Experiences of nurses caring for respiratory patients during the first wave of the COVID-19 pandemic: an online survey study

Abstract

BackgroundNurses have been at the forefront of the pandemic response, involved in extensive coordination of services, screening, vaccination and front-line work in respiratory, emergency and intensive care environments. The nature of this work is often intense and stress-provoking with an inevitable psychological impact on nurses and all healthcare workers. This study focused on nurses working in respiratory areas with the aim of identifying and characterising the self-reported issues that exacerbated or alleviated their concerns during the first wave of the COVID-19 pandemic.MethodsAn online survey was developed consisting of 90 questions using a mixture of open-ended and closed questions. Participant demographic data were also collected (age, gender, ethnicity, number of years qualified, details of long-term health conditions, geographical location, nursing background/role and home life). The online survey was disseminated via social media and professional respiratory societies (British Thoracic Society, Primary Care Respiratory Society, Association of Respiratory Nurse Specialists) over a 3-week period in May 2020 and the survey closed on 1 June 2020.ResultsThe study highlights the experiences of nurses caring for respiratory patients during the first wave of the pandemic in early 2020. Concerns were expressed over the working environment, the supply and availability of adequate protective personal equipment, the quality of care individuals were able to deliver, and the impact on mental health to nurses and their families. A high number provided free-text comments around their worries and concerns about the impact on their household; these included bringing the virus home, the effect on family members worrying about them, mental health and the impact of changing working patterns, and managing with children. Although both formal and informal support were available, there were inconsistencies in provision, highlighting the importance of nursing leadership and management in ensuring equity of access to services.ConclusionsSupport for staff is essential both throughout the pandemic and afterwards, and it is important that preparation of individuals regarding building resilience is recognised. It is also clear that psychological support and services for nurses and the wider healthcare team need to be available and quickly convened in the event of similar major incidents, either global or local.

A Glance at the Barriers and Enablers of the Nursing Role in Pandemics: An Integrative Review

“…The search strategy used achieved an initial retrieval of 11,031 potential articles for the study, out of which 32 articles were finally included in the final sample (Table 1 Once the 32 selected studies had been evaluated (Table 1), it was observed that more than half of the articles stemmed from the Americas: Canada (3,35), The USA (1, 23-30, 34, 37, 45), Brazil (47) and one article that refers to the American continent in general (3); the rest of the evidence is distributed across studies from Asia (10, 14,32,38,40,40,42,43,43,44,49), Europe (39,41,46), Oceania (6,31,48), and Africa (33); therefore, all the articles are written in English. Regarding the journals where these articles were published, it was noted that all were published in journals indexed in the Proquest, Scopus, and Pubmed databases.…”

“…On the other hand, the evidence also reports that there are enabling factors for the performance of the role, firstly, when it is considered that these professionals provide "constructive" support with their work (38); in addition, they are resilient, capable of self-care and adaptability towards the continuous changes in protocol and scarcity of resources (42), as well as their capacity for planning, support, information, active participation in research and adequate use of resources (39), relevant aspects that should be considered by the employers of healthcare services, since they must ensure clear practices in the care to be provided, control measures for infections and personal protection equipment that is adequate for the use of healthcare providers, which are all indispensable variables to en-sure the health of healthcare providers and their families (28); in addition, the need for psychological support for these professionals is also evident (48), as well as the need for their continuing education. This need should not only satisfy nurses but also other healthcare providers who are for the implementation of programs and protocols with the objective of minimizing cross-infection for patient and staff safety in the face of a pandemic (10, 33,48), strengthening interdisciplinary work (46). One strategy reported in this review that will undoubtedly support their performance in improving communication with isolated populations is telehealth.…”

“…Among the factors that hinder the performance of their role were the fear of working with patients with infectious diseases experienced by nursing professionals (32) -and therefore, the need for support in case of contracting the disease (48) -, the insecurity of not having adequate personal protective equipment (46,48), the fear of contaminating members of their family, the social isolation that these professionals must face (3,46), as well as the limited infrastructure and the deficit of nursing professionals (33), the feeling of ignorance and underestimation of the efforts of nurses compared to physicians (38), and the lack of social recognition (46), all of which undoubtedly affect their willingness to work with and provide care for patients with infectious diseases (28); in addition, the crucial contribution and work of immigrant nurses in support of the existing workforce is often overlooked, since despite the different nature and environment of their jobs, they can play a key role during times of crisis such as what has been witnessed in the COVID-19 pandemic (35).…”

Stress and substance abuse among workers during the COVID-19 pandemic in an intensive care unit: A cross-sectional study

“…From the experiences with the severe acute respiratory syndrome virus (SARS) outbreak in the early 2000’s, it has been demonstrated that ICU professionals may need long term support for mental health issues developed during their work time with infected patients [ 25 ]. As recently proposed by other authors [ 26 , 27 ], intervention plans should be traced not only during the pandemic but also after it, due to the prolonged course of diseases such as PTSD, ASD, and SA. For that reason, we believe that this study could be used for guiding larger, multicenter studies and institutional interventions to prevent and reduce the suffering of professionals dealing with similar situations in Brazil and in other countries.…”

Increasing Burden of Nursing Care on the Treatment of COVID-19 Patients in the Aging Society: Analyses During the First to the Third Wave of Pandemic in Kyoto City, Japan

“…A recent report from the United Kingdom also shows that in the early stages of the COVID-19 pandemic, many nurses felt strong concerns about their work environment (especially in infection control), maintaining nursing quality, and maintaining mental health. It has also been found that there is inadequate access to systems to care for them ( 11 ). International surveys have also shown that health care workers feel strong psychological stress in the early stages of the COVID-19 pandemic, and this is especially true for young female health care workers ( 12 ).…”