Jill Murphy, Associate Editor

More than 40% of nurses and other health care professionals had risks associated with an increased likelihood of burnout early in the COVID-19 pandemic, according to a survey published in the 

The study investigates risk factors for poor well-being and factors associated with greater resilience, which may reduce the risk of burnout for hands-on care providers, according to research from Lindsay Thompson Munn, RN, PhD, and her colleagues of a North Carolina health care system.

"The insights gained from this study can help health care leaders to target these risk factors and develop strategies that allow organizations to better support well-being and resilience among clinicians," the study authors said in a press release.

The online survey of nurses and other non-physician health care workers received 2459 responses from participants who provided direct patient care and focused on risk factors for decreased well-being, which was a key contributor to the burnout epidemic among health care professionals. Data were collected in June and July 2020.

During the time of the survey, 44% of health care workers surveyed had “at risk” well-being, which is closely associated with increased risk of burnout, fatigue, and patient care errors.

The analysis of the responses identified several factors linked to increased odds of poor well-being, such as:

Feeling supplies of personal protective equipment were insufficient

Believing the organization did not understand health care workers’ emotional support needs during COVID-19

Inadequate staffing for safe patient care

Having a lower degree of psychological safety

There were opposite levels of some of these factors associated with higher scores for resilience, including:

Feeling the organization does not understand emotional support needs

Believing staff were being redeployed to areas of critical need

Having a higher degree of psychological safety

Further, fewer than one-fourth of health care workers surveyed had used available resources to support their well-being and resilience, such as meditation apps and counseling. Munn and her co-authors believe that this study had practical implications for health care professionals to promote well-being and resilience among other workers during the pandemic and beyond.

"While it may seem obvious that nurses and other [health care workers] would sustain burnout and poor well-being after dealing with providing care under arduous circumstances, it's important to establish the contributing factors and to learn how some were able to mitigate the effects of the stressors," said Maureen Shawn Kennedy, MA, RN, FAAN, in the press release. "We're in serious need of successful strategies to support frontline caregivers."

Munn noted some of the next steps that will help support resilience while addressing the factors that are negatively attached to burnout in the environment.

"[L]eaders can take crucial steps toward optimizing workers' well-being by paying careful attention to workload and staffing, creating a culture of psychological safety within teams and units, and recognizing and actively addressing the unique challenges posed by the pandemic," Munn said in the press release.

During COVID-19, nurses face significant burnout risks, reports 

. EurekAlert! July 22, 2021. Accessed July 26, 2021. 

https://www.eurekalert.org/pub_releases/2021-07/wkh-dcn072221.php

Articles

Survey Shows Nurses Face Significant Burnout Risks in COVID-19 Pandemic

Recent survey results from ValuePenguin found that the rate for sunburn is higher among the younger generations, specifically 61% of Gen Zers and 58% of millennials, according to a press release.

Sun protection etiquette is still low in practice, with many Americans not wearing sunscreen daily. In particular, 82% reported that they do not wear sunscreen every day in the summer whereas 64% typically wear sunscreen 5 to 6 days a week.

In terms of getting checked for skin cancer, half of the survey participants are not confident they can detect a cancerous mole themselves and most have not visited a doctor for a professional skin exam. Approximately 45% do not think they could detect a cancerous mole on their body, and around the same percentage (43%) have never been given a full skin exam.

Cost concerns play a major role in sun protection, with more than a third of respondents (35%) reporting they have not done so due to cost concerns. Additionally, 43% did not know funds from a health savings account (HSAs) or flexible spending account (FSAs) could be used towards sunscreen purchases.

"People may think of contributions as money leaving their pockets since it is taken from their salary before taxes," said ValuePenguin insurance analyst Sterling Price in a press release. "But they need to realize that the money in that account can actually be used for a ton of items that they might be buying anyway."

The online survey was conducted between June 18 to June 22, 2021 and analyzed 1048consumers in the United States using a nonprobability-based sample. Generations were defined as the following ages:

45% of Americans have already been sunburned this year. ValuePenguin. July 12, 2021. Accessed July 14, 2021. 

https://www.valuepenguin.com/skin-care-survey

Sun protection etiquette is still low in practice, with many Americans not wearing sunscreen daily.

Survey Finds 45% of Americans Already Sunburnt This Year

Being an expert on immunization and cognizant on social determinants of health for communities and patients as a whole are some of the important keys to being a successful nurse practitioner, according to Rachel C. Vandemark, MHA, BSN in an interview with 

Vandemark is a Doctor of Nursing Practice (DNP) student in the Pediatric Nurse Practitioner Primary Care Track at the University of Washington School of Nursing (Class of 2022) with experience in pre-hospital care as well as hospital safety and quality. A mother of 3 children, Vandemark was prepared to take on whatever the School of Nursing’s courses threw at her, even a worldwide pandemic.

Based in Seattle and close to the city of Kirkland, Washington, where the first major COVID-19 outbreak took place, gave her a true firsthand experience of where the pandemic was headed.

“There was a really rapid shift from 100% in-person to 100% online classes, and I saw my DNP classmates provide care to COVID-19 patients while trying to take care of young children at home, and even sharing Wi-Fi with others just to get things done,” Vandemark said.

This experience reminded her about how people’s home lives and lived experiences are not always visible to health care providers, but they are extremely essential to the health care system.

“We need experts on immunizations and such, but we also need to be advocates for systems and policies that optimize health for everyone,” Vandemark said.

As for other nurse practitioners who are about to enter the field, Vandemark highly emphasized being flexible as things begin to unfold, whether it is a pandemic or a change in direction in health care. Additionally, continuing to promote good public health always helps, such as helping with the immunization movement and practicing safe health care policies.

In an interview with Contemporary Clinic, Rachel C. Vandemark, MHA, BSN, spoke about her experience in nursing during the COVID-19 pandemic.

Flexibility, Grit, Gratitude Are Key to Being Great Nurse Practitioner

New research from the American Heart Association found that older adults taking blood pressure-lowering medications known to cross the blood-brain barrier had better memory recollection over time versus those taking other types of medicines to treat high blood pressure, as published in the journal 

Blood pressure-lowering medicines include ACE inhibitors, angiotensin 2 receptor blockers (ARBs), calcium channel blockers, and diuretics, and each class of these medicines acts differently to reduce blood pressure while crossing the blood-brain barrier and impacting cognitive function.

“Research has been mixed on which medicines have the most benefit to cognition,” said study author Daniel A. Nation, PhD, ​in the press release. ”Studies of angiotensin II receptor blockers and angiotensin-converting-enzyme (ACE) inhibitors have suggested these medicines may confer the greatest benefit to long-term cognition, while other studies have shown the benefits of calcium channel blockers and diuretics on reducing dementia risk.”

According to the press release, this is the first meta-analysis to compare the potential impact over time of blood pressure lowering medicines that do compared to those that do not cross the blood-brain barrier. The medicines were then evaluated for their effects on several cognitive domains, including attention, language, verbal memory, learning, and recall.

“Hypertension occurs decades prior to the onset of dementia symptoms, affecting blood flow not only in the body but also to the brain,” Nation said in the press release. “Treating hypertension is likely to have long-term beneficial effects on brain health and cognitive function later.”

The research team gathered information from 14 studies consisting of approximately 12,900 adults from 50 years of age and older, including studies done in the United States, Australia, Canada, Germany, Ireland, and Japan.

A highlight of the study was that older adults who took blood pressure-lowering medicines that cross the blood-brain barrier had better memory recall for up to 3 years of follow-up compared to those taking medicines that do not cross the blood-brain barrier, even with a higher level of vascular risk. Further, adults who were taking hypertension medications that did not cross the blood-brain barrier had improved their attention span for up to 3 years of follow-up, according to the press release.

“These findings represent the most powerful evidence to-date linking brain-penetrant ACE-inhibitors and angiotensin receptor blockers to better memory,” said study co-author Jean K. Ho, PhD, in the press release. “It suggests that people who are being treated for hypertension may be protected from cognitive decline if they medications that cross the blood-brain barrier.”

There were a few limitations to the study, including that the study authors could not account for differences in racial and ethnic background based on the available studies and the difference in proportion between men and women in the group who took medications crossing the blood-brain barrier. Future research should focus on this area, since previous studies have shown that those with various racial/ethnic backgrounds may respond differently to different blood pressure medications, according to the study authors.

Some blood pressure-lowering meds linked to less memory decline in older adults. American Heart Association. Published June 21, 2021. Accessed June 21, 2021. 

https://newsroom.heart.org/news/some-blood-pressure-lowering-meds-linked-to-less-memory-decline-in-older-adults

ACE inhibitors, angiotensin 2 receptor blockers, calcium channel blockers, and diuretics, and each reduce blood pressure while crossing the blood-brain barrier and impacting cognitive function. 

Jill Murphy, Associate Editor

Articles

Survey Shows Nurses Face Significant Burnout Risks in COVID-19 Pandemic

Survey Finds 45% of Americans Already Sunburnt This Year

Flexibility, Grit, Gratitude Are Key to Being Great Nurse Practitioner

Study Finds Certain Blood Pressure-Lowering Meds Linked to Less Memory Decline in Older Adults