The value of human resources: Experience of critical care nurses during the COVID-19 epidemic.

The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units. OBJECTIVE: To learn about the experience of nurses in caring for people with coronavirus in critical care units. METHOD: A qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis. RESULTS: This article shows the findings around the theme "the value of human resources" which is nuanced through sub-themes "it's not the beds, it's the expert staff", "shouldering the patient's burden", and suffering because "they have not cared well". DISCUSSION: Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge. CONCLUSIONS: Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.

El valor del recurso humano: experiencia de profesionales enfermeros de cuidados críticos durante la pandemia por COVID-19 / The value of human resources: experience of critical care nurses during the COVID-19 epidemic

La pandemia por COVID-19ha supuesto una crisis sanitaria sin precedentes. La presión asistencial sobre el Sistema Nacional de Salud ha generado escenarios insólitos de demanda especialmente llamativos en algunos servicios o unidades asistenciales como las Unidades de Cuidados Críticos.Objetivo: Conocer la experiencia de los profesionales enfermeros referida a la atención de personas infectadas por coronavirus en las Unidades de Cuidados Críticos.Método: Estudio cualitativo de carácter fenomenológico que constituye la segunda fase de un proyecto de metodología mixta. Se realizaron entrevistas a 17 enfermeras que prestaron cuidados en Unidades de Cuidados Críticos a pacientes afectados de COVID-19. Las entrevistas fueron audiograbadas, transcritas y analizadas mediante análisis temático del discurso.Resultados: En este artículo se muestran los hallazgos en torno al tema «el valor del recurso humano» que matiza su significado a través de los subtemas «no son las camas, es el personal experto», «llevando la carga del paciente» y sufriendo por «no haber cuidado bien».Discusión: Los profesionales enfermeros expertos se erigen como profesionales líderes en el cuidado del paciente crítico durante la pandemia por COVID-19. Este liderazgo se ejerce desde un perfil enmarcado en una filosofía integradora donde sabiduría, agilidad e intuición son los elementos clave que dan soporte a la identificación y resolución de problemas de forma creativa adaptándose a las necesidades emergentes de los pacientes y equipo de cuidados.Conclusiones: Los profesionales enfermeros expertos han desempeñado un rol avanzado en la gestión de cuidados y de recursos humanos mediante el ejercicio de un liderazgo eficiente en el entorno clínico. Los cuidados se han visto mermados por la situación de crisis, circunstancia que les genera sufrimiento moral por no haber podido cumplir con los estándares de calidad y excelencia en el cuidado.

The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units.Objective: To learn about the experience of nurses in caring for people with coronavirus in critical care units.MethodA qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis.Results: This article shows the findings around the theme “the value of human resources” which is nuanced through sub-themes “it's not the beds, it's the expert staff”, “shouldering the patient's burden”, and suffering because “they have not cared well”.Discussion: Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge.Conclusions: Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.

[The value of human resources: experience of critical care nurses during the COVID-19 epidemic]. / El valor del recurso humano: experiencia de profesionales enfermeros de cuidados críticos durante la pandemia por COVID-19.

The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units. Objective: To learn about the experience of nurses in caring for people with coronavirus in critical care units. Method: A qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis. Results: This article shows the findings around the theme "the value of human resources" which is nuanced through sub-themes "it's not the beds, it's the expert staff", "shouldering the patient's burden", and suffering because "they have not cared well". Discussion: Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge. Conclusions: Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.

La visita infantil a la unidad de cuidados intensivos pediátricos desde la experiencia de las enfermeras / Children's visits to the paediatric intensive care unit from the nurses’ experience

Objetivo Explorar la experiencia de las enfermeras en relación con la facilitación de la visita infantil a la UCIP. Método Estudio fenomenológico interpretativo mediante entrevistas en profundidad. El estudio se desarrolló en las UCIP de dos centros públicos madrileños de nivel IIIC. Participaron 12 enfermeras con experiencia mayor de dos años en UCIP que, en el momento de la entrevista, prestaban servicios en dichas unidades. Además, se entrevistó a una psicóloga con experiencia de cuatro años en UCIP cuya información se consideró en el contexto de los datos en la sombra. La información se analizó mediante un análisis temático del discurso. ResultadosLa experiencia de las enfermeras en relación a la facilitación de la visita infantil a la UCIP se puede condensar en cuatro temas: el emerger de la demanda, la preparación progresiva, la toma de decisiones desde el consenso y la creación de espacios de intimidad. Conclusiones Las experiencias de facilitación de la visita responden, principalmente, a la demanda de las familias que viven hospitalizaciones prologadas o al final de la vida. El rol de la enfermera es de acompañamiento reconociendo la labor prioritaria de los padres en la preparación de los niños y el desarrollo de la visita. Las enfermeras se sienten inseguras y faltas de recursos para el apoyo emocional y reclaman protocolos de actuación que orienten la intervención y toma de decisiones. (AU)

Aim To explore nurses’ experience related to promoting the visits of siblings to PICU. Methods An interpretative phenomenological study was carried out through in-depth interviews in two PICUs belonging to third level public hospitals in Madrid. Twelve nurses with more than two years of experience in PICU were interviewed. They all were working in PICU during the study. Furthermore, a PICU psychologist with an experience of four years was interviewed and this was considered shadowed data. Data analysis followed a thematic discourse analysis. Results Nurses’ experience of facilitating children's visits to PICU can be condensed into four themes: emerging demand for visits, progressive preparation, decision-making through common consensus and creating intimate spaces. Conclusions The experience of nurses in facilitating visits is mainly in response to the demand of families going through prolonged hospitalisation or end-of-life situations. The role of the nurse is one of accompaniment, recognising the major role of parents in the preparation of children and in developing the visit. Nurses feel insecure and lack resources for emotional support and demand action protocols to guide intervention and decision making. (AU)

Children's visits to the paediatric intensive care unit from the nurses' experience.

BACKGROUND: Family process disruption is one of the main consequences of the hospitalization of a critically ill child in a Paediatric Intensive Care Unit (PICU). Children's visits to PICU may help improve family coping. However, this is not standard practice and nurses' experiences in facilitating children's visits to units where it is encouraged is unknown. AIM: To explore nurses' experience related to promoting the visits of siblings to PICU. METHODS: An interpretative phenomenological study was carried out through in-depth interviews in two PICUs belonging to third level public hospitals in Madrid. Twelve nurses with more than two years of experience in PICU were interviewed. They were all were working in PICU during the study. Furthermore, a PICU psychologist with an experience of four years was interviewed and this was considered shadowed data. Data analysis followed a thematic discourse analysis. RESULTS: Nurses' experience of facilitating children's visits to PICU can be condensed into four themes: emerging demand for visits, progressive preparation, decision-making through common consensus and creating intimate spaces. CONCLUSIONS: The experience of nurses in facilitating visits is mainly in response to the demand of families going through prolonged hospitalisation or end-of-life situations. The role of the nurse is one of accompaniment, recognising the major role of parents in the preparation of children and in developing the visit. Nurses feel insecure and lack resources for emotional support and demand action protocols to guide intervention and decision making.

Sentirse vulnerable (o no): repensando la noción de grupo vulnerable / Feeling vulnerable (or not): rethinking the notion of vulnerable group

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LOXL2-mediated H3K4 oxidation reduces chromatin accessibility in triple-negative breast cancer cells.

Oxidation of H3 at lysine 4 (H3K4ox) by lysyl oxidase-like 2 (LOXL2) generates an H3 modification with an unknown physiological function. We find that LOXL2 and H3K4ox are higher in triple-negative breast cancer (TNBC) cell lines and patient-derived xenografts (PDXs) than those from other breast cancer subtypes. ChIP-seq revealed that H3K4ox is located primarily in heterochromatin, where it is involved in chromatin compaction. Knocking down LOXL2 reduces H3K4ox levels and causes chromatin decompaction, resulting in a sustained activation of the DNA damage response (DDR) and increased susceptibility to anticancer agents. This critical role that LOXL2 and oxidized H3 play in chromatin compaction and DDR suggests that functionally targeting LOXL2 could be a way to sensitize TNBC cells to conventional therapy.

Case study: community nursing care plan for an elderly patient with urinary incontinence and social interaction problems after prostatectomy.

PURPOSE: The purpose of this paper is to show nursing procedures and standardized languages in care provided by community nurses to a patient affected by urinary incontinence after a prostatectomy. DATA SOURCES: Data were extracted from patient interviews during various consultations with the community nurse, and from electronic health records. The care plan was based on available scientific evidence. DATA SYNTHESIS: Clinical reasoning was used to select NANDA-I diagnoses, nursing outcomes classification, and nursing interventions classification. CONCLUSIONS: Urinary incontinence problems have a physical, psychological, and social development impact on people who suffer from this condition.

[Ineffective sexuality pattern in an adolescent: nursing approach in primary health care]. / Patrón sexual ineficaz en un adolescente: abordaje enfermero en atención primaria.

Adolescent is a phase of continual physiological, psychological and social adaptation. It is during this time that young people tend to have their first sexual experiences. Sexual dysfunctions are characterized by important clinical changes in sexual desire and/or by psycho-physiological changes in the sexual response cycle. Premature ejaculation is one of the most frequent sexual dysfunction amongst men, with a higher prevalence in the younger population compared to other populations. The clinical case is presented of a 17 year-old male who experienced difficulties during his sexual relations. It is discussed whether his condition was a sexual dysfunction or ineffective sexual pattern. The care plan which was developed in nursing consultation was described for ineffective sexual pattern; the pending nursing treatment incorporated activities recommended by scientific evidence. Finally, the role of primary health care nursing professionals is pointed out in the detection and approach of sexual problems in adolescents.

Patrón sexual ineficaz en un adolescente: abordaje enfermero en atención primaria / Ineffective sexuality pattern in an adolescent: Nursing approach in primary health care

La adolescencia es una etapa de continua adaptación fisiológica, psicológica y social. Es durante este tiempo cuando los jóvenes suelen tener sus primeras experiencias sexuales. Los trastornos sexuales se caracterizan por alteraciones clínicas importantes del deseo sexual y/o por cambios psicofisiológicos en su ciclo de respuesta. La eyaculación precoz es una de las alteraciones sexuales más frecuentes en hombres, presentando una prevalencia mayor en jóvenes que en otros grupos etarios. Se presenta el caso clínico de un varón de 17 años que manifiesta dificultades durante sus relaciones sexuales. Se discute sobre el diagnóstico diferencial entre las etiquetas diagnósticas disfunción sexual y patrón sexual ineficaz Se describe el plan de cuidados desarrollado en consulta de enfermería ante el problema patrón sexual ineficaz, incorporándose, en el tratamiento enfermero a realizar, las actividades recomendadas por la evidencia científica. Finalmente se señala el papel de los profesionales enfermeros de atención primaria en la detección y abordaje de los problemas sexuales en adolescentes (AU)

Adolescent is a phase of continual physiological, psychological and social adaptation. It is during this time that young people tend to have their first sexual experiences. Sexual dysfunctions are characterized by important clinical changes in sexual desire and/or by psycho-physiological changes in the sexual response cycle. Premature ejaculation is one of the most frequent sexual dysfunction amongst men, with a higher prevalence in the younger population compared to other populations. The clinical case is presented of a 17 year-old male who experienced difficulties during his sexual relations. It is discussed whether his condition was a sexual dysfunction or ineffective sexual pattern. The care plan which was developed in nursing consultation was described for ineffective sexual pattern; the pending nursing treatment incorporated activities recommended by scientific evidence. Finally, the role of primary health care nursing professionals is pointed out in the detection and approach of sexual problems in adolescents (AU)

Aprendizaje basado en problemas en la formación de estudiantes de enfermería. Impacto en la práctica clínica / Assessing the impact on clinical internship of problem-based learning applied to nursing studies

Objetivo. Evaluar el impacto en la práctica clínica de la implantación de la metodología del aprendizaje basado en problemas (ABP) aplicada a los estudios de enfermería. Sujetos y métodos. Estudio longitudinal prospectivo en dos cohortes de estudiantes de enfermería: el grupo intervención fue la promoción 2005-2006 de la escuela de enfermería, que recibió su educación con la metodología del ABP, y el grupo control fue la promoción de 2004-2005, que recibió su formación a través de otras metodologías docentes, fundamentalmente clases magistrales y seminarios. Se analizó la posible asociación, en cada uno de los elementos del formulario de evaluación del tutor, entre la calificación obtenida por los estudiantes y la metodología de aprendizaje empleada durante su educación (ABP o no ABP). Los criterios de evaluación fueron: responsabilidad, iniciativa, habilidad y destreza en técnicas y procedimientos manuales, organización y metodología en las actividades, comunicación/relación con usuarios y familiares y comunicación/relación con el equipo de trabajo, y grado de consecución de los objetivos docentes. Resultados. Se obtuvieron 651 formularios de evaluación válidos, 383 para el grupo control y 268 para el grupo intervención. Se encontraron diferencias estadísticamente significativas sólo en el tercer año, en la categoría ‘habilidad y destreza en las técnicas relacionadas con los procedimientos manuales’ (p = 0,007). El grupo control obtuvo una mejor puntuación. Conclusiones. Los resultados sugieren que el uso de ABP en la formación académica de los estudiantes de enfermería no modifica la puntuación obtenida en su práctica clínica en las categorías recogidas en nuestra herramienta de evaluación (AU)

Aim. To assess the impact on clinical internship of problem-based learning (PBL) methodology applied to nursing studies. Subjects and methods. Longitudinal and prospective study of two cohorts of nursing students: the intervention group was the promotion 2005-2006 of the nursing school, that received their education with PBL, and the control group was the promotion 2004-2005 of the nursing school, that received their education with other pedagogic methods, mainly lectures and seminars. We analysed the possible correlation in each of the items on the mentor’s assessment form between the grade obtained by students and the learning methodology employed during their education (PBL or non-PBL). The assessment criteria were: responsibility; initiative; skill and proficiency in techniques related to manual procedures; organization and methodology in activities carried out; communication/relationship with patients and families; communication/relationship with the work team; and degree to which training objectives were reached. Results. We had 651 valid assessment forms, 383 for the control group and 268 for the intervention group. Clear significant differences were found only in the third year, in the ‘skill and proficiency in techniques related to manual process’ category (p = 0.007). The control group had higher scores. Conclusions. The results suggest that the use of PBL in students’ academic coursework does not modify the score obtained in their clinical internship on the items specified in our assessment tool (AU)

Determination of fat in foods by compleximetric back-titration with ethylenediaminetetraacetic acid.

A titrimetric method has been developed for the determination of fat in solid or liquid foods. The method is based on the hydrolysis of fat, precipitation of carboxylate anions with BaII and the compleximetric back-titration of the excess of BaII with ethylenediaminetetraacetic acid. The relative standard deviations for the analysis of different solid foods were in the range 1.04-1.53%. Fat levels in liquid milk of as low as 0.3% were determined with good results; however, a correction had to be made, as 7.2 +/- 1% of the fatty acids comprising milk fat do not precipitate with BaII.

Mildiomycin: a nucleoside antibiotic that inhibits protein synthesis.

Mildiomycin, a new nucleoside antibiotic, selectively inhibits protein synthesis in HeLa cells, and is less active in the inhibition of RNA or DNA synthesis. An increased inhibition of translation by mildiomycin is observed in cultured HeLa cells when they are permeabilized by encephalomyocarditis virus. This observation suggests that this antibiotic does not easily pass through the cell membrane, as occurs with other nucleoside and aminoglycoside antibiotics. The inhibition of translation is also observed in cell-free systems, such as endogenous protein synthesis in a rabbit reticulocyte lysate or the synthesis of polyphenylalanine directed by poly (U). Finally the mode of action of mildiomycin was investigated and the results suggest that the compound blocks the peptidyl-transferase center.