Using the Tasmanian Palliative and End of Life Care Policy Framework (2022) to assess service delivery in a rural general practice.

AIMS: This commentary uses the Tasmanian Palliative and End of Life Care Policy Framework (2022; the TPE Framework) to reflect upon palliative care services delivered by a rural Tasmanian general practice. CONTEXT: Rural populations have challenges in accessing many healthcare services, including palliative care. General practitioners (GPs) and other primary healthcare workers are frequently relied upon to deliver palliative care in rural Australia. Palliative care is often needed before the end-of-life phase and patients prefer this to be delivered in the community or at home. GPs face challenges and barriers in continuing to deliver home-based palliative care services. APPROACH: All Medical Benefit Scheme billings for after-hours or home-based palliative care provided by the practice, between September 2021 and August 2022, were identified and patient demographic and clinical details collated. To further understand this data, nine GPs were surveyed to explore their attitudes to provision of palliative care service to the local rural communities they serve. These data highlighted several priority areas of the TPE Framework. The TPE Framework is used here to add to the shared understanding of palliative care service delivery in a rural community, and to see if GP's responses align with the priorities of the TPE Framework. Of the 258 after-hours and home-visits delivered over a 12-month period, almost 58% (n = 150) were for palliative care. Patients receiving palliative care were generally older than non-palliative patients visited (79.9 years vs. 72.0 years respectively; p = 0.004). Patients not at imminent risk of death (64.0%) were more frequently recipients of home-visits. Of the nine GPs responding to the survey, most intended to continue home visits for palliative patients. Disincentives to providing palliative care during home visits included a lack of time during the day (or after hours), low levels of interdisciplinary coordination or role-definition, and inadequate remuneration. CONCLUSION: Existing frameworks can be used as an implementation and evaluation guide to help understand local palliative care services. Using a Framework, a rural general practice in Tasmania reflected on their provision of palliative care services. Providing holistic palliative care services from a rural general practice is desirable and achievable with a coordinated, team-based approach. Access to and integration with specialist services remains a key component of community-based palliative care pathways.

Competencia emocional y características sociodemográficas y profesionales de las enfermeras / Competência emocionais e características sociodemográficas e profissionais de enfermeiros / Emotional competence and sociodemographic and professional characteristics of nurses

Introducción: En los profesionales de la salud, las habilidades que les permitan lidiar con las emociones propias y ajenas garantizan la calidad de la atención brindada y una relación terapéutica eficaz. Por lo tanto, son fundamentales para los enfermeros, es decir, para aquellos que actúan en las unidades de salud de la familia. Objetivo: Analizar la relación entre la competencia emocional de las enfermeras que trabajan en unidades de salud de la familia en un grupo de centros de salud en el norte de Portugal y sus características sociodemográficas y profesionales. Método: Metodología cuantitativa, de tipo transversal descriptivo-correlacional. Datos recogidos a través de un cuestionario electrónico que constaba de dos partes: características sociodemográficas y profesionales de los participantes y cuestionario de competencia emocional. 66 enfermeras compusieron la muestra. Resultados: Las enfermeras del estudio mostraron altos niveles de competencia emocional (media = 205,1, desviación estándar = 20,9). No hubo diferencias estadísticamente significativas entre las características sociodemográficas y profesionales y la competencia emocional.Conclusiones: Aunque no está clara la relación entre la competencia emocional y las características sociodemográficas y profesionales, es cierta la importancia de la inteligencia emocional en la práctica asistencial. (AU)

Introdução: Em profissionais de saúde, competências que permitam lidar com as próprias emoções e com as dos outros garantem a qualidade dos cuidados prestados e uma relação terapêutica eficaz. Daí serem fundamentais para enfermeiros, nomeadamente para os que executem funções em unidades de saúde familiares. Objetivo: Analisar a relação entre a competência emocional dos enfermeiros das unidades de saúde familiar de um agrupamento de centros de saúde do norte de Portugal e as suas características sociodemográficas e profissionais. Método: Metodologia quantitativa, do tipo transversal descritivo-correlacional. Dados recolhidos através de um questionário eletrónico que consistia em duas partes: características sociodemográficas e profissionais dos participantes e questionário de competência emocional. 66 enfermeiros compuseram a amostra. Resultados: Os enfermeiros do estudo apresentaram elevados níveis de competência emocional (média = 205,1, desvio padrão = 20,9). Não se evidenciaram diferenças estatisticamente significativas entre as características sociodemográficas e profissionais e a competência emocional. Conclusões: Apesar de não ser clara a relação entre a competência emocional e as características sociodemográficas e profissionais, é certa a importância da inteligência emocional na prática de cuidados. (AU)

Introduction: In health professionals, skills that allow them to deal with their own emotions and those of others guarantee the quality of care provided and an effective therapeutic relationship. Hence, they are fundamental for nurses, namely for those who work in family health units. Objective: To analyze the relationship between the emotional competence of nurses working in family health units in a group of health centers in the north of Portugal and their sociodemographic and professional characteristics.Method: Quantitative methodology, of the transversal descriptive-correlational type. Data collected through an electronic questionnaire that consisted of two parts: sociodemographic and professional characteristics of the participants and emotional competence questionnaire. 66 nurses composed the sample.Results: The nurses in the study showed high levels of emotional competence (mean = 205.1, standard deviation = 20.9). There were no statistically significant differences between sociodemographic and professional characteristics and emotional competence. Conclusions: Although the relationship between emotional competence and sociodemographic and professional characteristics is unclear, the importance of emotional intelligence in care practice is certain. (AU)

Percepção dos enfermeiros sobre condições de trabalho na atenção primária durante a pandemia de sars-cov-2 / Nurses perception of working conditions in primary care during the sars cov-2 pandemic / Percepción de las enfermeras sobre las condiciones de trabajo en atención primaria durante la pandemia por sars-cov-2

Objetivo: Analisar a percepção do enfermeiro acerca das condições de trabalho no contexto da Atenção Primária à Saúde (APS) durante a pandemia de SARS-CoV-2. Métodos: Trata-se de um estudo descritivo, transversal, de abordagem qualitativa, recorte de um estudo multicêntrico e de abrangência nacional. Os dados apresentados neste estudo correspondem aos obtidos no estado do Rio Grande do Norte, onde foram entrevistados 45 enfermeiros da APS no período de dezembro de 2020 a abril de 2021. Após as entrevistas, as narrativas gravadas foram transcritas e analisadas através da Análise de Conteúdo de Bardin. Resultados: A partir da fala dos enfermeiros, evidenciou-se que a utilização de Equipamentos de Proteção Individual, a organização e desenvolvimento de novos protocolos e fluxos assistenciais trouxeram sofrimento psíquico aos profissionais, tanto pelas condições de trabalho inadequadas, quanto pela proximidade com o sofrimento de pacientes e o medo de contágio. Conclusão: Mesmo com tantas dificuldades, os enfermeiros lotados na atenção primária à saúde tiveram que reconstruir suas práticas na perspectiva de garantir, dentro dos limites impostos pela situação adversa, a melhor assistência possível, mostrando a força e resiliência das equipes da APS nos mais diversos contextos. (AU)

Objective: To analyze the perception of nurses about working conditions in the context of PHC during the COVID-19 pandemic. Methods: This is a descriptive, cross-sectional study with a qualitative approach, part of a multicenter study with a national scope. The data presented in this study correspond to those obtained in the state of Rio Grande do Norte, in which 45 nurses from primary health care were interviewed from December 2020 to April 2021. After the interviews, the recorded narratives were transcribed and analyzed through the Bardin's Content Analysis. Results: The collective discourse showed that the use of Personal Protective Equipment, the organization and development of new protocols and care flows brought psychic suffering to professionals, both due to inadequate working conditions and the proximity to the suffering of patients and the fear of Contagion. Conclusion: Even with so many difficulties, nurses working in primary health care had to rebuild their practices in order to guarantee, within the limits imposed by the adverse situation, the best possible assistance, showing the strength and resilience of PHC teams in the most diverse contexts. (AU)

Objetivo: Analizar la percepción de los enfermeros sobre las condiciones de trabajo en el contexto de la APS durante la pandemia de COVID-19. Métodos: Se trata de un estudio descriptivo transversal con enfoque cualitativo, parte de un estudio multicéntrico de alcance nacional. Los datos presentados en este estudio corresponden a los obtenidos en el estado de Rio Grande do Norte, en el que fueron entrevistados 45 enfermeros de atención primaria de salud entre diciembre de 2020 y abril de 2021. Después de las entrevistas, las narraciones grabadas fueron transcritas y analizadas a través de la escala de Bardin. Análisis de contenido. Resultados: El discurso colectivo mostró que el uso de Equipos de Protección Individual, la organización y desarrollo de nuevos protocolos y flujos de atención trajeron sufrimiento psíquico a los profesionales, tanto por las inadecuadas condiciones de trabajo como por la proximidad al sufrimiento de los pacientes y el miedo al Contagio. Conclusión: Incluso con tantas dificultades, los enfermeros que actúan en la atención primaria de salud tuvieron que reconstruir sus prácticas para garantizar, dentro de los límites impuestos por la situación adversa, la mejor asistencia posible, mostrando la fortaleza y resiliencia de los equipos de APS en los más diversos contextos. (AU)

Um olhar sobre a autonomia: percepções de enfermeiras sobre suas práticas na atenção primária / A look at autonomy: nurses' perceptions about their practices in primary care / Una mirada a la autonomía: percepciones de los enfermeros sobre sus prácticas en la atención primaria

Objetivo: Analisar a percepção de enfermeiras sobre a autonomia no exercício de suas práticas no contexto da atenção primária à saúde. Métodos: Estudo descritivo de abordagem qualitativa que analisou 108 entrevistas realizadas com enfermeiras(os) das quatro capitais da região sudeste do Brasil. As entrevistas, guiadas por roteiro semiestruturado, foram gravadas e transcritas. Os dados produzidos foram tratados e explorados com auxílio do software NVIVO®. Resultados: A maior parte das participantes eram mulheres, brancas, residiam na mesma cidade onde trabalham, graduaramse em instituições privadas. Foram organizadas duas categorias: repercussões da autonomia e seus desdobramentos para a resolutividade das necessidades em saúde dos usuários; e (des)conhecimento sobre a regulamentação das práticas da enfermeira: desafios para a autonomia. Conclusão: As enfermeiras compreendem a importância da autonomia para suas práticas, mas enfrentam interferências no cotidiano do trabalho, tanto por parte da gestão, da estrutura dos serviços ou da necessidade do uso de protocolos que garantam o exercício de sua atividade profissional de modo autônomo. (AU)

Objective: To analyze nurses' perception of autonomy to exercise their practices in the context of primary health care. Methods: A descriptive study with a qualitative approach that analyzed 108 interviews carried out with nurses from the four capitals of the southeastern region of Brazil. The interviews, guided by a semi-structured script, were recorded and transcribed. The data produced were processed and explored with the help of the NVIVO® software. Results: Most of the participants were women, white, lived in the same city where they work, and graduated from private institutions. Two categories were organized: repercussions of autonomy and its consequences for solving users' health needs; and (lack of) knowledge about the regulation of nursing practices: challenges for autonomy. Conclusion: Nurses understand the importance of autonomy for their practices, but they face interference in their daily work, either by management, the structure of services or the need for protocols that guarantee the exercise of their professional activity. (AU)

Objetivo: Analizar la percepción de autonomía de los enfermeros para ejercer sus prácticas en el contexto de la atención primaria de salud. Métodos: Estudio descriptivo con enfoque cualitativo que analizó 108 entrevistas realizadas con enfermeros de las cuatro capitales de la región sureste de Brasil. Las entrevistas, guiadas por un guión semiestructurado, fueron grabadas y transcritas. Los datos producidos fueron procesados y explorados con la ayuda del software NVIVO®. Resultados: La mayoría de los participantes eran mujeres, de raza blanca, vivían en la misma ciudad donde trabajan y egresaron de instituciones privadas. Se organizaron dos categorías: repercusiones de la autonomía y sus consecuencias para la solución de las necesidades de salud de los usuarios; y (falta de) conocimiento sobre la regulación de las prácticas de enfermería: desafíos para la autonomía. Conclusión: Los enfermeros comprenden la importancia de la autonomía para sus prácticas, pero enfrentan interferencias en su trabajo diario, ya sea por parte de la dirección, la estructura de los servicios o la necesidad de protocolos que garanticen el ejercicio de su actividad profesional. (AU)

Who Provides Outpatient Clinical Care for Adults With ADHD? Analysis of Healthcare Claims by Types of Providers Among Private Insurance and Medicaid Enrollees, 2021.

OBJECTIVE: To characterize provider types delivering outpatient care overall and through telehealth to U.S. adults with ADHD. METHOD: Using employer-sponsored insurance (ESI) and Medicaid claims, we identified enrollees aged 18 to 64 years who received outpatient care for ADHD in 2021. Billing provider codes were used to tabulate the percentage of enrollees receiving ADHD care from 10 provider types overall and through telehealth. RESULTS: Family practice physicians, psychiatrists, and nurse practitioners/psychiatric nurses were the most common providers for adults with ESI, although the distribution of provider types varied across states. Lower percentages of adults with Medicaid received ADHD care from physicians. Approximately half of adults receiving outpatient ADHD care received ADHD care by telehealth. CONCLUSION: Results may inform the development of clinical guidelines for adult ADHD and identify audiences for guideline dissemination and education planning.

Building capacity for ATLS trauma education: role of nurse practitioners and physician assistants.

Objectives: Advanced Trauma Life Support (ATLS) focuses on care of injured patients in the first hour of resuscitation. Expanded demand for courses has led to a concurrent need for new instructors. Nurse practitioners and physician assistants (NPs/PAs) work on trauma services and duties include patient, staff, and outreach education. The goal of this project was to assess NP/PA self-reported knowledge and skills pertinent to ATLS and identify potential barriers to becoming instructors. Materials: This was a voluntary 91-question survey emailed to NP/PA lists obtained from professional societies and online social media channels. NPs/PAs completed a survey reflecting self-reported knowledge, experience, comfort level, and barriers to teaching ATLS interactive discussions and skills. Responses were recorded using a Likert scale and results were documented as percentages. Number of years of experience versus perceived knowledge and comfort teaching were compared using a χ2 test of independence. Results: There were 1696 completed surveys. Most NPs/PAs thought they had adequate knowledge and experience to teach interactive discussions and skills. Those with more years of experience and those who completed more ATLS courses had higher percentages. The number 1 barrier to teaching was lack of formal teaching experience followed by perceived hierarchy concerns. Experience and comfort with skills that fell below 50% were pediatric airway (49.5%), needle and surgical cricothyrotomy (49.8% and 44.8%), diagnostic peritoneal lavage (21.6%), and venous cutdown (20.8%). Conclusion: NPs/PAs with experience in trauma reported having the knowledge and skill to teach ATLS. A majority are comfortable teaching interactive discussions and skills for which they are knowledgeable. The primary barrier to teaching was lack of formal teaching experience, which is covered in the ATLS Instructor course. Training NPs/PAs to become instructors would increase the instructor base and allow for increased promulgation of ATLS and trauma education. Level of evidence: IV.

State scope of practice restrictions and nurse practitioner practice in nursing homes: 2012-2019.

Increased engagement of nurse practitioners (NPs) has been recommended as a way to address care delivery challenges in settings that struggle to attract physicians, such as primary care and rural areas. Nursing homes also face such physician shortages. We evaluated the role of state scope of practice regulations on NP practice in nursing homes in 2012-2019. Using linear probability models, we estimated the proportion of NP-delivered visits to patients in nursing homes as a function of state scope of practice regulations. Control variables included county demographic, socioeconomic, and health care workforce characteristics; state fixed effects; and year indicators. The proportion of nursing home visits conducted by NPs increased from 24% in 2012 to 42% in 2019. Expanded scope of practice regulation was associated with a greater proportion and total volume of nursing home visits conducted by NPs in counties with at least 1 NP visit. These relationships were concentrated among short-stay patients in urban counties. Removing scope of practice restrictions on NPs may address clinician shortages in nursing homes in urban areas where NPs already practice in nursing homes. However, improving access to advanced clinician care for long-term care residents and for patients in rural locations may require additional interventions and resources.

Application of an Antiracism Framework to Improve Pediatric APRN Education.

Poor health outcomes for children are directly tied to poor social determinants of health and systemic, embedded health care inequities. To prepare the next generation of pediatric advanced practice registered nurses (APRNs), nursing schools must educate students to address inequities through innovative curricular models and teaching modalities. The purpose of this manuscript is to describe the application of an antiracism framework to a graduate APRN program. This article describes the application of this framework, which led to significant administrative, curricular, and course changes to prepare pediatric-focused APRN students to address the health inequities and poor social determinants of health facing children today. By describing our journey to embed an antiracism framework, other nursing schools can make substantive changes necessary to prepare their students to address these health inequities.

Developing a NAPNAP Research Agenda to Guide Future Research and Quality Improvement in Pediatrics: Process, Challenges, and Future Directions.

INTRODUCTION: This study aimed to develop a revised pediatric Research Agenda that highlights the clinical and research priorities for pediatric-focused advanced practice registered nurses and is culturally sensitive and inclusive. METHOD: The National Association of Pediatric Nurse Practitioners (NAPNAP) Research Committee developed the Research Agenda 2021-2026 by conducting a cross-sectional study that surveyed the membership on their research and clinical priorities in June 2020. Twenty-four priorities were identified within seven areas of focus. RESULTS: Among the 7,509 National Association of Pediatric Nurse Practitioners members, 273 (3.6%) responded to the email and 199 completed the survey. DISCUSSION: This revised Research Agenda is a bold and innovative guide for grant funding, publications, continuing education offerings, conference planning, and abstract submissions for posters and podium presentations aimed at improving pediatric health care. A discussion of the process and considerations for the future development of pediatric Research Agendas is described.

Barriers and facilitators to giving prehabilitation advice by clinical nurse specialists and advanced nurse practitioners in oncology patients.

PURPOSE: This is the second article in this series on the knowledge, attitudes and beliefs of clinical nurse specialists (CNSs) and ANPs (advanced nurse practitioners) regarding prehabilitation advice in oncology patients, exploring the barriers and facilitators to giving prehabilitation advice by CNSs and ANPs in oncology patients. METHODS: A Cross-sectional online questionnaire opens for 3 months to establish the knowledge, attitudes and beliefs of ANPs and CNSs to prehabilitation disseminated through professional organisations and social media. RESULTS: The questionnaire gained (n = 415) responses. Prehabilitation advice was routinely given by 89% (n = 371) of respondents. Many (60%) identified a lack of guidance and referral processes as a barrier to giving prehabilitation advice; this corresponded between respondents' confidence to give prehabilitation advice and subsequent referrals (< 0.001). Other factors included time (61%), a lack of patient interest (44%) and limited relevance to patients (35%). CONCLUSION: The implementation of standardised nurse prehabilitation advice resources would enable CNSs and ANPs to provide personalised prehabilitation advice in their consultations.

Utilizing Nurse Practitioners and Physician Assistants in Academic Emergency Departments Does Not Reduce Residents' Exposure to More Complex Patients.

BACKGROUND: Whether integration of nurse practitioners (NPs) and physician assistants (PAs) into academic emergency departments (EDs) affects emergency medicine (EM) resident clinical learning opportunities is unclear. OBJECTIVE: We sought to compare EM resident exposure to more-complex patients, as well as patients undergoing Accreditation Council for Graduate Medical Education (ACGME)-required procedures, at nonpediatric academic EDs with lower, moderate, and higher levels of NP/PA utilization. METHODS: In this cross-sectional study of National Hospital Ambulatory Medical Care Survey (NHAMCS) data for 2016-2020, nonpediatric academic EDs were classified into the following three groups based on the percentage of patients seen by an NP or PA: lower (≤ 10%), moderate (10.1-30%), and higher (> 30%) NP/PA utilization. The proportion of EM resident-seen patients meeting previously established complex patient criteria was then determined for EDs at each level of NP/PA utilization. The proportion of EM resident-seen patients receiving certain ACGME-required procedures was also determined. Survey analytic procedures and weighting as recommended by NHAMCS were used to calculate and compare proportions using 95% CIs. RESULTS: The weighted 2016-2020 NHAMCS data sets represent 44,130,996 adult resident-seen patients presenting to nonpediatric academic EDs. The proportion of resident-seen patients meeting complex patient criteria did not significantly differ for lower (43.2%; 95% CI 30.6-56.8%), moderate (41.7%; 95% CI 33.0-50.9%), or higher (38.9%; 95% CI 29.3-49.4%) NP/PA utilization EDs. The proportion of patients undergoing an ACGME-required procedure also did not significantly differ across level of NP/PA utilization. CONCLUSIONS: Higher levels of NP/PA utilization in nonpediatric academic EDs do not appear to reduce EM resident exposure to more-complex patients or ACGME-required procedures.

Implementation of a nurse practitioner service in a rural setting: a qualitative analysis of healthcare practitioners' experiences.

BACKGROUND: Nurse Practitioners work independently and collaboratively within multidisciplinary teams to fill unmet service delivery needs. Despite strong evidence of the benefits of the nurse practitioner service model, organisational support for nurse practitioners varies in terms of resources and support from leadership and other healthcare professionals. AIMS: The study aimed to explore healthcare practitioners' experiences of implementation of a NP service in a rural setting. METHODS: Semi-structured interviews were conducted with ten healthcare practitioners to investigate their perspectives of a recently implemented NP service. Data were analysed inductively using thematic analysis. FINDINGS: Themes emerged related to facilitating collaborative practice, person-centred continuity of care and positive health outcomes for the community. Challenges and limitations related to operational role clarity, scopes of practice and leadership. CONCLUSION: Healthcare practitioners were mostly satisfied with the service however challenges caused tension. Change management principles provide a framework to strengthen the effective clinical alignment of the service.

Interprofessional education within a nurse practitioner led paediatric service: A multi-methods study.

AIM: This project explored whether a nurse practitioner led mobile paediatric screening service in early learning centres could incorporate allied health and nursing students and develop their confidence in interprofessional collaboration. BACKGROUND: Interprofessional collaboration is essential for health professionals across all contexts of care, including early childhood screening and intervention that enables children to thrive. METHODS: This multi-methods study (pre-test/post-test design) was conducted with nursing, physiotherapy, occupational therapy and nutrition and dietetics students attending clinical placement within the nurse practitioner led mobile paediatric service. Data were collected via pre and post placement surveys (ISVS-21) and post placement semi-structured interviews. RESULTS: Twelve students participated from July to December 2022. Survey findings demonstrated students improved inter-professional socialisation and readiness, supported by qualitative findings that uncovered unique mechanisms for how positive experiences were achieved. Unique pedagogical elements included 1) the nurse practitioner's professional attributes and 2) the mobile nature of the service leveraging learning opportunities within the shared commute. CONCLUSIONS: This study provides proof-of-concept of a placement model that facilitates interprofessional collaboration in nursing and allied health students. Further research should explore longer-term outcomes and scalability.

Pediatric Mental Health Care and Scope-of-Practice Expansions.

To examine the association between psychologist and nurse practitioner scope-of-practice (SoP) regulations and pediatric mental health service access. A nationally representative sample of children with mental health needs was identified using 5 years of National Survey of Children's Health (2016-2020). Utilization was measured in two ways: (1) unmet mental health care needs and (2) receipt of mental health medication. Expanded SoP for psychologists and nurse practitioners was measured based on the child's state of residence and the year of the survey. The associations between both SoP expansion and both outcomes were assessed using logistic regression models adjusted for multiple covariates. The probability of having unmet mental health needs was 5.4 percentage points lower (95% CI - 0.102, - 0.006) for children living in a state with psychologist SoP expansion; however, there was no significant difference in unmet mental health needs between states with and without NP SoP expansion. The probability of receiving a mental health medication was 2.0 percentage points higher (95% CI 0.007, 0.034) for children living in a state with psychologist SoP expansion. Conversely, the probability of receiving a mental health medication was 1.5 percentage points lower (95% CI - 0.023, - 0.007) for children living in a state with NP SoP expansion. Expanded SoP for psychologists is associated with improved access to pediatric mental health care in terms of both unmet need and receiving medication. Expanded SoP for NPs, however, was not associated with unmet need and lower receipt of medication.

The impact of psychological distress, socio-demographic and work-related factors on coping strategies used by nurses during the COVID-19 pandemic: A cross-sectional study.

AIM: This study aimed to determine factors associated with coping strategies used by nursing staff during the COVID-19 pandemic in Iran. DESIGN: Cross-sectional study. METHODS: A convenience sample of 365 nurses were selected from referral hospitals for COVID-19 patients in Tabriz, Iran between February 2022 and July 2022. An online self-administered questionnaire was distributed through social media platforms, including WhatsApp and Instagram. The survey package included a modified Brief COPE scale, socio-demographic and work-related questions, and a measure of psychological distress. Multiple regression analysis examined associated factors with coping strategies in SPSS. The study adhered to the STROBE guidelines for reporting. RESULTS: The mean age of participants was 31.2 (7.3) years old. Of the 365 participants, 209 (58.9%) used maladaptive coping strategies, and 214 (57.6%) reported experiencing psychological distress. Psychological distress was the strongest predictor of maladaptive coping strategies (ß = 4.473, p < 0.001). Female nurses (ß = 3.259, p < 0.05), nurses who were under 35 years of age (ß = 3.214, p < 0.05), nurses with fewer than ten years of experience (ß = 2.416, p < 0.001), those who worked in COVID-19 ICUs (ß = 4.321, p < 0.001), floor nurses (ß = 2.344, p < 0.001), and those who worked two or more years in COVID-19 settings (ß = 3.293, p < 0.001) had higher mean scores in maladaptive coping strategies. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contributions.