Caregiving During COVID and Beyond: The Experience of Workplace Stress and Chaplain Care Among Healthcare Workers.

Healthcare workers (HCWs) experience occupational stressors that negatively impact emotional well-being and exacerbate turnover intentions. In the wake of the COVID-19 pandemic, the resultant acute care turnover rates have reached an all-time high. In addition, occupational stressors lead to psychological stress, including moral distress, defined as the dissonance between perceiving what the right course of action is and encountering an obstacle to acting accordingly. This qualitative descriptive study explored the perceptions of patient-facing HCWs in acute care hospital settings regarding the workplace stressors they encountered and the role of hospital-based chaplains in addressing emotional well-being and stress with 33 interviews. Findings suggest that HCW frequently experience work-related moral distress and seek relief by interacting with hospital chaplains. Chaplain care, common in American healthcare facilities for the spiritual care of patients, is an easily accessible resource to HCWs. Facilitating chaplain-HCW interactions may be an effective strategy for responding to moral distress and improving healthcare workers' well-being.

Evaluating Factors That Influence Influenza Vaccination Uptake among Pregnant People in a Medically Underserved Area in Washington State.

INTRODUCTION: Despite substantial evidence demonstrating the effectiveness of influenza vaccines, only 38.6% of the adult United States population received an influenza vaccine during the 2023-2024 flu season. Vaccination rates are typically lower among U.S. minority groups, and in 2022, pregnant persons from U.S. minority racial and ethnic groups showed a decrease in influenza vaccine coverage. METHODS: A survey was conducted with residents of Yakima County, Washington, which is home to one of the state's largest percentages of people who identify as Hispanic or Latino/a. The objective was to evaluate the uptake of influenza vaccine among pregnant persons. Surveys were sent to a random sample of 3000 residential mailing addresses. Of the 500 respondents, 244 (52.1%) reported that they had been pregnant, with those identifying as Hispanic or Latino/a constituting 23.8% of this total. Only 62 (26.2%) reported being immunized against influenza during pregnancy. Respondents who were immunized against influenza chose to be vaccinated to protect themselves from the flu (85.5%, n = 53); because a healthcare provider recommended getting vaccinated (85.5%, n = 53); to protect the baby from the flu (82.3%, n = 51); because it was available for free or low cost (62.9%, n = 39); and because vaccination was convenient (54.8%, n = 34). Qualitative evaluation identified that participants who were not vaccinated against influenza during pregnancy believed the vaccination was not needed, was not recommended by a healthcare provider, was difficult to access, they were against vaccination in general, or they were concerned about the safety and ingredients of the vaccine. CONCLUSION: Barriers to vaccination identified in this study included vaccine distrust, lack of awareness, and concerns about vaccine efficacy and safety. Healthcare providers can help address these concerns by providing education and recommendations about the importance of influenza vaccination during pregnancy.

Hypothermia as a Possible Symptom of Serotonin Toxicity: A Case Report.

Background There are three commonly used sets of criteria to diagnose serotonin syndrome and all three diagnostic tools have all been shown to have shortcomings that do not fully encompass the possible symptoms of serotonin toxicity. Objective To describe a case of an atypical presentation of possible drug-induced serotonin syndrome, characterized by hypothermia, night sweats, muscle tremors, and confusion. Setting A rural and medically underserved area in eastern Washington State. Practice Description This patient case was identified as a part of a project to identify and intervene with complex and high-risk patients from local rural and underserved populations. The pharmacist identified the symptoms of possible drug-induced serotonin syndrome during a comprehensive medication review with the patient. Results The pharmacist identified a possible case of drug-induced serotonin syndrome and made a recommendation to the patient's physician that led to discontinuation of both fluoxetine and trazodone. At the follow-up visit, the patient reported that his symptoms had resolved completely. Discussion The three sets of diagnostic criteria for serotonin syndrome all include fever as a symptom, but do not list hypothermia. Effects at various 5-HT receptors and receptor subtypes have been linked to symptoms often seen in serotonin syndrome, but there are gaps in the currently used diagnostic criteria. Conclusion Pharmacists' comprehensive review of medications can allow identification of symptoms, such as hypothermia to identify possible serotonin syndrome.