This communication has been published in the middle of the coronavirus disease 2019 pandemic and is available via expedited publication to assist patients and healthcare providers.
Aim To explore how nurses experienced working in a newly organized COVID‐19 ward with high‐risk patients during a new and unknown pandemic. Design A qualitative explorative study using a phenomenological‐hermeneutic approach. Methods Semi‐structured individual telephone interviews were conducted in June–July 2020 with 23 nurses working in COVID‐19 wards from three regional hospitals in Denmark. The nurses had been transferred from other departments at their hospital to the newly organized COVID‐19 wards. Data analysis was influenced by Paul Ricoeur's theory of narrative and interpretation, including three analytical levels: naïve reading, structural analysis and critical interpretation and discussion. Results During the structural analysis four themes were generated: (a) Challenging and uncertain situation, but also a positive experience (b) Professional and personal development (c) Lack of nurses' rights during a pandemic (d) Reward in itself or a desire for financial reward.
Research indicates that active involvement of patients' relatives generally has a positive impact on patients' hospitalisation, including patient safety. Campaigns urge relatives to ask questions in relation to nursing care and treatment to enhance patient safety and to increase involvement of both patient and relatives. The question is how nurses experience relatives who ask questions. The aim of this study was to explore how nurses experienced contact with patients' relatives during admissions to a somatic emergency ward including nurses' experience of relatives asking questions related to nursing care and treatment. Six nurses were interviewed. The participants gave written consent to participate after receiving both oral and written information about the study. Data were analysed using combined theory and data-driven qualitative content analysis. The findings formed three main themes: (i) relatives' involvement as a means to efficiency during hospitalisation, (ii) relatives welcomed on the terms of the system and (iii) tension between high ideals and frustrating realities. The six interviews answered the research questions. However, more interviews could have broadened the study and contributed with further details. The nurses experienced relatives as an important resource - 'an ace up the sleeve', while reality seemed to challenge the relationship between nurses and relatives. The study contributes to discussions before development and implementation of specific initiatives aiming at increasing involvement of relatives of patients in a somatic emergency ward.
Background During the COVID‐19 pandemic, visitors were restricted from hospitals, separating them from hospitalised friends and family to reduce the infection risk. Objectives The objective was to explore how relatives of older people acutely admitted to hospital with COVID‐19 experienced being a relative, and how they felt about their contact with health care professionals (HCPs) when visitor restrictions prevented their physical presence in the ward. Method This study employed a qualitative design. We used individual qualitative semi‐structured interviews and the participants were relatives of acutely admitted older people from three COVID‐19 wards in Denmark. A total of 18 relatives participated, 14 female and 4 male, aged between 45 and 83 years. The analysis was guided by Graneheim and Lundman’s qualitative content analysis. Results The analysis derived the following three themes: (1) the importance of trust in a period of uncertainty; (2) the meaning of contact with HCPs, and (3) active but at a distance—a balancing act. The participants' feelings of uncertainty were prominent. The unknown nature of the disease and the unusual situation challenged relatives' trust in HCPs and the health care system. Conclusions and relevance to practice The findings highlight relatives' stress when the possibilities for visiting are restricted and the importance of trust in, and the relationship with HCPs. This study can strengthen HCPs' understanding of relatives' situation when older people are hospitalised during and after the COVID‐19 pandemic.
BACKGROUNDChanges in the current welfare models, demographic challenges, increasing organisational complexity and the limited healthcare system resources all require citizens to be active and take personal responsibility for their health [1,2]. The policies and strategies of the modern healthcare system assume that patients are well informed and are able to take care of themselves [3][4][5].In this regard, according to Katrin Hjort's theory, citizens must have strong client competencies to obtain access to welfare benefits, including quality care and treatment from
(Abstracted from Hum Reprod 2021;36(1):40–47) Pregnant women are at an increased risk of viral infections and increased risk of serious morbidity such as severe pneumonia, particularly during the first trimester. COVID-19 (coronavirus disease 2019) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
PurposeThe COVID-19 pandemic has influenced hospital work and healthcare workers all over the world. We explored how Danish nurses coped with the fast, comprehensive organisational changes in their workplace and identified barriers to and facilitators for organisations ensuring the best possible conditions for nurses to meet these challenges. The study focuses on the organisational setting and how it did or did not support the nurses in their work.MethodsA qualitative explorative design was used in interviewing 23 nurses who had worked at a COVID-19 ward in one of three hospitals. Data were collected in the summer of 2020, and the analysis was inspired by Paul Ricoeur’s theory of narratives and interpretation.ResultsThe presence of managers in the wards helped the nurses in the form of psychological and practical support. Working within an organisation that provides a safe environment was essential for nurses. The experience of a safe environment allowed nurses to ask questions, which supported them in finding solutions to specific tasks in the new and critical working environment. Barriers to handling the new situation were an absence of managers and a lack of a sense of belongingness and trust.ConclusionThis study highlights the need for management to be present in the ward and for organisational support to be available to nurses so they can provide optimal treatment and care when working in new and unknown conditions during a pandemic. Practical assistance from managers to ease the job is beneficial. Furthermore, the presence of management is essential to provide psychological support and create a safe environment because this allows nurses to ask questions about how to better manage new and critical tasks.
Background and Objectives: The rise in cesarean deliveries, has led to increase in maternal complications in subsequent pregnancies such as abnormal placental implantation, uterine rupture, hemorrhage and, less commonly, cesarean scar pregnancies (CSP). Our objective was to describe patient characteristics following a combined medical and surgical treatment approach to first trimester cesarean scar pregnancies. Methods: This was a case series approved by the Institutional Review Board of cesarean scar pregnancies over a two-year period at a single academic institution. The study included five patients with diagnosed cesarean scar pregnancies opting for pregnancy termination with the desire for fertility preservation. Medical treatment involved intra-gestational sac injection of lidocaine followed by systemic injection of methotrexate. At a minimum of two months later, surgical resection of cesarean scar pregnancy and repair of the uterus was performed. Results: Median patient age was 36 (range 34 – 42) years, with 4 (3 – 10) prior pregnancies and 2 (1 – 3) prior cesarean deliveries. 40% (2/5) were Hispanic, 20% (1/5) Caucasian, 20% (1/5) African-American, and 20% (1/5) South Asian. After medical intervention, patients waited on average 4.6 ± 2.3 months before surgery. No post-intervention complications or recurrences occurred. Two patients had a subsequent pregnancy. Conclusion: This case series demonstrates an ideal management of cesarean scar pregnancy using combined medical and surgical approach in treating current ectopic pregnancy and repairing the uterine defect successfully without recurrence.
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