Background: Intensive care unit (ICU) nurses are enduring unprecedented burden caring for COVID-19 patients. Few studies have reported types of work-related events that lead to occupational stress and post-traumatic stress disorder (PTSD). Methods: ICU nurses were recruited at an academic health science center to explore their experiences of caring for COVID-19 patients. Participants were interviewed for 1 hour using open-ended questions. Symptoms of PTSD were assessed using the PTSD Checklist, job satisfaction with a Likert-type scale, and intention to leave their job with a “yes or no” question. Semi-structured interviews were transcribed and analyzed using NVivo software; quantitative data were analyzed using frequencies and means with R 4.0.5. Findings: The ICU nurse sample comprised nine females and one male, all Caucasian, with a mean age of 26.6 years. Analysis of interview transcripts revealed six recurring themes: Change in Practice, Emotion, Patient’s Family, Isolation, Job Satisfaction, and Public Reaction. Quantitative findings revealed 7 of 10 met diagnostic criteria for PTSD. Most participants (7/10) were “somewhat satisfied” with their job. Five of 10 considered leaving their job in the last 6 months. Conclusion/Implications for Practice: Understanding the impact stressful pandemic-related patient care has on ICU nurses provides evidence that new policies are needed. Furthermore, qualitative findings provide insight into the best design and deployment of interventions to reduce stress and prevent development of PTSD. More research is needed to understand long-term effects of PTSD and to evaluate strategies to prevent PTSD during stressful emergency surges in intensive care.

Background: Intensive care unit (ICU) nurses are at an increased risk of post-traumatic stress disorder (PTSD) due to their stressful work environment. Using the Walker and Avant conceptual analysis method, we sought to review the literature to better understand PTSD as it pertained to ICU nurses and its impact on their lives, patient care, and health care organizations. Methods: For the review, we searched the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, and PsycINFO. The keyword searches included the terms “post-traumatic stress disorder” AND “psychological stress” AND “intensive care unit nurses.” Abstract and full text reviews were conducted. Ten articles met our inclusion criteria of being published in the past 10 years (2010–2020), peer reviewed, written in English, and referred specifically to PTSD and psychological stress in ICU nurses. Findings: Antecedents for PTSD in ICU nurses are their stressful work environment, where exposure to traumatic events is experienced, and a lack of support from their manager, coworkers, and organization. Defining attributes for ICU nurses with PTSD included reexperiencing, avoidance, negative alterations in cognition and mood, and hyperarousal. Consequences identified included burnout, job dissatisfaction, and the intention to leave their job. The conceptual definition of PTSD in ICU nurses was illustrated by the attributes, antecedents, consequences, model case, empirical referents, and by the negative impact on the nurse, patients, and the health care organization. Conclusion/Application to Practice: Hospital administrators, nurse managers, and occupational health nurses should ensure that policies and interventions are in place to recognize and reduce the risk of PTSD among ICU nurses.

INTRODUCTION/BACKGROUNDPhysical inactivity is a global health concern and the fourth leading cause of global death (1). Annually, physical inactivity is responsible for more than 5 million deaths worldwide, with an overall health care cost estimated at 53.8 billion US dollars (2). To continue ongoing efforts to address this public health concern, in 2018, the Department of Health and Human Services issued the Physical Activity Guidelines for Americans to promote lifelong health benefits. These science-based guidelines were proposed to provide policymakers, clinicians, public health practitioners and the general public with comprehensive information regarding achievable physical activity (PA) goals to manage chronic conditions, including hypertension, type 2 diabetes, obesity, heart disease, stroke, dementia, selected cancers, and depression (3-5).National guidelines recommend that adults perform at least 150 min of moderate aerobic activity, or 75 min of vigorous aerobic activity, or a combination of moderate and vigorous activity weekly (5). Despite the long-term health benefits of PA, many Americans across the life span do not meet the recommended levels (5). The global initiative "Exercise is Medicine" (EIM) was developed in 2007 by the American Medical Association and the American College of Sports Medicine (6). The principal goal of the initiative calls for health care providers (HCPs) to include PA assessments and promotion as a standard in clinical care, connecting health care with evidence-based PA resources for people everywhere and of all abilities (6). Since then, the US Department of Health and Human Services' Healthy People 2020 Initiative established their goal for 85% of HCPs to counsel patients on the importance of regular PA. However, according to US national sample surveys, only 33% of adults received counseling on PA activity from their HCP (7).PA discussions in the clinic setting may actually hold promise because the majority of adults visit their HCPs annually (8-11). The HCPs' role in delivering PA counseling has been