Limited research exists about the experiences of nurses’ caring for patients during the COVID-19 pandemic post hoc. To understand nurses’ realities of caring for patients with COVID-19, I aimed to understand the lived experience of nurses caring for patients with COVID-19 in the United States. A qualitative design with a hermeneutic phenomenological methodology was used. Sixteen participants were recruited via purposive sampling, augmented with snowball sampling. Data were collected through unstructured interviews and were analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Nurses’ experiences of caring for patients with COVID-19 in the U.S. were consolidated into four themes: “a living hell”; “rationing patient safety”; “mental aftermath of the war zone”; and “post-pandemic pride”. Nurses provided patient care amidst challenging environments of limited to no resources, with extensive, large-scale critically ill patients, and patient deaths. Due to overwhelming patient care demands, nurses were unable to provide safe patient care to everyone in need, resulting in patient deterioration and death. These experiences caused nurses to endure maladaptive mental effects, such as compassion fatigue and moral suffering, which can threaten the safety of patients. Despite these undesirable results, nurses continued to provide patient care and expressed feelings of pride in the profession of nursing for surviving the COVID-19 pandemic. However, this study demonstrates the persistent impacts on nurses’ abilities to provide safe care after the crisis years. Support for nurses is recommended to preserve patient safety.

Atrial fibrillation (AF), the most common cardiac arrhythmia in persons over age 65, is associated with an increased stroke risk necessitating the need for long-term oral anticoagulation for risk reduction. With the introduction of direct thrombin and factor Xa inhibitors in the US since 2010, these novel oral anticoagulants (NOACs) are increasingly being prescribed, replacing the use of warfarin, a vitamin K antagonist. AF catheter ablation (CA), an elective procedure requiring femoral vascular access is a treatment for drug refractory and persistent AF. Bedrest, limb immobilization, and limited head of bed elevation are nursing measures utilized following femoral venous, and sometimes arterial, sheath removal and hemostasis. Limited research is available on the appropriate duration of bedrest to minimize bleeding complications associated with AF ablation in patients who use NOACs. The purpose of this quality improvement project was to compare and evaluate the effect of bedrest duration on post-procedure bleeding outcomes, urinary complaints, and back pain among patients taking NOACs while undergoing AFCA. Thirty patients undergoing elective AFCA on NOACs were orally consented to participate in the study and placed on shortened (8 hours) or prolonged (>8 hours) bedrest following vascular hemostasis. Outcome measurements included bleeding after ambulation, back pain, and urinary complaints. Fifteen patients (50%) were on shortened bedrest and 15 (50%) were on prolonged bedrest. No statistically significant difference in bleeding, urinary complaints, or back pain were found. Since there is no clear advantage to prolonged bedrest for patients on NOACS after an AFCA procedure, clinicians should consider this when deciding on bedrest duration for their patients.

Effective pain management and time to treatment is essential in patient care. Despite scientific evidence supporting the need to treat pain and an emphasis on addressing pain as a priority, pain management continues to be an unresolved issue. As a member of the health care team, nurses are integral to optimal pain management. Currently, nursing schools have limited innovative or alternative methods for teaching pain assessment and management. Simulation in nursing education provides a unique opportunity to expose students to realistic patient situations and allow them to learn and make mistakes without causing harm. However, modern low- and high-fidelity simulation technology is unable to display emotion, pain, or any facial expression. This limits training and education of conditions that may partially rely on the identification of symptoms based on the alteration of facial appearance, such as pain or stroke. This research explored student nurses’ perception of new technology that displayed computer-generated faces, each expressing varying degrees of physical expressions of pain. A total of 15 nursing students participated in the study. Students were asked to interpret the level of pain in four sequential faces using a numeric rating scale of 0-10, with 0 indicating no pain, and 10 the most severe pain possible. After scoring the faces, students were asked to answer four open-ended questions addressing the technology. Results of the study indicate a majority of nursing students believe the technology should be implemented into nursing curriculum and interacting with the projected faces was more beneficial than traditional teaching methods. Eventually, the potential for increased identification of conditions requiring observation of subtle facial changes will be explored.

Purpose: The purpose of this integrative literature review is to explore the effectiveness of different training modalities on the acquisition and retention of CPR knowledge and psychomotor skill among undergraduate nursing students. Background: It is well known that standard CPR-training is ineffective at preparing nurses for the rigors of a cardiac arrest event. Survival rates for in-hospital cardiac arrests remain low and the proportion of neurobehavioral sequelae among survivors is very high. Methods: A review of relevant literature published between 2006 and 2016 was conducted using the CINAHL and MEDLINE databases. The following key terms were used in the search: ‘student*’, ‘nurs* student*’, ‘cardiopulmonary resuscitation (CPR)’, ‘Basic Life Support (BLS)’, ‘Advanced Life Support (ALS)’, ‘Advanced Cardiac Life Support (ACLS)’, and ‘Retention’. Results: The initial database search yielded a total of sixty-seven articles; of which, nine articles met the inclusion criteria and were utilized in the final analysis. The articles analyzed explored the effectiveness of different training modalities including: self-directed, CD-based, low-fidelity simulation, high-fidelity simulation, collaborative high-fidelity simulation, and deliberate practice. Conclusion: Current training is ineffective both in promoting long-term retention and in delaying the decay of previously learned information. The most effective training modality identified was high-fidelity simulation in conjunction with deliberate practice. The use of collaborative simulation through ‘mock codes’ maximizes the acquisition and retention of CPR knowledge and skill by providing the highest degree of fidelity. Deliberate practice was the only modality, which resulted in improvement of knowledge and skill over time. The absence of individualized feedback diminishes the effects of repeated practice. Practical experience is also susceptible to the detrimental effects exerted by the lack of feedback.

This qualitative study was aimed at exploring and describing the theoretical and practical experiences of second-year critical care nursing students. Purposive sampling was done, and unstructured interviews and narrative descriptions were used as data collection tools. An adaptation of Johns's Framework, the Guideline for the Facilitation of Reflection as Teaching Strategy, was used during interviews to guide participants in reflecting on theory-practice integration. Multiple strategies were used to ensure the trustworthiness of the study. Concerning patient data, communication, and the administration of life-saving medications, theory-practice integration did occur. Regarding treatment and the outcome of nursing interventions, it seemed that knowledge deficiencies and a lack of exposure to practical situations contributed to the inability to apply theory to practice. This apparent inability evoked negative feelings, such as guilt. Discrepancies between practice and theory taught led to confusion. Guided reflection assisted students in gaining a new perspective on nursing and theory-practice integration. / Health Studies / M.A. (Health Studies)

This qualitative study was aimed at exploring and describing the theoretical and practical experiences of second-year critical care nursing students. Purposive sampling was done, and unstructured interviews and narrative descriptions were used as data collection tools. An adaptation of Johns's Framework, the Guideline for the Facilitation of Reflection as Teaching Strategy, was used during interviews to guide participants in reflecting on theory-practice integration. Multiple strategies were used to ensure the trustworthiness of the study. Concerning patient data, communication, and the administration of life-saving medications, theory-practice integration did occur. Regarding treatment and the outcome of nursing interventions, it seemed that knowledge deficiencies and a lack of exposure to practical situations contributed to the inability to apply theory to practice. This apparent inability evoked negative feelings, such as guilt. Discrepancies between practice and theory taught led to confusion. Guided reflection assisted students in gaining a new perspective on nursing and theory-practice integration. / Health Studies / M.A. (Health Studies)