Aims To identify the organisational changes faced by front‐line nurses working with COVID‐19 patients during the first wave and describe how they responded to these changes. Background The COVID‐19 pandemic has altered the provision of care and the management of health care around the world. Evolving information about SARS‐CoV‐2 meant that health care facilities had to be reorganised continually, causing stress and anxiety for nurses. Methods Qualitative study based on Rapid Research Evaluation and Appraisal (RREAL). The research took place in hospital and community health settings of the Spanish national health system with a purposive sampling of 23 front‐line nurses. Semi‐structured interviews were conducted between May and June 2020. The duration was 30–45 min per interview. We used the Dedoose® data analysis software to perform a thematic analysis. Results Nurses responded to organisational changes using the following strategies: improvisation, adaptation and learning. Conclusion Our rapid approach allowed us to record how nurses responded to changing organisation, information that is easily lost in a disaster such as the COVID‐19. Implications for nursing management: Knowing about their strategies can help planning for future health disasters, including subsequent waves of the COVID‐19.
Aims and Objetives Explore nurses' experiences and perception of risk regarding the use of personal protective equipment during the first wave of the pandemic in Spain. Background The contribution of our study is to use qualitative methods to understand nurses' experiences and perceptions of the risk of the contagion linked to the shortage of PPE during the first wave of the pandemic, whose explosive start strained health systems around the globe. Design Qualitative descriptive design according to the Rapid Research Evaluation and Appraisal model. Methods Semi‐structured videoconference interviews were conducted to explore the experiences of 29 nurses including staff nurses, nursing supervisors and nursing directors from hospital and community services of the Spanish health system. Interviews lasted 30–45 min and were conducted in May 2020. We carried out a thematic analysis using Dedoose. The COREQ checklist was used to report findings. Results We identified the following themes and subthemes: 1. Experiences with personal protective equipment: scarcity, inequality, reutilization, self‐protection, delegation of responsibility, and gap between protocols and reality; 2. Perception of the risk of contagion: lack of credibility, lack of trust, lack of support, and meeting subjective needs. Conclusions The scarcity of personal protective equipment and inequality in its distribution led nurses to take initiatives to feel more protected. Mid‐ranking supervisors were caught between the responsibility of monitoring and rationing personal protective equipment and providing the necessary protection to nurses. The disjuncture between protocols and the available supply of personal protective equipment caused confusion. Lack of credibility, lack of trust and lack of support from management influenced participants' perception of the risk of contagion. Mid‐ranking supervisors were often responsible for trying to alleviate fear among nursing staff. Relevance to clinical practice Understanding the factors involved in risk perception can be helpful to decision‐makers who help protect nurses in clinical practice. These results can help administrators and policymakers because they point to the need for nurses to feel that their departments and centers look after their safety at work. Transparent communication and emotional support may contribute to their well‐being in the face of risk.
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