Aim This multisite study describes the lived experience of registered nurses (RNs) caring for coronavirus (COVID‐19) patients during the pandemic in rural America. Design A qualitative phenomenological design was used. Methods From January to June 2021, using the purposeful sampling method, 19 frontline nurses were interviewed regarding their experience caring for seriously ill COVID‐19 patients in three Upper Midwest tertiary care hospitals. Three doctoral prepared nurses transcribed and analyzed verbatim interviews with data interpreted separately and conjointly. Approved qualitative methods specific to transcendental phenomenology were used. Results This phenomenological study identified four themes describing the lived experience: (1) feeling of being overwhelmed, (2) feeling of role frustration related to chaos in the care environment, (3) feeling of abandonment by leaders, families, and communities, and (4) progressing from perseverance to resilience. Implications for Practice Significant implications include ensuring frontline RNs are in communication with leaders, and are involved in tactical planning. Leaders can provide a stabilizing presence, build resilience, confidence, and security. Recommendations for additional research are provided. Conclusion Nurses in intensive care and COVID‐19 designated medical units had experiences similar to high population United States and international cities. Their shared experience included high volumes of critically ill patients in hospitals frenzied by rapid change, uncertainty, and capacity strain. Differences in the experience of rural nurses included close social connection to patients, families, and community members. This rural connectedness had both positive and negative effects.
Cannabinoid CB1 inverse agonists such as rimonabant and AM 251 hold therapeutic promise as appetite suppressants, but the extent to which non-motivational factors contribute to their anorectic effects is not fully known. Examination of the behavioral satiety sequence (BSS) in rats, the orderly progression from eating to post-prandial grooming and then resting, has revealed that these compounds preserve the order of events but differ markedly from natural satiation. The most notable difference is that grooming (particularly scratching) is profoundly enhanced at anorectic doses, while eating and resting are diminished, raising the possibility that the anorectic effect is simply secondary to the grooming effect. In the current design, the neutral CB1 antagonist AM 4113, which has been found to lack some of the undesirable effects of AM 251, produced nearly identical effects on the BSS as AM 251. The possibility that competition from enhanced grooming could account for the anorectic effect of AM 4113 was examined by yoking the pattern of disruptions caused by grooming in the AM 4113-treated group to forced locomotion in a different group fed in a modified running wheel. This response competition did not significantly reduce food intake. It was concluded that AM 4113, a CB1 neutral antagonist, produces the same effects on the BSS as AM 251, but that response competition from enhanced grooming may not be a sufficient explanation for the anorectic effects of CB1 antagonists/inverse agonists.
Nurses report feeling abandoned in their workplace, at home, and within their community.
Nurses play an important role in pandemic and disaster response, often at a personal cost to their overall well-being. Interviews with 19 frontline COVID-19 nurses helped illuminate priority focus areas involving nurses in the planning process, providing clear communication and offering mental health services. These recommendations align with and reinforce conclusions and recommendations from The Future of Nursing 2020-2030 Report.Nurses play an important role in disaster and pandemic response, often at a personal cost. Interviews of frontline nurses demonstrated their willingness to help in the recent pandemic came with an expense to their own well-being. 1 Interviews were conducted with 19 nurses working in intensive care and COVID-19designated medical units of 3 tertiary hospitals in an Upper Midwest healthcare system to gain a better understanding of their experience in caring for COVID-19 patients and balancing work and home life. These nurses were overwhelmed by the high volume of critically ill patients, frustrated by the care environment chaos and felt abandoned at work as well as by their families and communities. 1 This group provided future pandemic advice for leadership and educators, which could be applied to other catastrophic events. Even though a small group was interviewed, their recommendations are congruent with The Future of Nursing 2020-2030 Report, which provides an important foundation addressing the current challenges faced by nurses during the pandemic. 1,2
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