Purpose This study measured levels of compassion fatigue, burnout and satisfaction among critical care and emergency nurses. It investigated coping strategies as moderating factors and as predictors to levels of compassion fatigue. Methods Using a cross–sectional design, this study was conducted on 228 (84.4%) out of 270 from four Jordanian hospitals. Nurses worked in different types of critical care units and emergency departments. Nurses completed a demographic questionnaire on the professional quality of life and coping strategies indicator scales. Results Nurses had low to average compassion satisfaction, burnout and secondary stress syndrome. Problem‐solving and avoidance ranged between very low and average levels. Nurses reported having very low to average levels on seeking social support scale. Female nurses had better compassion satisfaction compared with their male colleagues, and the type of unit had a significant impact on the secondary stress syndrome, problem‐solving, and seeking social support. Nurses from the surgical cardiovascular ICU scored the highest mean scores on the secondary stress syndrome. Better coping strategies were associated with higher compassion satisfaction and lower levels of secondary stress syndrome. Problem‐solving significantly predicted compassion satisfaction, avoidance significantly predicted secondary traumatic syndrome. Conclusions Coping strategies are moderating factors that could improve compassion satisfaction among critical care nurses. Managers could use findings to create healthier and supportive work environments. We recommend focusing on activities that promote better coping strategies, including improving the social support system. We also recommend replicating this study using a qualitative approach to identify further causes of compassion fatigue.

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A short training course is needed to make sure that students are able to use the GCS effectively while minimising errors.

Patients admitted to the intensive care unit (ICU) are at a high risk for developing pressure injuries. A patient requiring multiorgan support is at a higher risk for pressure injuries related to immobility, sedation, vasopressors, and hypoxia. To mitigate pressure injuries, our hospital utilizes a bundle approach to prevent skin injury. However, despite efforts to prevent pressure injuries, we found our patients in the ICU with the diagnosis of COVID-19 went on to develop significant pressure and mucosal injuries. This is a case report of 4 patients diagnosed with COVID-19 who developed significant skin and mucosal injuries during their ICU admissions in the month of March 2020. We found that patients developed skin conditions that were initially thought to be deep-tissue injuries (DTIs) early in the admission. The DTIs progressed over the course of the admission in the ICU and evolved to thick adherent eschar that appeared to be unstageable pressure injuries, which extended beyond the soft tissue directly over the bony prominence. We also found that skin damage to the mucosa of the nares, tongue, lips, and urethra presented first as inflammation and then progressed to thick eschar. Despite maximum pressure relief with the use of a pressure-relieving turn and position system, bordered foam dressings, fluidized positioners, specialty beds, and leadership support for twice-a-week skin checks, our patients diagnosed with COVID-19 developed extensive skin damage across the fleshy portion of the buttocks and on the mucosa of the nares, tongue, lips, and urethra during minimal exposure to pressure. Although the initial presentation of the skin damage appeared to be related to pressure, the extent of the skin damage suggests a vascular inflammatory process beyond skin damage related to pressure.

Study findings strongly suggest the use of a PPIPB decreases PI incidence in pediatric hospitals and should be considered when implementing a PI prevention program.

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This study explored barriers to nurses' roles in pain management following surgery in Jordan. A qualitative approach using four focus group discussions (n = 4) was used. The total convenience sample of surgical wards nurses included 25 nurses. The analysis revealed two categories explaining the context and perceived barriers affecting nurses' roles in pain management. First were barriers within bedside nursing, comprising attention-seeking patients, 'buzzer obsession' and family interferences. Second were barriers within nursing, comprising lack of staff and 'nurses need pain relief before patients', and the perception of 'we are nurses, they are doctors.' Nurses' roles in managing patients' pain following surgery is hindered by contextually complex barriers identified by this research. Multidisciplinary actions are therefore urgently needed to address barriers to pain management at the nursing professional, ward culture and policy levels. Failure to do so might lead to more pain sufferers following surgery, and thus poor recovery.

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