Using the Nurse Coaching Process to Support Bereaved Staff During the COVID-19 Crisis

Grieving Children' Death in an Intensive Care Unit: Implementation of a Standardized Process

Background: The grief that accompanies witnessing the death of a child puts health care professionals at risk of secondary trauma, burnout, and turnover when left unaddressed. Objective: Support staff well-being and promote resiliency. Methods: Descriptive implementation of a structured, peer-to-peer bereavement support program for intensive care unit (ICU) staff at a tertiary children's hospital. Results: Thirty-five virtual sessions were held over the period of one year.Through these sessions, participants shared perspectives and normalized reactions, and explored potential coping strategies. Post-session feedback surveys demonstrated the negative impact of a death on the personal or work life of ICU staff. Additionally, nearly all reported some level of burnout. Conclusions: The sessions were feasible and positively impacted staff coping and well-being. Barriers and facilitators to session attendance, as well as suggestions for improvement, were also explored. Implications for practice and future research are discussed. No clinical trial registration is applicable.

Pivoting Continuing Professional Development During the COVID-19 Pandemic: A Narrative Scoping Review of Adaptations and Innovations

INTRODUCTION

Most formal continuing professional development (CPD) opportunities were offered in person until March 2020 when the COVID-19 pandemic disrupted traditional structures of CPD offerings. The authors explored the adaptations and innovations in CPD that were strengthened or newly created during the first 16 months of the pandemic.

METHODS

The objectives of the narrative review were to answer the following questions: (1) what types of adaptations to CPD innovations are described? and (2) what may shape future innovations in CPD? The following databases were searched: Medline, Embase, CINAHL, and ERIC to identify the literature published between March 2020 to July 2021. The authors conducted a comprehensive search by including all study types that described adaptations and/or innovations in CPD during the stated pandemic period.

RESULTS

Of the 8295 citations retrieved from databases, 191 satisfied the inclusion criteria. The authors found three categories to describe adaptations to CPD innovations: (1) creation of new online resources, (2) increased use of the existing online platforms/software to deliver CPD, and (3) use of simulation for teaching and learning. Reported advantages and disadvantages associated with these adaptations included logistical, interactional, and capacity building elements. The review identified five potential future CPD innovations: (1) empirical research on the effectiveness of virtual learning; (2) novel roles and ways of thinking; (3) learning from other disciplines beyond medicine; (4) formation of a global perspective; and (5) emerging wellness initiatives.

DISCUSSION

This review provided an overview of the adaptations and innovations that may shape the future of CPD beyond the pandemic.

Hospital-Based Interventions to Address Provider Grief: A Narrative Review

CONTEXT

Provider grief, i.e., grief related to the death of patients, often forms an ongoing and profound stressor impacting healthcare providers' ability to maintain their sense of well-being, avoid feeling overwhelmed, and sustain quality and compassionate patient care over time.

OBJECTIVES

This narrative review presents findings on the types of interventions hospitals have offered to physicians and nurses to address provider grief.

METHODS

Searches of PubMed and PsycINFO were conducted for articles (e.g., research studies, program descriptions and evaluations) focused on hospital-based interventions to help physicians and nurses cope with their own grief.

RESULTS

Twenty-nine articles met inclusion criteria. The most common adult clinical areas were oncology (n = 6), intensive care (n = 6), and internal medicine (n = 3), while eight articles focused on pediatric settings. Nine articles featured education interventions, including instructional education programs and critical incident debriefing sessions. Twenty articles discussed psychosocial support interventions, including emotional processing debriefing sessions, creative arts interventions, support groups, and retreats. A majority of participants reported that interventions were helpful in facilitating reflection, grieving, closure, stress relief, team cohesion, and improved end-of-life care, yet mixed results were found related to interventions' effects on reducing provider grief to a statistically significant degree.

CONCLUSION

Providers largely reported benefits from grief-focused interventions, yet research was sparse and evaluation methodologies were heterogenous, making it difficult to generalize findings. Given the known impact provider grief can have on the individual and organizational levels, it is important to expand providers' access to grief-focused services and to increase evidence-based research in this field.

Integrating Palliative Care into Nursing Care

ABSTRACT

The need for palliative care in our health care system has exponentially increased in the past few years as a result of the COVID-19 pandemic, the aging population, and the increasing number of people living with serious illnesses. While nurses play a critical role in delivering palliative care, many lack confidence and knowledge, causing practice gaps in the clinical and psychological management of seriously ill patients. The collective burden of the pandemic has demonstrated the importance of palliative care education and training, specifically in communication, symptom management, and continuing education. All nurses, including nursing students, transitioning nurses, and practicing nurses, should be trained to offer generalist (or primary) palliative care, in accordance with the American Association of Colleges of Nursing Essentials: Core Competencies for Professional Nursing Education. Provision of holistic, relationship-based, and integrated palliative care for patients and their families is an ethical obligation for all nurses.

Coaching as a Model for Facilitating the Performance, Learning, and Development of Palliative Care Nurses

Palliative care nurses experience huge pressures, which only increased with coronavirus disease 2019 (COVID-19). A reflection on the new demands for nursing care should include an evaluation of which evidence-based practices should be implemented in clinical settings. This paper discusses the impacts and challenges of incorporating coaching strategies into palliative care nursing. Evidence suggests that coaching strategies can foster emotional self-management and self-adjustment to daily life among nurses. The current challenge is incorporating this expanded knowledge into nurses’ coping strategies. Coaching strategies can contribute to nurses’ well-being, empower them, and consequently bring clinical benefits to patients, through humanized care focused on the particularities of end-of-life patients and their families.