1
|
Jaensson M, Hedlund J, Blomberg K. Experience of Student Nurse Anesthetists' Learning in the Operating Room During the COVID-19 Pandemic: A Qualitative Interview Study. J Perianesth Nurs 2024:S1089-9472(24)00162-X. [PMID: 39093236 DOI: 10.1016/j.jopan.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/25/2024] [Accepted: 04/25/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE This study explores student nurse anesthetists' (SNAs) learning in the operating room during the coronavirus 2019 pandemic. DESIGN An explorative design with semistructured interviews was used. METHODS Thirteen former SNAs and 12 clinical supervisors (8 of whom were included in the final analysis) were recruited from 6 counties in Sweden. Participants were purposively recruited. Inclusion criterion for former SNAs was having completed the nurse anesthesia program in the fall of 2020 to spring 2022; and for nurse anesthetists, those who have experience in supervising SNAs. The interviews were analyzed with thematic analysis. FINDINGS The analysis identified one theme and five subthemes. The theme was that student learning was in focus despite an ongoing pandemic. Every learning situation contributed, and learning was triggered by the challenges. Both the SNAs and the supervisors exhibited resilience by accepting the situation and striving to do their absolute best in a nonoptimal learning environment. Over time, learning and supervision returned to normal. CONCLUSIONS During the pandemic, learning was ongoing despite stress, fear, and other challenging factors. Students' learning appears to have been prioritized. The study highlights that nurse anesthetists and SNAs were resilient, resourceful, and able to find new ways to keep learning going.
Collapse
Affiliation(s)
- Maria Jaensson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
| | - Jakob Hedlund
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden; Department of Anesthesia and Intensive Care, Örebro University Hospital, Region Örebro County, Örebro, Sweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| |
Collapse
|
2
|
Abstract
BACKGROUND Frontline nurses who care for patients with COVID-19 work in stressful environments, and many inevitably struggle with unanticipated ethical issues. Little is known about the unique, ethically sensitive issues that nurses faced when caring for patients with COVID-19. AIM To better understand how frontline nurses who care for patients with COVID-19 experience ethical issues towards others and themselves. METHODS Systematic review of qualitative evidence carried out according to the Preferred Reporting Items for Systematic reviews and Meta-analyses on ethical literature (PRISMA-Ethics). The electronic databases PubMed, Embase, Cinahl, Web of Science, Philosopher's Index, and Scopus were queried to identify candidate articles. Articles appearing from March 1, 2020 to December 31, 2022 were considered if they met the following inclusion criteria: (1) Published qualitative and mixed method studies and (2) ethical issues experienced by nurses caring for patients with COVID-19. We appraised the quality of included studies, and data analysis was guided by QUAGOL principles. FINDINGS Twenty-six studies meeting our inclusion criteria for how nurses experience ethical issues were characterised by two key themes: (1) the moral character of nurses as a willingness to respond to the vulnerability of human beings and (2) ethical issues nurses acted as barriers sometimes, impeding them from responding to requests of vulnerable human beings for dignified care. CONCLUSION Our review provides a deeper understanding of nurses' experiences of ethically sensitive issues, while also highlighting the critical need for adjustments to be made at organisational and societal levels. Ethical issues that emerged in situations where organisational and situational constraints impeded nurses' ethical responses to patients' appeals suggests that early practical support should be made available to resolve ethical issues recognised by nurses. Such support contributes to protecting and promoting not only the dignity of patients with COVID-19 but also of fellow humans in need during crisis.
Collapse
|
3
|
Castaño-García M, Granero-Molina J, Fernández-Férez A, Fernández-Medina IM, Ventura-Miranda MI, Jiménez-Lasserrotte MDM. "Who Takes Care of Carers?": Experiences of Intensive Care Unit Nurses in the Acute Phase of the COVID-19 Pandemic. Healthcare (Basel) 2024; 12:162. [PMID: 38255051 PMCID: PMC10815385 DOI: 10.3390/healthcare12020162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/28/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Introduction: The COVID-19 pandemic caused an international health emergency situation where nursing took on a fundamental role. The high number of patients in hospital ICUs led to a shift in nurses' working conditions and workload. Objective: The objective of this study was to describe the experiences of nurses who worked in ICUs during the acute phase of the COVID-19 pandemic. Methodology: A qualitative, descriptive study was carried out, with the participation of 21 nurses who worked in the ICU during the pandemic. Data collection took place between May and July 2021 through 21 in-depth interviews. Results: Three main themes emerged: (1) COVID-19 in ICUs: nurses on the frontline. (2) United against adversity: teamwork. (3) New optics of critical care and the nursing profession. COVID-19 was perceived with harshness, and the lack of knowledge about the virus generated confusion, anxiety and fear due to the risk of transmission to family members and relatives. The pandemic marked a shift in the management of human, material and economic resources. Novice nurses learned critical care at an accelerated pace, with significant physical and psychological strain. Expert nurses carried the burden of training new nurses. Although there were tense situations, experiencing these adverse situations as a team led to feelings of increased belonging, togetherness and professional bonding for nurses. While the participants noted an increase in motivation to continue in their profession, they also had a feeling of not having been cared for as they deserve by healthcare institutions.
Collapse
Affiliation(s)
| | - José Granero-Molina
- Nursing, Physiotheraphy and Medicine Department, University of Almería, 04120 Almería, Spain
- Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago 7500000, Chile
| | | | | | | | | |
Collapse
|
4
|
Valeberg BT, Meland‐Tangen L, Sollie AK, Borgersen SK, von Heimburg L, Eide C, Leegaard M. 'Both assistant and specialist': Nurse Anaesthetists' experiences of being relocated during the COVID-19 pandemic: A qualitative study. Nurs Open 2024; 11:e2057. [PMID: 38268275 PMCID: PMC10728767 DOI: 10.1002/nop2.2057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/18/2023] [Accepted: 11/19/2023] [Indexed: 01/26/2024] Open
Abstract
AIM The aim of the study was to explore the experiences of nurse anaesthetists being relocated during the COVID-19 pandemic. DESIGN The study has a qualitative design. METHODS A total of 12 nurse anaesthetists from four different hospitals were included. Data were collected using individual semi-structured interviews and then analysed using content analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used. RESULTS The 12 respondents, of whom three were men, were between 46 and 64 years old and had 7 to 30 years of experience as NAs. Two themes emerged in the analysis: (1) 'Diverse experiences' with the sub-themes 'Preparedness' and 'Insecurity' and (2) 'Both assistant and specialist' with the sub-themes 'Exhausting' and 'Meaningful'. CONCLUSION This study shows that the NAs competencies made them prepared to handle many of the situations. They also experienced situations where they were uncomfortable being pressured to take responsibility. They were regarded as a uniform group without considering their prior experiences. Mapping the personnel's former experiences is required to utilize best possible matching of personnel to assignments and create less stress and insecurity among them.
Collapse
|
5
|
Klein DO, Moelans B, Savelberg W, van der Horst ICC, Van Mook WNKA, Rennenberg RJMW. COVID-19 pandemic: a qualitative study with an opportunity-centric approach from an ICU perspective in a teaching hospital. Upsides worth to secure? BMJ Open 2023; 13:e065931. [PMID: 37019494 PMCID: PMC10083527 DOI: 10.1136/bmjopen-2022-065931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
OBJECTIVES During the COVID-19 pandemic, the staff in the intensive care unit (ICU) was materially, physically and emotionally challenged. This qualitative study investigated the effects that ICU staff experienced and were considered of value to be permanently implemented. SETTING ICU in an university medical centre during the first wave of the COVID-19 pandemic. DESIGN An opportunity-centric approach was applied in individual semi-structured interviews to optimise the achieved results and was guided by the theoretical model of appreciative inquiry (AI). PARTICIPANTS Fifteen ICU staff members (8 nurses and 7 intensivists) participated. RESULTS Working during the COVID-19 pandemic catalysed interprofessional collaboration and team learning in the ICU on an individual and team level, centred around a common goal: taking care of critically ill patients with COVID-19. The effect of interprofessional collaboration was that provisions were taken care of quicker than usual, without bureaucratic delays. However, this effect was experienced to be transient. Also, ICU staff perceived limited possibilities to help patients and families around the palliative phase, and they perceived a lack of appreciation from higher management. This is a point of future attention: how to make this perceived lack of appreciation more visible to all (ICU) staff. CONCLUSION Regarding our primary question, the ICU staff voiced that the direct communication and collaboration are the most important elements of the COVID-19 peak they would like to preserve. Furthermore, it was learnt that consolation and support for family members should not be forgotten. Considering the results, we believe that further research concerning team reflexivity might contribute to (or enhance) our knowledge about working together during and after a crisis.
Collapse
Affiliation(s)
- Dorthe O Klein
- Clinical Epidemiology and Medical Technology Assessment, Maastricht UMC+, Maastricht, The Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Bodine Moelans
- Intensive Care, Maastricht UMC+, Maastricht, The Netherlands
| | - Wilma Savelberg
- Quality and Safety, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Iwan C C van der Horst
- Intensive Care, Maastricht UMC+, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
| | - Walther N K A Van Mook
- Intensive Care, Maastricht UMC+, Maastricht, The Netherlands
- School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
| | | |
Collapse
|
6
|
Emmesjö L, Hallgren J, Gillsjö C. Home health care professionals' experiences of working in integrated teams during the COVID-19 pandemic: a qualitative thematic study. BMC PRIMARY CARE 2022; 23:325. [PMID: 36517792 PMCID: PMC9749624 DOI: 10.1186/s12875-022-01934-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Since COVID-19 emerged, over 514 million COVID-19 cases and 6 million COVID-19-related deaths have been reported worldwide. Older persons receiving home health care often have co-morbidities that require advanced medical care, and are at risk of becoming severely ill or dying from COVID-19. In Sweden, over 10,000 COVID-19-related deaths have been reported among persons receiving municipal home health and social care. Home health care professionals have been working with the patients most at risk if infected. Most research has focused on the experiences of professionals in hospitals and assistant nurses in a home care setting. It is therefore valuable to study the experiences of the registered nurses and physicians working in home health care during the COVID-19 pandemic to learn lessons to inform future work. METHOD A thematic qualitative study design using a semi-structured interview guide. RESULTS The health care professionals experienced being forced into changed ways of working, which disrupted building and maintaining relationships with other health care professionals, and interrupted home health care. The health care professionals described being forced into digital and phone communication instead of in-person meetings, which negatively influenced the quality of care. The COVID-19 pandemic brought worry about illness for the health care professionals, including worrying about infecting patients, co-workers, and themselves, as well as worry about upholding the provision of health care because of increasing sick leave. The health care professionals felt powerless in the face of their patients' declining health. They also faced worry and guilt from the patients' next of kin. CONCLUSION Home health care professionals have faced the COVID-19 pandemic while working across organizational borders, caring for older patients who have been isolated during the pandemic and trying to prevent declining health and feelings of isolation. Due to the forced use of digital and phone communication instead of in-person visits, the home health care professionals experienced a reduction in the patients' quality of care and difficulty maintaining good communication between the professions.
Collapse
Affiliation(s)
- Lina Emmesjö
- School of Health Sciences, University of Skövde, P.O. Box 408, SE-541 28 Skövde, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Jenny Hallgren
- School of Health Sciences, University of Skövde, P.O. Box 408, SE-541 28 Skövde, Sweden
| | - Catharina Gillsjö
- School of Health Sciences, University of Skövde, P.O. Box 408, SE-541 28 Skövde, Sweden
- College of Nursing, University of Rhode Island, Kingston, RI USA
| |
Collapse
|
7
|
Engström Å, Fredholm A, Nordin A, Andersson M. Institutional Constraints as an Obstacle for Prioritizing Nursing Interventions During the COVID-19 Pandemic—Critical Care Nurses’ Experiences. SAGE Open Nurs 2022; 8:23779608221133656. [PMCID: PMC9629708 DOI: 10.1177/23779608221133656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 09/08/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction The demands of the pandemic such as staff shortages and limited resources combined with new guidelines regarding infection control may have required the prioritizing of nursing interventions. Objectives The aim of this study was to describe critical care nurses’ experiences of prioritizing nursing interventions for patients with COVID-19 in intensive care units (ICUs) during the pandemic. Method A qualitative descriptive study was gathered from open-ended questions included in a cross-sectional online questionnaire. Characteristics were presented using descriptive statistics, and open-ended questions were analyzed using qualitative content analysis with an inductive approach. The study was conducted in Sweden and focused on critical care nurses working in ICUs during spring 2021 and the second year of the COVID-19 pandemic. Results During the COVID-19 pandemic, 87% of the critical care nurses had provided orientations for new co-workers, and 52% had supervised intensive care nursing students. In all, 70 answered the question of whether they had prioritized nursing care differently during the pandemic; 86% reported that they had and 14% had not. The qualitative analysis resulted in one theme, Institutional constraints as an obstacle for nursing interventions, with three categories: Prioritizing lifesaving interventions, Performing nursing interventions less frequently, and Not able to provide the nursing care I wish to provide. Conclusion Institutional constraints as an obstacle for nursing interventions is the overall theme. It illustrates how critical care nurses have been forced to prioritize, thereby not being able to provide the nursing interventions they wanted to do provide, and it describes their feelings in this situation. The nurses need recovery and possibilities for reflection. The organization must also recover and not only return to how it was before the pandemic but also to learn from recent events and take actions to reduce the long-term effects on staffing.
Collapse
Affiliation(s)
- Åsa Engström
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Lulea University of Technology, Luleå, Sweden,Åsa Engström, Department of Health, Education and Technology, Division of Nursing and Medical Technology, Lulea University of Technology, SE-97187 Luleå, Sweden.
| | - Angelica Fredholm
- County Council, Värmland, Sweden,Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden
| | - Anna Nordin
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Lulea University of Technology, Luleå, Sweden,Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden
| | - Maria Andersson
- Department of Health, Education and Technology, Division of Nursing and Medical Technology, Lulea University of Technology, Luleå, Sweden,Swedish Red Cross University College, Huddinge, Sweden
| |
Collapse
|
8
|
Hörold M, Drewitz KP, Piel J, Hrudey I, Rohr M, Brunnthaler V, Hasenpusch C, Ulrich A, Otto N, Brandstetter S, Apfelbacher C. Intensive Care Units Healthcare Professionals’ Experiences and Negotiations at the Beginning of the COVID-19 Pandemic in Germany: A Grounded Theory Study. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221081059. [PMID: 35522185 PMCID: PMC9082755 DOI: 10.1177/00469580221081059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Faced with the pandemic of the novel coronavirus (SARS-CoV-2), healthcare professionals (HCPs) in intensive care units (ICU) adjusted their organizational, operational, and personal procedures to ensure care for COVID-19 patients. We used grounded theory approach to explore ICU HCPs' perspectives on professional action at the beginning of the COVID-19 pandemic in Germany from March to July 2020. The study aimed to examine implicit principles on negotiating social practice and interaction of ICU HCPs in an exceptional situation, which was characterized by a high level of changes. We conducted theme-guided qualitative telephone/virtual interviews with 39 ICU HCPs from ten German federal states. The data collection followed the principles of theoretical sampling. We adpoted grounded theory approach proposed by Charmaz and discussed using Lüscher’s theoretical concept of ambivalence. The analysis revealed five interconnected categories about the ICU HCPs’ negotiation of social practice and interaction at the beginning of the COVID-19 pandemic in Germany. In this context, a complex field of ambivalence (key category) emerged between habits and routines of a pre-pandemic normality. Pragmatic restructuring processes were initiated, which quickly resulted in a new normality of a “daily routine of preparation”. Dealing with ambivalence offers the potential for change.
Collapse
Affiliation(s)
- Madlen Hörold
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Karl Philipp Drewitz
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Julia Piel
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Ilona Hrudey
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Magdalena Rohr
- University of Regensburg, Faculty of Medicine, Medical Sociology, Regensburg, Bavaria, Germany
- University of Regensburg, University Children’s Hospital Regensburg (KUNO-Clinics), Regensburg, Bavaria, Germany
| | - Vreni Brunnthaler
- University of Regensburg, Faculty of Medicine, Medical Sociology, Regensburg, Bavaria, Germany
| | - Claudia Hasenpusch
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Angela Ulrich
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| | - Niklas Otto
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
- University Hospital Magdeburg, Magdeburg, Saxony-Anhalt, Germany
| | - Susanne Brandstetter
- University of Regensburg, University Children’s Hospital Regensburg (KUNO-Clinics), Regensburg, Bavaria, Germany
| | - Christian Apfelbacher
- Otto von Guericke University Magdeburg, Faculty of Medicine, Institute of Social Medicine and Health Systems Research, Magdeburg, Saxony-Anhalt, Germany
| |
Collapse
|