Experiences of new nurses in the United States during the acute phase of the COVID-19 pandemic.

AIM: This qualitative descriptive study describes the experiences of new nurses during the acute phase of the COVID-19 pandemic in the United States. BACKGROUND: New nurses faced the dual challenge of transitioning to practice while working during a global pandemic. Although multiple studies have described nurses' experiences during the COVID-19 pandemic, research is warranted to understand new nurses' experiences during the acute phase of the pandemic. METHODS: Registered nurses (n = 46) with less than two years of work experience, who participated in the COVID-19 Study and Registry of Healthcare and Support Personnel (CHAMPS), participated in this study. Thematic analysis was used to examine their responses. The COREQ guidelines were used in reporting this study. RESULTS: Five themes were extracted: feelings of increasing isolation, feelings of intense fear, personal health concerns, shattered and disrupted expectations, and living in a constant dilemma. DISCUSSION: New nurses described their distress and profound sense of isolation which was compounded by their status as new employees and being shunned by others. There was intense fear for their safety and health. They viewed their limited nursing experience with only COVID-19 patients as detrimental to their careers and encountered complex dilemmas and were obligated to make problematic choices. CONCLUSIONS: New nurses revealed unrelenting psychological and physical distress during the pandemic. Identification and implementation of strategies to address their distress and alleviate its negative consequences were needed but not provided. IMPLICATIONS FOR NURSING POLICY: The development and implementation of policies to address the challenges new nurses encounter are needed. Action strategies to promote professional socialization and job retention are required.

A thematic analysis of shared experiences of essential health and support personnel in the COVID-19 pandemic.

AIMS AND OBJECTIVES: Studies have shown that the COVID-19 pandemic has taken a toll on individuals who interact with patients with SARS-CoV-2 but focused largely on clinicians in acute care settings. This qualitative descriptive study aimed to understand the experiences and well-being of essential workers across settings during the pandemic. BACKGROUND: Multiple studies of the well-being of individuals who have cared for patients during the pandemic have included interviews of clinicians from acute care settings and revealed high levels of stress. However, other essential workers have not been included in most of those studies, yet they may also experience stress. METHODS: Individuals who participated in an online study of anxiety, depression, traumatic distress, and insomnia, were invited to provide a free-text comment if they had anything to add. A total of 2,762 essential workers (e.g., nurses, physicians, chaplains, respiratory therapists, emergency medical technicians, housekeeping, and food service staff, etc.) participated in the study with 1,079 (39%) providing text responses. Thematic analysis was used to analyze those responses. RESULTS: Four themes with eight sub-themes were: Facing hopelessness, yet looking for hope; Witnessing frequent death; Experiencing disillusionment and disruption within the healthcare system, and Escalating emotional and physical health problems. CONCLUSIONS: The study revealed major psychological and physical stress among essential workers. Understanding highly stressful experiences during the pandemic is essential to identify strategies that ameliorate stress and prevent its negative consequences. This study adds to the research on the psychological and physical impact of the pandemic on workers, including non-clinical support personnel often overlooked as experiencing major negative effects. RELEVANCE TO CLINICAL PRACTICE: The magnitude of stress among all levels of essential workers suggests the need to develop strategies to prevent or alleviate stress across disciplines and all categories of workers.

A Year in the Life of U.S. Frontline Health Care Workers: Impact of COVID-19 on Weight Change, Physical Activity, Lifestyle Habits, and Psychological Factors.

Healthcare workers (HCWs) experienced significantly higher burdens and life demands due to the COVID-19 pandemic. This study sought to assess the longitudinal effects among HCWs throughout the pandemic. Qualtrics surveys collected self-reported data on weight changes, eating patterns, physical activity (PA), and psychological factors with data organized by timepoints prior to the pandemic (PP0­prior to March 2020), baseline (M0­January 2021), month 6 (M6­July 2021), and month 12 (M12­January 2022). Eating patterns were negatively impacted at the M0, with reported increases in snacking/grazing (69.7%), fast food/take-out consumption (57.8%), and alcohol (48.8%). However, by M6 and M12 there were no statistically significant differences in eating patterns, suggesting that eating patterns normalized over time. Mean weight increased from PP0 to M0 by 2.99 pounds (p < 0.001, n = 226) and from PP0 to M6 by 2.12 pounds (p < 0.027, n = 146), though the difference in mean weight from PP0 to M12 was not statistically significant (n = 122). PA counts decreased from 8.00 sessions per week PP0 to 6.80 by M0 (p = 0.005) before jumping to 12.00 at M6 (p < 0.001) and 10.67 at M12 (p < 0.001). Psychological factors comparing M0 to M12 found statistically significant differences for depression (p-value = 0.018) and anxiety (p-value = 0.001), meaning depression and anxiety were initially increased but improved by M12. Additionally, higher scores on depression and insomnia scales were associated with lower PA levels. These overall results imply that the COVID-19 pandemic had immediate effects on the eating patterns, weight changes, PA, and psychological factors of HCWs; however, routines and lifestyle habits appeared to have normalized one year later.

Percutaneous Revascularization for Atherosclerotic Renal Artery Stenosis: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: Percutaneous revascularization (PR) of atherosclerotic renal artery stenosis (RAS) improves patency in the renovascular disease. However, whether PR is associated with additional clinical benefits in the patients with atherosclerotic RAS remains controversial. We conducted a meta-analysis to evaluate the outcomes of PR versus medication alone for atherosclerotic RAS. METHODS: We compiled an electronic database of prospective, randomized, controlled trials related to the efficacy of PR versus medication for RAS. The standardized mean difference (SMD) or relative risk ratios (RRs) were estimated with 95% confidence intervals (CI) based on an intention-to-treat analysis. We considered the following outcomes: changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP), reduction in antihypertension medication, serum creatinine, worsening renal failure, mortality, stroke, and congestive heart failure. RESULTS: Seven trials with a total of 1916 patients (937 with PR, 979 with medication alone) were analyzed. The changes in SBP/DBP from baseline were similar between the 2 groups (changes in SBP: P = 0.69; changes in DBP: P = 0.15). PR treatment led to a statistically significant decrease in the number of antihypertensive medications compared with medical management alone (SMD -0.18, 95% CI -0.27 to -0.10, P < 0.001). The pooled RR for deteriorating renal function, congestive heart failure, or stroke showed no significant difference. CONCLUSION: PR is equally effective to medical management in the treatment of RAS. Therefore, patients with atherosclerotic RAS along with hypertension or chronic kidney disease should receive medical therapy to control blood pressure, but they should not be considered for a renal artery stent.