No abstract

Not alone: One network' s approach to pandemic nurse staffing N urse leaders faced an unprecedented staffing crisis during the height of the COVID-19 pandemic. As COVID-19 spread throughout New Jersey, acute care hospitals quickly had to shift from treating patients with various medical conditions to treating those with COVID-19 or persons under investigation (PUI). With the surge of COVID-19 patients needing ICU care, nurse leaders didn't have a blueprint for the emergency staffing response required to handle this crisis. Despite disaster experiences, such as 9/11 and Hurricane Sandy, nurse leaders needed resiliency, innovation, and creative decision-making as they faced this new challenge. 1 Hackensack Meridian Health (HMH) is one of the largest healthcare systems in New Jersey, employing over 8,000 nurses. Despite the impressive staffing numbers of this clinically integrated network, HMH's nurse leaders struggled to meet the clinical demands of caring for more than 13,000 patients with COVID-19. Turning to the literature for evidence-based staffing guidance, minimal evidence was found regarding staffing ratios, options, and models and how to successfully implement a staffing model during a pandemic. Thus, at the beginning of the COVID-19 pandemic, there was a gap in the literature relative to staffing in hospitals during pandemics, epidemics, or illness outbreaks.

During the COVID-19 pandemic, nurses were faced with challenges when caring for patients, safely administering intravenous (IV) medications and solutions, and protecting themselves from the virus. To address these challenges, nurses moved infusion pumps outside of intensive care unit (ICU) rooms of patients with COVID-19 to minimize their exposure to the virus, conserve personal protective equipment, and efficiently administer IV medications and solutions. The purpose of this qualitative descriptive study was to explore and describe nurses' perception of managing infusion pumps outside the ICU rooms of patients with COVID-19 at 6 acute care hospitals. Eight interviews were conducted with ICU nurse managers, assistant nurse managers, clinical nurses, and vascular access team staff. From the interviews, the overarching theme was “figure out a way,” with the subtheme “no clear-cut policy.” Additional themes were: (1) limiting nurses' exposure, (2) increased risk for infection and error, (3) teamwork, and (4) roller coaster of emotions. The findings from this study revealed that, during this unprecedented pandemic, nurses were innovative and figured out a way to care for patients who were critically ill with COVID-19. Understanding this experience provides insight into creating policies and procedures to guide patient care in future pandemics or emergency care.