Navigating Professional and Personal Knowing Through Reflective Storytelling Amidst Covid-19

The paper offers space for dialogue illustrating reflection as lived, exploring both my personal and professional experiences of grief and loss surrounding the death of my Dad from Covid −19. In my role as a nurse educator, I share understandings of reflection in facilitating learning and person centered practices with students. I illustrate my approach with two stories generating a narrative giving testimony to those who have died and highlighting the ensuing grief for those who have cared for older people during the pandemic. The first reflective story has been shared with students and snapshots of student responses during virtual sessions are incorporated. The second story shifts to a more personal focus reflecting personal knowing. Insights emerge bringing forth personal and professional knowing, about the art and science of holistic nursing. I explore the challenges in separating ourselves from personal knowledge and experience in reflective writing. I invite readers to take time to pause amidst a global healthcare pandemic to consider the potential of reflection to support nurses in recovering from suffering experienced during a pandemic.

Working After Loss: How Bereavement Counsellors Experience Returning to Therapeutic Work After the Death of Their Parent

Despite increased interest in the impact of external events on counsellors, surprisingly little has been written on counsellor bereavement. To address the research question: How do bereavement counsellors experience therapeutic work after the death of their parent? Interviews were conducted with four bereaved counsellors who reflected on its impact on their work. Data were analysed using Interpretative Phenomenological Analysis (IPA). Three major themes emerged; how decisions about returning to work were informed by colleagues and supervision; the benefits of returning to work and the use of ‘bracketing’; long-term implications for practice including heightened empathy with clients’ and disclosure of loss. In addition, participants felt they had insufficient guidance regarding fitness to practice. The possible limitations of the study were that self-selection may have introduced an element of bias to the results. These findings support existing literature and also revealed potential gaps in grief and loss training for counsellors and supervisors. A particular training issue for supervisors might be identifying and discussing fitness to practice issues with supervisees. There are also implications for counsellors in terms of the use of self-disclosure in therapy. Suggested further research to explore the use of self-disclosure in greater depth.

Bereavement behind bars: Grief support groups with and without therapy dogs for incarcerated females

Grief is a universal experience; however not everyone experiences grief and loss in the same way. People who are incarcerated are often informed of losses via phone, are unable to attend funeral services or participate in supportive rituals, and can have difficulty expressing feelings in a place where showing emotion can be dangerous. Being unable to obtain support and process grief and loss may contribute to impaired functioning. In this study of bereavement support for women in prison, incarcerated women with recent or unresolved losses (n=32) were randomly assigned to grief support groups with therapy dogs (animal-assisted, AA) or without therapy dogs (non-AA). Pre- and post-test measures of bereavement symptoms and prolonged grief disorder (PGD) were obtained. This study shows that AA groups had more significant decreases in symptoms, lower rates of post-group diagnostic criteria for PGD and higher rates of perceived support/benefit from the groups.

The Children

The children’s early experiences provide a context for assessing subsequent outcomes. Data collected from case files and records presented to the courts show that before separation from birth parents, almost all 210 adoptees had experienced serious and often multiple forms of maltreatment; this was the primary reason for removal. Before entering their adoptive homes, 69% of the adoptees had had four or more adverse childhood experiences (ACEs), 32% had experienced failed reunifications and 48% had had three or more foster placements. Adverse childhood experiences before entry to care, harmful experiences in care and repeated exposure to grief and loss are likely to have contributed to the high prevalence of emotional and behavioural difficulties, displayed by 49% of the adoptees. According to our classification, 57% were at high risk of experiencing adverse outcomes in adulthood.

Coping with the Subjective Impact of COVID-19 among Older Adults in Puerto Rico

The COVID-19 pandemic poses serious physical and mental health risks for older adults worldwide. To develop culturally and contextually congruent services to mitigate these risks requires understanding their stress and coping processes, which remain understudied in Latin America. This study examines qualitative data from 51 adults aged 60 and over who participated in an ongoing study of older Puerto Ricans’ knowledge, attitudes, and practices about COVID-19. Trained interviewers collected the data by telephone from January to August, 2021. Two-thirds of participants were female, 60% had less than high school education and 90% had poverty-level incomes. Drawing on Lazarus and Folkman’s Stress and Coping Theory, we conducted a thematic analysis of responses to open-ended questions about the nature and extent of COVID-related stressors, stress management, and meanings and guidance they had gleaned from their experience. Participants perceived the pandemic as an added threat to ongoing chronic stressors (e.g., Hurricane Maria, poverty, political instability); disruptions in daily routines, family cohesion, and grief and loss processes; and increased isolation and loneliness. They reported using cognitive, behavioral, socioemotional and spiritual coping, including positive thinking, keeping occupied, relaxation, religious practices and, in a few cases, social media. Participants highlighted a revitalized appreciation for emotional qualities of relationships, freedom and life in general. Consistent with our guiding theory, cultural, contextual, religious, and socio-political factors shaped their appraisals of stress and their coping strategies. Future research should examine how these practices relate to health outcomes and quality of life and how they can inform effective, appropriate interventions.

The 4Ms in a Pandemic: A Survey of Training Needs Among Healthcare Professionals, Older Adults, and Community Members

The University of New England, in collaboration with the University of Maine, received a five-year grant from the Health Resources and Services Administration (HRSA) to improve the health and well-being of Maine’s older adults through enhanced training under HRSA’s Geriatrics Workforce Enhancement Program (GWEP). As part of these efforts, stakeholder training needs assessment data were collected via a statewide electronic survey that was distributed to community members and providers throughout Maine. The survey, which focused on the 4M’s of Age-Friendly Healthcare, received 68 responses from older adults/community members (N = 26), program administrators (N = 12), along with community leaders, and those working in the public and non-profit sector (N = 13). A significant emphasis on social isolation, mental health, and grief and loss issues was noted and dominating themes centering on two dimensions of the 4M framework: “What Matters” and “Mentation.” Findings reflect an overriding priority by providers and consumers to keep older adults socially connected (28%, N = 34) and maintaining mental health and well-being during the pandemic (21%, N = 14). Qualitative response analysis identified additional COVID-19-related training topics such as: what to do if you or a loved one contracts coronavirus, how to handle grief and loss related to COVID-19, strategies for supporting loved ones during COVID-19, and socially distanced bereavement support. Results indicate a need to focus on meeting the emotional and mental health needs of older adults, as well as the importance of encouraging connections and mitigating the effects of social isolation during COVID-19.