Background: Since March 2020, when the World Health Organization classified COVID‐19 (coronavirus disease 2019) as a pandemic, nurses in Brazil have been reviewing procedures and changing the way they treat patients with the disease. This study aimed to assess the changes in nursing care between the pandemic years of 2020 and 2021 in hospitals in Marabá, a municipality in the Brazilian Amazon.Methods: This retrospective observational study separately evaluated 499 and 572 medical records from 2020 and 2021, respectively. The nursing care protocols (NCPs) consisted of a checklist with nursing tasks for treating critically ill patients with acute COVID‐19. The data from 27 nursing protocols were divided into five organ system groups: neurological, cardiovascular, respiratory, digestive/urinary, and musculoskeletal systems.Results: With respect to the neurological, cardiovascular, respiratory, and digestive/urinary system protocols, 14 of the 16 nursing care interventions were practised significantly more often in 2021 than in 2020 (p < 0.0001 for all). Aspiration of the upper airways was performed significantly less often (p < 0.0001), and vital signs were monitored in 100% of the subjects in both years. With respect to the musculoskeletal system, in 2021, seven protocols were practised at significantly higher rates than in 2020, and four interventions showed no significant differences between the years. In 2021, care across all organ systems was significantly greater than it was in 2020 (p < 0.0001). Among the 27 NCPs evaluated, the percentage of care performed by nurses was significantly greater in 2021 than in 2020 (69.2% ± 9.4% versus 56.2% ± 15.3%, p < 0.0001).Conclusion: Patients with COVID‐19 experienced an increase in nursing care from 2020 to 2021 across all evaluated organ systems, indicating that nursing care improved as knowledge about the pandemic was gained.