Medical Staff Working Research Articles

Clinical Audit of the Awareness of Safety Guidelines on Lithium Prescribing Within the Acute Hospital- James Cook University Hospital

AimsLithium is a useful drug and is of particular benefit in patients with chronic mood disorders like bipolar affective disorder and recurrent depression. Lithium requires careful monitoring and dose adjustment for safe use due to its narrow therapeutic index and high potential for toxicity. Monitoring must carry on even when mental health patients taking Lithium are admitted to acute hospital. Therefore, the main aim of this clinical audit was to evaluate the level of awareness of the lithium safety guidance amongst medical staff working within the Acute Hospital, James Cook University Hospital. Ideally 100% of staff should have the appropriate knowledge.MethodsQuestionnaire consisted of 6 items which were derived from key points within the Trust guidelines for Lithium. It was designed to highlight the key points in the document and check the level of awareness of the respondents. Respondents were drawn from James Cook University Hospital and South Tees Liaison Psychiatry team. A total of 25 respondents were included in the study.Results96% (24/25) of the respondents were aware that renal and thyroid function should be checked for patients on Lithium. 84% (21/25) were aware of the potential impact of Lithium on Kidney function (eGFR) and 68% (17/25) were aware of signs of Lithium toxicity.60% (15/25) of acute staff were aware about referring patients with deranged Lithium levels to the Liaison Psychiatry team. 40% (10/25) were aware of the drugs that could potentially increase lithium levels like Diuretics, Non-steroidal anti-inflammatory drugs, ACE (angiotensin converting enzyme) inhibitors. Only 24% (6/25) of acute trust staff were aware about checking lithium levels on admission.ConclusionIdeally, a 100% compliance and positive response rate should be achieved as these relate to completion of expected safety checks. Lithium is a potentially high-risk drug with a narrow therapeutic index. Possibility of its acute and chronic side effects, including lithium toxicity, makes it essential to follow safety guidelines on lithium prescribing and hence ensure patient safety.In view of this, the clinical audit results clearly show that there is significant room for improvement to achieve a 100% positive response rate for awareness of safety guidelines on Lithium prescribing.Overall, there were an average of 57% positive responses and 42% negative responses for awareness of various aspects of the safety guidelines for Lithium.A robust action plan which included teaching sessions on creating awareness about lithium monitoring was planned because of this audit.

Healthcare professionals’ experiences with education in short term medical missions: an inductive thematic analysis

BackgroundShort-term medical mission (STMM) providers supplement healthcare delivery and education in low- and middle-income countries (LMIC). Despite numerous providers working in this space, the views of volunteers who contribute their time and skills to these programs are rarely sought.MethodA qualitative study of 24 volunteers for Pangea Global Health Education (Pangea) was undertaken using semi-structured interviews to better understand their perspectives on program design and delivery, personal and professional outcomes of their volunteer experiences and the resulting implications for STMM program design. An inductive thematic analysis of their responses was completed. Social constructionist theory was utilised to contextualise themes and implications for program design.ResultsParticipants highlighted the importance of co-creation with local learners and staff, the necessity to understand clinical context and the importance of relating to culture in the advancement of patient care. They reported personal growth, including a better understanding of others, and identifying commonalities between people. Professionally, participants reported learning from their colleagues, including new medical content, as well as refining their teaching practices. They also reported learning from those they taught and respecting the resourcefulness of medical and nursing staff working in LMIC.ConclusionSTMM providers may benefit from co-creation with their learners in the development of health professional education programs. A deep understanding of local context and culture provides for a richer learning environment and enables sustainable long-term program delivery. Utilising a social constructionist framework enables a better understanding of cultural barriers, which inhibit group learning, including the tendency to maintain hierarchical divides; addressing these will allow for optimised patient care.

Factors affecting online knowledge sharing and its effect on academic performance

PurposeThis study aims to explore the factors that affect online knowledge sharing among the scientific performance of academics at the University of Mosul, Republic of Iraq.Design/methodology/approachData were collected by using a random sample by means of an electronic questionnaire distributed to 211 academics at the University of Mosul via online platforms. Structural equation modeling was used to test hypotheses using AMOS 24 software.FindingsThe results showed that collaboration, perceived flexibility and willingness to share had a significant effect on online knowledge sharing behavior and that which in turn had an effect on the academic performance of respondents, while the results showed no influence of knowledge self-efficacy and communication on the behavior of online knowledge sharing.Research limitations/implicationsIn this research, the effects of five factors on online knowledge sharing behavior were studied, in addition to the effect of the latter on academic performance. The research did not study the effect of the participants’ personal characteristics on the behavior of knowledge sharing online, which could be an area of future investigation. The study was limited to online knowledge sharing for academics working in public universities, and the authors suggest conducting a future study from the perspective of medical staff working in hospitals and its impact on their performance.Practical implicationsBased on the findings of the current study, this study suggests that the academic staff at the University of Mosul and similar universities pay attention to scientific cooperation between researchers and teaching staff, by creating online groups to carry out joint research projects that contribute to sharing knowledge among participants through social media in general and scientific platforms in particular. Establishing a scientific research portal could serve this well for example.Originality/valueMost previous studies have focused on areas related to knowledge sharing in higher education institutions from the traditional perspective and therefore studies that examine the factors affecting online knowledge sharing among academics are limited, so this study fills this gap. This paper focuses on identifying the scientific benefits for academics through knowledge exchange and the use of electronic platforms at the University of Mosul. The study is expected to contribute to enhance the exchange of knowledge online between academics in similar universities in Asia and Africa due to the convergence of cultures and the nature of the work of these universities, as well as the possibility of generalization due to the research’s use of the deductive method.

Prevalence of Complaints Due to Musculoskeletal Disorders and Its Effective Factors Among Medical Staff Working in Emam-Reza Hospital of Larestan

Background: Work-related musculoskeletal injuries and complaints are widespread. Medical staff are exposed to these injuries depending on their duties. Objectives: This study aimed to investigate the occupational musculoskeletal complaints and related risk factors among medical staff working in Emam-Reza hospital of Larestan. Methods: Following a cross-sectional, descriptive-analytical design, this study was performed on 124 medical staff working in Emam-Reza hospital of Larestan city in 2021. Participants were selected using convenient sampling. Data collection was performed using questionnaires filled out by participants from August to October 2021. The questionnaires were divided into demographic and musculoskeletal complaints using the Nordic questionnaire. Data analysis was administered using SPSS version 25. Statistical significance was considered when P-value < 0.05. Results: Of 124 participants, 92 (74.2%) were women. The mean age of participants was 34.97 ± 7.51 years. Most of the musculoskeletal complaints were related to the lumbar region, followed by one or both knees, and neck in the last 12 months and 7 days, respectively. Musculoskeletal complaints in the back during the previous 12 months and lumbar complaints during the previous 12 months and 7 days were significantly higher among nurses than others (P < 0.05). Also, in all body parts, the prevalence of musculoskeletal disorders was significantly higher in women than men (P < 0.05). Conclusions: Given the musculoskeletal complaints among female nurses participating in this study, the authors recommend training them to prevent and focus attention on appropriate conditions and improving working conditions.

Understanding what wellbeing means to medical and nursing staff working in paediatric intensive care: an exploratory qualitative study using appreciative inquiry

Aims and objectivesTo explore what wellbeing means to medical and nursing staff working in a large paediatric intensive care (PIC).DesignExploratory qualitative design using an appreciative inquiry framework.SettingPIC unit; primary, secondary...

COVID-19 among workers of a comprehensive cancer centre between first and second epidemic waves (2020): a seroprevalence study in Catalonia, Spain

ObjectivesPatients with cancer are at higher risk for severe COVID-19 infection. COVID-19 surveillance of workers in oncological centres is crucial to assess infection burden and prevent transmission. We estimate the...

Examination of a patient with left ventricular assist device in an emergency condition — proposal for adaptation of the ABCDE examination algorithm

Heart failure is becoming a medical issue that concerns more and more patients. The most effective treatment method is heart transplantation, however, more people are waiting for the procedure than there are available donors. The improvement of left ventricular assist device (LVAD) method was possible because of the joining forces of technological and medical advances. In recent years more patients have undergone the LVAD treatment. It has been a considerable challenge for medics in prehospital conditions. Device malfunction, bleeding, chest pain, or collapse pose a threat to life for those patients. The aim of this paper was to adjust the ABCDE examination algorithm to be applied for patients with LVAD. Additionally, the author has described the method in detail. The article itself and the modification of the algorithm are based on the analyses of available source literature. The biggest challenge for medics who examine patients with LVAD is a lack of pulse and inability to measure the pressure in a classical method. The most visible differences in the examination scheme have been observed in points C and E. The authors have identified the need for simulation-based trainings dedicated to medical staff working in prehospital conditions. Additionally, a special system informing emergency services about LVAD patients living in their area should be implemented.

Mental health status of medical staff working in hospitals during COVID-19 pandemic in Pakistan: A cross-sectional study

Background: The ongoing global pandemic of novel coronavirus (COVID-19) infection has created unrest and fear among frontline healthcare workers worldwide. Objective: To investigate the mental health status of medical staff working in the COVID-19 outbreak, and to compare anxiety, insomnia, and post-traumatic distress syndrome among healthcare workers dealing directly and indirectly with confirmed COVID-19 patients.Methods: The cross-sectional study was carried out in seven tertiary care hospitals as designated COVID-19 centers, between July and September 2020 with a response rate of 76.3%. The study population comprised of medical staff working in COVID-19 dedicated tertiary care hospitals managing COVID-19 patients. Mental health assessment was done by using GAD-7, ISI-7, and IES-R-22 standardized scales to evaluate depression, anxiety, insomnia, and distress among healthcare workers.Results: 458 healthcare workers participated in the study, 254 (55.5%) males and 204 (44.5%) females with a mean age of 31.98±7.18 years. Study participants were divided into two groups based on their interaction with confirmed cases of COVID-19. More number of healthcare workers directly dealing with COVID-19 patients (Group A) were at risk of developing anxiety (GAD score ≥10) with crude odds of 3.16 (adjusted OR=3.40, 95% CI 2.1 – 5.7, p<0.001) as compared to those indirectly or not dealing with COVID-19 patients (Group B). Similarly, Group A was more likely to suffer from insomnia (ISI score ≥15) and post-traumatic distress syndrome (IMS-R score ≥33) with crude odds of 2.88 (adjusted OR=2.14, 95% CI 1.2 – 3.8, p<0.001) and 3.36 (adjusted OR=3.2, 95% CI 2.0 – 5.3, p<0.001) respectively.Conclusion: A significant number of healthcare workers were found to be suffering from mental health illnesses during the COVID-19 outbreak.

Exposure Risk to Medical Staff in a Nasopharyngeal Swab Sampling Cabin under Four Different Ventilation Strategies

Medical staff working in a nasopharyngeal swab sampling cabin are exposed to a higher exposure risk of COVID-19. In this study, computational fluid dynamics (CFD) are used to evaluate the exposure risk to medical staff in a nasopharyngeal swab sampling cabin of Chinese customs under four different ventilation strategies, i.e., multiple supply fans ventilation (MSFV), multiple exhaust fans ventilation (MEFV), single exhaust fan and outer windows closed ventilation (SEFV), and single exhaust fan and outer windows opened ventilation (SEFV-W). The impact of physical partitions on exposure risk is also discussed. The results show that MSFV performed best in reducing exposure risk. No significant difference was found between MEFV and SEFV. SEFV-W performed better than SEFV with a ventilation rate of 10–50 L/(s∙Person), while it performed worse with a ventilation rate of 50–90 L/(s∙Person). The exposure risk to medical staff did not decrease linearly with the increase in the ventilation flow rate under the four ventilation strategies. For MSFV, the installation of partitions is conducive to the reduction in the exposure risk. This study is expected to provide some guidance for ventilation designs in sampling cabins.

Medical Staff at Sanatorium-Resort Organizations: Working Conditions and Health Risk Factors

Medical staff working conditions are characterized by a range of adverse workplace factors investigated primarily at hospital organizations. However, sanitary audit of working conditions and health risk factors for medical workers in the sanatorium-resort industry is also a task that needs attention. Aim. To analyze the results of the working conditions special assessment and identify the main work-related factors affecting health state of medical staff at sanatorium-resort organizations. Material and methods. Scientific search and analysis of publications on the safety of working conditions and health protection of medical workers. Systematization of research materials, statistical and comparative analysis of the results of working conditions special assessment carried out at branches of the Medical Research Center and data provided in publications. Results. Medical staff are exposed to a wide range of hazards. Work-related factors that do not meet established hygiene standards cause the greatest concern among medical workers. These are microclimate, lighting and working equipment (47.0%, 37.8% and 24.0%, respectively). A number of devices inspected in the physiotherapy room exceeded hygienic standards for alternating electric and magnetic field intensity. Analysis of air pollution in the physiotherapy department working area showed that some of the harmful chemicals exceeded permissible exposure limits. The results of the special assessment of working conditions performed at branches of the Medical Research Center showed that a high percentage of medical workers was exposed to harmful biological factors and high severity of the labor process. Conclusion. Physical and chemical factors are the greatest workplace hazards for healthcare workers at health resorts. However, a special assessment of working conditions showed that the biological factor was the most significant one across all professional groups.

Determining Contributory Factors to the Competitiveness of Iran’s Medical Tourism: An Importance-Performance Analysis

Introduction: Medical tourism is developing more rapidly, particularly in developing countries, as a tool to enhance economic growth and achieve a competitive position. The present study aims to investigate and identify contributory factors to the competitiveness of Iran’s medical tourism using importance-performance analysis. Methods: This is an applied study with a descriptive nature conducted using field studies and surveys. A conceptual model was adopted and contributory factors were extracted from previous studies. A questionnaire was designed based on extracted factors and opinions of experts who are specialists in the field of medical tourism. The statistical population consisted of tourism experts, health experts, physicians, and medical staff working in hospitals with international units. Data analysis was performed using SPSS. Results: The results showed that "medical services" were more important than the two components "special factors of tourism" and "characteristics of medical tourism destinations". It was also revealed that the current situation of "medical tourism destination characteristics" is unfavorable compared to the other two components. Conclusion: This study provided an insight into the importance and quality of performance of the factors affecting the competitiveness of medical tourism, which can be beneficial for managers and planners in Iran and other medical tourism destinations.

The risk of post-traumatic stress disorder (PTSD) in Italian Highly Specialized Research Hospitals staff within two months of the pandemic declaration: an on-line survey.

The whole hospital system was stressed and at risk in the first phase of the pandemic. This study examined the prevalence of post-traumatic stress disorder (PTSD) in all hospital staff, medical and non-medical, within two months of the pandemic declaration. Survey concerned staff 4510 health workers of Italian Highly Specialized Research Hospitals. Subjects were asked to complete an on-line self-reported questionnaire, the PTSD Checklist 5 (PCL-5) and subjective perception of safety related to personal protective equipment (PPE). The sample included staff working in hospitals with or without COVID-19 patient admissions. Overall, 11.56% of the hospitals staff met the symptoms criteria for probable PTSD. The sample included 80.63% (3467) medical staff workers and 19.37% (833) non-medical staff workers. The 31.91% of participants worked in COVID-19 hospitals/wards. The prevalence of positive screening for PTSD symptoms in medical staff was 12.42% (426) and in non-medical staff, 8.59% (70). Among medical staff, anesthesiologists had a significant prevalence of PTSD (22.35%), followed by health care assistants/technicians (15.38%) and physicians (10.11%). Among non-medical staff, personnel involved in cleaning, catering, maintenance, security, and transportation, the symptoms of PTSD reached a rate of 12.24% and in administrative staff 8.47%. Risk factors associated with PTSD included working as an anesthesiologist, perceiving PPE as inadequate, and working in COVID-19 hospitals/wards. In the present study, as in other studies, the prevalence of PTSD symptoms among hospital workers was significatively higher than the lifetime prevalence of PTSD in the general population, showing the pandemic's incredible impact.

Position and Pose Measurement of 3-PRS Ankle Rehabilitation Robot Based on Deep Learning

Introduction: The position and pose measurement of the rehabilitation robot plays a very important role in patient rehabilitation movement, and the non-contact real-time robot position and pose measurement is of great significance. Rehabilitation training is a relatively complicated process, so it is very important to detect the training process of the rehabilitation robot in real time and accuracy. The method of the deep learning has a very good effect on monitoring the rehabilitation robot state. Methods: The structure sketch and the 3D model of the 3-PRS ankle rehabilitation robot are established, and the mechanism kinematics is analyzed to obtain the relationship between the driving input - the three slider heights - and the position and pose parameters. The whole network of the position and pose measurement is composed of two stages: (1) measuring the slider heights using the CNN based on the robot image and (2) calculating the position and pose parameter using the BPNN based on the measured slider heights from the CNN. According to the characteristics of continuous variation of the slider heights, a regression CNN is proposed and established to measure the robot slider height. Based on the data calculated by using the inverse kinematics of the 3-PRS ankle rehabilitation robot, a BPNN is established to solve the forward kinematics for the position and pose. Results: The experimental results show that the regression CNN outputs the slider height and then the BPNN accurately outputs the corresponding position and pose. Eventually, the position and pose parameters are obtained from the robot image. Compared with the traditional robot position and pose measurement method, the proposed method has significant advantages. Conclusion: The proposed 3-PRS ankle rehabilitation position and pose method can not only shorten the experiment period and cost, but also get excellent timeliness and precision. The proposed approach can help the medical staff to monitor the status of the rehabilitation robot and help the patient rehabilitation in training. Discussion: The goal of the work is to construct a new position and pose detection network based on the combination of the regression convolutional neural network (CNN) and the back propagation neural network (BPNN). The main contribution is to measure the position and pose of the 3-PRS ankle rehabilitation robot in real time, which improves the measurement accuracy and the efficiency of the medical staff work.

Electrocardiogram Signal Classification in the Diagnosis of Heart Disease Based on RBF Neural Network.

Heart disease is a common disease affecting human health. Electrocardiogram (ECG) classification is the most effective and direct method to detect heart disease, which is helpful to the diagnosis of most heart disease symptoms. At present, most ECG diagnosis depends on the personal judgment of medical staff, which leads to heavy burden and low efficiency of medical staff. Automatic ECG analysis technology will help the work of relevant medical staff. In this paper, we use the MIT-BIH ECG database to extract the QRS features of ECG signals by using the Pan-Tompkins algorithm. After extraction of the samples, K-means clustering is used to screen the samples, and then, RBF neural network is used to analyze the ECG information. The classifier trains the electrical signal features, and the classification accuracy of the final classification model can reach 98.9%. Our experiments show that this method can effectively detect the abnormality of ECG signal and implement it for the diagnosis of heart disease.

Stressors faced by healthcare professionals and coping strategies during the early stage of the COVID-19 pandemic in Germany.

BackgroundThe COVID-19 pandemic has exerted great pressure on national health systems, which have aimed to ensure comprehensive healthcare at all times. Healthcare professionals working with COVID-19 patients are on the frontline and thereby confronted with enormous demands. Although early reports exist on the psychological impact of the pandemic on frontline medical staff working in Asia, little is known about its impact on healthcare professionals in other countries and across various work sectors. The present cross-sectional, online survey sought to investigate common work stressors among healthcare professionals, their psychological stress as well as coping resources during the pandemic.MethodsA sample of 575 healthcare professionals (57% male) in three different sectors (hospital, prehospital emergency care, and outpatient service) reported their experiences concerning work and private stressors, psychological stress, and coping strategies between April 17, 2020 and June 5, 2020. To capture pandemic-specific answers, most of the items were adapted or newly developed. Exploratory factor analyses (EFA) were conducted to detect underlying latent factors relating to COVID-specific work stressors. In a next step, the effects of these latent stressors across various work sectors on psychological stress (perceived stress, fatigue, and mood) were examined by means of structural equation models (SEM). To add lived experience to the findings, responses to open-ended questions about healthcare professionals’ stressors, effective crisis measures and prevention, and individual coping strategies were coded inductively, and emergent themes were identified.ResultsThe EFA revealed that the examined work stressors can be grouped into four latent factors: “fear of transmission”, “interference of workload with private life”, “uncertainty/lack of knowledge”, and “concerns about the team”. The SEM results showed that “interference of workload with private life” represented the pivotal predictor of psychological stress. “Concerns about the team” had stress-reducing effects. The latent stressors had an equal effect on psychological stress across work sectors. On average, psychological stress levels were moderate, yet differed significantly between sectors (all p < .001); the outpatient group experienced reduced calmness and more stress than the other two sectors, while the prehospital group reported lower fatigue than the other two sectors. The prehospital group reported significantly higher concerns about the team than the hospital group (p < .001). In their reports, healthcare professionals highlighted regulations such as social distancing and the use of compulsory masks, training, experience and knowledge exchange, and social support as effective coping strategies during the pandemic. The hospital group mainly mentioned organizational measures such as visiting bans as effective crisis measures, whereas the prehospital sector most frequently named governmental measures such as contact restrictions.ConclusionThe study demonstrated the need for sector-specific crisis measures to effectively address the specific work stressors faced by the outpatient sector in particular. The results on pandemic-specific work stressors reveal that healthcare professionals might benefit from coping strategies that facilitate the utilization of social support. At the workplace, team commitment and knowledge exchange might buffer against adverse psychological stress responses. Schedules during pandemics should give healthcare workers the opportunity to interact with families and friends in ways that facilitate social support outside work. Future studies should investigate cross-sector stressors using a longitudinal design to identify both sector- and time-specific measures. Ultimately, an international comparison of stressors and measures in different sectors of healthcare systems is desirable.

Measures to prevent nosocomial transmissions of COVID-19 based on interpersonal contact data.

With the global spreading of Coronavirus disease (COVID-19), many primary care medical workers have been infected, particularly in the early stages of this pandemic. Although extensive studies have explored the COVID-19 transmission patterns and (non-) pharmaceutical intervention to protect the general public, limited research has analysed the measures to prevent nosocomial transmission based upon detailed interpersonal contacts between medical staff and patients. This paper aims to develop and evaluate proactive prevention measures to contain the nosocomial transmission of COVID-19. The specific objectives are (1) to understand the virus transmission via interpersonal contacts among medical staff and patients; (2) to define proactive measures to reduce the risk of infection of medical staff and (3) evaluate the effectiveness of these measures to control the COVID-19 epidemic in hospitals. We observed the operation of a typical primary hospital in China to understand the interpersonal contacts among medical staff and patients. We defined effective distance as the indicator for risk of transmission. Then three proactive measures were proposed based upon the observations, including a medical staff rotation system, the establishment of a separate fever clinic and medical staff working alone. Finally, the impacts of these measures are evaluated with a modified Susceptible-Exposure-Infected-Removed model accommodating the situation of hospitals and asymptomatic and latent infection of COVID-19. The case study was conducted with the hospital observed in December 2019 and February 2020. The implementation of the medical staff rotation system has the most significant impact on containing the epidemic. The establishment of a separate fever clinic and medical staff working alone also benefits from inhibiting the epidemic outbreak. The simulation finds that if effective prevention and control measures are not taken in time, it will lead to a surge of infection cases in all asymptomatic probabilities and incubation periods.

INTERNATIONAL YEAR OF MEDICAL AND SOCIAL WORKERS IN UKRAINE: RECOGNITION OF THE ROLE IN THE FIGHT AGAINST THE COVID-19 PANDEMIC AND PROTECTING HEALTH AND WELL-BEING.

The aim: Defining the role of health workers and problems in combating the COVID-19 pandemic, outlining ways to protect health and safety in the workplace. Materials and methods: The following methods were used: content analysis of international and domestic legal documents of state and sectoral level on the problem of functioning and social protection of medical and social workers in the COVID-19 pandemic and statistical reporting on the dynamics of their number and wages. Conclusions: With the advent of COVID-19, tensions in the work of medical staff have increased, which has contributed to a reduction in the number of health workers in Ukraine due to death, permanent disability, termination / change of professional activity and migration of medical personnel. It has been found that the slow growth of wages is inadequate to carry out socially necessary activities with a risk to life and health. Fair pay for health and social workers is a necessary but not sufficient component of measures to combat the COVID-19 pandemic at the present stage. The International Year of Health and Social Workers should be an opportunity to draw attention to the need to increase investment in education, training and social protection of these professionals and to minimize the risks posed by the pandemic to the economy and development of countries and people's lives.

Appraisal of Biosafety Measures in Governmental Medical Laboratory Personnel: Knowledge, Attitude, Practice (KAP) Study

Laboratory staff is always exposed to a variety of hazards according to their work nature and so, they must be conscious at all times. This study is aimed at the assessment of safety awareness to get knowledge attitude and practice among governmental medical laboratory staff in Khartoum state. A descriptive cross-sectional study performed on 210 Sudanese governmental medical laboratory staff working in 15 governmental hospitals lab. Data was collected by direct interviews using structured, prete

Ethics of Care: Philosophical Propaedeutics as a Therapy for Emotional Burnout in Medicine

The purpose of this article is to comprehend the reasons for the exponential growth and specificity of «burnout» of medical personnel during the Covid-19 pandemic and to substantiate the therapeutic potential of philosophy based on P. Ricoeur’s narrative identity theory. The pandemic has forced a new way of looking at the attitude to time, convincing us that in general we are not badly prepared for emergency medical care, but we are not coping with the problem in the long run. An example of this is the ineffectiveness of the treatment of many chronic diseases against the background of covid, which inscribe the disease in the time limits of the individual life. The temporality of patient care is partly determined by the nature of the organization of the health care worker&amp;apos;s work — its routinization and the emphasis placed on individual performance evaluation. This artificially creates conditions for the actual dilution of professional teams, creating competition between doctors, between services and between patients. Time turns out to be fragmented, and treatment, developed mainly for the short term, is reduced to a certain sequence of actions, sometimes without any real coherence. As a result of the disruption of temporality, the identity of the subject caring for the patient is blurred, the “meaning of the profession” is also questioned. The risks of burnout associated with a decrease in the level of responsibility of a medical worker and an increase in the probability of professional errors, require an understanding of the causes of subjective suffering experienced by medical workers and the construction of a collective narrative. Its necessity is also explained by the need to ensure the protection of the medical worker in the face of both the administration and the patient community, which requires a return to the collective history and the creation of a system of internal and external protective mechanisms of the medical community. This requirement, based on the public recognition of the value of medical staff work, is well respected in several leading Western countries and completely ignored in Russia.

Investigation of nurses' readiness levels in different wards of the hospital.

The level of nurses' readiness and knowledge can significantly influence on the quality of treatment and patients' health. Nurses should have a high level of knowledge and understanding of clinical care and its aspects. According to this issue, our study has been performed with the aim to compare the readiness of different wards of the hospital in evaluating important indicators of clinical care. This descriptive cross-sectional study was performed on 99 medical staff working in different wards of the hospital - during July 2020 to December 2021. Nurses in different wards of the hospital were compared in terms of care indicators. The tool used was a checklist for the effectiveness and evaluation of clinical care. The data were analyzed by SPSS statistical software. About 16.3% of the nurses were male, and 85.7% were female. Nurses in different wards were significantly different in terms of catheter and ligament care, blood transfusion and products, serum therapy and IV therapy, communication and training skills, pharmaceutical processes, and working with ventilators (p < 0.05). Emergency and general wards' nurses showed better readiness for pharmaceutical processes and emergency, and neonatal intensive care unit (NICU) ward nurses showed the best readiness in relation to catheter care and absorption and excretion processes and blood transfusion and products (p < 0.05). Despite an appropriate readiness in many wards, care readiness was placed on a lower extent in some wards. There were also limitations, strengths, and weaknesses in some aspects, including medication, care and standards, and infection control, which, because of this issue, can help improve nurses' performance in the future.