McAndrew Natalie S, Rosa William E, Moore Kaylen M, Christianson Jacqueline, AbuZahra Tala, Mussatti Megann, McCracken Colleen, Newman Amy R, Calkins Kelly, Breakwell Susan, Klink Katie, Guttormson Jill
College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
Froedtert & the Medical College of Wisconsin Froedtert Hospital, Milwaukee, WI, USA.
SAGE Open Nurs. 2023 Mar 28;9:23779608231165688. doi: 10.1177/23779608231165688. eCollection 2023 Jan-Dec.
To describe the lived experience of nursing staff and nurse leaders working in COVID-19 devoted units (intensive care or medical unit) prior to vaccine availability.
Qualitative phenomenological design with a focus group approach.
The study team recruited a convenience sample of nursing staff (nurses, and nursing assistants/nurse technicians) and nurse leaders (managers, assistant nurse managers, clinical nurse specialists, and nurse educators) at an academic medical center in the midwestern United States. Focus groups and individual interviews were conducted to encourage participants to describe their (1) experiences as nursing professionals, (2) coping strategies, and (3) perspectives about supportive resources. Moral distress was measured with the moral distress thermometer and qualitative data were analyzed with Giorgi-style phenomenology.
We conducted 10 in-person focus groups and five one-on-one interviews ( = 44). Seven themes emerged: (1) the reality of COVID-19: we are sprinting in a marathon; (2) acute/critical care nurse leaders experience unique burdens; (3) acute/critical care staff nurses experience unique burdens; (4) meaning of our lived experience; (5) what helped us during the pandemic; (6) what hurt us during the pandemic; and (7) we are not okay. Participants reported a moderate level of moral distress ( = 5.26 = 2.31). They emphasized that peer support was preferred over other types of support offered by the healthcare organization. Participants expressed positive feedback about the focus group experience and commented that group processing validated their experiences and helped them "feel heard."
These findings affirm the need for trauma-informed care and grief support for nurses, interventions that increase meaning in work, and efforts to enhance primary palliative communication skills. Study findings can inform efforts to tailor existing interventions and develop new, more comprehensive resources to meet the psychosocial needs of nursing staff and nurse leaders practicing during a pandemic.
描述在有疫苗可用之前，在新冠肺炎专门病房（重症监护室或内科病房）工作的护理人员和护士长的实际经历。
采用焦点小组方法的质性现象学设计。
研究团队在美国中西部的一家学术医疗中心，招募了一个便利样本的护理人员（护士、护理助理/护士技术员）和护士长（经理、助理护士长、临床护理专家和护理教育工作者）。进行焦点小组讨论和个人访谈，以鼓励参与者描述他们（1）作为护理专业人员的经历，（2）应对策略，以及（3）对支持资源的看法。用道德困扰温度计测量道德困扰，并采用 Giorgi 式现象学分析定性数据。
我们进行了10次面对面的焦点小组讨论和5次一对一访谈（n = 44）。出现了七个主题：（1）新冠肺炎的现实：我们在马拉松中冲刺；（2）急性/重症护理护士长经历独特的负担；（3）急性/重症护理 staff nurses 经历独特的负担；（4）我们实际经历的意义；（5）疫情期间帮助我们的因素；（6）疫情期间伤害我们的因素；（7）我们状态不佳。参与者报告了中等程度的道德困扰（M = 5.26，SD = 2.31）。他们强调，同伴支持比医疗保健组织提供的其他类型的支持更受青睐。参与者对焦点小组经历给予了积极反馈，并表示小组讨论证实了他们的经历，帮助他们“感到被倾听”。
这些发现证实了对护士进行创伤知情护理和悲伤支持的必要性、增加工作意义的干预措施，以及提高初级姑息沟通技能的努力。研究结果可为调整现有干预措施和开发新的、更全面的资源提供参考，以满足大流行期间执业的护理人员和护士长的心理社会需求。
