space to share experiences and reflect, and to build teams where trust and respect develops in groups.

Causal Model Analysis of the Effect of Formalism, Fear of Infection, COVID-19 Stress on Firefighters' Post-Traumatic Stress Syndrome and Insomnia

As the front line of epidemic prevention, firefighters are responsible for the transportation of infected cases. Firefighters are under a lot of stress from the new COVID-19, especially the fear that they may contract the virus at work and spread the virus to their families. In particular, the framework of this study incorporates Riggs' formalism variables. When firefighters think that the epidemic prevention regulations are inconsistent with the actual epidemic prevention, it will increase their work pressure on COVID-19. In this study, firefighters from all over Taiwan were used as the respondents, and a total of 453 respondents were obtained. This study uses confirmatory factor analysis and structural equation modeling to test the established hypotheses. The findings confirm that formalism, fear of self and family infection are positively influencing COVID-19 stress. COVID-19 stress positively affects PTSD and insomnia. COVID-19 stress negatively affects problem-focused strategies. Problem-focused strategies negatively affect post-traumatic stress disorder.

Ethics, COVID-19 and nursing vulnerability: analysis of photographs released by the media

OBJECTIVES

to analyze nursing vulnerability through photos released by the media amidst the COVID-19 pandemic.

METHODS

a documentary study, with a qualitative approach. The object of analysis were photographic images selected between January 2020 and March 2021, published by the main news portals in countries such as Brazil, the United States, France, Spain, England and Germany. Thematic categorical analysis was the method of analysis used.

RESULTS

we found 74 photographs that portrayed nursing professionals in different work situations. It was possible to identify stigma and social devaluation about this class's representation and professional attribution. Moreover, we found an underrepresentation of black professionals in Brazilian portals and the man as the prominent figure in the spaces of claims.

FINAL CONSIDERATIONS

the photographs represented an important tool for the social analysis of nursing vulnerability, favoring the unveiling of situations that may go unnoticed by nursing and society.

Causal Model Analysis of Police Officers' COVID-19 Fear, Resistance to Organizational Change Effect on Emotional Exhaustion and Insomnia

Since the end of 2019, COVID-19 has continued to spread around the world. The police have performed various epidemic prevention and routine duties. This study explores how police officers' COVID-19 fear, resistance to organizational change, intolerance of uncertainty, and secondary trauma affect emotional exhaustion and insomnia in the context of COVID-19. A total of 205 valid police samples were collected in this study, and the established hypotheses were tested using confirmatory factor analysis and structural equation modeling. The results of the study confirmed that during the COVID-19 outbreak, secondary trauma of police officers positively affects emotional exhaustion and insomnia; intolerance of uncertainty positively affects emotional exhaustion; resistance to organizational change positively affects intolerance of uncertainty and emotional exhaustion; intolerance of uncertainty mediates the relationship between resistance to organizational change and emotional exhaustion; COVID-19 fear positively influences secondary trauma.

Relationship between perceived threat of COVID-19 and burnout among frontline nurses: A mediation analysis

BACKGROUND

Burnout of nurses during the Coronavirus of 2019 pandemic can end up extremely expensive for societies. It is found that positive religious coping (PRC) and a secure God attachment are effective for shielding against the adverse consequences of being exposed to stressful situations.

METHODS

This research explores the relationships among God attachment, religious coping, and burnout among nurses who are confronted with COVID-19 as a perceived threat through a model based on the combination of attachment theory and the Job Demands-Resources model. Analysis was done using SMART-PLS.

RESULTS

The results reveal that perceived threat of COVID-19 (PTC) positively correlates with burnout among nurses and that secure attachment to God and PRC can buffer this relationship, while insecure attachment to God, including anxious and avoidant attachment, along with negative religious coping positively mediates the relationship between PTC and burnout.

CONCLUSION

Finally, this study suggests managerial implications of these findings for healthcare organizations and a recommendation for helping out staff to help them manage such threats and their attachment to God.

The psychological experiences of Lebanese ground zero front-line nurses during the most recent COVID-19 outbreak post Beirut blast: A qualitative study

BACKGROUND

For the past 2 months the number of COVID-19 cases in Lebanon has been on the rise, while frontline nurses after the Beirut Blast of August 4th have been practicing through limited resources and a challenging context.

AIM

This paper aims at exploring the psychological experiences of Lebanese frontline nurses serving at ground zero hospital during the current COVID-19 outbreak.

SETTING

This study was carried out in three main ground-zero hospitals in Beirut which are receiving COVID-19 cases.

METHOD

This study have employed a phenomenological exploratory qualitative research design, where virtual interviews were conducted with 18 frontline nurses during the second week of January 2021.

RESULTS

Thematic analysis of the data expressed by the frontline nurses working in the approached ground-zero hospitals gave rise to five themes, namely 'helplessness and impending doom', 'increased mortality rates and depressive mood', 'fear of death and obsessive thinking', 'flashbacks, panic, and incompetence', and 'public recklessness, governmental responsibility, and anger'.

CONCLUSION

The frontline nurses working at ground zero hospitals in Beirut are facing significant psychological challenges that should be mediated by the government and health policymakers in order to safeguard the quality of care and avoid higher mortality rates.

Predictors of organizational commitment among Chinese nurses during the COVID-19 pandemic

AIM

To investigate organizational commitment among Chinese nurses and analyze factors influencing organizational commitment during COVID-19.

BACKGROUND

Organizational commitment is the most important link between nurses and the organization because it is effective in work retention and the motivation of nurses, especially when addressing the COVID-19 crisis. However, there has been no empirical study conducted to predict organizational commitment in the field of nursing by combining work values with professional practice environments.

METHODS

A cross-sectional predictive study was done with 362 nurses recruited from two tertiary hospitals in China. The Organizational Commitment Questionnaire, the Work Values Scale, and the Practice Environment Scale of the Nursing Work Index were used to collect data. Two factors related to the organizational commitment of nurses were investigated by using binary logistic regression analyses.

RESULTS

Increased work values and a professional practice environment were associated with an increased likelihood of higher organizational commitment.

DISCUSSION

The COVID-19 crisis became the utmost challenge to global healthcare systems and professional organizational commitment. Nurses' organizational commitment was directly influenced by the professional practice environment and work values, especially intrinsic work values, in which the spirit of collectivism was consequential. CONCLUSION AND IMPLICATIONS FOR THE FIELD OF NURSING AND HEALTH POLICY: Study results provide information for global hospital administrators to promote these organizational commitment predictive factors, including work values and a professional practice environment in nursing practice. This helped foster a stronger organizational commitment among nurses to reduce nurse resource flow during COVID-19.

Perceived stress and quality of life among frontline nurses fighting against COVID-19: A web-based cross-sectional study

BACKGROUND

The coronavirus disease-2019 (COVID-19) crisis has changed many aspects of frontline nurses' lives. Nurses caring for patients with COVID-19 reported experiencing significant psychological distress and work-related anxiety. This study aimed to assess the perceived stress and quality of life among frontline nurses fighting against COVID-19.

MATERIALS AND METHODS

This web-based cross-sectional study was conducted on 322 frontline nurses fighting against COVID-19 in hospitals affiliated to Mazandaran University of Medical Sciences. Data were collected using the two following online questionnaires: the Perceived Stress Scale and World Health Organization Quality of Life-Brief. Data were compiled from October 23, 2020, to November 25, 2020. Data were analyzed using the independent sample t-test, Pearson's correlation test, and regression analysis test in the SPSS-21.

RESULTS

Average perceived stress scores was 30.27 (standard deviation [SD] = 7.01). Average quality of life subscale scores consist of physical health, psychological health, social relationships, and environment were 57.71 (SD = 12.74), 44.3 (SD = 15.58), 45.61 (SD = 16.99), and 47.6 (SD = 18.11), respectively. There was an inverse significant association between all the subscales of quality of life and perceived stress (P = 0.008). Based on the multiple linear regression analysis, the variables of age, gender, marital status, and perceived stress were the significant predictors of quality of life subscales.

CONCLUSIONS

Paying serious attention to addressing the concerns of frontline nurses, especially those who are at high risk, is necessary. It is recommended to take action as soon as possible to reduce the perceived stress and improve quality of life on nurses who care for patients with COVID-19.

Corporatising compassion? A contemporary history study of English NHS Trusts' nursing strategy documents

The purpose of this contemporary history study is to analyse nursing strategy documents produced by NHS Trusts in England in the period 2009-2013, through a process of discourse analysis. In 2013 the Francis Report on the Mid-Staffordshire NHS Foundation Trust was published. The Report highlighted the full range of organisational failures in a Trust that valued financial efficiency over patient care. The analysis that followed, however, dwelt heavily on the failings of the nurses. Nursing strategy documents at that time served to set the future direction for NHS Trusts, prescribing specific value frameworks for each nursing workforce. However, the values chosen frequently conflicted with each other pitting nursing values against a managerial trope. It is argued that documents provided a response to wider NHS concerns and high-profile failures in care, particularly the Francis Report, paying lip service to staff engagement whilst maintaining a corporate focus. Nursing values were placed firmly within a managerialist discourse, one that has needed to be re-evaluated in the current Covid-19 pandemic. Wider implications of the research suggest discussion of value conflict may be beneficial within nursing education and a truly local approach to strategy creation would potentially promote staff buy-in to strategy documents.

WhatsApp-Delivered Intervention for Continued Learning for Nurses in Pakistan During the COVID-19 Pandemic: Results of a Randomized-Controlled Trial

The COVID-19 pandemic has necessitated support for continued learning in frontline practitioners through online digital mediums that are convenient and fast to maintain physical distancing. Nurses are already neglected professionals for support in training for infection control, leadership, and communication in Pakistan and other developing countries. For that reason, we aimed to deliver a WhatsApp-based intervention for continued learning in nurses who are currently working in both private and public sector. A 12-week intervention was delivered to 208 nurses (102 in the control group and 106 in the intervention group) who had been employed in the clinical setting during data collection. The analysis reveals that nurses in the intervention group show significantly better results for learning in “infection prevention and control” and “leadership and communication.” Results of a content analysis based on participant's feedback also confirm that the WhatsApp-based intervention is a valuable tool for education. This study highlights the effectiveness of online-based digital interventions as a convenient training tool for awareness and management of infectious diseases, leadership, and communication during COVID-19 and beyond. Furthermore, this study emphasizes that group interventions with other healthcare practitioners and the role of on-going longer WhatsApp-based interventions can become integral tools to support continued learning and patient safety practices.

Being a Nurse at the Ground Zero of Care in Turkey During the COVID-19 Pandemic: A Qualitative Study

This study was conducted to examine the experiences of nurses working during the COVID-19 pandemic using a qualitative descriptive research design. The study sample, determined using the criterion sampling method, consisted of nine nurses who work in a COVID-19 clinic of a pandemic hospital. The data were collected through interviews. The data were analyzed using content analysis. COREQ reporting guidelines were used in the study. From the content analysis, five main themes emerged in the study: "nurses' perceptions of the pandemic process", "nurses' feelings about the pandemic process", "difficulties nurses experienced in caring for patients with COVID-19", "professional achievements nurses gained while working in the COVID-19 clinic" and "nursing care practices and changes during the COVID-19 pandemic". The results of the study showed that during the pandemic, nurses experienced both positive and negative feelings/thoughts, faced various difficulties as well as several professional gains while providing care, and witnessed the changing face of self-care and patient care.

Nursing in the Spotlight: Talk about Nurses and the Nursing Profession on Twitter during the early COVID-19 Pandemic

Background

Nurses comprise the largest portion of healthcare workers and are integral to the COVID-19 response. Twitter has become a popular platform for the public, including nurses, to engage in pandemic-related discourse.

Purpose

We sought to analyze the representation of the nursing profession and characterize nurses’ experiences during the pandemic from tweets published in April 2020.

Methods

We analyzed tweets using natural language processing, Word Adjacency Graph (WAG) Modeling, and thematic analysis. Authors independently reviewed 10% of raw tweets in each WAG-generated topic, qualitatively analyzed tweets, and identified emerging themes.

Findings

Six themes emerged: Support and Recognition of Nurses, Military Metaphors, Superhuman/Spiritual Metaphors, Advocacy, Personal Experiences with Nurses, and Social/Political Commentary. Public perception of nurses was positive, but nurses conveyed harsh realities of their work.

Discussion

Findings highlight discrepancies in nursing experiences and public perceptions of nursing. Further research should accurately identify and convey the complexities of the nursing profession.

Exploring the experiences of nurses caring for patients with COVID-19: a qualitative study in Iran

BACKGROUND

The coronavirus disease (COVID-19) is now a major public health emergency in the world. Nurses as key members of the COVID-19 patient care team are exposed to most challenges caused by the disease. As exploring the experiences of nurses as patient supporters and caregivers can play an important role in improving the quality of care for patients with COVID-19 disease, the present study explored the experiences of nurses caring for patients with COVID-19.

METHODS

The study employed a qualitative design. This study employed purposive sampling to select 10 nurses with bachelors and master's degrees in nursing who were taking care of patients with COVID-19 in ICUs or inpatient wards in southern Iran. Data were collected through semi-structured interviews. The collected data were analyzed using the qualitative content analysis procedure proposed by Graneheim and Lundman.

RESULTS

The analysis of the data revealed four main themes and ten sub-themes: A) physical, psychological, and social burden of care (excessive workload; fear, anxiety, worry; unpleasant social experiences; compassion fatigue) B) unmet needs (personal needs and professional needs) C) positive experiences (pleasant social experiences and inner satisfaction), and D) strategies (problem-solving strategies and stress symptom mitigation strategies).

CONCLUSIONS

An analysis of the themes and subthemes extracted in this study suggested that the nurses who participated in this study faced many personal and professional challenges. Therefore, health officials and specialists need to pay special attention to nurses' challenges and needs.

The Psychological Condition of Healthcare Professionals during the COVID-19 Pandemic at a Referral Hospital in Southeast Sulawesi, Indonesia

Background: A significant increase in positive cases in Indonesia has increased the number of health care personnel, nurses, and physicians who have been exposed to COVID-19, which creates a unique psychological burden for health professionals. Aim: The purpose of this study is to analyze the relationship between the psychological responses of health professionals and anxiety/depression in the hospital by using the Fear of COVID-19 scales and the Hospital Anxiety And Depression Scale (HADS), respectively. Methods: The method is quantitative with a cross-sectional survey approach using an online questionnaire. A total of 207 health professionals working at the COVID-19 referral hospital are selected as participants. Results: The result of the Pearson correlation test showed that the highest fear level of health professionals against COVID-19 was 41.5 %, while the most anxiety and depression levels are at the usual level of 76.3 % and 60.4 %, respectively. There is a direct relationship between fear of COVID-19 and anxiety and depression, with significant values of 0.000 and 0.026, respectively. Conclusions: This research shows the significance of paying close attention to the psychological state of health professionals during a pandemic. As a result, the government must support their mental health by providing counselling with more accurate and up-to-date information.

Ética, COVID-19 e vulnerabilidade da enfermagem: análise de fotografias divulgadas pela mídia

RESUMO Objetivos: analisar a vulnerabilidade da enfermagem por meio de fotos divulgadas pela mídia no contexto da pandemia de COVID-19. Métodos: estudo documental, com abordagem qualitativa. O objeto de análise foram imagens fotográficas selecionadas entre janeiro de 2020 e março de 2021, veiculadas pelos principais portais de notícia de países, como Brasil, Estados Unidos, França, Espanha, Inglaterra e Alemanha. A análise categorial temática foi o método de análise utilizado. Resultados: foram encontradas 74 fotografias que retratavam profissionais de enfermagem em diferentes situações de trabalho. Pôde-se identificar o estigma e a desvalorização social acerca da representação e atribuição profissional desta classe. Além disso, foi constatada uma sub-representação de profissionais negras nos portais brasileiros e o homem como a figura de destaque nos espaços de reivindicações. Considerações Finais: as fotografias representaram importante ferramenta para análise social da vulnerabilidade da enfermagem, favorecendo o desvelar de situações que podem passar despercebidas pela profissão e sociedade.

Development and evaluation of virtual reality simulation education based on coronavirus disease 2019 scenario for nursing students: A pilot study

Aim

This research is designed to establish and evaluate the effectiveness of a virtual reality simulation program using COVID‐19 scenario for nursing students.

Design

This is a quasi‐experimental study using a non‐equivalent control group pre‐test‐posttest design.

Methods

The participants were 65 students in their fourth year in nursing college. The knowledge about communicable infectious diseases in the respiratory system, self‐efficacy, clinical reasoning capacity and learning satisfaction was evaluated.

Results

The experimental group showed a significantly higher learning satisfaction (t = 3.01, p = .004). Both groups presented statistically significant differences in knowledge on infectious respiratory diseases, self‐efficacy and clinical reasoning between pre‐test and posttest. However, knowledge (t = 0.47, p = .643), self‐efficacy (t = 0.70, p = .944) and clinical reasoning were not different between the groups.

Challenges faced by nurses while caring for COVID-19 patients: A qualitative study

INTRODUCTION

In the COVID-19 crisis, nurses are directly involved in patient care, so they face many challenges. This study was performed to determine the challenges faced by nurses while caring for COVID-19 patients in Iran in 2020.

MATERIALS AND METHODS

This qualitative, content analysis was conducted in Iran on ten nurses directly involved in the fight against the corona epidemic, selected through a purposeful sampling strategy. Data were collected through deep interviews consisting of open questions. All the interviews were recorded, and immediately after each interview, it was transcribed into written form. The data were analyzed using MAXQDA software.

RESULTS

All the challenges could be classified into three main categories and 17 subcategories. The main categories were miss-management in controlling corona conditions, mental and physical complications and challenges in corona work conditions, and lack of sufficient workforce.

CONCLUSION

Hospital managers and authorities play a significant role in meeting the financial needs and requirements of nurses, and can minimize the job discrimination prevalent at medical centers through providing financial and nonfinancial incentives for nurses. Moreover, the findings of the present study can help hospital managers and authorities to gain a better understanding of the experiences of nurses, and to take the necessary measures to obviate the challenges faced by nurses in public health emergencies.

Nursing beyond the pandemic: Resilience and determination will shape our future options

The years 2020-21 have been significant for nurses, midwives and all healthcare professionals across the world. While nurses and midwives faced immense pressure and challenges in performing their roles, the pandemic has contributed to bringing a spotlight to the work that nurses, midwives do and the significance of that work. In this article, the author introduces herself as the Editor-in-Chief of International Nursing Review and shares her vision for the journal.

The Impact of Social Media Exposure and Interpersonal Discussion on Intention of COVID-19 Vaccination among Nurses

COVID-19 vaccine hesitancy among nurses is a global public health concern and it is imperative to understand associated factors. Information environment plays a critical role in shaping health behaviors, while few studies explored such effects in the context of COVID-19 vaccination. A cross-sectional survey was conducted among 1902 nurses in China. The study investigated the effects of social media exposure/interpersonal discussion on intention of COVID-19 vaccination and tested whether perceived effectiveness of COVID-19 vaccines (perceived vaccine efficacy, perceived duration of protection, and perceived effectiveness in preventing resurgences) mediated such associations. Results showed that about 68.0% and 56.5% of the participants had an intention of free and self-paid COVID-19 vaccinations, respectively. Frequent social media exposure and interpersonal discussion were positively associated with vaccination intentions. Perceived vaccine efficacy significantly mediated the effects of frequent social media exposure and interpersonal discussion, whereas perceived effectiveness in preventing resurgences suppressed the effects of frequent social media exposure. In conclusion, the prevalence of intention of COVID-19 vaccination was relatively low among Chinese nurses and health promotion is needed. Frequent social media exposure and interpersonal discussion potentially enhanced vaccination intentions via increased perceived vaccine efficacy. The findings can help inform the development of relevant health communication interventions.

The Year of the Nurse during the COVID-19 Pandemic

The year 2020 was established by the World Health Organization as The Year of the Nurse and Midwife to emphasize the importance of this profession to the healthcare system. Strange but true, nurses around the world celebrated it by being frontline workers during the COVID-19 pandemic. Thus, the phrase "Nursing Now" has become more important than ever. The main aim of this article was to draw attention to the fact that 2020 was the Year of the Nurse and Midwife and, indeed, their role in the fight against the pandemic is difficult overlook. Through the use of available scientific databases, documents and scientific publications related to the subject were collected and analyzed. Nurses are able to fulfill their duties as long as they are properly rewarded and provided not only with support but also better terms and conditions of employment. The investment in nurses should also be treated as an investment in the healthcare system.

Quality of Life, Sleep Quality, Depression, Anxiety, Stress, Eating Habits, and Social Bounds in Nurses during the Coronavirus Disease 2019 Pandemic in Qatar (The PROTECTOR Study): A Cross-Sectional, Comparative Study

There have been numerous concerns regarding the physical and mental health of nurses during the COVID-19 pandemic. Stress, sleep deprivation, anxiety, and depression potentiated nurses’ vulnerability to poor eating habits. Aims and Objectives: The purpose of this study was to explore the differences between nurses’ characteristics with COVID-19 facility designation, and sleep quality, depression, anxiety, stress, eating habits, social bonds, and quality of life. Design: A cross-sectional, comparative study. Methods: An online survey was sent using the corporation’s email to nurses working in three hospitals in Qatar from September to December 2020. One of them is a designated COVID-19 facility. The sleep quality, depression, eating habits, social bonds, and quality of life were measured using The Insomnia Severity Index (ISI), Depression Anxiety and Stress Scale 21 (DASS-21), Emotional Eater Questionnaire (EEQ), Oslo Social Support Scale (OSSS-3), and the World Health Organization Quality of Life (WHOQOL-BREF), respectively. Results: A total of 200 nurses participated in the study (RR: 13.3%). No statistically significant association was found between designated facility (COVID-19 vs. not COVID-19) or nurses’ characteristics and ISI categories (OR 1.15; 95% CI 0.54, 2.44). Nurses working in COVID-19 facilities had increased odds of having higher EEQ categories by 2.62 times (95% CI 1.18, 5.83). Similarly, no statistically significant associations were found between any of the nurses’ characteristics and OSSS-3 categories. On the other hand, no statistically significant associations were found between any of the nurses’ characteristics and QOL domains except for the gender and social relationships’ domain. Conclusion: Overall, the quality of life of nurses in Qatar is on a positive level whether they are assigned to a COVID-19 facility or not. Although no significant difference was found with regard to the sleep quality, stress, anxiety, depression, and eating habits between nurses in a COVID-19 facility and in a non-COVID-19 facility, special interventions to diminish stressors need to be implemented and maintained.

Educational Needs of Nurses for Respiratory Communicable Infectious Disease Care: A Cross-Sectional Descriptive Study

Clinical nurses have training needs related to the strategies for infection spread prevention. This study aimed to investigate the levels of importance of and performance in the various areas of care for communicable respiratory infections among clinical nurses and to determine the priority of educational needs. Hospitals in which a baseline survey could be conducted were considered, and nurses working in six hospitals that were designated as COVID-19 care centers in Korea were enrolled. The training needs for the care of patients with communicable respiratory infections were analyzed using Borich’s needs equation, and the locus for focus model. Among participants with prior COVID-19 patient care experience, according to Borich’s equation, the need score was the highest for “initial response to communicable respiratory infection”, followed by “management of aerosol-generating procedures in patients with communicable respiratory infection” and “reporting of patients with communicable respiratory infection and death of patient”. An item rated highly in both Borich’s equation and the locus for focus model among the participants with prior experience was “initial response to communicable respiratory infection”. Among participants without prior relevant experience, according to Borich’s equation, the need score was highest for “management of aerosol-generating procedures in patients with a communicable respiratory infection”, followed by “initial response to communicable respiratory infection” and “reporting of patients with communicable respiratory infection and death of patient”. None of the items were rated high in both Borich’s equation and the locus for focus model among participants without relevant prior experience.

[The popular identity of nurses during the COVID-19 pandemic: An integrative review]

Context : The current COVID-19 context has placed nurses at the heart of the pandemic, due to the critical role they play within the population. However, media and professional discourses are influencing the identity and clinical practice of nurses.Objective : Review the literature on the construction of the popular identity of nurses and their roles during the COVID-19 pandemic.Method : Several data sources were consulted : Eureka, Google News, Education Resources Information Center (ERIC), Sociological Abstracts, Cumulative Index to Nursing Information and Allied Health Literature (CINAHL), MEDLINE, and Social Sciences Abstracts. Manual searches of government and professional sites were also conducted.Results : Of a total of 281 papers indexed, 73 were retained. The literature analysis identified the following themes : 1) identity images of nurses during this pandemic and their professional roles ; 2) the sometimes paradoxical nature of media and political discourse ; and 3) the fact that this discourse seems to influence clinical nursing practice, which is being assigned new roles.Conclusion : This article raises awareness among decision-makers about the multiple roles of nurses and the public image of nurses during a pandemic, and takes a critical look at popular discourses related to nurses' identity and how this identity changes during a pandemic.

Primary socialization in the process of professional choice and identity of nurses: a Dubarian approach

OBJECTIVES

to analyze the experiences of management nurses over the primary socialization process that contributed to their professional choice and identity.

METHODS

qualitative and explanatory study grounded in Dubar's theory, carried out with 11 management nurses. Semi-structured interviews were conducted, transcribed, and categorized by applying discourse analysis.

RESULTS

the motivations for the professional choice and identity of management nurses were found. They were related to family influence in childhood, nursing representations, perception of care practices experienced in a health-related situation in the family, choice of nursing given its academic titles, lack of knowledge about the nursing profession, and assertive choice of this profession.

FINAL CONSIDERATIONS

professional choice was closely linked to initial social processes in people's lives and the idea of a socially and uniquely built professional identity.

Information flow and nursing care during the early phase of the COVID-19 pandemic

AIMS

This study aimed to understand the dissemination of information relating to coronavirus disease 2019 (COVID-19) and its impact on nursing care in the early phase of transmission.

BACKGROUND

COVID-19 has spread globally, causing an unprecedentedly large number of casualties. Nurses face challenges in dealing with patients with COVID-19 with limited information about the pathogen.

DESIGN

This qualitative study followed the COREQ guidelines.

METHODS

Fifteen nurses were recruited from two university hospitals in South Korea using a snowballing technique for in-depth interviews in May 2020. All interviews were recorded and transcribed verbatim. Content analysis was performed on the interview data.

RESULTS

Two themes emerged: access to COVID-19 information and the impact of information on nursing care. The categories of access to COVID-19 information were lack of nursing-specific information, limited information cascading from top management and confusion due to varying points of view. The categories of the impact of information on nursing care were unprepared management that aggravates exhaustion, lack of personal protective equipment that creates anxiety and being a nurse leader to overcome the pandemic.

CONCLUSION

During a pandemic of emerging infectious diseases, nurses should have access to up-to-date information tailored to their working environment. Human resources, material resources and systematic support are needed for nurses who provide care for patients with an infectious disease.

RELEVANCE TO CLINICAL PRACTICE

A collaborative interprofessional education system for emerging infectious diseases is needed for effective communication and consistent care during a pandemic. Nurse leaders should be prepared to deliver profession-specific information for standardised care and respond to nursing management needs by using resources and tailoring the workforce.

COVID-19 impact on nurses in Spain: a considered opinion survey

AIM

To survey nurses' opinions about their work conditions at the onset of the COVID-19 pandemic in Spain.

BACKGROUND

For the Spanish General Council of Nursing (the Consejo General de Enfermería de España), it was essential to have information on nursing workforce conditions and nurses' preparedness to wear protective measures at the pandemic's onset. The coronavirus outbreak was believed to have started in China and rapidly spread as a global pandemic requiring policies and actions for planning emergency healthcare delivery.

METHODS

A cross-sectional survey was conducted online. Data were collected during April 2020 and covered social demography, working conditions, training, availability of personal protective equipment, and nurses' health conditions, including the impact of COVID-19.

FINDINGS

From all national territories in Spain, 11 560 registered nurses from different services completed the questionnaire. Findings indicated that the lack of personal protective equipment was a crucial issue, as well as service planning and organization, and 80.2% reported high or very high psychological impact of COVID-19. Alarmingly, 29.5% of the nurses reported COVID-19 symptoms. Of these 23.3% had been tested, and 30.2% were confirmed as being positive to the virus. The nurses deemed proper preparedness for emergencies and disasters as a significant concern.

CONCLUSION

Nurses' responses showed evidence of health services deficiencies as a source of damage to their capacity to provide safe patient care and protect themselves and their families' health. The working conditions of the nurses are at critical levels and are unacceptable. The study results provide evidence regarding the necessity of suitable planning and actions being taken to enable safe patient care and safety for nurses.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Our survey gathered nurses' views at the pandemic's onset. The evidence gathered is being used to advise policymakers and nursing organizations to take actions to control public health risks to populations. It is necessary that more investment in growing nursing workforce expertise and health infrastructure for pandemic and epidemic emergencies is provided.

Nurses' core emergency competencies for COVID-19 in China: A cross-sectional study

Aim

To investigate nurses’ core emergency competencies for handling the coronavirus disease‐19 (COVID‐19) and analyse the factors associated with those competencies.

Background

COVID‐19 has become a major global public health event. Nursing staff have played an important role in COVID‐19 prevention and control. Understanding their emergency competencies for handling COVID‐19, and the potential disadvantages will help governments to develop targeted training policies and improve nurses’ capacities in relation to pandemics and emergency preparedness.

Introduction

COVID‐19 is a disastrous infectious disease, but the competencies of nurses in China to handle COVID‐19 have not been well documented.

Methods

We conducted a cross‐sectional survey on nurses from 22 provinces of China in February 2020. The scores of self‐report questionnaires were used to analyse their competencies for core emergency care, and linear regression analysis was used to explore influential factors.

Results

A total of 2570 nurses participated. The study revealed that nurses had a good grasp of COVID‐19 knowledge, but the majority of nurses lacked experience in isolation ward work and emergency training. We found that age, professional title, work department, major work content, total work time, disaster rescue history, emergency training and infectious disease training were associated with core emergency competencies.

Conclusions

Chinese nurses were qualified for handling COVID‐19 but still need to strengthen the accumulation of practical experience.

Implications for nursing

Nurses should actively participate in emergencies to strengthen their operational capacity, whether in training or actual practice.

Implications for nursing/health policy

Managers should improve relevant policies to ensure that nurses have more opportunities to participate in the practical training of health emergencies and explore effective training methods to improve the ability of nurses to respond to these.

COVID-19 Pandemic: The Importance of Supporting Civilian and Military Transition-to-Practice Programs to Avert Current and Future Nursing Shortages

Registered nurses (RNs) are national assets who provide quality patient care, especially during the corona virus disease 2019 pandemic. Currently, healthcare organizations are overwhelmed with ill patients who require RNs with specialty experiences. Curtailment and cancellation by healthcare organizations of civilian and military transition-to-practice programs for newly licensed RNs are at risk. If this phenomenon continues, current and future nursing shortages will prevail.

Challenges facing nurse managers during and beyond COVID-19 pandemic in relation to perceived organizational support

Aim

To explore challenges facing nurse managers during and beyond coronavirus disease, 2019 (COVID‐19) pandemic and its relation to perceived organizational support.

Background

When faced with high‐pressure situations like the COVID‐19 pandemic, it is critical that nurse managers be equipped with the support they need to successfully surpass these hard times.

Methods

Descriptive correlational design was utilized. The study was conduct at different health care settings across Egypt. Convenience sampling technique was employed to recruit (214) nurse managers. Two instruments were used; questionnaire of challenges faced by nurse managers and survey of perceived organizational support. Mann–Whitney test, Kruskal–Wallis test, Spearman's correlation, and regression analysis were utilized.

Results

The highest percentage of managers reported being faced with high level of challenges. There was a highly statistically significant negative correlation between challenges currently faced by managers and their perception of organizational support.

Conclusion

The COVID‐19 pandemic had placed additional challenges on nurse managers and these challenges are expected to persist in the future. Higher perception of organizational support minimizes managers' perception of being challenged in times of pandemics.

Implications for Nursing Management

Better training focused on disaster management, ethical decision making, leading in times of uncertainty, and maintaining well‐being will help nurse managers lead better their teams.

Enhancing students learning experiences in nursing programmes: An integrated review

Nursing as a profession is both fragmented and complex. The education setting is demanding, and prepared students are more clinically and academically robust. Therefore, nursing programmes should implement high-quality teaching based on the best available scientific evidence to improve learning quality and students' experience. This study aimed to identify the teaching tools used to enhance students' perceived experiences in undergraduate nursing programmes. Nine databases were systematically searched to identify quantitative and qualitative studies regarding the teaching tools utilised across nursing education programmes. Results were summarised following a systematic integrated review framework. The searches identified 15,886 citations, and after title/abstract/full-text screening, 66 primary research studies were included comprising data from 4,411 participants with a mean sample size of 66 (range 6-447). Educators utilising a student-centred wrapping approach exploiting knowledge building and self-development were found to improve students' experiences; however, consensus on success factors was lacking. The findings indicate that educators' knowledge and pedagogical skills used in a flexible way, tailored and sensible to students and the learning context, enhance student experiences. Nursing educators should identify learning situations that make students vulnerable and pay particular attention to the students' learning experiences. We identified several tools accommodating the students' experience.

Italian Nurses' experiences during the COVID-19 pandemic: a qualitative analysis of internet posts

Aim

To investigate the experience of Italian nurses during the first wave of the COVID‐19 outbreak by analysing professional social media posts.

Background

The COVID‐19 outbreak has overwhelmed health care institutions; as a consequence, nurses’ lives and psycho‐physical health have been affected.

Introduction

The COVID‐19 pandemic forced nurses to work in physically and psychologically stressful conditions impacting on their life.

Methods

A qualitative descriptive study. All narratives (texts and videos) posted by nurses from the 23^rd of February 2020 to the 3^rd of May (from the start of the outbreak to the end of the first lockdown) were analysed and published on the five most popular Italian professional social media platforms. The Consolidated Criteria for Reporting Qualitative research guidelines were followed.

Results

Five themes emerged from the 380 narratives explored: ‘Sharing what is happening within myself’; ‘Experiencing unprecedented working conditions’; ‘Experiencing a deep change’; ‘Failing to rehabilitate the image of nurses in society’; and ‘Do not abandon us’. Even though nurses appreciated the recognition of their communities, they still felt devalued and not recognized as professionals.

Discussion

Several psychological, physical, social and professional implications emerged from nurses working during the COVID‐19 pandemic. Despite being highly praised, nurses perceived they had failed in rehabilitating the image of nurses in society.

Conclusion

The experience of working during the COVID‐19 pandemic represented a traumatic event for nurses but it offered them personal and professional growth opportunities.

Implications for nursing practice, nursing policy and health policy

Supporting nurses’ mental health is highly recommended, together with a cultural investment on nurses’ role recognition, and a zero‐tolerance policy towards violence and aggression towards nurses.

Challenges experienced by ICU nurses throughout the provision of care for COVID-19 patients: A qualitative study

Aim

To explore the challenges experienced by ICU nurses throughout the provision of care for COVID‐19 patients.

Background

The intensive care unit nurses, who are at the frontline of fighting against COVID‐19 and defusing this crisis, are faced with various challenges throughout the provision of care for COVID‐19 patients.

Methods

In this qualitative descriptive study, a total of 17 nurses working in intensive care units were selected using purposive sampling. Data were collected using semi‐structured face‐to‐face interviews. After recording and transcribing interviews, the concepts were extracted using the content analysis method.

Findings

The nurses reported the four following challenges throughout the provision of care for COVID‐19 patients: ‘organization's inefficiency in supporting nurses’, ‘physical exhaustion’, ‘living with uncertainty’ and ‘psychological burden of the disease’.

Conclusion

The present study portrayed a clear understanding of the challenges faced by nurses working in intensive care units during the crisis of the COVID‐19 pandemic based on their lived experiences.

Implications for Nursing Management

A profound understanding of these challenges in the current critical situation can help health care authorities adopt appropriate measures to resolve these challenges, provide health care facilities, support the health workforce, give accurate and evidence‐based information and perform psychological interventions on how to handle the current crisis.

The principle of salvage in the context of COVID-19

The prioritisation of scarce resources has a particular urgency within the context of the COVID‐19 pandemic crisis. This paper sets out a hypothetical case of Patient X (who is a nurse) and Patient Y (who is a non‐health care worker). They are both in need of a ventilator due to COVID‐19 with the same clinical situation and expected outcomes. However, there is only one ventilator available. In addressing the question of who should get priority, the proposal is made that the answer may lie in how the pandemic is metaphorically described using military terms. If nursing is understood to take place at the ‘frontline’ in the ‘battle’ against COVID‐19, a principle of military medical ethics—namely the principle of salvage—can offer guidance on how to prioritise access to a life‐saving resource in such a situation. This principle of salvage purports a moral direction to return wounded soldiers back to duty on the battlefield. Applying this principle to the hypothetical case, this paper proposes that Patient X (who is a nurse) should get priority of access to the ventilator so that he/she can return to the ‘frontline’ in the fight against COVID‐19.

The Relationship Among Organizational Identity, Psychological Resilience and Work Engagement of the First-Line Nurses in the Prevention and Control of COVID-19 Based on Structural Equation Model

Purpose

To explore how the organizational identity and psychological resilience affect work engagement of the front-line nurses in the prevention and control of coronavirus disease 2019 (COVID-19) and to establish the relationship model based on these factors.

Material and Methods

Convenience sampling was applied to collect questionnaire samples from 216 nurses (from 12 cities in 6 provinces). General information questionnaires, organizational identity scale (OIQ), psychological resilience scale (CD-RISC), and Utrecht Work Engagement Scale (UWES) were used as tools for data collection.

Results

Both organizational identification and psychological resilience had a positive impact on work engagement (r=0.457~0.669). The structural equation model indicated that psychological resilience had a significant partial mediating effect on the relationship between organizational identity and work engagement; the mediating effect value was 0.25, the overall effect value of work engagement was 0.73, and the mediating effect accounted for 34.2%.

Conclusion

Our results revealed that organizational identity could directly affect nursing. It can also indirectly affect nurses’ work engagement through the intermediary role of psychological resilience. In face of the COVID-19 epidemic, hospitals and nursing managers could improve the level of nurses’ job involvement by improving organizational identity, which in turn may have a positive effect on psychological resilience.

Are data on missed nursing care useful for nursing leaders? The RN4CAST@IT cross-sectional study

AIM

To describe nurses' reported missed nursing care activities among hospitalized adult patients medical and surgical wards and explore gaps in service provision.

BACKGROUND

In 2015, Italy replicated the RN4CAST study, which heralded the exposition of missed care as an international phenomenon. In Italy, nurse-patient workload is high, with high levels of burnout and dissatisfaction reported, all factors associated with missed care.

METHODS

A cross-sectional study (n = 3,590) was conducted using the 13-item online Task Left Undone Tool aimed at collecting data on missed nursing care.

RESULTS

The frequency of omission of activities ranged between 7% and 50%. There were significant differences between morning, afternoon and night shifts and the various clinical settings. Oral care was the most frequently missed care activity.

CONCLUSIONS

This study takes step forward in identifying and reducing missed care on medical and surgical wards, both in Italy and also internationally, which needs to take into account the specific organisational characteristics of each setting.

IMPLICATIONS FOR NURSING MANAGEMENT

Although more essential activities are missed less frequently, much is known about the relational deficits such as information giving, education, communication and discharge advice, which managers ought to spearhead through local initiatives to improve these practices.