Critical care nurses' experiences of caring challenges during post-resuscitation period: a qualitative content analysis.

BACKGROUND: Patients in the post-resuscitation period experience critical conditions and require high-quality care. Identifying the challenges that critical care nurses encounter when caring for resuscitated patients is essential for improving the quality of their care. AIM: This study aimed to identify the challenges encountered by critical care nurses in providing care during the post-resuscitation period. METHODS: A qualitative study was conducted using semi-structured interviews. Sixteen nurses working in the intensive care units of three teaching hospitals were selected through purposive sampling. The Data collected were analyzed using qualitative content analysis. RESULTS: Participants experienced individual, interpersonal, and organizational challenges when providing post-resuscitation care. The most significant challenges include inadequate clinical knowledge and experience, poor management and communication skills, lack of support from nurse managers, role ambiguity, risk of violence, and inappropriate attitudes of physicians towards nurses' roles. Additionally, nurses expressed a negative attitude towards resuscitated patients. CONCLUSION: Critical care nurses face several challenges in providing care for resuscitated patients. To enhance the quality of post-resuscitation care, address the challenges effectively and improve long-time survival it is crucial to implement interventions such as In-service education, post-resuscitation briefing, promotion of interprofessional collaboration among healthcare teams, providing sufficient human resources, clarifying nurses' roles in the post-resuscitation period and increasing support from nursing managers.

Nurses' Perceptions Towards Resuscitated Patients: A Qualitative Study.

Nurses' perceptions of resuscitated patients may affect their care, and this has not been investigated in previous literature. The aim of this study was to explore nurses' perceptions towards resuscitated patients. In this descriptive-qualitative study seventeen clinical nurses participated using purposive sampling. In-depth, semi-structured interviews were conducted and data were analyzed by conventional content analysis. Four main categories emerged: Injured, undervalued, problematic, and destroyer of resources. Participants considered resuscitated patients to have multiple physical injuries, which are an important source of legal problems and workplace violence, and they believed that these patients will eventually die. Resuscitated patients are considered forgotten and educational cases. Iranian nurses have a strong negative perception towards resuscitated patients. Improving the quality of cardiopulmonary resuscitation, improving the knowledge and skills of personnel in performing resuscitation, and supporting managers and doctors to nurses in the post-resuscitation period can change the attitude of nurses and improve post-resuscitation care.

Stress management protocol for nurses working in the COVID-19 wards.

Purpose: Due to necessity of immediate support strategies for nurses during COVID-19 pandemic and lack of comprehensive and applied standard guidelines, the present study was conducted to develop stress management protocol for nurses working in COVID-19 wards with an approach based on the best scientific evidences. Methods: This descriptive methodological and validation study was conducted with evidence-based approach based on Stetler model in two hospitals of Iran in 2020. In order to identify the resources of stress and the solutions provided to deal with it to design the protocol, a comprehensive literature review was performed. After extracting evidence, they were ranked based on the levels of evidence and designed as a protocol. Quality appraisal of guideline was done using AGREEII instrument by an expert panel. The applicability of the protocol was assessed by a group of nurses through focus group discussion. Results: Out of 184 studies, 28 articles related to the topic were selected. According to the expert panel, in the AGREEII domains, Scope and Purpose (87.5%) and Applicability (70.5%) were the highest and the lowest scores respectively. The "Stress Management Protocol for Nurses Working in COVID-19 Wards" was designed in six sections, which was elaborated relative to each stress resources. Members of the focus group mostly considered the evidence-based recommendations feasible by making suggestions to some items. Conclusion: This study emphasized the important role of proper planning by health care system officials according to the designed protocol to manage stress and increase the self-efficacy of nurses in critical situations.

Nurses' experiences of provision family-centred care in the postresuscitation period: A qualitative study.

AIM: This study aimed to explore nurses' experiences of providing family-centred care in the postresuscitation period. DESIGN: An exploratory-descriptive qualitative design was used. METHODS: In this qualitative study, in-depth, semi-structured interviews were conducted with 22 nurses in three educational hospitals. There were six participants who completed follow-up interviews to resolve questions generated during initial interviews. Data were analysed using conventional content analysis. RESULTS: Five main categories were extracted: continuous monitoring, facilitation of attendance, involvement in care, informing and emotional support. Despite the lack of organizational policies and guidelines, nurses explained how they work to provide family-centred care for families, especially those they assessed as having less possibility of aggressive behaviour and those with a better understanding of their loved one's condition. To provide postresuscitation family-centred care, nurses facilitated family attendance, involved them in some basic nursing care, and provided information and emotional support to the family members. CONCLUSION: Nurses attempted to follow the basic principles of family-centred care in the postresuscitation period. However, to improve the provision of care by nurses, it is necessary to embed family-centred care principles in institutional policies and guidelines and to conduct training for nurses. IMPLICATIONS FOR THE PROFESSION: Iranian nurses are interested in engaged families in the postresuscitation period. Correct implementations of such care that include all families need institutional policies and guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Health anxiety and its association with perceived subjective workload in psychiatric nurses during the COVID-19 outbreak: a correlational study.

Background: Health care professionals, especially nurses, experience added workload, and psychological impact during the COVID-19 outbreak. This study aimed to investigate health anxiety and its association with perceived subjective workload in nurses working in psychiatric hospital wards. Methods: This descriptive correlational study was conducted on 206 nurses working in the psychiatric wards of Razi Psychiatry Hospital in Tabriz, Iran, in 2020-2021. Census sampling was applied and data were collected using the National Aeronautics and Space Administration Task Load Index, and the Health Anxiety Inventory. Data were analyzed using descriptive statistics, t-tests, and Pearson correlation in SPSS software version 16. Results: The mean (SD) of health anxiety and workload of nurses was 23/22(6/86) score range of 0-54 and 71.46 (12.37) score range of 0-100, respectively. The correlation between the mean of health anxiety and workload was significant only in the temporary dimension. Conclusions: Given the high workload and moderate level of health anxiety and the significant correlation between health anxiety and the temporary dimension of workload and the important role of appropriate workload in the health of nurses and the quality of nursing care, organizations and nursing managers should provide some strategies, like stuff shortage management in psychiatric wards and creating a suitable organizational culture.

The Relationship between Nurses' Moral Sensitivity and Patients' Satisfaction with the Care Received in the Medical Wards.

Introduction: The quality of care affects patients' satisfaction. To provide high quality care, nurses face ethical challenges in daily practice. Moral sensitivity is the first phase in moral implementation. This study aimed to determine the relationship between nurses' moral sensitivity and patients' satisfaction in medical wards. Methods: In descriptive correlational study 198 nurses and 198 patients in 17 medical wards filled out the Moral Sensitivity Questionnaire (MSQ) and Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), respectively. Nurses were sampled by the census method. For each nurse, a patient was selected randomly from the same ward. Data were analyzed using SPSS version 13. Results: The highest scores were in the dimensions of "relational orientation" and "following the rules", and the lowest scores were in the dimensions of "autonomy" and "experiencing moral conflicts". The highest level of patients' satisfaction was with "nurses' professional performance" 3.98 (1.09), and the lowest level was with "nurses' routine work" 2.69 (1.22). There was no significant relationship between the mean of patient satisfaction and moral sensitivity of nurses. Conclusion: Considering that nurses had a higher score in dimension of "following the rules" and a lower score in dimension of "autonomy", it seems ethical performance in the real situation is not merely due to the nurses' moral sensitivity and it seems the complexity of the organization causes nurses face difficulties in making decisions related to clinical practice; therefore, policy makers in the health system should be able to identify barriers.

Happiness and its Relationship with Job Burnout in Nurses of Educational Hospitals in Tabriz, Iran.

BACKGROUND: Happiness is a positive feeling that is vital and significant to maintain health. Nurses are working in difficult conditions which may heavily affect their level of happiness and ability to provide care. Job burnout is a mental reaction against some persistent source of workplace stress. The purpose of this study was to identify happiness and its relationship with job burnout in nurses working at Tabriz's educational hospitals. METHODS: This descriptive-correlational study was conducted on 344 nurses working at Tabriz's hospitals in 2018. The subjects were selected by means of proportionate stratified random sampling. Data were collected using three questionnaires (demographic information, job burnout with 22 items and three subscales and Oxford happiness with 29 items) and analyzed in SPSS version16 using descriptive statistics. Statistical tests such as Pearson correlation coefficient, independent t-test, one-way ANOVA, and multiple linear regression analysis were used to analyze the data. RESULTS: The age range of the participants was 23-57 years with a mean of 35.9±7.5. The mean score of happiness was 64.2±11.5, (score range 35 to 116), which suggests an average level of happiness among the nurses. There was a negative correlation between happiness and total job burnout (r=-0.29, P<0.001). This negative correlation remained significant (B=-0.15, P<0.001) even when nurses' perception of own health status (B=-5.24, P=0.01), history of illness (B=-4.47, P=0.04), job position (B=-6.61, P=0.001), and type of employment (B=3.56, P=0.03) as potential confounding factors were adjusted. CONCLUSION: Considering the reverse relationship between job burnout and happiness, it is suggested that managers try to improve the workplace by managing condition which could lead to job burnout, and therefore use the results to increase the happiness of nurses.

The Relationship between Emotional Intelligence and Perception of Job Performance among Nurses in North West of Iran.

Emotional intelligence skills help nurses to cope with the emotional demands of healthcare environment. The aim of this study was to identify the relationship between emotional intelligence and perception of job performance among nurses. Using a correlational descriptive design with stratified random sampling, 338 registered nurses from teaching hospitals in North West of Iran were surveyed. Emotional intelligence and perception of job performance were measured using validated self-report measures. The collected data were analyzed through descriptive and inferential methods using SPSS/13. The mean of nurses' emotional intelligence and their perception of job performance was, respectively, 235.83 ± 37.98 and 157.63 ± 33.23. There was no significant relationship between nurses' emotional intelligence and their perception of job performance. Although there was a significant relationship between intrapersonal subscale of emotional intelligence and job performance, there was none with other subscales. In order to get rid of the physical and psychological effects of stressful work in wards, it seems that nurses just do routine activities and refuse working closely with the patients. It seems that fitting the patient to nurse ratio, dividing work between nurses, and supporting each other are necessary.