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Background: As a result of the COVID-19 pandemic, we implemented a novel nurse-led symptom monitoring and virtual telehealth program for patients with advanced cancer on palliative care., Aims: To evaluate the reach, effectiveness, adoption, implementation, maintenance and acceptability of our program., Methods: This was a prospective study carried out in a cohort of patients with advanced cancer over the period of 3rd June 2020 to 22nd October 2021. Demographic characteristics, cancer diagnosis, and functional status of patients were collected upon recruitment. Patients were asked to complete a patient-reported outcome measure (the Integrated Palliative Care Outcome Scale, IPOS) prior to the first palliative care consult and subsequently every week for the duration of their participation in the program (12 weeks). The IPOS measures the severity of physical symptoms, emotional concerns, information, and financial needs. Participants' utilization of healthcare services by participants 3 months before, during and 3 months after the telemedicine program was reviewed. At the end of the program, a client satisfaction questionnaire (CSQ-4) to survey participants' experience with the telehealth program and their willingness to pay for this program was administered., Results: Reach: The recruitment to adoption ratio of the program was 0.71. Acceptability:: Participants expressed satisfactory experience., Effectiveness: We noted that the severity of patients' symptoms and number of emergency department visits decreased over time with nurse support. Adoption: we received referrals from 23 oncologists, yielding an adoption rate of 70%., Implementation: Of the 99 patients recruited for the program, 88.9% of them managed to complete their initial video consults as planned. 16% of them failed to complete the program due to factors such as patient demising. Maintenance: The declining rate of IPOS completion throughout the study period (98.9% at week 1 to 60.8% at week 12) demonstrated the difficulties in sustaining regular administration of self-reported patient outcome measures., Conclusion: The telemedicine program was effective and acceptable. We noted challenges in sustaining the administration of patient reported outcome measures over time. Further studies on how we can improve the sustainability of symptom monitoring in a telehealth program for patients with advanced illnesses, under palliative care, should be conducted., (© 2024. The Author(s).)

Background: Research shows that front-line nurses' workload and stress levels increased during the coronavirus disease 2019 (COVID-19) pandemic, however, there is little research of these factors in relation to nurse managers. Previous research undertaken in Austria found that some nurse managers working in nursing homes undertook clinical as well as managerial functions during the pandemic, a double burden that could have increased their stress levels and have had adverse psychological, physical and social consequences., Aim: To investigate the effects of the COVID-19 pandemic on nurse managers' workload, perceptions of teamwork and stress levels, and the physical, psychological and social consequences of working during the pandemic., Method: A cross-sectional design was used. Respondents (n=238) were sent an online questionnaire during the second wave of the pandemic (which in Austria was November 2020 to March 2021) containing questions on demographics and fear of infection, their current workload compared with pre-pandemic workload, their perceptions of the influence of the pandemic on teamwork, their levels of stress measured using the Perceived Stress Scale (PSS), and the physical, psychological and social consequences of working during the pandemic., Results: Most respondents (95%) had to undertake more or much more work than usual during the pandemic, while just over half (52%) perceived that the influence of the pandemic on teamwork had been positive throughout or partially positive. Overall, the respondents' level of stress was moderate, as measured by the PSS. Around 28% of respondents were afraid of infecting someone other than themselves, notably their families, employees and patients. Fear for themselves, their families and their patients or residents were commonly reported psychological consequences of working during the pandemic, while confusion due to information overload was the second most commonly reported psychological consequence., Conclusion: Comparing results with previous research is difficult due to the lack of research of nurse managers' experiences of the pandemic. Fear appears to have been a major issue for nurse managers during the pandemic, particularly in relation to infection and information overload. This emphasises the need for healthcare organisations to focus on the mental health and well-being of nurse managers, as well as front-line staff, during and after crisis situations such as a pandemic. Organisations may consider reworking and adopting already-established COVID-19 regulations, schedules and local guidelines, particularly in terms of communication and infection control, which could help to reduce nurse managers' fear in future crisis situations., Competing Interests: None declared, (© 2024 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

During the COVIDicine, many nurses awoke to the ways that the Healthcare-Industrial Complex (HIC) dictates the care we are able to provide. Using the Foucauldian concepts of pastoral power and governmentality, we explore the ways that nurses participate in upholding power structures within the HIC and reproducing them in our work, contributing to a carceral culture based on hierarchy and power dynamics. We also explore the ways nurses are both agentic in this system and subject to it, reluctant to make waves and lose our place within a system that can offer nurses safety and security in, and most importantly, a paycheck. This paper articulates a prefigurative anarchist approach to nursing praxis. Through the writing of Emma Goldman, we locate a historically founded philosophical basis for practical tactics that nurses can use to actualise this praxis. Both individually and as a collective, nurses can assert their own ethic and power through direct action, micro-insurgency and solidarity to build the world we know can be. Our only limitation is our imagination., (© 2024 John Wiley & Sons Ltd.)

Aim: To examine the correlation between moral courage and caregiving behaviour among nurses who are employed in the COVID-19 ward in Iran., Design: This study is a descriptive-correlational and cross-sectional research conducted in 2021 in the city of Tehran, Iran., Methods: A total of 270 nurses employed in COVID-19 wards, who had been working in these wards for at least 1 month, were recruited from XXX hospitals and XXX Hospital. Data collection was conducted from September to November 2021. The data collection tools included a demographic information form, the Caring Dimension Inventory (CDI-25), and the Professional Moral Courage Scale (PMC). The designed questionnaire links were provided to the participants virtually through the Persian platform 'Pars Line' and via WhatsApp. Descriptive statistics and inferential statistics were used to examine the relationship between moral courage and care behaviour., Results: There was a significant difference in the mean of caring behaviour between the age groups (<30 and >40 years old), and the work experience groups (<5 years and >15 years) (p < 0.05). Ethical values also varied significantly between certain age and experience groups (p < 0.05), but no significant differences were found in ethical behaviour across most ages (30-40 years) and work experience categories (>10 years) (p > 0.05). The level of moral courage among the nurses was higher than the median score of the instrument (87.31 ± 10.37). Among the dimensions of moral courage, the highest score was related to the dimension of ethical factors (17.64 ± 2.64), and the lowest score was related to the dimension of multiple values (17.26 ± 2.78). The level of caring behaviours among the nurses was lower than the median score of the instrument (46.11 ± 10.84). Among the dimensions of caring behaviours, the highest score was related to physical-technical behaviours (19.22 ± 5.27), and the lowest score was related to professional behaviours (1.35 ± 0.67). Based on the analysis, moral courage had a weak and inverse correlation with caring behaviours among nurses. The higher moral courage does not necessarily result in improved caregiving behaviours, emphasizing the need for further research to explore and address this relationship., Patient: No Patient or Public Contribution., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Purpose: To review support systems for nursing home caregivers (NHCGs) that were implemented during the first year of the coronavirus disease 2019 (COVID-19) pandemic., Method: Database searches in PubMed, ScienceDirect, and CINAHL resulted in five publications., Results: Studies differed in design, interventions, and outcomes. An urgent eye movement desensitization and reprocessing protocol was feasible and effective among nurses in services highly mobilized during the acute phase of the pandemic. The "self-help plus" psychological intervention was not associated with significant reductions in anxiety or posttraumatic symptoms but prompted exploration of non-specific factors influencing its effectiveness. The Extension for Community Healthcare Outcomes in Long-Term Care of the Elderly virtual program increased confidence among NHCGs. Self-compassion training was associated with positive changes for certified nursing assistants. Weekly debriefing sessions implemented at one hospital highlighted pathogenic and salutogenic factors., Conclusion: The COVID-19 pandemic had a marked psychosocial impact on NHCGs and necessitated targeted interventions. Despite their limitations, these promising studies provided insights into potential support avenues. Policy considerations should stress the pivotal role of advanced practice nurses in shaping supportive work environments. Future research should focus on robust assessments of the efficacy of psychosocial interventions for NHCGs facing ongoing challenges posed by the pandemic, and even recurrent viral epidemics. [ Journal of Gerontological Nursing, 50 (10), 24-33.].

Purpose: To explore the experiences of family caregivers of older adults with dementia in Korea during the coronavirus disease 2019 pandemic., Method: In-depth interviews were conducted with eight family caregivers of older adults with dementia from September to October 2021. Collected data were analyzed using Giorgi's phenomenological methodology., Results: Four themes were derived: A Rough Journey With Worry , A Desolate Life in a Disconnected World , Frustration Due to Health Deterioration , and Looking Toward the Future Despite Heavy Responsibility ., Conclusion: This study is meaningful as it increases our understanding of the experiences and needs of individuals with dementia and their family caregivers, and results can assist in finding ways to help them cope with their difficulties during future pandemic situations. [ Journal of Gerontological Nursing, 50 (10), 42-48.].

Background: Decreases in size, capability, clinical volumes, case mixes, and complex care opportunities in military treatment facilities contribute to the atrophy of clinical skills among medical professionals in these facilities., Local Problem: The COVID-19 pandemic resulted in a 39% decline in admissions to a military critical care unit. The decrease in patient census contributed to skill sustainment challenges., Methods: To identify methods to combat skill atrophy, the CINAHL and PubMed databases were searched using the terms peacetime effect, military-civilian partnership, and skill sustainment. Active-duty critical care nurses stationed at a military treatment facility implemented a military-civilian partnership with a civilian medical facility for clinical skill sustainment., Results: One year after implementation, 39 critical care nurses had completed 511 shifts, gaining clinical experiences seldom achieved at the military facility. A survey of these nurses demonstrated that 8 of 17 (47%) gained experience treating patients requiring intra-aortic balloon pumps or continuous renal replacement therapy, 6 of 17 (36%) gained experience with patients requiring a ventricular assist device, 12 of 17 (71%) acquired hands-on experience with intracranial pressure monitoring, and 14 of 17 (82%) reported vasoactive intravenous infusion manipulation., Conclusions: This article highlights the importance of evaluating clinical practice within the military health system, developing military-civilian partnerships, and removing military-civilian partnership barriers for nurses and other health care professionals. Failure to implement military-civilian partnerships may adversely affect the clinical competency of the military nurse force., (©2024 American Association of Critical-Care Nurses.)

Background: Social support can help nurses cope with occupational stress and trauma, and maintain overall well-being, particularly in stressful situations such as outbreaks., Aim: To determine the mediating role of social support on the relationship between secondary traumatic stress (STS) and burnout among nurses who cared for COVID-19 patients., Design: A cross-sectional, correlational, descriptive design., Methods: Two hundred nurses who had provided direct care to COVID-19 patients were recruited from wards in two hospitals in Riyadh, Saudi Arabia. Data were collected using the Multidimensional Scale of Perceived Social Support and the Professional Quality of Life Scale tools., Results: STS had a significant and positive correlation with burnout (r = 0.610, p = 0.000); social support from family, friends, and significant others were each significantly and negatively associated with STS (r = -0.147, p = 0.038; r = -0.547, p < 0.0001; r = -0.225, p = 0.001, respectively) and burnout (r = 0-0.282, p < 0.0001; r = -0.716, p = 0.026; r = -0.377, p < 0.0001, respectively). STS had a significant effect on social support (β = -0.21, p = 0.042) and burnout (β = 0.61, p < 0.0001). Social support had a significant and partial effect on the relationship between STS and burnout (Z = 2.99, p = 0.002)., Conclusion: Social support can reduce and mitigate the negative effects of STS and burnout. This understanding could enhance nurses' occupational lives by assisting policymakers and nurse managers in creating positive work environments that promote social support. Such policies could reduce the incidence and impact of burnout and STS., Competing Interests: Declaration of competing interest The authors have no conflict of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Burn survivors often experience a plethora of post-burn residual needs following their discharge including psychological issues and poor sleep. These needs are often overlooked with a significant focus on resolving physical issues. Aftercare support is particularly limited. The emergence of the Coronavirus pandemic worsened the situation as burn survivors were unable to return to utilise available services outpatient basis. Thus, an innovative nurse-led aftercare programme was developed and delivered via WeChat social medial platform. The current study sought to examine the effects of the intervention on anxiety, depression, and sleep pattern among adult burn survivors., Methods: This is a randomised controlled trial. Sixty adult burn survivors were randomly assigned to intervention and control groups. Participants in the intervention group received the nurse-led aftercare programme which involved pre-discharge support and active follow-up on WeChat over an 8-week period and an additional 4 weeks to examine the sustained effects of the intervention. Data were collected at three timepoints: baseline (T0), post-intervention (T1), and follow-up (T2). Generalised estimating equation was employed to ascertain the group, time, and interaction effects., Results: Using Bonferroni corrected p value (0.017), Anxiety and depression improved at T1 and sustained at T2 with mean scores demonstrating a reduction in both variables and total score. No statistically significant improvement was however observed regarding sleep., Conclusion: Continuous, comprehensive support is required by burn survivors following discharge to improve psychological outcomes. Delivering aftercare via WeChat should be considered a feasible option to supporting burn survivors following discharge., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Abstract: Adjunct nursing instructors (ANIs) are used to meet the needs of nursing education programs, but challenges of adjusting to unfamiliar academic settings often lead to poor job satisfaction and low retention of ANIs. The Adjunct Instructor Survey (Milliken & Jurgens, 2008) was used to query 25 ANIs regarding the importance and availability of support services pre-COVID-19 pandemic and post-pandemic. Mentoring was identified as most important pre- and post-pandemic, with a reported decrease in mentoring opportunities post-pandemic. Developing quality mentoring programs for ANIs needs to be a priority., (Copyright © 2024 InterVarsity Christian Fellowship.)

Aim: To assess heart rate variability (HRV) as a measure to assess job stress and sleep quality among nurses in the post-COVID-19 period., Background: The COVID-19 pandemic significantly affected nurses, with heightened job stress and impaired sleep quality impacting their well-being and effectiveness in patient care. HRV could offer insights for supporting strategies in the pandemic aftermath., Design: A quantitative cross-sectional study., Methods: This study involved 403 clinical nurses recruited from a teaching hospital in Taiwan. Data on job stress, work frustration, sleep quality and HRV were collected and analysed., Results: Among the nurses surveyed during the COVID-19 pandemic, 72.7% reported poor sleep quality (PSQI = 9.369). Job stress emerged as a strong predictor of work frustration. High stress levels and poor sleep quality were correlated with significantly decreased HRV, indicating a potential physiological impact of stress on the nurses' health and well-being., Conclusions: HRV is a valuable and cost-effective measure for monitoring and managing nurses' well-being in the post-COVID-19 era. Targeted interventions can be implemented to support nurses' overall performance and promote their well-being by identifying those at high risk of job stress and poor sleep quality., (© 2024 John Wiley & Sons Australia, Ltd.)

Background: During the Covid-19 pandemic, Covid-19 mortality varied depending on the hospital where patients were admitted, but it is unknown what aspects of hospitals were important for mitigating preventable deaths., Objective: To determine whether hospital differences in pre-pandemic and during pandemic nursing resources-average patient-to-registered nurse (RN) staffing ratios, proportion of bachelor-qualified RNs, nurse work environments, Magnet recognition-explain differences in risk-adjusted Covid-19 mortality; and to estimate how many deaths may have been prevented if nurses were better resourced prior to and during the pandemic., Methods: This is a cross-sectional study of 87,936 Medicare beneficiaries (65-99 years old) hospitalized with Covid-19 and discharged (or died) between April 1 and December 31, 2020, in 237 general acute care hospitals in New York and Illinois. Measures of hospital nursing resources (i.e. patient-to-RN staffing ratios, proportion of bachelor-qualified RNs, nurse work environments, Magnet recognition) in the pre-pandemic period (December 2019 to February 2020) and during (April to June 2021) were used to predict in-hospital and 30-day mortality using adjusted logistic regression models., Results: The mean age of patients was 78 years (8.6 SD); 51 % were male (n = 44,998). 23 % of patients admitted to the hospital with Covid-19 died during the hospitalization (n = 20,243); 31.5 % died within 30-days of admission (n = 27,719). Patients admitted with Covid-19 to hospitals with better nursing resources pre-pandemic and during the pandemic were statistically significantly less likely to die. For example, each additional patient in the average nurses' workload pre-pandemic was associated with 20 % higher odds of in-hospital mortality (OR 1.20, 95 % CI [1.12-1.28], p < 0.001) and 15 % higher odds of 30-day mortality (OR 1.15, 95 % CI [1.09-1.21], p < 0.001). Hospitals with greater proportions of BSN-qualified RNs, better quality nurse work environments, and Magnet recognition offered similar protective benefits to patients during the pandemic. If all hospitals in the study had superior nursing resources prior to or during the pandemic, models estimate many thousands of deaths among patients hospitalized with Covid-19 could have been avoided., Conclusions: Patients with Covid-19 admitted to hospitals with adequate numbers of RNs caring for patients, a workforce rich in BSN-qualified RNs, and high-quality nurse work environments (both prior to and during the Covid-19 pandemic) were more likely to survive the hospitalization. Bolstering these hospital nursing resources during ordinary times is necessary to ensure better patient outcomes and emergency-preparedness of hospitals for future public health emergencies., Competing Interests: Declaration of Competing Interest An author (Linda Aiken) is an Editorial Board Member for IJNS and was not involved in the editorial review or the decision to publish this article., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Abstract: Nursing school is a highly stressful experience for most nursing students. The COVID-19 pandemic intensified stress levels for undergraduate students with serious impacts on mental health. Faculty acted to provide solutions such as debriefings and fostering safe places inside and outside of class where students could release negative emotions and develop positive coping skills. The integration of faith and the caring outreach by the faculty also strengthened students' emotional, mental, and spiritual health., (Copyright © 2023 InterVarsity Christian Fellowship.)

Purpose: This study aimed to explore help-seeking preference categories and crucial influencing factors among community nurses exposed to COVID-19 in China using a new person-centered approach., Design: A cross-sectional design including an online self-reported questionnaire survey was used., Methods: A total of 667 nurses who participated in COVID-19 prevention and control work were recruited. Latent class analysis and logistic regression were used to analyze the data using Mplus and SPSS., Findings: Two latent classes of help-seeking preferences were identified: high help-seeking preferences (33.58%) and low help-seeking preferences (66.42%). Most sampled nurses had relatively low help-seeking preferences when facing psychological threats during COVID-19. Logistic regression showed that career duration, perceived social support, online help-seeking intention, and social media exposure negatively affected low help-seeking preferences., Conclusions: Career duration, perceived social support, online help-seeking intention, and social media exposure could be key factors influencing help-seeking preferences among Chinese nurses exposed to public emergencies. It is necessary to implement relevant intervention measures, such as focusing on nurses whose career durations are shorter, improving nurses' perceived social support, strengthening positive media publicity, and developing comprehensive online mental health services that promote nurses' help-seeking preferences and behaviors to reduce mental illness during public health emergencies., Clinical Evidence: Help-seeking preferences are relatively low among Chinese nurses during public emergencies. Based on the major influencing factors of help-seeking preferences, including social support and social media exposure, more interventions must be developed for prompting psychological help-seeking intentions among Chinese nurses.

Objective: To describe the nursing strategies used to mitigate the impact of forced separation between hospitalized acute and critical care patients and their families during the COVID-19 pandemic., Research Methodology/design: A scoping review was performed in accordance with JBI methodology., Settings: Those acute and critical care areas in which sudden, often unexpected, emergent episodes of illness or injury were treated., Main Outcome Measures: Articles written in English and French between March 2020 and September 2023 in Medline, CINAHL Complete, APA PsycInfo, Embase and the Cochrane COVID-19 study register databases that met our inclusion criteria were included. Gray literature included dissertations, theses and Base Bielefeld Academic Search Engines., Results: Among the 1,357 articles screened, 46 met the criteria for inclusion. Most of the articles were published in North America. Adult critical care units were the most frequently reported settings, followed by neonatal intensive care units. The most frequently reported strategies were virtual telephone or video communications. A majority of the innovative strategies involved interprofessional collaboration at the unit level. Core components included the provision of relational nursing practices, virtual visits, tailored information, fostering relationships between family members, palliative care support regarding end of life, and general information about hospitalization and COVID-19. Pediatric care settings were more likely than adult care settings to accommodate physical visitation., Conclusion: Nurses used synchronous, episodic, and structured virtual interactions, either alone or as part of an interprofessional team, to mitigate separation between patients and families during the COVID-19 pandemic in acute and critical care settings., Implications for Clinical Practice: Permanent policy changes are needed across acute and critical care settings to provide support for nurses in mitigating patient and family separation. We recommend that family members be considered as caregivers and care receivers, not visitors in patient and family-centered care in acute and critical care settings., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Memorializing nurses' experiences during the COVID-19 pandemic had the potential to allow scientists and policymakers to learn about the impact on the nursing profession and health care systems. Yet, nurses are considered a difficult population to recruit for research., Objective: To describe an innovative qualitative data collection method for capturing current practice experiences among nurses working during the COVID-19 pandemic., Methods: Guerilla theory served as the theoretical framework. Utilizing a qualitative descriptive design, a telephone voicemail messaging system was developed to capture nurses' experiences., Results: Nurses were recruited with convenience and snowball sampling via social media and state listservs. The telephone voicemail messaging system, Twilio, was used. After listening to the recording of the consent form, the participants shared their experiences by leaving a voice message where they answered the prompt, "Tell us about your experiences working during the COVID-19 pandemic." Seventy voicemails were included, and the voicemails were transcribed. After a nurse shared their experience via an email sent to the research team, emails were added to the data collection; 16 emails were received. Transcripts and emails were uploaded to the qualitative data analysis software program, Dedoose, and coded by 2 researchers using content analysis. Main themes were derived and discussed among the research team., Conclusion: Allowing participants multiple modes of expressing their experiences promote inclusivity in data collection. Further development and standardization of this method is needed for future research., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Moral injury occurs when one witnesses or perpetrates an act that transgresses strongly held moral beliefs and expectations. First documented among active military and veterans, moral injury is increasingly studied in healthcare personnel impacted by the coronavirus pandemic. Measurement of moral injury among this population, particularly nurses, is still in its infancy., Objective: To develop the Moral Injury Symptom Scale - Clinician-Short Form and validate it among United States based acute care nurses. ., Methods: The Moral Injury Symptom Scale - Military Version was modified for a healthcare audience. 174 acute care nurses responded to a survey package including the scale and related instruments. Reliability and validity, including convergent and discriminant validities, were assessed, and a cutoff score was calculated using the area under the receiver operating characteristic curve., Results: Reliability (Cronbach α = .75) and validity were established and a cutoff score of 41, based on functional impairment caused by moral injury, demonstrated 86.4% sensitivity and 69.6% specificity. Nurses who screened positive for moral injury experienced higher depression, anxiety, work exhaustion, interpersonal disengagement, emotional exhaustion, and depersonalization. ., Conclusions: The Moral Injury Symptom Scale - Clinician Version - Short Form is a valid and reliable instrument with strong psychometric properties that can assess moral injury in acute care nurses, a population at risk due to the challenges of providing care during the pandemic. Appropriate measurement and establishing prevalence should prompt support and intervention from healthcare organizations. .

Background: The COVID-19 pandemic has placed a significant pressure on the nursing workforce, leading to an increased risk of infection and work-related issues impacting nurses' mental health. This review aims to explore the workplace challenges faced by older nurses and their impact on mental health., Method: This qualitative systematic review followed the Joanna Briggs Institute methodology., Results: The review included 32 studies and identified three interconnected themes: heavy workload and nature of nursing, lack of recognition and feeling undervalued, and challenges in balancing personal life and work. These themes illustrated the complexity of the workplace challenges faced by older nurses., Discussion and Conclusion: Workplace demands and shift work were common negative contributors to mental health and wellbeing. The physical and cognitive capacity of older nurses may diminish due to age-related changes, making the workload more challenging. Recognition and support from the organisation, especially from management and leadership, played a crucial role in nurses' resilience.

Objectives: to assess the socio-cognitive factors determining adherence to standard precautions by nursing professionals in care practice during the COVID-19 pandemic in Brazil., Methods: an analytical cross-sectional study, carried out with 9,039 nursing professionals in Brazil, using an electronic form containing participant sociodemographic, training and work variables, and the Brazilian version of the Standard Precautions Questionnaire. Descriptive and inferential statistics were used using the statistical software R., Results: participants recognize standard precautions as effective measures to reduce infections and report intention to perform them. Training regarding standard precautions was evidenced as a facilitator of adherence (4.72; SD: 0.73), and problems related to materials (3.78; SD: 1.45) were a hindrance., Conclusions: among the determining factors, facilitating organization presented the highest score, followed by intention to perform. Facilitating and hindering factor identification makes it possible to develop intervention strategies to strengthen patient safety and reduce occupational risks among professionals.

In the UK, student nurses, nursing associates and midwives are supervised by practice supervisors and practice assessors while completing the placement-based component of their training. Because of increased clinical commitments, staff shortages and rising student numbers, demands for the supervision and assessment of student nurses have increased in recent years and this was exacerbated by COVID-19. The Nursing and Midwifery Council's Standards for Student Supervision and Assessment separated the roles of practice supervisor and assessor, giving rise to opportunities to assess students in a different way. Some integrated care systems are exploring the new role of roaming assessor. Roaming assessors can fulfil the role of practice assessors while providing additional support for student nurses. This role could be expanded to other health professions. This article explores the use of practice learning facilitators as roaming assessors for student nurses in the UK and evaluates the potential benefits and limitations of this approach. Roaming assessors may provide a useful service to deliver practice assessments, increasing the reliability and availability of assessments.

Objective: To understand how nursing care management occurred during the COVID-19 pandemic., Method: A qualitative study conducted at a university hospital in São Paulo, Brazil. The sample consisted of eight nurses who worked caring for patients who tested positive for COVID-19. Data collection was carried out through semi structured interviews about experiences in managing care in coping with the pandemic. Thematic analysis and interpretation based on psychodynamics of work were used in data analysis., Results: The results allowed constructing three thematic categories: The invisible that limits: biosafety, distress, uncertainty and fear of the pandemic, protecting oneself and ensuring the protection of others; Management work process instruments: team training, staff sizing, materials management, creative practice in the face of insufficiency; The competencies involved with the team, teamwork and leadership., Conclusion: Care management in COVID-19 was permeated by objective and subjective conditions, with situations of distress, pleasure, fear, insecurity and creative adaptation. Teamwork and leadership competencies, when present, can alleviate the distress that occurs in nursing work.

Events such as the COVID-19 pandemic and the war in Ukraine have increased people's awareness of mental health issues. Psychological trauma impacts patients in the acute care setting through physical and mental health presentations. Trauma is a public health issue crossing all socioeconomic groups and is related to social determinants of health. Trauma-informed care (TIC) is an evidence-based approach to providing care. TIC is within the scope of nursing practice and improves outcomes for patients. However, there is a lack of standard terms or practices within healthcare. Additionally, there is superficial acknowledgment of the need for TIC at the local or national level regarding policy. Nurses need to adopt TIC into practice and advocate for policy change to improve the health and lives of those seeking care.

Aim: This study aimed to determine clinical nurse and nurse manager perspectives on missed nursing care (MNC) during the COVID-19 pandemic., Design: This study utilized a qualitative exploratory descriptive design., Methods: Data were obtained through focus groups and virtual interviews. Purposive sampling was used to select nurse and nurse manager participants in COVID-19 units and the Emergency Department in one large healthcare organization in the northeastern United States of America., Results: A total of 15 nurses and nurse managers participated in the study. Results revealed five categories: medication delivery, turning patients, double checks, communication and rapport, and patient surveillance., Conclusions: A variety of factors contributed to the perceptions and experiences of MNC of COVID-19 patients during the early stage of the pandemic. The COVID-19 crisis put additional and unparalleled pressure on a strained nursing workforce. Hospital leaders are responsible for ensuring their frontline nurses have the resources they need to feel supported in their roles regardless of the presenting circumstances., Implications for the Profession: Nurse leaders should employ evidence-based strategies such as promoting and championing teamwork to support staff and reduce incidences of MNC during crises. Our current work may serve as a basis for informing future revisions of pre-pandemic measurement tools when applied in a pandemic-specific context., Reporting Methods: This manuscript adheres to the standards for reporting qualitative research (SRQR); a synthesis of recommendations., Public Contribution: There was not patient or public contribution for this study., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

The population experiencing Alzheimer's disease (AD) and their caregivers have been tremendously impacted by the global COVID-19 pandemic. Outpatient services became less accessible during the pandemic lockdown which caused increased caregiver burden more than usual. Further examination discovered that caregivers were unable to properly take care of themselves because of the need to provide around-the-clock care to loved ones, who pre-pandemic were able to receive supplemental caregiving services. The purpose of this integrative review was to provide a synthesis of information regarding caregiver experiences, during a time of limited resources, such as with the COVID-19 global pandemic. A comprehensive search of the literature databases Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Medline was completed yielding qualitative and mixed-methods studies. The literature search yielded 14 articles which met the criteria. Three themes emerged during this review. They include: Deprivation of self-care and social connectedness, Fragmented care and resources, and Improved policy development. Multiple gaps in caregiver needs have been identified throughout the literature. Outpatient services, home health aides, and respite care remain necessary elements of care for those with AD and for the relief of the caregiver. Forward planning should include government policies to support caregiving of those with AD, especially in the light of service restrictions or unavailable services., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

The team is a fundamental and structuring dimension of care, founded on the principles of complementarity, interdependence, and shared objectives and responsibilities towards the patient. As a result of the pandemic and the rationalization of public hospitals, teams are faced with changes in the role of supervisors and the arrival of new figures such as advanced practice nurses. While these changes can bring new dynamism and questioning of practices, they can also be destabilizing. The institution must preserve the role of the team and its members., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

In the post-Covid context, which is unstable and changing, what is the role of the team when it is reduced to operating with a growing number of temporary staff? The medical desertification that is gradually taking hold in certain regions is a cause for concern, as is the growing disaffection of nurses throughout France. It is essential to draw up a map that incorporates survival oases, in order to meet the essential need to provide care anyway, while at the same time perpetuating the process of improving care. Advanced practice nursing faces many challenges., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Retaining mid-career nurses is a priority to address the nursing shortage exacerbated by COVID-19. Nurses are more likely to stay if they feel valued. This scoping review revealed a variety of intrapersonal, interpersonal, and external factors that influence how mid-career nurses feel valued. Nursing professional development practitioners can influence satisfaction and retention by implementing mentoring and professional development programs for nurses and managers. More research is needed to understand the impact of the mid-career nurse-nurse manager relationship., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Coronavirus disease 2019 (COVID-19) presented unique challenges to the United States Navy given that the major components of controlling an infectious disease outbreak are not easily achieved on ships., Purpose: To understand shipboard Navy nurses' activities during the COVID-19 pandemic., Methods: Virtual semistructured interviews were conducted in 2021 with 30 Navy nurses who deployed to sea during the pandemic. Data were coded using directed content analyses whereby remarks were categorized according to 16 public health interventions (PHIs) of the Minnesota Department of Health Intervention Wheel. Data were also coded via conventional content analysis., Discussion: Multiple PHIs were utilized to improve the public health of those on Navy ships during the height of the pandemic. Also, four themes were constructed via conventional content analysis., Conclusion: Shipboard Navy nurses overcame unprecedented challenges to protect the health of their crew, all the while preserving operational readiness during the COVID-19 pandemic., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

COVID-19 escalated the already challenged nursing workforce, causing hospitals to address their unstable staffing. This report details the journey of a large rural level 1 academic healthcare market postpandemic to stabilize their nursing workforce and create a sustainable pipeline of nurses. The results demonstrated reductions in turnover rates, vacancy rates, and days to fill nursing positions., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Problem: Limited research has examined and synthesized the adaptation of midwives and midwife-led interventions during crises., Background: Evidence suggests that midwives are essential to respond to sexual and reproductive health care needs during disruptive times, and that they adapt to continue to provide their services during those circumstances., Aim: To map the adaptations of midwives when providing care during crises globally. Secondary objectives include identifying which midwives adapted, what services were adapted and how, and the demographic receiving care., Study Methods: Scoping review using Levac's modifications of Arksey and O'Malley's methods. Publications and grey literature, in English and Spanish, with no limitations based on study design or date were included. Data was extracted and mapped using Wheaton and Maciver's Adaptation framework., Findings: We identified 3329 records, of which forty-two were included. Midwives' prior training impacted adaptation. Midwives adapted to the COVID-19 pandemic, epidemics, natural disasters, and World War II. They adapted in hospital and community settings around the provision of antenatal, labor and birth, postpartum, and contraceptive care. However, no specific data identified population demographics. Midwifery adaptations related to their practice, role, and scope of practice., Conclusion: The limited available evidence identified the challenges, creativity, and mutual aid activities midwives have undertaken to ensure the provision of their services. Evidence is highly concentrated around maternal health services. Further high-quality research is needed to provide a deeper understanding of how midwifery-led care can adapt to guide sustainable responses to ensure access to sexual and reproductive health services during crises., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The COVID 19 pandemic has had a tremendous impact on nursing and health care delivery systems. Recent research demonstrates a correlation between the stress of providing complex health care and the decline of nurse well-being. Investing in the well-being of nurses can benefit the entire health care system. Educational institutions can play a role in enhancing nurse well-being by incorporating holistic nursing education principles into the curriculum, including reflective practice methods to promote self-awareness and self-care. This may be challenging for some nursing programs, but the Power of Nursing course can help close this gap. This noncommercial course incorporates key elements of holistic nursing including authenticity, empathy, compassion, unconditional acceptance, and self-care; elements not always emphasized in a traditional curriculum. Power of Nursing, offered as an elective in nursing schools or part of nursing residency programs, provides attendees with tools and strategies to boost resilience, strengthen personal commitment to nursing, and increase well-being preparing them to thrive in any health care environment., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Following the COVID-19 pandemic, a community emergency department was facing a staffing crisis with new emergency registered nurse turnover rates as high as 83.3%. There were limited experienced emergency nurses available to train the large number of novice nurses hired to fill vacancies. Based on this, the emergency department needed to restructure the orientation process to better align with evidence-based strategies and available resources., Methods: The Seven Steps of Evidenced-based Practice were used to identify the best practices for an orientation program specific to the emergency department. Based on the evidence, a 16-week, competency-based, emergency nurse internship was implemented in the 33-bed community emergency department., Results: The primary outcome of this initiative was new emergency nurse retention, which demonstrated a statistically significant reduction from 81.8% (pre-intervention) to 11.1% (post-intervention) (P < .001). Additionally, there was an improvement in the scores for each of the 6 healthy work environment standards., Discussion: Based on the outcomes of this initiative, an emergency nurse internship is an effective method to improve emergency nurse competence and retention, contributing to a healthier work environment., (Copyright © 2024 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.)

Nursing documentation is essential to communicate patient care delivery. This review explores available evidence on the contribution of nursing documentation toward quality care delivery during the COVID-19 pandemic. Nine articles were evaluated for at least one of the 6 factors of quality (eg, safe, timely, equitable, patient-centered, effective, and efficient). Analysis suggests that right-sizing documentation for optimal care quality requires continued efforts to reinforce the value and need of nursing documentation as a primary data source. Continued practice and research efforts are needed to reframe nursing documentation's essential role in benefiting a patient's current and future health care needs., Competing Interests: Disclosure The author has nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Newly licensed registered nurses (NLRNs) were significantly impacted by the COVID-19 pandemic. NLRNs experienced interruptions or significant alterations across, academia, clinical rotations, precepted experiences, and transition to practice programs. All NLRNs were impacted, especially those in critical care who cared for the most acutely ill patients. This article represents a program evaluation of NLRNs in the critical care area during the COVID-19 pandemic and a comprehensive review of the literature related to COVID-19s impact on NLRNs., Competing Interests: Disclosure A. Renkema was previously employed by Vizient, Inc and K. Gallagher is currently employed at Vizient, Inc., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Abstract: The number of people facing mental health issues continues to grow in the aftermath of COVID-19. Nurses are challenged with providing care for an increasing number of patients, including veterans, with complex mental health needs across healthcare settings. Of concern, many students transitioning into practice feel they lack the necessary confidence, education, and skills to competently care for patients with mental health illness. This article discusses an innovative mental health immersion experience strategically integrated within a new-nurse residency program., Competing Interests: The authors have declared no conflict of interest., (Copyright © 2024 National League for Nursing.)

Background: Cardiopulmonary resuscitation training is a mandatory competency, especially for healthcare professionals. However, the spread of COVID-19 caused a sharp decline in the number of participants on advanced life support training, thereby accelerating the diversification of educational methods. Gamification is an increasingly popular method of diversifying instruction, but its effectiveness remains controversial., Aim: To evaluate the effectiveness of gamification learning in advanced life support training., Design: A cluster randomized controlled trial., Setting: A single advanced life support training center., Participants: Clinical nurses who are currently practicing in a hospital., Methods: A part of the existing advanced life support course was gamified using Kahoot! platform. Conventional learning and gamified learning were each conducted 11 times, and the level of knowledge after training was assessed. The assessment questions were categorized into advanced life support algorithms, teamwork, and cardiac arrest rhythms., Results: A total of 267 were enrolled in the study, and 148 and 139 learners were assigned to CL and GL, respectively. There was no difference in post-training knowledge related to teamwork, and cardiac arrest rhythms between the conventional learning and gamified learning groups, but knowledge related to the advanced life support algorithm was low in the gamified learning group., Conclusions: Even if the learners are the same, advanced life support gamification training can lead to negative outcomes depending on the simplicity or goal of the training content. To improve the effectiveness of the training, various methods of gamification training should be applied depending on the goal and content of the training., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Ltd.)

Aim: To develop a framework for understanding the stress appraisal process among acute care nurses during the COVID-19 pandemic., Design: A secondary analysis of open-ended responses from a cross-sectional survey of 3030 frontline, acute care nurses in New Jersey and the effect of burnout during the COVID-19 pandemic., Methods: Lazarus and Folkman's transactional model of stress and coping guided the study. Thematic analysis was used to analyse 1607 open-ended responses., Results: Nine themes emerged during the secondary appraisal of stress. Five themes contributed to distress and burnout including (1) high patient acuity with scarce resources, (2) constantly changing policies with inconsistent messaging, (3) insufficient PPE, (4) unprepared pandemic planning and (5) feeling undervalued. Four themes led to eustress and contributed to post-traumatic growth including (1) team nursing to ensure sufficient resource allocation, (2) open channels of communication, (3) sense- of-duty and (4) personal strength from new possibilities., Conclusion: The COVID-19 pandemic was a traumatic event for patients and the nursing workforce. Internal and external demands placed on acute care nurses increased burnout, however, a subset of nurses with adequate support experienced personal growth., Implications for the Profession And/or Patient Care: Beyond mental health interventions for acute care nurses, organizational interventions such as reevaluation of emergency action plans to optimize resource allocation, and work environment strategies such as improved communication and decision-making transparency are necessary., Impact: To better understand how frontline acute care nurses experienced stress during COVID-19, a data-informed framework was developed that included a primary and secondary appraisal of stress. Themes contributing to distress and burnout were identified, and themes leading to eustress and post-traumatic growth were also identified. These findings can assist nurse leaders in optimizing strategies to reduce burnout and promote post-traumatic growth in the post-COVID years., Reporting Method: No patient or public contribution., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background: The mass redeployment of nurses was critical across countries necessitated by the acute health impact of Covid-19. Knowledge was limited regarding how to manage nurse redeployment or the impact that redeployment might have. Redeployment continues, particularly in response to the current staffing crisis and surges such as winter pressures. This study aims to address these gaps in evidence to inform guidance on how best to manage nurse redeployment in practice., Objectives: First, to understand the processes and underpinning decisions made by managers when managing nurse redeployment prior to and during the Covid-19 pandemic. Second, to identify the lessons that can be learned to improve the management of on-going nurse redeployment., Design: Qualitative study utilising semi-structured interviews and focus groups with nurse managers (ISRCTN: 18172749)., Setting(s): Three acute National Health Service (NHS) Trusts in England with geographical and ethnic diversity, and different Covid-19 contexts., Participants: Thirty-two nurse managers and four Human Resource advisors responsible for redeploying nurses or receiving and supporting redeployed nurses., Methods: Participants took part in face-to-face or virtual semi-structured interviews from February 2021 to November 2021 and virtual focus groups from July to December 2021. Qualitative data were analysed using reflexive thematic analysis., Results: Four themes were evident in the data, capturing four distinctive phases of the redeployment process. There was a fundamental mismatch between how different parts of the nursing and managerial workforce conceived of their decision-making responsibilities across different phases. This led to managers taking inconsistent and sometimes contradictory approaches when redeploying nurses, and a disconnect between nursing staff at all levels of the chain of command. Furthermore, in conjunction with limited guidance in operationalising redeployment and the distressing experiences vocalised by nurses, nurse managers found nurse redeployment logistically and emotionally challenging; and felt 'caught in the middle' of meeting both their managerial and mentoring responsibilities. This became increasingly challenging during subsequent phases of redeployment and remained challenging once the pandemic waned., Conclusions: The approach to nurse redeployment in response to the Covid-19 pandemic prioritised nurse staffing numbers over personal well-being. Key principles of good practice relating to nurse redeployment during the Covid-19 pandemic can be applied to improve future redeployment of nurses and support positive outcomes. Having a planned approach for staff redeployment during normal service delivery comprising operational guidance for those tasked with implementing redeployment, that is scalable in a crisis setting, would be beneficial for the nursing workforce., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: This study investigated the job performance and predictability of job demands, job resources, personal resources, work engagement, job crafting, and the transformational leadership of nurse managers on this among nurses in Myanmar., Background: The ongoing crisis of nursing shortages along with heavy workloads combines to form a major challenge in Myanmar and these affected the job performance of nurses during the COVID-19 pandemic., Methods: Utilizing a stratified random sample of 474 nurses from tertiary-level general hospitals in the Republic of the Union of Myanmar, a descriptive predictive analysis was carried out. The Demographic Data Sheet, Job Performance Scale, Work Engagement Scale, Job Demands Scale, Job Resources Scale, Personal Resources Scale, Job Crafting Scale, and Global Transformational Leadership Scale were utilized to collect data., Results: The overall level of job performance was perceived to be high, considering various factors such as job demands, personal resources, work engagement, and job crafting were found as significant predictors of nurses' job performance, explaining 63.30% of the total variance., Discussion: These findings make a valuable contribution toward enhancing nurses' job performance by addressing job demands, fostering work engagement, and nurturing their job-crafting capabilities. Self-reporting data collection may not have accurately represented the actual level of study variable., Conclusion: This study highlighted factors that significantly affect nurses' job performance in general hospitals in Myanmar., Implications for Nursing and Health Policy: The findings provide important evidence for nursing administrators and policymakers wishing to develop strategies to enhance the working environment and remain active in helping the performance of nurses., (© 2023 International Council of Nurses.)

Aim: To explore the benefits and challenges of a recently introduced Registered Undergraduate Student of Nursing workforce from the perspective of Nurses and Registered Undergraduate Students of Nursing, in a major metropolitan hospital in Australia in 2020., Design: A qualitative descriptive study was undertaken using individual interviews and focus groups., Methods: Purposively selected employed Registered Undergraduate Students of Nursing and nurses who worked with them were interviewed, using a semi-structured format. Recordings were transcribed and coded using NVivo software. Reflexive thematic analysis using an inductive approach was undertaken., Results: Four major themes were revealed: (i) Navigating the programme, (ii) Belonging and integration; (iii) Patient care; and (iv) Continuing Development. Initial challenges were common, often related to clarifying the scope of practice for the new role. Ongoing issues were associated with gaps in understanding the role and lack of integration into the team. Mostly, nurses and Registered Undergraduate Students of Nursing built positive, professional relationships. Nurses valued the Registered Undergraduate Student of Nursing knowledge and skill level, reporting improved workload and work experiences when the Registered Undergraduate Student of Nursing was on shift. Nurses believed that the Registered Undergraduate Students of Nursing enhanced patient care. Registered Undergraduate Students of Nursing described positive, therapeutic relationships with patients. Registered Undergraduate Student of Nursing employment provided opportunities for new learning, leading to increased efficiency and confidence on clinical placement., Conclusions: This employment model benefited the Registered Undergraduate Students of Nursing and nurses who worked with them. In the absence of adequate training and support, challenges remained unresolved and negatively impacted the experience for nurses. In addition to university-level education and clinical placement, the employment model can create a third space for student learning via on-the-job training. The study supports the ongoing employment of student nurses through the Registered Undergraduate Student of Nursing model., Implications for the Profession And/or Patient Care: Impact This study contributes to the very small body of literature investigating Registered Undergraduate Student of Nursing workforces in Australian hospitals. It is the first to explore the experiences of both nurses and students working together in a major metropolitan setting and also the first in the context of the COVID-19 pandemic. This study reflected a mostly positive experience for Registered Undergraduate Student of Nursing and the nurses who worked with them and highlighted the importance of adequate oversight and support in the implementation and maintenance of a Registered Undergraduate Student of Nursing workforce. Employed Registered Undergraduate Students of Nursing reported improved confidence, skills, and felt like they started clinical placement at an advantage, ready to step up and learn the Registered Nurse scope of practice. In addition to university-level education and clinical placement, this employment model creates a third space for learning via on-the-job training., Reporting Method: COREQ guidelines were followed in the reporting of this study., Patient or Public Contribution: No patient or public contribution., (© 2024 John Wiley & Sons Ltd.)

Purpose of Study: Nurses around the world have faced challenges during the coronavirus disease 2019 (COVID-19) pandemic. This study examined the association between depression and anxiety and trait energy and trait fatigue, and baseline health status and work characteristics. Design of Study: A cross-sectional study. Methods: A survey was conducted to collect self-reported data from nurses involved in patient care in Northern Virginia. Depression and anxiety were assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) depression and anxiety scales. To measure trait energy and trait fatigue, the Mental and Physical State and Trait Energy and Fatigue Scale (MPSTEFS) was used. Findings: There was a significant association between depression and energy ( b =-0.46, t  = -1.78, p <  .001) and loneliness ( b =1.38, t  = 4.00, p <  .001) and increased alcohol use ( b =2.11, t  = 2.04, p  = .045). We also found that nurses with depression were significantly more likely to seek mental health counseling ( b =-2.91, t  = 2.54, p  = 0.013), which was also the case for anxiety ( b =3.13, t  = 2.14, p  = .036). Conclusions: Our study highlights the mental health burden among nurses who worked in the early phase of the COVID-19 pandemic and its association with increased alcohol use and loneliness. The findings may help healthcare leaders identify early signals of deterioration in nurses' well-being.

Purpose: This study described pediatric nurses' professional quality of life during COVID-19 and explored demographic/clinical practice factors independently associated with compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS)., Design and Methods: The Relational Caring Complexity Theory was used. This study employed a cross-sectional, descriptive, correlational design to describe professional quality of life of pediatric nurses (demographic questionnaire and ProQOL 5 measure) working during the COVID-19 pandemic., Results: From 150 pediatric nurses, the mean scores were CS 40.8 (± 4.8), BO 22.6 (± 4.7), and STS 22.8 (± 5.8). Results of the multiple regression revealed that two variables, deployed to the same unit versus not deployed (β = 2.424, p = .02) and currently practicing in perioperative/ambulation settings versus intensive care (β = -0.272, p = .03), were independently associated with CS. Deployed to the same unit versus not deployed was found to be independently and significantly associated with BO (β = -0.28, p = .005). The number of patients cared for with COVID-19 (β = 0.196, p = .03) was significantly associated with STS., Conclusions: While the overall response was positive, these nurses were more likely to experience BO when deployed to the same area (likely a COVID-19 adult unit) and STS as they cared for more patients with COVID-19., Practice Implications: Leaders should be aware of the impact of caring in times of crisis. Decentralized staffing may help meet emergent needs on a particular shift, but ensuring deployed nurses are well-supported is vital., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: The increase in intensive care unit (ICU) capacity compelled by the COVID-19 pandemic required the rapid deployment of non-critical-care registered nurses to the ICU setting. The upskill training needed to prepare these registered nurses for deployment was rapidly assembled due to the limited timeframe associated with the escalating pandemic. Scoping the literature to identify the content, structure, and effectiveness of the upskill education provided is necessary to identify lessons learnt during the COVID-19 pandemic response so that they may guide workforce preparation for future surge planning., Aim: The aim of this scoping review was to map the literature to identify the available information regarding upskill training and preparedness of non-critical-care registered nurses deployed to the ICU during the COVID-19 pandemic., Methods: This scoping review was conducted in accordance with JBI methodology. A protocol outlined the review questions and used the participants, concept, and context framework to define the inclusion and exclusion criteria. A search of healthcare databases MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), Cochrane, and Scopus was supplemented with a grey literature search via Google., Results: Screening and review found 32 manuscripts that met the inclusion criterion for examination. Analysis revealed variation in duration of programs, theoretical versus practical content, face-to-face or online mode of delivery, and duration of preparation time at the bedside in the ICU setting. Data on contributors to preparedness for deployment were sparse but included training, support, peer education, buddy time, and clarity around responsibilities and communication., Discussion: Evaluation of upskill education was mostly limited to post-training surveys. Few studies explored the preparedness of deployed registered nurses as an outcome of their upskill training or described measures of effectiveness of ICU deployment., Conclusion: There is limited evidence describing preparedness of non-critical-care registered nurses on deployment to the ICU. Further research is needed to identify what elements of upskill education led to preparedness and effective deployment to the ICU setting., (Copyright © 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Background: The coronavirus disease 2019 (COVID-19) pandemic has put an exceptional strain on intensive care delivery and has significantly impacted nursing practice in the intensive care unit, consequently affecting nurses' working environment and health. Little is known about the long-term impact on the nursing workforce and care delivery in intensive care and anaesthetic departments., Aim/objective: This cross-sectional study aimed to describe the long-term impact of the COVID-19 pandemic on the nursing profession and nursing care from the perspectives of anaesthetic and critical care nurses., Methods: In this study, an online questionnaire with open- and close-ended questions was distributed to registered nurses working in anaesthesia and intensive care between February 8 and March 7, 2022. The data were analysed using content analysis and descriptive statistics., Results: Of the 514 registered nurses who responded to the questionnaire, 256 (50%) worked in anaesthesia care and 215 (42%) in intensive care. The long-term impact of COVID-19 was expressed in three categories: nursing care on hold, insights and experiences forming a new professional identity, and the impact of organisational conditions on the profession. Critical care nurses considered nursing care comparable to that before the COVID-19 pandemic. Nurse anaesthetics experienced changes in nursing tasks and activities compared to that before the COVID-19 pandemic., Conclusions: Nursing care is still influenced by the pandemic due to the lack of resources and persistent high workload and needs to be reclaimed and prioritised. Re-establishing high-quality nursing care is a shared responsibility of the organisation and nursing profession, and the organisation needs to create prerequisites for this. Furthermore, nurses' views and insights into their profession developed both positively and negatively during the pandemic, which must be further considered, including the profession's values., (Copyright © 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Background: Early career nurses (ECNs) can be expected to assume shift charge nurse leadership roles quickly upon entering practice. Since the emergence of the COVID-19 pandemic, junior nurses may find their leadership capabilities tested further as the challenges of leadership are made increasingly complex in the context of an infectious disease outbreak., Purpose: The purpose of this qualitative study was to explore early career registered nurses' (RNs) experiences of engaging in shift charge nurse roles in hospital settings., Methods: This study used an interpretive descriptive (ID) approach. Semi-structured, in-depth interviews were conducted with 14 RNs across Ontario, who had up to three years of experience and who had engaged in a shift charge nurse role in a hospital setting. Recruitment and data collection took place from January to May 2021 during the COVID-19 pandemic. Interviews were recorded, transcribed, and analyzed following the principles of content analysis., Results: Content analysis of the 14 participant interviews revealed four main themes: nominated and necessitated into leadership , diverse and demanding responsibilities, factors that help and hinder , and leadership as an impactful experience ., Conclusions: Study findings provide insights into potential strategies to support ECNs in shift charge nurse roles, during the remaining course of the COVID-19 pandemic and beyond. Greater support for nurses who engage in these roles may be achieved by promoting collaborative unit and organizational cultures, prioritizing leadership training programs, and strengthening policies to provide greater clarity regarding charge nurse role responsibilities., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The enhancement of nursing care quality is closely related to the clinical competence of nurses, making it a crucial component within health systems., Objective: The present study investigated the relationship between nurses' clinical competence, moral identity, and moral injury during the COVID-19 outbreak., Research Design: This cross-sectional study was carried out among frontline nurses, using the Moral Identity Questionnaire (MIQ), the Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP), and the Competency Inventory for Registered Nurse (CIRN) as data collection tools., Participants: and research context: The research population for this study consisted of all frontline nurses ( n = 251) employed in a hospital in southern Iran. Sampling was conducted between May 1, 2021 and September 30, 2021, during the COVID-19 outbreak., Ethical Considerations: The present study received approval from the research ethics committee of Rafsanjan University of Medical Sciences, with project No. 99267 and code of ethics ID No. IR. RUMS.REC.1399.262, dated 15.02.2021., Results: According to the study findings, 42.2% of the nurses demonstrated high clinical competence, while 51.4% exhibited moderate clinical competence. The results indicated a positive correlation between moral identity and clinical competence but a negative correlation between moral injury and clinical competence. Furthermore, the variables of moral identity and moral injury were found to predict 10% of the variance in clinical competence., Conclusion: According to the results, moral identity and moral injury had an impact on the clinical competence of nurses. Therefore, implementing a program aimed at enhancing moral identity and providing training strategies to address moral injury during crises like the COVID-19 pandemic can lead to improvements in nurses' clinical competence and the overall quality of care they provide., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: This study examines the impact of nurse uniforms, the coronavirus pandemic, and the image of nurses and the nursing profession on the career choice of young Muslim Arab women in nursing, with a focus on policy implications., Background: The global nursing shortage poses significant challenges, including in Israel. Attracting young Muslim Arab women to nursing careers is vital. Understanding how nurse uniforms, the pandemic, and perceptions of nurses and the nursing profession shape their career decisions can inform policy interventions., Methods: A cross-sectional study utilized digital questionnaires administered to 200 Muslim Arab women aged 20-30 in Israel. The study adhered to the EQUATOR checklist for cross-sectional studies., Results: Only 29.2% of participants expressed interest in studying nursing. Findings revealed a positive correlation between the pandemic's impact and intention to pursue nursing. A linear regression analysis shows the impact of the white uniform, the image of nurses, and the image of the profession on the choice of a career in nursing., Discussion: The study emphasizes the significance of nurse uniforms, the image of nurses, and the image of the nursing profession in shaping young Muslim Arab women's career choices in nursing. Policy interventions should raise awareness about nursing roles, expand responsibilities, and highlight nurses' contributions to society., Conclusion: Strategies to attract young Muslim Arab women to nursing careers should address nurse uniforms, the image of nurses, and the image of the nursing profession., Implications for Policy: Policy interventions should prioritize diversity, promote positive images of nurses and the nursing profession, and raise awareness of nursing roles and contributions among young Muslim Arab women., (© 2023 International Council of Nurses.)

Objective: To evaluate the workload and severity of patients in the Intensive Care Unit (ICU) with COVID-19., Method: Cross-sectional, analytical study carried out in the ICU of a private hospital. All patients over the age of 18 with a diagnosis of COVID-19 admitted from September 2020 to June 2021 were included. Workload assessed by the Nursing Activities Score (NAS), and severity by the Sequential Organ Failure Assessment. Descriptive and inferential analyses were performed., Results: 217 patients were included, mostly men, mean age 62.41 years, white, obese, non-smokers and sedentary. The average NAS was 84.79. Staffing was in line with legislation and NAS. NAS was not associated with severity. Severity was associated with higher age, gender, comorbidities, sedentary lifestyle, time on mechanical ventilation, hospitalization and death., Conclusion: Workload was high and not associated with severity or outcomes. Severity was associated with demographic and clinical conditions. This study shows the importance of staff sizing, with a view to promoting safety and quality of care.