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      Experiences of intensive care unit nurses with COVID-19 patients Translated title: Vivência de enfermeiros que atuam na Unidade de Terapia Intensiva com pacientes infectados pela COVID-19 Translated title: Experiencia de enfermeros actuantes en Unidad de Terapia Intensiva con pacientes infectados por COVID-19

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          Abstract

          ABSTRACT Objective: To understand the experiences of intensive care unit nurses who provide care to patients with COVID-19. Methods: Qualitative study grounded in Alfred Schütz’s social phenomenology in which 20 nurses who work in intensive care units at public and private hospitals were interviewed between July and September 2020. Data were analyzed according to the adopted theoretical-methodological framework and the literature related to the subject. Results: The interviewed nurses mentioned demands about working conditions, professional recognition and training, and support to physical and mental health, which proved necessary considering the care intensity experienced by these professionals during the COVID-19 pandemic. Conclusion: Learning the nurses’ experiences evidenced the need to adjust to a new way of providing care that included the physical space, new institutional protocols, continuous use of protective equipment, and patients’ demand for special care. This originated the necessity to be around situations that interfered with their health and motivated them to carry out professional projects after the COVID-19 pandemic.

          Translated abstract

          RESUMEN Objetivo: Comprender la experiencia de enfermeros actuantes en Unidad de Terapia Intensiva con pacientes infectados por COVID-19. Método: Investigación cualitativa basada en la fenomenología social de Alfred Schütz, entrevistándose a 20 enfermeros actuantes en Unidades de Terapia Intensiva de hospitales públicos y privados, entre julio y setiembre de 2020. Datos analizados según referencial teórico-metodológico adoptado, y con literatura correspondiente al tema. Resultados: Los enfermeros manifiestan demandas relacionadas a condiciones laborales, valoración y capacitación profesional, además del apoyo a la salud física y mental, considerando la intensa atención practicada en pandemia. Conclusión: La comprensión de la experiencia de los enfermeros mostró que fue necesario adaptarse a ese nuevo modo de cuidar, que incluye espacio físico, nuevos protocolos institucionales, uso permanente de equipos de protección y atención diferenciada requerida por los pacientes. Esto generó necesidad de convivir con situaciones que interferían en su salud y en la motivación para realizar proyectos para la vida profesional luego de la pandemia por el nuevo coronavirus.

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          Most cited references25

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          Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

          In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
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            Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study

            Summary Background Data for front-line health-care workers and risk of COVID-19 are limited. We sought to assess risk of COVID-19 among front-line health-care workers compared with the general community and the effect of personal protective equipment (PPE) on risk. Methods We did a prospective, observational cohort study in the UK and the USA of the general community, including front-line health-care workers, using self-reported data from the COVID Symptom Study smartphone application (app) from March 24 (UK) and March 29 (USA) to April 23, 2020. Participants were voluntary users of the app and at first use provided information on demographic factors (including age, sex, race or ethnic background, height and weight, and occupation) and medical history, and subsequently reported any COVID-19 symptoms. We used Cox proportional hazards modelling to estimate multivariate-adjusted hazard ratios (HRs) of our primary outcome, which was a positive COVID-19 test. The COVID Symptom Study app is registered with ClinicalTrials.gov, NCT04331509. Findings Among 2 035 395 community individuals and 99 795 front-line health-care workers, we recorded 5545 incident reports of a positive COVID-19 test over 34 435 272 person-days. Compared with the general community, front-line health-care workers were at increased risk for reporting a positive COVID-19 test (adjusted HR 11·61, 95% CI 10·93–12·33). To account for differences in testing frequency between front-line health-care workers and the general community and possible selection bias, an inverse probability-weighted model was used to adjust for the likelihood of receiving a COVID-19 test (adjusted HR 3·40, 95% CI 3·37–3·43). Secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were also important factors. Interpretation In the UK and the USA, risk of reporting a positive test for COVID-19 was increased among front-line health-care workers. Health-care systems should ensure adequate availability of PPE and develop additional strategies to protect health-care workers from COVID-19, particularly those from Black, Asian, and minority ethnic backgrounds. Additional follow-up of these observational findings is needed. Funding Zoe Global, Wellcome Trust, Engineering and Physical Sciences Research Council, National Institutes of Health Research, UK Research and Innovation, Alzheimer's Society, National Institutes of Health, National Institute for Occupational Safety and Health, and Massachusetts Consortium on Pathogen Readiness.
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              COVID-19: protecting health-care workers

              The Lancet (2020)
              Worldwide, as millions of people stay at home to minimise transmission of severe acute respiratory syndrome coronavirus 2, health-care workers prepare to do the exact opposite. They will go to clinics and hospitals, putting themselves at high risk from COVID-2019. Figures from China's National Health Commission show that more than 3300 health-care workers have been infected as of early March and, according to local media, by the end of February at least 22 had died. In Italy, 20% of responding health-care workers were infected, and some have died. Reports from medical staff describe physical and mental exhaustion, the torment of difficult triage decisions, and the pain of losing patients and colleagues, all in addition to the infection risk. As the pandemic accelerates, access to personal protective equipment (PPE) for health workers is a key concern. Medical staff are prioritised in many countries, but PPE shortages have been described in the most affected facilities. Some medical staff are waiting for equipment while already seeing patients who may be infected or are supplied with equipment that might not meet requirements. Alongside concerns for their personal safety, health-care workers are anxious about passing the infection to their families. Health-care workers who care for elderly parents or young children will be drastically affected by school closures, social distancing policies, and disruption in the availability of food and other essentials. Health-care systems globally could be operating at more than maximum capacity for many months. But health-care workers, unlike ventilators or wards, cannot be urgently manufactured or run at 100% occupancy for long periods. It is vital that governments see workers not simply as pawns to be deployed, but as human individuals. In the global response, the safety of health-care workers must be ensured. Adequate provision of PPE is just the first step; other practical measures must be considered, including cancelling non-essential events to prioritise resources; provision of food, rest, and family support; and psychological support. Presently, health-care workers are every country's most valuable resource. © 2020 Denis Lovrovic/AFP/Getty Images 2020 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
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                Author and article information

                Journal
                reeusp
                Revista da Escola de Enfermagem da USP
                Rev. esc. enferm. USP
                Universidade de São Paulo, Escola de Enfermagem (São Paulo, SP, Brazil )
                0080-6234
                1980-220X
                2021
                : 55
                : e20210194
                Affiliations
                [3] Juiz de Fora Minas Gerais orgnameUniversidade Federal de Juiz de Fora orgdiv1Faculdade de Enfermagem orgdiv2Departamento de Enfermagem Básica Brazil
                [4] São Paulo São Paulo orgnameUniversidade de São Paulo orgdiv1Escola de Enfermagem orgdiv2Departamento de Enfermagem Materno-Infantil e Psiquiátrica Brazil
                [1] São Paulo SP orgnameUnidade de Terapia Intensiva orgdiv1Hospital do Coração Brazil
                [2] São Paulo São Paulo orgnameUniversidade de São Paulo orgdiv1Escola de Enfermagem orgdiv2Programa de Pós-Graduação em Enfermagem Brazil
                Article
                S0080-62342021000100558 S0080-6234(21)05500000558
                10.1590/1980-220x-reeusp-2021-0194
                34570870
                8f8e0d1d-4403-4a00-97ca-6a909a29a6b1

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 28 April 2021
                : 05 August 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 0
                Product

                SciELO Brazil


                Coronavirus,Unidades de Terapia Intensiva,Enfermagem de Cuidados Críticos,Estresse Psicológico,Prática Profissional,Unidades de Cuidados Intensivos,Enfermería de Cuidados Críticos,Estrés Psicológico,Práctica Professional,Intensive Care Units,Critical Care Nursing,Stress, Psychological,Professional Practice

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