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Rangel T, Weisbrich G, Sumner S, Gaines A, Leavitt R. Factors associated with health personnel-chaplain interactions in the hospital setting: a cross-sectional survey study. J Health Care Chaplain 2024:1-15. [PMID: 39224946 DOI: 10.1080/08854726.2024.2393551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Health personnel may seek chaplain support to discuss stressors related to complex patient cases, difficult team dynamics, and personal issues. In this survey study of 1376 healthcare interprofessional clinicians, participants reported interacting with chaplains most frequently over patient-related stressors in the prior 12 months. Factors associated with chaplain interactions to discuss all three stressors included: reporting chaplains provide spiritual support to health personnel, more years of service, seeking professional help to deal with stressors, and higher levels of secondary traumatic stress. Being a registered nurse (RN) and working in a critical care specialty were associated with increased odds of interactions with a chaplain to discuss patient-related stressors while identifying as Catholic or Protestant was associated with chaplain interactions to discuss team-related and personal stressors. Chaplains should tailor interventions to promote health personnel's spiritual well-being based on patient-related, team-related, and personal stressors. Healthcare institutions which do not employ chaplains should advocate for this resource. Leaders in healthcare settings with chaplains should promote increased staff awareness that chaplains are available to support wellbeing by discussing patient, team, or personal stressors.
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Affiliation(s)
- Teresa Rangel
- Clinical Excellence, Research, and Practice, Providence Central Division, Spokane, WA, USA
| | - Gary Weisbrich
- Spiritual Care, Providence St. Patrick Hospital, Missoula, MT, USA
| | - Sarah Sumner
- Intensive Care Unit, Providence Saint Joseph Medical Center, Burbank, CA, USA
| | - Adam Gaines
- Spiritual Care, Providence Sacred Heart Medical Center, Spokane, WA, USA
| | - Robert Leavitt
- Palliative Care, Providence Sacred Heart Medical Center, Spokane, WA, USA
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Taylor EJ, Pangan JC. Should Healthcare Organizations Promote a Spiritually Healthy Work Environment? Holist Nurs Pract 2024; 38:148-150. [PMID: 38709130 DOI: 10.1097/hnp.0000000000000641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Both personal spirituality/religiosity and perception of a spiritually respectful work climate are inversely related to burnout among nurses. In addition to briefly reviewing the empirical evidence that consistently supports these assertions, this essay offers some practical suggestions for how nurses can promote a spiritually healthy work environment.
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Affiliation(s)
- Elizabeth Johnston Taylor
- Author Affiliations: School of Nursing, Loma Linda University, Loma Linda, CA (Dr Taylor and Mr Pangan); and UC/Irvine Medical Center, Orange, CA (Mr Pangan)
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Wilson MA, Shay A, Harris JI, Faller N, Usset TJ, Simmons A. Moral Distress and Moral Injury in Military Healthcare Clinicians: A Scoping Review. AJPM FOCUS 2024; 3:100173. [PMID: 38304024 PMCID: PMC10832382 DOI: 10.1016/j.focus.2023.100173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Introduction Healthcare clinicians are often at risk of psychological distress due to the nature of their occupation. Military healthcare providers are at risk for additional psychological suffering related to unique moral and ethical situations encountered in military service. This scoping review identifies key characteristics of moral distress and moral injury and how these concepts relate to the military healthcare clinician who is both a care provider and service member. Methods A scoping review of moral distress and moral injury literature as relates to the military healthcare clinician was conducted on the basis of the Joanna Briggs Institute scoping review framework. Databases searched included CINAHL, Cochrane Central Register of Controlled Trials, MEDLINE (Ovid), Embase (Ovid), PsycInfo, 2 U.S. Defense Department sources, conference papers index, and dissertation abstracts. Reference lists of all identified reports and articles were searched for additional studies. Results A total of 573 articles, published between the years 2009 and 2021, were retrieved to include a portion of the COVID-19 pandemic period. One hundred articles met the inclusion criteria for the final full-text review and analysis. Discussion This scoping review identified moral distress and moral injury literature to examine similarities, differences, and overlaps in the defining characteristics of the concepts and the associated implications for patients, healthcare clinicians, and organizations. This review included the unfolding influence of the COVID-19 pandemic on moral experiences in health care and the blurring of those lines between civilian and military healthcare clinicians. Future directions of moral injury and moral distress research, practice, and care are discussed.
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Affiliation(s)
- Melissa A. Wilson
- U.S. Air Force Research Laboratory, Dayton, Ohio
- College of Health, Education and Human Services Department of Nursing, Wright State University, Dayton, Ohio
| | - Amy Shay
- School of Nursing, Indiana University, Indianapolis, Indiana
| | | | | | - Timothy J. Usset
- Division of Health Policy & Management, University of Minnesota, Minneapolis, Minnesota
| | - Angela Simmons
- Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Callis AB, Saul T, Bindler RJ. The Impact of Moral Injury on Self-reported Work Performance in Hospital Nurses Following the Global Pandemic Surge. J Nurs Adm 2024; 54:177-183. [PMID: 38381573 DOI: 10.1097/nna.0000000000001404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVE The aim of this study was to determine relationships between moral injury (MI) and self-reported nurse work performance (NWP) among hospital nurses after the COVID-19 pandemic surges. BACKGROUND Previously studied in the military, nurse MI became evident due to the pandemic. No previous studies have examined the impact of MI on NWP. Few studies have attended to how MI in nurses can be addressed by nursing leadership. METHODS A convenience sample of 191 nurses from 7 hospitals in Southern California participated in a multisite correlational survey-design study. RESULTS Significant levels of MI occurred in 57% (n = 114) of participants. Increased levels of MI were a significant predictor of decreased levels of self-reported NWP. Younger and less experienced nurses reported greater levels of MI. CONCLUSIONS This study relates MI in nurses to NWP. There is a need for further research to assist nursing administrators in ameliorating MI in nurses and in preparing for the impact of MI on the nursing workforce in future emergent situations.
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Affiliation(s)
- Annette Browning Callis
- Author Affiliations: Professor and Director of Graduate Nursing (Dr Callis), Vanguard University, Costa Mesa; Director of Research (Dr Saul), Providence Southern California Region, Irvine; and Biostatistician (Dr Bindler), Independent Contractor, Providence Southern California Region, Irvine, California; and Research Investigator (Dr Bindler), College of Nursing, Washington State University-Spokane
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Tartaglia A, White KB, Corson T, Charlescraft A, Johnson T, Jackson-Jordan E, Fitchett G. Supporting staff: The role of health care chaplains. J Health Care Chaplain 2024; 30:60-73. [PMID: 36520544 DOI: 10.1080/08854726.2022.2154107] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The aim of this study was to describe the range of spiritual care activities in support of clinical colleagues at a subset of U.S. hospitals. A descriptive cross-sectional design using a 76-item Zoom/telephone guided survey containing a subset of staff care questions was employed. Data were provided by directors/managers responsible for spiritual care services at the 2020-2021 U.S. News & World Report top hospitals. Results identified staff support as an important chaplaincy function at both organizational and spiritual care department levels. Staff chaplains at over half of the hospitals spend an estimated 10-30% of their time on staff care, with chaplains in five hospitals spending greater than 30%. The most frequently reported activities were religiously associated, such as blessings and rituals for hospital events. Additionally, chaplains actively support staff during critical events such as patient deaths and through organizational protocols such as code lavender and critical incident debriefings. Chaplain support for staff most commonly grew out of personal relationships or referrals from clinical managers. Future research opportunities in this area include systematic data collection for chaplains' specific staff support activities as well as efforts to investigate the impact of those activities on patient experience.
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Affiliation(s)
- Alexander Tartaglia
- Patient Counseling, College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA
| | - Kelsey B White
- Patient Counseling, College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA
| | - Tyler Corson
- Adjunct Faculty, College of Health Sciences, Rush University, Chicago, IL, USA
| | - Ann Charlescraft
- Retired Faculty, Patient Counseling, College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA
| | - Tricia Johnson
- Professor, Health Systems Management, College of Health Sciences, Rush University Chicago, IL, USA
| | | | - George Fitchett
- Professor, Religion, Health and Human Values, College of Health Sciences, Rush University, Chicago, IL, USA
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Kubitza J, Große G, Schütte-Nütgen K, Frick E. Influence of spirituality on moral distress and resilience in critical care staff: A scoping review. Intensive Crit Care Nurs 2023; 76:103377. [PMID: 36669436 PMCID: PMC9850638 DOI: 10.1016/j.iccn.2022.103377] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/06/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The Covid 19 pandemic has created a situation in which critical care staff experience moral distress. For reducing moral distress, resources such as spirituality can be used. The aim of this scoping review is to explore whether spirituality mitigates the moral distress of critical care staff and strengthens their resilience. The spiritual resources will be identified and the ability of the staff to use spiritual resources will be explored. METHODOLOGY A scoping review of studies reporting on the association between spirituality, moral distress, and resilience. Qualitative and quantitative studies from 2020 that examined critical care staff are included. This scoping review used the five-step framework proposed by Arksey and O'Malley and was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework for scoping reviews. The literature searches were conducted in 12 databases. RESULTS 13 studies met inclusion criteria. Critical care staff declaring themselves as spiritual have a higher risk of moral distress and are often not able to use spiritual resources on their own. For effective use of spiritual resources to reduce moral distress, staff need to be skilled in the practice of spirituality with the aim to find inner peace, focus on the positive, and regain a sense of purpose in the work. CONCLUSION Spirituality does not automatically help the critical care staff to cope with moral distress and strengthen resilience. Institutions need to create conditions in which the critical care staff are supported to use their spiritual resources. IMPLICATION FOR CLINICAL PRACTICE Institutions need to involve staff more in the design, implementation, and delivery of spiritual interventions to minimise moral distress. Further research is necessary to examine the impact of critical care staff's demographic characteristics on their spirituality, moral distress, and resilience.
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Affiliation(s)
- Jenny Kubitza
- University Hospital rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy, Professorship of Spiritual Care and Psychosomatic Health, Technical University of Munich, Kaulbachstraße 22a, Munich 80539, Germany,Corresponding author
| | - Greta Große
- Ludwig-Maximilians-Universität München, Faculty of Medicine, Munich, Germany
| | - Katharina Schütte-Nütgen
- University Medical Center Freiburg, Clinic of Palliative Medicine, Robert-Koch-Straße 3, Freiburg 79106, Germany
| | - Eckhard Frick
- University Hospital rechts der Isar, Department of Psychosomatic Medicine and Psychotherapy, Professorship of Spiritual Care and Psychosomatic Health, Technical University of Munich, Kaulbachstraße 22a, Munich 80539, Germany
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Tunks Leach K, Simpson P, Lewis J, Levett-Jones T. The Role and Value of Chaplains in an Australian Ambulance Service: A Comparative Study of Chaplain and Paramedic Perspectives. JOURNAL OF RELIGION AND HEALTH 2023; 62:98-116. [PMID: 36402854 PMCID: PMC9676825 DOI: 10.1007/s10943-022-01685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 05/11/2023]
Abstract
Chaplains are embedded in several ambulance services across Australia, however as Australia's religiosity is currently in decline and questions are being asked about retaining chaplains, little is actually known about their role and value within Ambulance services. The aim of this paper is to present the key findings from interviews with chaplains about their role and value of being ambulance chaplains. These findings are then compared with those of paramedics derived from an earlier phase of this study. Thirteen chaplains participated in semi-structured interviews, and data were analysed using framework analysis. The results indicated that ambulance chaplains provided paramedic-centred emotional and spiritual care through proactively and reactively supporting paramedics in their work. Chaplains saw value in their relational approach which facilitated trust and access, did not seek to 'fix' or diagnose but instead offered physical and emotional presence, and promoted supportive conversations. Chaplains and paramedics valued operationally trained and equipped ambulance chaplains who provided a relational, around the clock, 'frontline' staff support presence in paramedic workplaces, regardless of the paramedic's personal religious/spiritual beliefs.
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Affiliation(s)
- Katie Tunks Leach
- Faculty of Health, University of Technology Sydney, Sydney, Australia.
- New South Wales Ambulance, Sydney, Australia.
| | - Paul Simpson
- School of Health Sciences, Western Sydney University, Sydney, Australia
| | - Joanne Lewis
- School of Nursing and Health, Avondale University, Wahroonga, Australia
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Hinzmann D, Schütte-Nütgen K, Büssing A, Boenisch O, Busch HJ, Dodt C, Friederich P, Kochanek M, Michels G, Frick E. Critical Care Providers' Moral Distress: Frequency, Burden, and Potential Resources. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:333. [PMID: 36612657 PMCID: PMC9819312 DOI: 10.3390/ijerph20010333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/25/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Critical Care Providers (CCPs) experience situations that challenge their ethics and professional standards and may entail moral distress (MD). AIM To analyze MD perceived by CCPs in intensive care units (ICUs) or emergency departments (EDs) and further clarify whether CCPs who rely on spiritual resources differ in their perception of MD from those who do not utilize these resources. METHODS A cross-sectional anonymous survey was administered using a modified version of the German language version of the Moral Distress Scale (MDS) with 2 × 12 items to assess the frequency and the respective perceived burden of specific situations by applying a 5-point Likert scale. Explorative factor analysis was performed and the sub-constructs of the respective items regarding MD frequency and burden were identified. Job burden and professional satisfaction were measured using visual analogue scales (VAS) and a four-point Likert scale, respectively. The 15-item SpREUK questionnaire was applied to measure spiritual attitudes and behaviours and to differentiate between religious and spiritual persons. Data from 385 German-speaking CCPs were included (55% physicians, 45% nurses). RESULTS Conflict situations are similar for physicians and nurses although they are perceived as more burdensome by nurses. Among physicians, the MDS factor Looking away/Resignation scores highest for assistant physician residents, whereas distress caused by looking away is more often perceived by specialist physicians without a managerial position. Work satisfaction is inversely associated with MD and emotional exhaustion is positively associated with it. Participants' spirituality is marginally associated with MD. The best predictors of both MD frequency and burden are emotional exhaustion with further influences of work satisfaction, being a nurse, and being a non-believer on the frequency of MD perception. Being a nurse, participants' experience in ICU/ED, and being of the male gender are further predictors of MD burden. CONCLUSIONS MD is experienced differently by different groups of CCPs depending on their place in the hierarchy of responsibility. As MD perception is best predicted by emotional exhaustion, these situations should be avoided. Although some CCPs may rely on spiritual resources, all need individual and team support to cope with MD.
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Affiliation(s)
- Dominik Hinzmann
- Department of Anaesthesiology and Intensive Care, University Hospital Rechts der Isar, 81675 Munich, Germany
- School of Medicine, Technical University of Munich, 80333 München, Germany
| | | | - Arndt Büssing
- Quality of Life, Spirituality and Coping, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Olaf Boenisch
- Department of Intensive Care, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Hans-Jörg Busch
- Department of Emergency Medicine, University Hospital Freiburg, 79106 Freiburg, Germany
| | - Christoph Dodt
- Emergency Department, München Klinik, 81925 Munich, Germany
| | | | - Matthias Kochanek
- Department of Intensive Care, University Hospital Cologne, 50937 Cologne, Germany
| | - Guido Michels
- Emergency Department, Sankt Antonius Hospital, 52249 Eschweiler, Germany
| | - Eckhard Frick
- School of Medicine, Technical University of Munich, 80333 München, Germany
- Spiritual Care and Psychosomatic Health, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Rechts der Isar, 80539 Munich, Germany
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Walsh E, Greider H, Ridling D. Tea for the Soul: An intervention to support nurse resilience. Nurs Manag (Harrow) 2022; 53:37-45. [PMID: 36449706 DOI: 10.1097/01.numa.0000897480.52072.a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Elaine Walsh
- Elaine Walsh is a nurse scientist at Seattle Children's Center for Pediatric Nursing Research and an associate professor, Child, Family, and Population Health Nursing at the University of Washington School of Nursing in Seattle, Wash. Heidi Greider is the manager of the Spiritual Care Department at Seattle Children's in Seattle, Wash. Debra Ridling is the associate chief nurse, the senior director of Nursing Practice and Research, and the director of the Center for Pediatric Nursing Research at Seattle Children's in Seattle, Wash
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New insights into workplace chaplaincy. REVIEW OF MANAGERIAL SCIENCE 2022. [DOI: 10.1007/s11846-022-00553-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractWorkplace chaplaincy, a concrete manifestation of workplace spirituality, is defined as pastoral care serving the specific needs of people in workplaces. While scientific publications have so far emphasized its beneficial implications, scrutiny of the possible instrumentalization of workplace chaplaincy by the management has been neglected. Workplace chaplaincy can signify a real integration of spirituality implying a debate on the meaning of life and work, as well as a critical analysis of organizational structures and management (critical workplace spirituality). Just as well, it can be instrumentalized as a management technique to impel employees to achieve improved organizational results (positive workplace spirituality).This paper contributes to the management literature by elaborating decisive characteristics of a critical and positive workplace spirituality and discussing those characteristics that pertain to workplace chaplaincy. Furthermore, we provide a qualitative study on workplace chaplaincy illustrating a critical thought-provoking model facing different challenges, allegiances and logics in the secular working world. The elaborated characteristics and the qualitative study extend our understanding of workplace spirituality and chaplaincy as they provide a view beyond traditional management perspectives. Moreover, this paper contributes to the discussion what kind of spirituality and chaplaincy we are referring to in management theory and practice.
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Pagador F, Barone M, Manoukian M, Xu W, Kim L. Effective Holistic Approaches to Reducing Nurse Stress and Burnout During COVID-19. Am J Nurs 2022; 122:40-47. [PMID: 35447650 DOI: 10.1097/01.naj.0000830744.96819.dc] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Prolonged exposure to work-related stress can lead to nurse burnout, potentiating clinical and medication errors and low-quality patient care. Holistic approaches (such as mindfulness training, "zen rooms," and massage chairs, among others) have been shown to reduce nurses' anxiety, stress, and burnout. PURPOSE To evaluate the use of "serenity lounges" (dedicated rooms where nurses can take workday breaks for the purposes of relaxation and rejuvenation) and massage chairs on nurses' anxiety, stress, and burnout. METHODS This quality improvement project analyzed 67 paired responses to surveys filled out by nurses before and after their use of serenity lounges at a medical center in Los Angeles between November 2020 and May 2021. Following successful implementation of a serenity lounge on a pilot unit, this project was expanded to a total of 10 units, including COVID-19 cohort units. As part of this expansion, massage chairs were added to 10 serenity lounges, along with items such as wipes, gloves, and shoe covers to enable nurses to adhere to infection control protocols. RESULTS Analysis of the 67 paired responses to pre- and post-lounge-use surveys revealed a significant reduction in feelings of emotional exhaustion, burnout, frustration, being worn out, stress, and anxiety after use of the serenity lounge. Improvements in feelings of emotional exhaustion, being worn out, and being anxious were also noted after using the massage chair for at least 10 to 20 minutes. CONCLUSIONS These results highlight the importance of providing a holistic approach, including a serene space, massage equipment, and other amenities, to help nurses reduce feelings of anxiety, stress, and burnout, particularly during challenging times such as the COVID-19 pandemic.
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Affiliation(s)
- Florida Pagador
- Florida Pagador is an assistant nurse manager, Melanie Barone is an associate nursing director, Mana Manoukian is a clinical nurse specialist, Wenrui Xu is a clinical research specialist, and Linda Kim is a research scientist, all at Cedars-Sinai Medical Center in Los Angeles. Contact author: Linda Kim, . The authors have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the authors is available at www.ajnonline.com
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