[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.

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.

[Appropriateness of admissions to an internal medicine service at a tertiary hospital]. / Adecuación de los ingresos en un servicio de medicina interna de un hospital de tercer nivel.

In the present study, clinical, epidemiological and management factors influencing the appropriateness of the 1076 admissions to a general Internal Medicine Section during one year are evaluated. 184 admissions (17%) corresponded to patients who did not meet the AEP (Appropriateness Evaluation Protocol) criteria for appropriateness. A remarkable finding was the low incidence of patients with inadequate admission in spite of social pressure, which we interpret as a consequence of an excessive demand for care and the subsequently low availability of hospital beds. Inadequate admission was more common in the younger age group than in patients over 64 years. Cardiovascular and respiratory disorders were more common among adequate admissions, whereas infective, neoplastic, and poorly defined conditions were more common among inadequate admissions. There were no differences in hospital stay between both groups. The patients who had been previously admitted had more commonly adequate admissions. A reduction in the inadequacy index could be achieved if diagnostic investigations were more speedily performed and a temporal hospitalization unit previous to admission were available.