The aim of this study was to identify the COVID-19 pandemic impacts on nurses' sensemaking and explore resilience and mitigation strategies nurses adopted to sustain their wellbeing. Frontline clinical nurses are an essential population within the health workforce. Although they are educated to deal with the many challenges working in health presents, this pandemic has created new stressors and vulnerabilities, placing strain on their wellbeing. This article reports on the qualitative data from a national mixed methodology study undertaken between October and December 2020. Twenty-nine interviews were conducted remotely using Zoom and telephone with nurses in a wide range of clinical front-line roles. Data were analysed thematically drawing from the theoretical lens of sensemaking, and related concept of liminality. Findings identified that early in the pandemic, participants who were frontline nurses prioritised patient care while negotiating shifting uncertainties, fear, under-resourcing, and variable leadership. They watched the unfolding international crisis and anticipated that we, in Aotearoa New Zealand, faced a similar disaster. Amidst significant stressors, they endured separation from their families while acting as substitute family for patients and residents isolated from whānau. Six themes were identified: liminality; teamwork and leadership; relational dynamics; health and safety precarity; care ethics; and heroes and pariahs. The study highlights that organisational culture, communication, and clinical leadership either fractured or strengthened nurses' professional commitment.Keywords / Ngā kupu matua: altruism / te whakaaro atawhai i ētahi atu; COVID-19; frontline nurses / ngā tapuhi i te aroākapa o ngā mahi; leadership / te mahi arataki; liminality / panonitanga o te āhua tangata; sensemaking / te mātai āhuatanga; wellbeing / hauora Te Reo Māori translation Te mātai āhuatanga a ngā tapuhi i te aroākapa o ngā mahi āwhina tūroro i ngā marama tuatahi o te mate urutā o Covid-19 i 2020 i Aotearoa New Zealand Ngā ariā matuaKo te whāinga ia o tēnei mātainga tūāhua he tautuhi i te pānga o te urutā o COVID-19 ki te mātainga āhuatanga a ngā tapuhi, he tūhura hoki i ngā rautaki tū pakari, whakangāwari hoki a ngā tapuhi kia mau tonu tō rātou hauora. He taupori taketake ngā tapuhi i te aroākapa o ngā mahi āwhina tūroro i roto i te kāhui kaimahi hauora. Ahakoa kua ākona rātou mō ngā tini wero ka tūponotia e te hunga mahi i te ao hauora, i tēnei o ngā urutā kua puta ake ētahi atu pēhitanga, whakaraeraetanga hoki, ā, hei whakataumaha ēnei āhua i tō rātou hauora. Tā tēnei tuhinga he tuku pūrongo mō ngā raraunga inekounga mai i tētahi rangahau tikanga-maha i kawea i waenga i ngā marama o Whiringa ā-
AimTo explore the moral emotions that frontline nurses navigated in endeavouring to ensure a ‘good death’ for hospital patients and care home residents during the first wave of the COVID‐19 pandemic.BackgroundUnder normal circumstances, frontline staff are focused on clinical ethics, which foreground what is best for individuals and families. Public health crises such as a pandemic require staff to adapt rapidly to focus on what benefits communities, at times compromising individual well‐being and autonomy. Visitor restrictions when people were dying provided vivid exemplars of this ethical shift and the moral emotions nurses encountered with the requirement to implement this change.MethodsTwenty‐nine interviews were conducted with nurses in direct clinical care roles. Data were analysed thematically informed by the theoretical concepts of a good death and moral emotions.ResultsThe data set highlighted that moral emotions such as sympathy, empathy, distress and guilt were integral to the decisions participants described in striving for a good palliative experience. Four themes were identified in the data analysis: nurses as gatekeepers; ethical tensions and rule bending; nurses as proxy family members; separation and sacrifice.ConclusionsParticipants reflected on morally compromising situations and highlighted agency through emotionally satisfying workarounds and collegial deliberations that enabled them to believe that they were party to painful but morally justifiable decisions.Implications for the profession and patient careNurses are required to implement national policy changes that may disrupt notions of best practice and therefore be experienced as a moral wrong. In navigating the moral emotions accompanying this shift, nurses benefit from compassionate leadership and ethics education to support team cohesion enabling nurses to prevail.Public contributionTwenty‐nine frontline registered nurses participated in the qualitative interviews that inform this study.Reporting methodThe study adhered to the Consolidated Criteria for Reporting Qualitative Research checklist.
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