Experiences of critical care nurses during the early months of the COVID-19 pandemic

Abstract

Background: Critical care nurses have risked their lives and in some cases their families through hazardous duty during the COVID-19 pandemic and have faced multiple ethical challenges. Research/aim: The purpose of our study was to examine how critical care nurses coped with the sustained multi-faceted pressures of the critical care environment during the unchartered waters of the COVID-19 pandemic. It was anticipated that our study might reveal numerous ethical challenges and decision points. Research design: A qualitative descriptive study, utilizing an interpretivist paradigm. Participants and research setting: Critical care nurses, working in either intensive care units or emergency departments (N = 11) who were primarily from Northern California hospitals. Individual in-depth ZOOM® session interviews, guided by semi-structured questions, were used to collect data. Interviews lasted between 18 and 59 min, with an average length of 33 min. Session interviews were transcribed and analyzed. Ethical considerations: This study was approved by the researchers’ university Institutional Review Board. Findings: Five main themes emerged: Fear of the Unknown, Adapting to Practice Changes and Challenges, Patient Advocacy and Moral Distress, Isolation and the Depersonalization of Care, and Professionalism and a Call to Duty. Discussion and conclusion: Fear of becoming ill or bringing COVID-19 home to their families was a constant source of anxiety for nurses. There were numerous changes in policy and challenges to standard practice protocols, including most notably shortages in personal protective equipment, which nurses navigated resourcefully. Most nurses interviewed were motivated by a sense of professional duty. The nurses experienced some moral distress in their inability to advocate as they might like for their patients, especially at end of life. Infection control requirements for isolation.

Strategies to enhance resilience to cope with workplace adversities post-COVID-19 among ICU nurses

“…Fear of the unknown dominated the ICU nurses and ICU management when new knowledge kept evolving how they operate in their role. A study that looked at the experiences of ICU nurses during the COVID-19 pandemic by Moore et al (2022) in the United States revealed that ICU nurses felt unsafe and feared for their lives while providing care for the COVID-19 infected patients. They were uncertain if the N95 masks are a http://www.curationis.org.za Open Access sufficient infection and prevention measure, as the pandemic progressed there was an exacerbation of limited personal protective equipment (PPE), which increased the feeling of being unsafe and putting their lives at risk.…”

“…They were uncertain if the N95 masks are a http://www.curationis.org.za Open Access sufficient infection and prevention measure, as the pandemic progressed there was an exacerbation of limited personal protective equipment (PPE), which increased the feeling of being unsafe and putting their lives at risk. In addition to their frustration, knowledge as to how COVID-19 is transmitted and the disease process and treatment was questioned, which led to changes in infection control policies, treatment and nursing care measures in the ICU (Moore et al 2022). A cross-sectional study conducted in China showed that in the first wave of COVID-19 there were about 32% of ICU nurses had direct exposure to COVID-19 (Chegini et al 2021).…”

“…However, because of the increasing number of ICU patients, the nurses were unable to provide the best care, in instances of end-oflife care, they were unable to providing closure to the families by nursing the patients in the presence of their loved one's because of COVID-19 restriction visiting in the ICU units. This resulted in a sense of guilt and hopelessness among the ICU nurses and this took a toll on ICU nurses' ethical standing (Chegini et al 2021;Hossain & Clatty 2022;Moore et al 2022). Moreover, the distraction of the clinical practice, the loss of sense of control and the subsequent fear of the destabilisation of healthcare services provoked conditions such as posttraumatic stress disorder (PTSD) and generalised anxiety disorders among ICU nurses (Rahman et al 2020).…”

Scandinavian Nurses’ Use of Social Media during the COVID-19 Pandemic—A Berger and Luckman Inspired Analysis of a Qualitative Interview Study

“…In addition, nurses have difficulties navigating the contradictory needs for both closeness to and distance from patients. Similar to many people during the pandemic, nurses experience an unpredictable future and feelings of worry and insecurity [ 2 , 3 , 4 , 5 ]. Several studies show that many nurses experience work-related stress and multiple psychological stressors during the pandemic, leading to burnout [ 4 , 5 , 6 , 7 , 8 , 9 , 10 ].…”

“…Similar to many people during the pandemic, nurses experience an unpredictable future and feelings of worry and insecurity [2][3][4][5]. Several studies show that many nurses experience work-related stress and multiple psychological stressors during the pandemic, leading to burnout [4][5][6][7][8][9][10].…”