新型冠状病毒肺炎对重症监护病房护士护理职责和专业角色的影响：一项质性内容分析
Impact of COVID-19 on Intensive Care Unit Nurse Duty of Care and Professional Roles: A Qualitative Content Analysis.
作者信息
Christianson Jacqueline, Guttormson Jill, McAndrew Natalie Susan, Calkins Kelly
机构信息
College of Nursing, Marquette University, Milwaukee, WI, USA.
College of Nursing, University of Wisconsin - Milwaukee, Milwaukee, WI, USA.
出版信息
SAGE Open Nurs. 2022 Jul 15;8:23779608221113539. doi: 10.1177/23779608221113539. eCollection 2022 Jan-Dec.
BACKGROUND
Nurse duty of care, the balance between nursing occupational obligations to provide care, the personal costs for providing such care, and the reward for providing care, has been significantly altered by the COVID-19 pandemic. ICU nurses are increasingly burdened with higher personal costs to fulfill their jobs, but little additional reward for continuing to provide care.
OBJECTIVES
The purpose of this study was to examine the impact of the COVID-19 pandemic on the duty of care balance among ICU nurses who manage COVID-19 patients.
DESIGN
This was a descriptive qualitative study using semi-structured interviews.
METHODS
Nurses were recruited for a parent study on ICU nursing during COVID-19; this is a secondary analysis of the interviews that took place during the parent study. Content analysis was utilized to identify themes from interview transcripts.
RESULTS
Thirteen nurses participated in interviews. Nurses reported betrayal at perceived breeches in their duty of care agreement by their employers, the general public, and national health authorities. They described alterations to previous standards of care such as significantly increased workloads, worsening understaffing, and changes to patient care expectations that were implemented for reasons other than betterment of patient care. Nurses reported they felt a moral obligation to provide care, however they experienced disempowerment and burnout that affected them both in and out of the workplace.
CONCLUSION
The COVID-19 pandemic has affected several aspects of the duty of care balance, resulting in a duty of care balance that is inequitable to nurses. Imbalance in the effort, risks, and rewards for nursing professionals may contribute to nurse burnout.
RELEVANCE TO CLINICAL PRACTICE
This research highlights the need for healthcare administrators to consider resource allocation, nurse appreciation, and commensurate compensation for professional nurses.
背景
护士的照护职责，即在护理职业义务（提供护理）、提供护理的个人成本以及提供护理的回报之间取得平衡，已因新冠疫情而发生显著改变。重症监护病房（ICU）护士履行工作职责的个人成本日益增加，但继续提供护理却几乎没有额外回报。
目的
本研究旨在探讨新冠疫情对管理新冠患者的ICU护士照护职责平衡的影响。
设计
这是一项采用半结构化访谈的描述性定性研究。
方法
护士被招募参与一项关于新冠疫情期间ICU护理的母研究；这是对母研究期间进行的访谈的二次分析。采用内容分析法从访谈记录中识别主题。
结果
13名护士参与了访谈。护士们表示，他们感觉雇主、公众和国家卫生当局违背了他们的照护职责协议，这让他们感到被背叛。他们描述了先前护理标准的改变，比如工作量大幅增加、人员配备不足情况恶化，以及患者护理期望的变化，而做出这些改变的原因并非是为了改善患者护理。护士们报告称，他们觉得自己有道义上的责任提供护理，然而他们却感到无力且身心俱疲，这在工作内外都对他们产生了影响。
结论
新冠疫情影响了照护职责平衡的多个方面，导致护士的照护职责平衡变得不公平。护理专业人员在努力、风险和回报方面的失衡可能会导致护士职业倦怠。
与临床实践的相关性
本研究强调医疗保健管理人员需要考虑资源分配、对护士的认可，以及为专业护士提供相应的薪酬。
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