Changes in Posttraumatic Growth After a Virtual Contemplative Intervention During the COVID-19 Pandemic.

OBJECTIVE: The aim of this study was to describe the effects of an intervention called "Compassion & Growth Workshops" on reported posttraumatic growth (PTG) using the Posttraumatic Growth Inventory-Expanded (PTGI-X). BACKGROUND: Few studies measure the impact of interventions, such as contemplative practices, on nurse PTG. METHODS: We delivered a series of three 2-hour microretreats to nurses and advanced practice nurses and measured their impact on PTG scores. Using multivariate logistic regression, we identified cofactors predictive of 25% overall improvement on the PTGI-X. RESULTS: Overall PTG increased among participants, with the greatest improvement in relating to others, new possibilities, and personal strength. Posttraumatic growth improved as workshop attendance increased; nurses providing direct patient care also benefitted the most. CONCLUSIONS: Contemplative interventions can substantively improve PTG. This may be particularly relevant for coping with COVID pandemic stress among nurses on the frontlines and for healthcare leaders seeking to strengthen psychological support within their teams and reform the workplace environment.

Managing Care Transitions to the Community During a Pandemic.

This column discusses the establishment of a multidisciplinary model for care transition of COVID-19-positive patients from hospital to community. The pandemic has presented challenging issues for discharge transition. A tiered patient identification and clinical messaging referral system was developed. The use of the COVID-19 transition model provided support to patients and physicians during the 30-day discharge period and can serve as a model for emerging public health issues in the future.

Pregnancy in Serious Illness: It's Not Just Medical Decision Making.

Pregnancy in the presence of serious illness and treatment can create a moral and ethical struggle. There is little literature to provide an ethical framework for decision making when women become pregnant while receiving aggressive care for any serious illness. The family and care team often have moral distress as they provide support and are integrally involved in decision making. A case study is presented to describe a complicated patient scenario and how all involved can develop emotional, moral, and ethical struggles as care is delivered. In clinical cases where nurses feel that their own ethical and moral frameworks are either in conflict with patient, family, or health care provider decisions, or feel that patient and family wishes conflict with one another or the health care system, emotions and distress rise to the surface. In these situations, nurses can advocate for standard practice and to use an ethical framework for decision making, such as the 4-box method, to help decrease moral and ethical struggles as technology continues to advance in health care.