The Coronavirus pandemic erupted in 2020 and new graduate registered nurses (RNs) found themselves caring for those with devastating illness as they were transitioning into nursing practice. The purpose of this study was to describe the experience of novice nurses working in acute care settings during a pandemic. This qualitative phenomenological study of novice nurses working in facilities providing acute care for COVID-19 patients was conducted in Phoenix, Arizona, USA. Purposive sampling identified 13 participants for interviews. Data were analyzed using thematic analysis. Eight themes emerged: Dealing with death, Which personal protective equipment (PPE) will keep us safe?, Caring for high acuity patients with limited training, Difficulties working short-staffed, Everything is not okay, Support from the healthcare team, Nursing school preparation for a pandemic, I would still choose nursing. Novice nurses felt challenged by the experience and were at times overwhelmed and struggling to cope. Support from peers and coping skills learned during nursing school helped them continue to work during a critical time. Data from this study suggest that some participants may have been experiencing symptoms of anxiety, depression, or post-traumatic stress disorder, and findings provide foundational insights for nursing education and psychological interventions to support the nursing workforce.

Creatine monohydrate (CrM) supplementation may increase strength in some types of muscular dystrophy. A recent study in myotonic muscular dystrophy type 1 (DM1) did not find a significant treatment effect, but measurements of muscle phosphocreatine (PCr) were not performed. We completed a randomized, double-blind, cross-over trial using 34 genetically confirmed adult DM1 patients without significant cognitive impairment. Participants received CrM (5 g, approximately 0.074 g/kg daily) and a placebo for each 4-month phase with a 6-week wash-out. Spirometry, manual muscle testing, quantitative isometric strength testing of handgrip, foot dorsiflexion, and knee extension, handgrip and foot dorsiflexion endurance, functional tasks, activity of daily living scales, body composition (total, bone, and fat-free mass), serum creatine kinase activity, serum creatinine concentration and clearance, and liver function tests were completed before and after each intervention, and muscle PCr/beta-adenosine triphosphate (ATP) ratios of the forearm flexor muscles were completed at the end of each phase. CrM supplementation did not increase any of the outcome measurements except for plasma creatinine concentration (but not creatinine clearance). Thus, CrM supplementation at 5 g daily does not have any effects on muscle strength, body composition, or activities of daily living in patients with DM1, perhaps because of a failure of the supplementation to increase muscle PCr/beta-ATP content.

Background: Burnout is a growing problem among health care professionals, with consequences for patient safety and personal satisfaction. The prevalence of burnout among hospital pharmacists in Canada is unknown; however, it has been documented at over 60% in other countries. Objectives: To assess the prevalence of burnout and variables associated with burnout among hospital pharmacists in Canada. Methods: This cross-sectional cohort study was based on a survey made available to more than 2600 Canadian hospital pharmacists from February 10 to April 2, 2020, through the Canadian Society of Hospital Pharmacists QID platform. The questionnaire collected data for the Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSSMP), demographic data, employment characteristics, and workplace factors; it also included an open-ended question about burnout. Results: A total of 171 respondents provided data suitable for analysis. Of these, only 13 (7.6%) met the criteria for burnout on all 3 subscales of the burnout inventory; however, 105 respondents (61.4%) surpassed the threshold for burnout on the emotional exhaustion subscale. In univariate analyses, not working to one’s full scope of practice was associated with meeting the criteria for burnout on all 3 scales. Linear regression highlighted associations between scores on the emotional exhaustion subscale and gender identity, perceived excessive on-call duties, area of practice, and positivity of workplace culture. Content analysis of the open-ended question supported the quantitative findings and pointed to 3 major themes: workload quantity, workload quality, and workplace culture. Conclusions: Results on the emotional exhaustion subscale of the MBI-HSSMP and responses to the open-ended question suggested a relatively high prevalence of burnout among Canadian hospital pharmacists, and indicated potential links between burnout and certain workplace characteristics. RÉSUMÉ  Contexte : L’épuisement professionnel est un problème croissant chez les professionnels de la santé qui entraîne des conséquences sur la sécurité des patients et la satisfaction personnelle des professionnels. La prévalence de l’épuisement professionnel chez les pharmaciens d’hôpitaux au Canada est inconnue; cependant, il a été documenté à plus de 60 % dans d’autres pays. Objectifs : Évaluer la prévalence de l’épuisement professionnel et les variables associées à celui-ci chez les pharmaciens d’hôpitaux au Canada. Méthodes : Cette étude de cohorte transversale se basait sur un sondage distribué à plus de 2600 pharmaciens d’hôpitaux canadiens entre le 10 février et le 2 avril 2020 via la plateforme QID de la Société canadienne des pharmaciens d’hôpitaux. Le questionnaire a permis de recueillir des données pour le Maslach Burnout Inventory Human Services Survey for Medical Personnel (MBI-HSSMP; un inventaire de l’épuisement professionnel chez les professionnels de la santé), des données démographiques, des caractéristiques professionnelles et des facteurs liés au lieu de travail; il comprenait également une question ouverte sur l’épuisement professionnel. Résultats : Au total, 171 répondants ont fourni des données se prêtant à l’analyse. Parmi ceux-ci, seuls 13 (7,6 %) répondaient aux critères de l’épuisement professionnel des 3 sous-échelles de l’inventaire de l’épuisement professionnel; cependant, 105 répondants (61,4 %) ont dépassé le seuil d’épuisement professionnel de la sous-échelle d’épuisement émotionnel. Dans les analyses univariées, le fait de ne pas travailler dans l’ensemble de son champ d’exercice était associé au respect des critères d’épuisement professionnel sur les 3 sous-échelles. La régression linéaire a mis en évidence des associations entre les scores sur la sous-échelle d’épuisement émotionnel et l’identité de genre, les tâches de garde excessives perçues, le domaine de pratique et la positivité de la culture sur le lieu de travail. L’analyse du contenu de la question ouverte étayait les résultats quantitatifs et a souligné 3 thèmes principaux : la quantité et la qualité de la charge de travail, ainsi que la culture sur le lieu de travail. Conclusions : Les résultats relatifs à la sous-échelle d’épuisement émotionnel du MBI-HSSMP et les réponses à la question ouverte suggèrent une prévalence relativement élevée d’épuisement professionnel chez les pharmaciens d’hôpitaux canadiens et indiquent des liens potentiels entre l’épuisement professionnel et certaines caractéristiques du milieu de travail.

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