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从健康促进视角看重症监护护士督导未经重症监护培训护士的经历:在危机中理解、管理并感受意义

A Salutogenic Perspective on Critical Care Nurse's Experiences of Supervising Nurses Without Training in Intensive Care: To Comprehend, Manage, and Feel Meaning During a Crisis.

作者信息

Fredholm A, Nordin A, Andersson M, Engström Å

机构信息

Department of Health Science, Faculty of Health, Science and Technology, Karlstad University, Karlstad, Sweden.

Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden.

出版信息

J Nurs Manag. 2024 Nov 16;2024:2393128. doi: 10.1155/jonm/2393128. eCollection 2024.

Abstract

Using the COVID-19 pandemic as an example of a national and international crisis, it has been possible to show how critical care nurses (CCNs) were affected by their work situation with impact on health and wellbeing. This study sought out to investigate how CCNs stress was affected and to provide some answers as to how to react and organize care in a future crisis. The specific focus was CCNs' stressors related supervision of nurses untrained in intensive care and how these were handled in a salutogenic perspective. The aim of this study was to analyze CCNs' experiences of supervision of nurses without training in intensive care during the COVID-19 pandemic, and to analyze these experiences with the help of the salutogenic concept sense of coherence. The phenomena under study were explored during the years of 2021-2022 through in-depth interviews and interpreted using deductive content analysis. By analyzing CCNs experiences of supervising nurses without training in intensive care with the lens of sense of coherence, it was possible to show in what way these concepts influenced how to cope with the demanding situation. Sense of coherence was influenced by the inevitable prioritization of patient care and nursing interventions. This prioritization caused moral distress, but was also enhanced or decreased by CCNs sense of coherence. When recruiting and introducing new personnel in a future crisis to any field of healthcare, but particularly to the intensive care, we would, on the basis of these findings, suggest that well-established plans are vital for how to move personnel throughout the organization, and for how to introduce the field of intensive care. Plans for how to model care with the help of RNs without specialist training should be put in place. A communication plan for the organization is also of importance to enhance transparency.

摘要

以新冠疫情这一国家和国际危机为例,可以展示重症护理护士(CCN)是如何受到其工作环境影响,进而对健康和幸福产生影响的。本研究旨在调查CCN的压力是如何受到影响的,并就未来危机中如何应对和组织护理工作提供一些答案。具体关注点是CCN在监督未接受过重症护理培训的护士时所面临的压力源,以及如何从健康生成视角来处理这些压力源。本研究的目的是分析CCN在新冠疫情期间对未接受过重症护理培训的护士进行监督的经历,并借助健康生成概念中的连贯感来分析这些经历。通过2021年至2022年期间的深入访谈对所研究的现象进行了探索,并采用演绎式内容分析法进行解读。通过从连贯感的角度分析CCN对监督未接受过重症护理培训的护士的经历,可以看出这些概念是如何影响应对这一严峻形势的。连贯感受到患者护理和护理干预不可避免的优先级影响。这种优先级导致了道德困扰,但也会因CCN的连贯感而增强或减弱。基于这些发现,当在未来危机中为医疗保健的任何领域,尤其是重症护理领域招募和引入新人员时,我们建议制定完善的计划对于人员在整个组织中的调配方式以及如何引入重症护理领域至关重要。应该制定借助未接受专科培训的注册护士进行护理模式的计划。组织的沟通计划对于提高透明度也很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2289/11919042/47d12eb918f1/JONM2024-2393128.001.jpg

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