Australian nurses' and midwives’ perceptions of their workplace environment during the COVID-19 pandemic

BackgroundWorking as a front-line worker during a pandemic is a unique situation that requires a supportive work environment. An informed understanding of nurses' and midwives’ workplace experiences during a pandemic, such as COVID-19, may enable better preparation and targeted support for future pandemics at an individual, organisational, and policy level.AimThe aim of this study was to explore nurses' and midwives’ workplace experiences during the COVID-19 pandemic response.MethodsA cross-sectional online survey consisting of open-ended questions was conducted with a convenience sample of nurses and midwives (n = 1003) working in New South Wales Health hospital settings, in Australia. Open-ended questions were analysed using content analysis.ResultsFive themes were identified; ‘organisational communication’, ‘workplace support’, ‘availability of personal protective equipment’, ‘flexible working’, and ‘new ways of working’. Nurses' and midwives’ workplace experiences during COVID-19 were influenced by leaders who were perceived to be adaptive, authentic, responsive, transparent, and visible. While many expressed a number of workplace challenges, including access to personal protective equipment, there was opportunity to explore, develop, and evaluate new and alternate models of care and working arrangements.ConclusionIt is important that nurses and midwives are supported and well prepared to cope during pandemics in the workplace. Organisational leadership and timely dissemination of transparent pandemic plans may support nurses’ adaptive workplace experiences.     

Critical care nurses’ experiences of working during the first phase of the COVID-19 pandemic – Applying the Person-centred Practice Framework

AimThe aim of the study was to deductively study person-centred care, based on critical care nurses’ experiences during the first phase of the CoViD-19 pandemic.DesignThe study used a qualitative design.MethodData collection was conducted as individual interviews and was analysed with qualitative content analysis with a deductive approach.ParticipantsSix critical care nurses working in a special CoViD-19 intensive care unit during the first phase of the pandemic participated.FindingsThe findings are presented within the four domains of person-centred practice: the prerequisites, the care environment, person-centred processes and person-centred outcomes. While the ambition and knowledge about how to work in accordance with person-centred practice were high, there were several obstacles to perform it.ConclusionWe need to prepare ahead of time so that nurses have optimal organisational prerequisites to be able to work in accordance with person-centred practice, also during pandemics and other crisis, which means to be able to give nursing care in accordance with the ill person’s needs and resources.     

COVID-19: Korean nurses’ experiences and ongoing tasks for the pandemic’s second wave

Nurses are the largest group of healthcare workers in the world, and during the COVID-19 pandemic, nurses have been recognized worldwide as frontline warriors working hard to stem suffering, infection rates and deaths. Korean nurses experienced the effects of the pandemic earlier than in most other countries, and the work of our nurses has been recognized as a successful model in responding COVID-19. In this paper, we share the experiences of Korean nurses, including their experiences of workload, acute shortages of staff and equipment and work overload, and suggest ongoing tasks that need to be addressed to combat the pandemic’s second wave and other possible waves. Specifically, the nursing issues relating to COVID-19 are critically reviewed and recommendations for each issue are suggested in terms of nursing staffing, practice and policy, as well as health policy.     

Evolution of emergency medical calls during a pandemic – An emergency medical service during the COVID-19 outbreak

IntroductionEmergency Medical Services (EMS) are expected to be affected by a pandemic outbreak. However, the available data about trends and extents of these effects is limited.MethodsWe analyzed numbers of ambulance calls for all 136 diagnosis codes used by Magen David Adom (MDA), Israel's national EMS during 121 days between January 01 and April 30, 2020.ResultsThere was an increase in calls for COVID-19 symptoms (cough, fever, throat pain). This trend followed the same shape as the curve for confirmed COVID-19 patients. Trends were found to increase for calls not followed by transport to the hospital as well as in calls for mental or psychiatric causes. Simultaneously, there was a decrease in calls for cardiovascular issues, pneumonia, and all injuries.ConclusionUnderstanding these correlations may allow better preparedness of the EMS and a better response towards the public needs in the period of an epidemic or a pandemic.     

Physicians’ and nurses’ perceptions of patient safety risks in the emergency department

The emergency department has been described as a high-risk area for errors. It is also known that working conditions such as a high workload and shortage off staff in the healthcare field are common factors that negatively affect patient safety. A limited amount of research has been conducted with regard to patient safety in Swedish emergency departments. Additionally, there is a lack of knowledge about clinicians’ perceptions of patient safety risks. Therefore, the purpose of this study was to describe emergency department clinicians’ experiences with regard to patient safety risks.MethodSemi-structured interviews were conducted with 10 physicians and 10 registered nurses from two emergency departments. Interviews were analysed by inductive content analysis.ResultsThe experiences reflect the complexities involved in the daily operation of a professional practice, and the perception of risks due to a high workload, lack of control, communication and organizational failures.ConclusionThe results reflect a complex system in which high workload was perceived as a risk for patient safety and that, in a combination with other risks, was thought to further jeopardize patient safety. Emergency department staff should be involved in the development of patient safety procedures in order to increase knowledge regarding risk factors as well as identify strategies which can facilitate the maintenance of patient safety during periods in which the workload is high.     

Intensive care nurses’ experiences and perceptions of delirium and delirium care

ObjectiveTo explore nurses’ experiences and perceptions of delirium, managing delirious patients, and screening for delirium, five years after introduction of the Confusion Assessment Method for Intensive Care into standard practice.Research design and settingTwelve nurses from a medical-surgical intensive care unit in a large teaching hospital attended two focus group sessions. The collected qualitative data was thematically analysed using Braun and Clarke’s framework (2006).FindingsThe analysis identified seven themes: (1) Delirium as a Secondary Matter (2) Unpleasant Nature of Delirium (3) Scepticism About Delirium Assessment (4) Distrust in Delirium Management (5) Value of Communication (6) Non-pharmacological Therapy (7) Need for Reviewed Delirium Policy.ConclusionNurses described perceiving delirium as a low priority matter and linked it to work culture within the intensive care specialty. Simultaneously, they expressed their readiness to challenge this culture and to promote the notion of providing high-quality delirium care. Nurses discussed their frustrations related to lack of confidence in assessing delirium, as well as lack of effective therapies in managing this group of patients. They declared their appreciation for non-pharmacological interventions in treatment of delirium, suggested improvements to current delirium approach and proposed introducing psychological support for nurses dealing with delirious patients.     

Undergraduate nursing students’ perceptions on nursing education during the 2020 COVID-19 pandemic: A national sample

BackgroundIn 2020, nursing educational programs were abruptly interrupted and largely moved online due to the COVID-19 pandemic.PurposeTo explore nursing students’ perspectives about the effects of the pandemic on their education and intention to join the nursing workforce.MethodsUndergraduate nursing students from 5 universities across 5 United States regions were invited to participate in an online survey to elicit both quantitative and qualitative data.FindingsThe final sample included quantitative data on 772 students and qualitative data on 540 students. Largely (65.1%), students reported that the pandemic strengthened their desire to become a nurse; only 11% had considered withdrawing from school. Qualitatively, students described the effect of the pandemic on their psychosocial wellbeing, adjustment to online learning, and challenges to clinical experiences.ConclusionFindings highlighted the need to develop emergency education preparedness plans that address student wellbeing and novel collaborative partnerships between schools and clinical partners.     

Impact of the COVID-19 pandemic on healthcare workers’ families

The coronavirus disease 2019 pandemic had a significant effect on the mental health, social lives, and family relationships of healthcare workers. During the pandemic, these workers had to prioritize their work over parenting, spending time with their kids or partners, planning weddings, and childbearing plans. Therefore, special recognition should be given to the families of these employees.     

Australian and Danish nurses’ and midwives’ wellbeing during COVID-19: A comparison study

BackgroundMost investigations of nurses’ and midwives’ psychological wellbeing during the COVID-19 pandemic have been conducted in a single setting.AimTo assess and compare the psychological wellbeing of nurses and midwives in Australia and Denmark during the COVID-19 pandemic.MethodsNurses and midwives employed at four metropolitan health services in Australia and one in Denmark completed an anonymous online survey, which assessed depression, anxiety, and stress symptoms (The Depression, Anxiety and Stress Scale - 21 Items (DASS-21)), and sociodemographic and employment factors.FindingsCompleted surveys were received from 3001 nurses and midwives (1611 Australian and 1390 Danish). Overall, approximately one in seven of the nurses and midwives surveyed reported moderate to extremely severe levels of depression (n = 399, 13.5%), anxiety (n = 381, 12.9%) and stress (n = 394, 13.4%). Australian nurses’ and midwives’ scores on all DASS-21 subscales were significantly higher (representing higher levels of depression, anxiety and stress) than the scores for the Danish nurses and midwives. Fewer years of clinical experience, living in Australia and being employed on a part-time basis were significantly associated with higher levels of psychological distress.DiscussionA considerable proportion of nurses and midwives experienced distress during the COVID-19 pandemic; however, the proportion and severity varied by country. Australian nurses and midwives experienced higher levels of distress than their Danish colleagues.ConclusionNurses and midwives working in countries with relatively low numbers of COVID-19 cases and deaths are also likely to experience psychological distress. Nurses and midwives would benefit from targeted country-specific support and wellbeing initiatives.