新研究突顯了大流行對一線護士造成的損失

我們的一線護士是他們在大流行期間如何服務的靈感和英雄,醫療機構有責任在可能的情況下理解和糾正路線,以更好地支援他們。

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Journal of Clinical Nursing publishes study on mental and emotional toll of COVID-19

COLUMBUS – A team of nurse scientists, evidence-based practice professionals and an ethicist from The Ohio State University College of Nursing have published their findings from their multi-site study with first-hand accounts of the psychological and emotional toll that the COVID-19 pandemic has taken on front-line nurses in the U.S.

Focus groups engaging 43 staff nurses at four sites across the country (California, New York, Ohio and Pennsylvania) informed the study, which identified four central themes:

  1. The challenges the nurses faced in their work;

  2. The feelings that dominated their emotional and mental health;

  3. Coping mechanisms with varying levels of success in dealing with the pandemic; and

  4. Ethical issues they were forced to wrestle with in real time as they treated the sickest COVID-19 patients.

“We were asked to perform this study by staff RNs themselves not only to capture the history and emotions of the pandemic as it was happening, but also to learn where there were gaps that must be filled,” said Esther Chipps, PhD, clinical nurse scientist and professor of clinical nursing at The Ohio State University College of Nursing who was the lead principal investigator. “Our front-line nurses are inspirations and heroes for how they have served during the pandemic, and it is incumbent upon healthcare organizations to understand and course-correct where possible to better support them.”

Many of the nurses interviewed for this study consistently echoed similar concerns regarding internal communication issues, ever-changing protocols as the pandemic evolved, overwhelming fatigue, growing stress and anxiety among the nursing population and the ethical dilemmas associated with the magnitude of the illness and death that they witnessed among their patients.

The study, published by the international nursing journal Journal of Clinical Nursing, spotlighted the urgent need for several evidence-based approaches to mitigate the situation that hampered the front-line response to the pandemic, including:

  • Consistent disaster preparation and management guidelines that front-line clinicians can count on.

  • Interventions to build coping and resiliency skills in front-line clinicians who are trying to handle elevated levels of stress, anxiety and burnout as they care for patients such as The Ohio State University Wexner Medical Center’s Mindfulness in Motion, STAR mental health and Buckeye Paws programs, as well as Ohio State’s MINDSTRONG™/MINDBODYSTRONG™ cognitive-behavioral skills-building program.

  • Opportunities to reflect on the current experience and document successes and failures to build a bank of institutional knowledge and memory that includes innovative practices, surge staffing plans, personal anecdotes and other documentation so that future crises of this kind can be met from a better-informed perspective to improve organizational preparedness.

“We cannot afford to repeat the tragedy of this pandemic ever again,” Chipps said. “Part of what we can control is the support infrastructure put into place for clinicians so that they have clarity, consistency and resources available that allow them to focus on: caring for patients and optimizing their own self-care.”

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臨床護理雜誌發表關於 COVID-19 精神和情感損失的研究

哥倫布——俄亥俄州立大學護理學院的一個由護士科學家、循證實踐專業人士和倫理學家組成的團隊公佈了他們的多地點研究結果,其中包括對 COVID-19 造成的心理和情感損失的第一手資料大流行已經席捲了美國的一線護士

來自全國四個地點(加利福尼亞、紐約、俄亥俄和賓夕法尼亞)的 43 名護士的焦點小組為該研究提供了資訊,該研究確定了四個中心主題:

  1. 護士在工作中面臨的挑戰;

  2. 支配他們情緒和心理健康的感覺;

  3. 在應對大流行方面取得不同程度成功的應對機制;和在治療病情最嚴重的 COVID-19 患者時,他們被迫實時處理道德問題。

臨床護士 Esther Chipps 博士説:“RN 工作人員要求我們自己進行這項研究,不僅是為了捕捉大流行病的歷史和情緒,而且還要了解哪些地方必須填補空白。”俄亥俄州立大學護理學院的科學家和臨床護理教授,他是首席首席研究員。“我們的一線護士是他們在大流行期間如何服務的靈感和英雄,醫療機構有責任在可能的情況下理解和糾正路線,以更好地支援他們。”

本研究接受採訪的許多護士一致表達了類似的擔憂,包括內部溝通問題、隨著大流行的演變而不斷變化的協議、壓倒性的疲勞、護理人群中日益增長的壓力和焦慮,以及與疾病和死亡的嚴重程度相關的道德困境他們在病人中目睹的。

該研究由國際護理雜誌《臨床護理雜誌》發表,強調迫切需要幾種基於證據的方法來緩解阻礙一線應對大流行的情況,包括:

一線臨床醫生可以信賴的一致的災難準備和管理指南。

在一線臨床醫生中建立應對和彈性技能的干預措施,他們在照顧患者時試圖應對壓力、焦慮和倦怠,例如俄亥俄州立大學韋克斯納醫學中心的運動正念、STAR 心理健康和Buckeye Paws計劃,以及俄亥俄州立大學的MINDSTRONG™/MINDBODYSTRONG™認知行為技能培養計劃。

反思當前經驗並記錄成功和失敗的機會,以建立一個機構知識和記憶庫,包括創新實踐、人員配備計劃、個人軼事和其他文件,以便可以從更知情的情況下應對未來的此類危機改善組織準備的觀點。

“我們不能再重演這場大流行的悲劇,”奇普斯説。“我們可以控制的部分內容是為臨床醫生建立的支援基礎設施,以便他們擁有清晰、一致和可用的資源,使他們能夠專注于:照顧病人和優化他們自己的自我保健。”

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