No abstract

Discouraging partial do-not-resuscitate(s) order may help promote more accurate and comprehensive advance care planning.

Background: Front-line workers (FLW) are at risk for secondary traumatic stress, burnout, and related psychiatric sequelae: depression, anxiety, suicidality, posttraumatic stress disorder, and sleep and substance use disorders. FLW are in need of self-care programs to support their mental health. Methods: Quasi-experimental study to assess the impact of a simple mental well-being and emotional regulation training, the Community Resiliency Model (CRM), using a convenience sample of FLW. Baseline scores of mental well-being and stress measures were compared with follow-up scores at 3 time points. Outcomes were psychological wellness (World Health Organization-5 Well-being Index); resilience (Connor-Davidson Resilience Scale-10); traumatic stress (Secondary Traumatic Stress Scale); physical symptoms (Somatic Symptom Scale-8). Results: Of the 104 participants who enrolled and attended the CRM training, 73 (70.2%) completed at least 1 posttest. Well-being scores increased at 1 year with a small-moderate effect size (Cohen d =0.32). Resilience scores increased with a small-moderate effect size by 1 year (Cohen d =0.36). Secondary traumatic stress scores declined, with the largest effect at 1 week (Cohen d =0.49). Somatic symptoms decreased at each posttest, with the largest change occurring from baseline to 1 week ( d =0.39). Participants reported an awareness of body sensations helped them when overwhelmed as a means of calming themselves. Conclusions: After a 3-hour CRM training, participants reported improved mental well-being and decreased secondary traumatic stress and somatic symptoms. This simple body awareness intervention may be a good resource during the COVID-19 pandemic.

A culture of excellence is not synonymous with a culture of perfection. Perfection is not attainable but excellence is when an infrastructure is developed that can rapidly and effectively adapt to change. Saint Joseph's Hospital in Atlanta, Georgia, is often asked about the challenges faced in developing, and sustaining, a culture of nursing excellence over time. Topics such as organizational hardiness, the emergence of a professional practice model, the development of a clinical nurse advancement program, and the implementation of the Forces of Magnetism and the Essentials of Magnetism will be discussed in relation to sustaining a culture of excellence.