Supporting resilience

Abstract

With the onset of COVID-19 1 and the strong possibility of large percentages of the U.S. population being admitted to the hospital and intensive care unit (ICU), the Society of Critical Care Medicine (SCCM) has updated its statistics on critical care with this new document focusing resources available for COVID-19 in the United States. 2 Our goal is to provide information regarding the resources needed and available to care for a potentially overwhelming number of critically ill patients, many of whom may require mechanical ventilation. 1 In this report, we address the most current data and estimates on the number of acute care, ICU, and step-down (eg, observation, progressive) beds; ICU occupancy rates; mechanical ventilators; and staffing. We also seek to provide context to the data. Acute care hospitals; ICU, step-down, and burn beds: The American Hospital Association (AHA) maintains a proprietary dataset of most non-federal hospitals in the United States. Data is gathered by voluntary survey. In April 2019, a study published in Critical Care Medicine analyzed the 2015 AHA data. 3 For this current report, we extended the analysis from that publication using the most currently available 2018 AHA data while noting minimal changes from 2015. 4 The 2018 AHA data indicate that there are 5256 AHA-registered community hospitals in the United States. Of these, 2704 (51.4%) provide ICU services (Figure 3). These hospitals have 534,964 staffed (operational) acute care beds, including 96,596 ICU beds (Table 1), accounting for a median 16.7% of all hospital beds. The ICU beds are categorized as adult, pediatric, or neonatal.

Promoting Well-being: A Scoping Review of Strategies Implemented During the COVID-19 Pandemic to Enhance the Well-being of the Nursing Workforce

“…Leaders who provided clear and timely communication helped to minimise stress, anxiety, and uncertainty amongst their nursing staff. Using diverse communication methods, such as rounding, huddles, weekly webinars, weekly virtual town halls, posting on social media, and daily written updates, allowed for transparency and authenticity that reflected the vulnerability staff felt during the first few months of the pandemic ( Brodrick et al., 2020 )…”

Not alone

“…Keeping staff and patients safe remained a primary area of concern for the nurse leaders 1. Recognizing that a different staffing model or approach was needed to care for the vast number of ICU patients, nurse leaders agreed to adopt the SCCM tiered staffing strategy.…”

“…Despite disaster experiences, such as 9/11 and Hurricane Sandy, nurse leaders needed resiliency, innovation, and creative decision-making as they faced this new challenge. 1 Hackensack Meridian Health (HMH) is one of the largest healthcare systems in New Jersey, employing over 8,000 nurses. Despite the impressive staffing numbers of this clinically integrated network, HMH's nurse leaders struggled to meet the clinical demands of caring for more than 13,000 patients with COVID-19.…”

“…With the surge of COVID-19 patients needing ICU care, nurse leaders didn't have a blueprint for the emergency staffing response required to handle this crisis. Despite disaster experiences, such as 9/11 and Hurricane Sandy, nurse leaders needed resiliency, innovation, and creative decision-making as they faced this new challenge 1…”

Self-efficacy in Clinical Nurse Specialists During the COVID-19 Pandemic

“…12 It has been identified that there is a tremendous need to strengthen HCP teams by providing real-time assessment, interventions, and development of programs that can build the HCP's ability to deal with stressors in general practice but especially during surge and novel crisis such as a pandemic. 2,11,[13][14][15][16] Systematic reviews compiled during the pandemic noted various demographic characteristics that were collected looking for correlations with HCPs' stress level, self-efficacy, and resilience. 2,14 High reported self-efficacy has been shown to be a protective factor against psychological distress and is a building block of resilience.…”