Caring through crisis: The professional quality of pediatric nurses during the COVID-19 pandemic.

PURPOSE: This study described pediatric nurses' professional quality of life during COVID-19 and explored demographic/clinical practice factors independently associated with compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS). DESIGN AND METHODS: The Relational Caring Complexity Theory was used. This study employed a cross-sectional, descriptive, correlational design to describe professional quality of life of pediatric nurses (demographic questionnaire and ProQOL 5 measure) working during the COVID-19 pandemic. RESULTS: From 150 pediatric nurses, the mean scores were CS 40.8 (± 4.8), BO 22.6 (± 4.7), and STS 22.8 (± 5.8). Results of the multiple regression revealed that two variables, deployed to the same unit versus not deployed (ß = 2.424, p = .02) and currently practicing in perioperative/ambulation settings versus intensive care (ß = -0.272, p = .03), were independently associated with CS. Deployed to the same unit versus not deployed was found to be independently and significantly associated with BO (ß = -0.28, p = .005). The number of patients cared for with COVID-19 (ß = 0.196, p = .03) was significantly associated with STS. CONCLUSIONS: While the overall response was positive, these nurses were more likely to experience BO when deployed to the same area (likely a COVID-19 adult unit) and STS as they cared for more patients with COVID-19. PRACTICE IMPLICATIONS: Leaders should be aware of the impact of caring in times of crisis. Decentralized staffing may help meet emergent needs on a particular shift, but ensuring deployed nurses are well-supported is vital.

Just-in-Time Video Using QR Codes: An Approach to Pediatric Trauma Nursing Education.

BACKGROUND: High acuity trauma and patients in cardiopulmonary arrest are not frequently seen in all pediatric Level I trauma centers. Yet, nurses are required to manage these patients in fast-paced, high-pressure environments. OBJECTIVE: This project aims to develop and evaluate an education program for high-risk, low-volume equipment and skills in the pediatric emergency department setting. METHODS: This is a pre- and post-quality improvement study conducted in a Northeastern United States pediatric Level I trauma center. Emergency department nurses were invited to view videos detailing high-risk, low-volume equipment use. For the convenience of access, Quick Response (QR) codes linked to the videos were placed on each piece of equipment reviewed. General self-efficacy and levels of self-efficacy in using the equipment were assessed before the intervention and again after 4 weeks from January to February 2023. RESULTS: A total of 43 pediatric emergency nurses participated in the education. The mean aggregate general self-efficacy score was 32.93. Mean scores in all areas (Level 1 rapid infuser, fluid warmer, blood administration, and securing an endotracheal tube) improved after the intervention. CONCLUSIONS: Easily accessible, brief refresher videos linked to QR codes in the pediatric emergency department can help empower nurses who need to use high-risk, low-volume equipment.

An Interprofessional Approach to Family-Centered Child Protective Services Referral: A Case Report.

BACKGROUND: Members of the trauma team often find themselves in a uniquely challenging position wherein their role on the care team may necessitate developing a working relationship with alleged or confirmed perpetrators of abuse. CASE PRESENTATION: A 9-week-old admitted to the hospital with hyponatremia and evaluation for suspected child physical abuse. Specific details of the case were a barrier to communication and interactions between the patient's mother and the trauma nurse. This report will provide a discussion of takeaway lessons to support communication with this patient population. CONCLUSION: Peplau's Theory of Interpersonal Relations is utilized as a framework for engaging in therapeutic communication with a family that is part of a child protective services evaluation. The mnemonic, A-TEAM (Aware, Transparent, Empathetic, A nonjudgmental approach, and Managed by an interprofessional team), is introduced as a strategy for trauma nurses and other health care team members to engage in therapeutic communication with a family that is part of a child protective services evaluation during their admission.

Recognizing Victims of a Hidden Crime: Human Trafficking Victims in Your Pediatric Trauma Bay.

Human trafficking is the second largest criminal industry in the United States and almost half of the victims are children. This crime against children is referred to as domestic minor human sex trafficking (DMHST). The majority DMHST victims access health care, often at an emergency department, at some point during their captivity. Trafficking of minors has been cited as the most underreported form of child abuse making education on this topic essential for all health care providers to help meet the needs of this population. A case study provides an illustration of a pediatric trauma patient who was a victim of DMHST and presented to an emergency department for care. As nurses who care for pediatric trauma patients in all settings strive to learn more about child abuse, topics in DMHST should also be included in these educational activities.

Prepared to Care: An Exploration of Continuing Education Trends of Nurses Caring for Injured Children.

The significance of nursing competence in the care of pediatric trauma patients has been well documented. Continuing education for trauma nurses is a critical component of maintaining competence in pediatric trauma care; yet, there is significant variability in the programs and resources used to support this goal. The purpose of this current study was to describe the educational activities that practicing registered nurses engage in to inform their care of injured children. A quantitative, descriptive nonexperimental research design was utilized to describe the educational programs that members of the Society of Trauma Nurses (STN) must complete to work in verified and designated trauma centers. Participants completed a survey instrument that included demographic questions, pediatric trauma educational programs required/offered by their employer, and feedback about pediatric trauma nursing education. A total of 266 STN members completed the electronic survey, reflecting a 9% response rate. Most of the participants reported that the verifying body required trauma nursing education hours (n = 187, 70.3%). The number of required courses ranged from 1 to 6, with 33 (12.4%) reporting this 3-course combination-emergency nursing pediatric course (ENPC), pediatric advanced life support (PALS), and trauma nursing core course (TNCC). The second most common combination of courses (n = 30; 11.3%) was required to take both PALS and TNCC. No significant relationship was found between verifying agency type and continuing education program required (p> .05). Trauma nursing core course was the most popular course (n = 208; 79%), followed by PALS (n = 194; 73%) and ENPC (n = 103; 38%). Participants also shared barriers to continuing education activities. It has been 10 years since pediatric trauma nursing course utilization was first explored in the literature. There continue to be significant opportunities to support nurses in continuing education activities related to the care of injured children. While barriers to accessing these types of activities sometimes exist, it is the responsibility of the pediatric trauma community to explore these challenges even further and collaborate with others interested in improving the care of injured children.

The Cost of Caring: An Exploration of Compassion Fatigue, Compassion Satisfaction, and Job Satisfaction in Pediatric Nurses.

PURPOSE: The purpose of this study was to describe levels of compassion satisfaction, compassion fatigue, and job satisfaction among pediatric nurses in the United States and determine if there was a relationship among these constructs. DESIGN AND METHODS: All members Society of Pediatric Nurses were sent an electronic invitation to participate, and those who consented received three measures; a demographic questionnaire, the Job Satisfaction Survey (JSS) and the Professional Quality of Life (ProQOL) measure. RESULTS: Three hundred eighteen (10.6%) of members of the Society of Pediatric Nurses participated in the study: Over three quarters (245, 76%) of the sample had another career before nursing. The sample's mean job satisfaction level was 149.8 (SD=29.74), which was significantly higher than published reported means for nurses. Bivariate analyses revealed a significant relationship between gender and the compassion satisfaction, in that women were more likely to evidence compassion satisfaction than men (t=1.967, p=.05, df=298). No other significant relationships were found. CONCLUSIONS: The majority of nurses had high levels of compassion satisfaction and job satisfaction; further, female gender was associated with higher levels of compassion satisfaction. PRACTICE IMPLICATIONS: This current study had a very high response from second-career nurses (n=245, 76.8%) and overall, the sample had higher levels of compassion satisfaction. It is possible that second career nurses are better equipped in some way that helps them mediate negative responses of caring as a pediatric nurse and future research should explore this. Due to the significant financial costs to institutions of having nurses who have low levels of job satisfaction and high levels on compassion fatigue, it is imperative for hospital administrators to develop infrastructures to support employees.

Improving care for patients who experience miscarriage in emergency departments: a practice innovation.

Vaginal bleeding during pregnancy is a common patient presentation in emergency departments (EDs), and in some cases this will occur due to miscarriage. However, there are several barriers to effective and sensitive communication with patients experiencing a miscarriage. Women presenting to EDs who are experiencing a miscarriage are more likely to be psychosocially vulnerable and less satisfied with their care compared with those seeking care in the outpatient setting. There is a gap in nursing and advanced practice provider preparation regarding techniques for breaking bad news to patients in the ED setting. At one high-volume, urban ED in the US, an education programme for staff regarding best practice in breaking bad news to patients experiencing a miscarriage was developed based on an established protocol. The intention was to increase the confidence levels of nurses and other healthcare professionals in breaking bad news to these patients. After the education programme, many participants self-reported increased confidence in breaking bad news and comfort in managing patients' emotions. The results can be used to inform education for healthcare professionals who deliver bad news in the ED and other departments.

Igniting Change: Supporting the Well-Being of Academicians Who Practice and Teach Critical Care.

Academicians who maintain a critical care clinical practice encounter numerous stressors, especially during the COVID-19 pandemic, which can influence well-being. This article provides historical perspectives on the stressors inherent in working in the critical care environment as well as the stressors of working in the academic environment. It proposes the application of the synergy model as a framework to help improve the well-being of academicians who practice and teach critical care. The most valuable strategy to improve professional well-being is for organizations to take a systems approach. The article focuses on approaches that are potentially within each individual's control.