Examining Burnout in Interprofessional Intensive Care Unit Clinicians Using Qualitative Analysis

[Onboarding in intensive care and emergency medicine in Germany]

BACKGROUND

The treatment of acute life-threatening conditions in intensive care and emergency medicine requires in-depth training and education, with initial training playing a key role.

RESEARCH QUESTION

What is the structure and quality of the initial training of physicians and nurses in intensive care units and emergency departments in Germany?

METHODS

With the help of survey software, an online questionnaire comprising 40 questions in German on the aforementioned topic was designed. It was distributed via the website of the German Society for Internal Intensive Care and Emergency Medicine (DGIIN) and via pertinent social media channels.

RESULTS

In total, 103 nurses and 125 physicians participated in the survey. The average work experience of the participating nurses and physicians was 8.5 ± 5.1 and 3.0 ± 3.1 years, respectively. The majority of participants worked primarily in intensive care units (59%) or in emergency departments (22%). On average, the initial training lasted 45 ± 27 and 13 ± 13 days for nurses and physicians, respectively. Only 20% of the initial training comprised seminars or hands-on workshops taught outside of routine clinical care. In all, 47% of the participants stated that they were not able to complete the entire initial training period. Only 49% had been officially certified for usage of the technical equipment in their department. A total of 35% reported feeling confident or somewhat confident in handling predictable tasks after initial training, but only 15% in handling acute emergencies.

DISCUSSION

The present study revealed that initial training in intensive care and emergency medicine is frequently incomplete, unstructured, as well as inadequate and bears both safety and liability risks. New concepts are needed to improve the initial training across clinics.

Enhancing Respiratory Therapists' Well-Being: Battling Burnout in Respiratory Care

Burnout is a major problem in health care and is associated with adverse sequelae for patients, health care workers, and organizations. Burnout among respiratory therapists (RTs) is as high as 79% and is associated with poor or ineffective leadership, inadequate staffing, high work load, non-leadership position, and work environment. An understanding of burnout is necessary for both staff and leadership to ensure RT well-being. This narrative review will discuss the psychology of burnout, prevalence, drivers, mitigation strategies, and future directions for research.

Using Retrofit, Reform, and Reimagine to Advance Toward Health Equity

OBJECTIVES

The purpose of this commentary is to provide an overview of the current landscape for childbearing families and pregnancy-capable people and a call to action toward the courage to align health and human services that support improved health outcomes. The commentary is broken into 3 parts.

RESEARCH

The framework of retrofit, reform, and reimagine is developed to provide a conceptual framework that supports a shared language.

METHODS

The current landscape is juxtaposed on the framework of retrofit, reform, and reimagine to connect the dots for health equity.

CONCLUSIONS

The commentary ends with a call to action that demonstrates a bold roadmap for birth workers, clinicians, nurses, doulas, physicians, and other clinical health services providers to coconstruct paths to human services that should resolve health inequities.

Interprofessional, Interdisciplinary, or Multidisciplinary?

As a longtime researcher in interprofessional collaborative care and deputy editor-in-chief of the Journal of Interprofessional Care, I was dismayed by the imprecise use of language in the article by Colbenson et al.1 The title says "interprofessional," the first sentence of the abstract says "interdisciplinary," and the abstract also uses the word "multidisciplinary." These words have different meanings and are not interchangeable. The first implies collaborative interactions, the second is often used by physicians to imply physicians with different specialties interacting (eg, oncologist and pathologist), and the third simply means that persons from different professions are in the same space per- haps working in parallel, perhaps sequentially. Another term the authors use, "ICU [intensive care unit] teams," may or may not actually be working as teams, but the terms are not defined. The theme "interdisciplinary dynamics" is really about multidisciplinary interactions and is minimally described. If nurses feel devalued and not involved in decision-making, the dynamics are not interprofessional or even interdisciplinary.