Intensive care nurses' experiences during the COVID‐19 pandemic: A qualitative study

Abstract

Background Because of the COVID‐19 pandemic, health care systems worldwide are working under challenging conditions. Patients, who are seriously ill, require intensive care admission. In fighting COVID‐19, nurses are frontline health care workers and, as such, have a great responsibility providing needed specialized patient care in intensive care units (ICU). However, working conditions and emotional factors have an impact on the quality of the care provided. Aim The purpose of the present study was to explore and describe the experiences and perceptions of nurses working in an ICU during the COVID‐19 global pandemic. Study design Qualitative research was undertaken, using an empirical approach and inductive content analysis techniques. Methods The selected population consisted of ICU nurses from a tertiary teaching hospital in Spain. Data were obtained via semi‐structured videocall interviews from Apr 12th to Apr 30th, 2020. Subsequently, transcribed verbatims were analysed using the template analysis model of Brooks. Findings A total of 17 nurses comprised the final sample after data saturation. Four main themes emerged from the analysis and 13 subthemes: “providing nursing care,” “psychosocial aspects and emotional lability,” “resources management and safety” and “professional relationships and fellowship.” Conclusion Providing health care by intensive care nursing professionals, during the COVID‐19 pandemic, has shown both strong and weak points in the health care system. Nursing care has been influenced by fear and isolation, making it hard to maintain the humanization of the health care. Relevance to clinical practice Implications for practice include optimizing resource management (human and material), providing psychological support, and adequate training for ICU nurses, as well as high‐quality protocols for future emergency situations.

Psychosocial experiences of frontline nurses working in hospital-based settings during the COVID-19 pandemic - A qualitative systematic review

“…Twenty-eight study characteristics were included in Table 4 . The studies were conducted in China ( Fan et al, 2020 , Gao et al, 2020 , Hou et al, 2020 , Jia et al, 2021 , Liu et al, 2020 , Liu et al, 2020 , Sheng et al, 2020 , Sun et al, 2020 , Tan et al, 2020 , Zhang et al, 2020 ), Iran ( Eftekhar et al, 2020 , Galehdar et al, 2020 , Kalateh et al, 2020 , Galehdar et al, 2020 ), Turkey ( Kackin et al, 2020 , Deliktas et al, 2021 , Muz and Erdoğan, 2021 , Coşkun and Günay, 2021 ), UK ( Bennett et al, 2020 , Vindrola-Padros et al, 2020 ), USA ( Arnetz et al, 2020 ), Brazil ( Góes et al, 2020 ), Pakistan ( Sethi et al, 2020 ), Spain ( Fernández-Castillo et al, 2021 ), Japan ( Ohta et al, 2020 ), South Korea ( Lee and Lee, 2020 ), Singapore ( Goh et al, 2020 ), and Nigeria ( Okediran et al, 2020 ). The setting for 25 of the included studies were hospitals, two were in COVID-19 designated wards, and one study was in a COVID-19 isolation center.…”

“…Theoretical methodologies adopted by the studies were phenomenology ( Gao et al, 2020 , Hou et al, 2020 , Kackin et al, 2020 , Liu et al, 2020 , Sheng et al, 2020 , Sun et al, 2020 , Tan et al, 2020 , Muz and Erdoğan, 2021 , Lee and Lee, 2020 ), and grounded theory ( Deliktas et al, 2021 ). Data collection methods included interviews ( Eftekhar et al, 2020 , Fan et al, 2020 , Galehdar et al, 2020 , Gao et al, 2020 , Hou et al, 2020 , Jia et al, 2021 , Kackin et al, 2020 , Kalateh et al, 2020 , Liu et al, 2020 , Liu et al, 2020 , Sheng et al, 2020 , Sun et al, 2020 , Tan et al, 2020 , Zhang et al, 2020 , Deliktas et al, 2021 , Muz and Erdoğan, 2021 , Galehdar et al, 2020 , Fernández-Castillo et al, 2021 , Ohta et al, 2020 , Lee and Lee, 2020 , Goh et al, 2020 , Vindrola-Padros et al, 2020 , Okediran et al, 2020 ), surveys or questionnaires ( Arnetz et al, 2020 , Góes et al, 2020 , Coşkun and Günay, 2021 , Sethi et al, 2020 ), and digital audio recording ( Bennett et al, 2020 ). Seven of 23 study interviews were conducted via voice or video ( Eftekhar et al, 2020 , Galehdar et al, 2020 , Liu et al, 2020 , Tan et al, 2020 , Deliktas et al, 2021 , Galehdar et al, 2020 , Vindrola-Padros et al, 2020 ), and the others were face-to-face interviews ( Fan et al, 2020 , Gao et al, 2020 , Hou et al, 2020 - ( Kalateh et al, 2020 , Liu et al, 2020...…”

“…The additional studies from the citation pearl search were included through the joint decisions of all the authors. Finally, 28 studies that met the inclusion criteria were assessed for quality and included for synthesis ( Arnetz et al, 2020 , Eftekhar et al, 2020 , Fan et al, 2020 , Galehdar et al, 2020 , Gao et al, 2020 , Góes et al, 2020 , Hou et al, 2020 , Jia et al, 2021 , Kackin et al, 2020 , Kalateh et al, 2020 , Liu et al, 2020 , Liu et al, 2020 , Sheng et al, 2020 , Sun et al, 2020 , Tan et al, 2020 , Zhang et al, 2020 , Deliktas et al, 2021 , Muz and Erdoğan, 2021 , Coşkun and Günay, 2021 , Galehdar et al, 2020 , Sethi et al, 2020 , Fernández-Castillo et al, 2021 , Ohta et al, 2020 , Lee and Lee, 2020 , Goh et al, 2020 , Bennett et al, 2020 , Vindrola-Padros et al, 2020 , Okediran et al, 2020 ). The study selection process is presented in a PRISMA flow diagram ( Figure 1 ).…”

“…How valuable is the research? Deliktas et al ( Deliktas et al, 2021 ) Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes 10/10 Muz et al ( Muz and Erdoğan, 2021 ) Yes Yes Yes Yes Yes No Yes Yes Yes Yes 9/10 Coşkun et al ( Coşkun and Günay, 2021 ) Yes Yes Yes Yes Yes No Yes Yes Yes Yes 9/10 Galehdar et al ( Galehdar et al, 2020 ) Yes Yes Yes Yes Yes No Yes Yes Yes Yes 9/10 Sethi et al ( Sethi et al, 2020 ) Yes Yes Yes Yes Yes Yes Yes Cannot tell Yes Yes 9/10 Fernández-Castillo et al ( Fernández-Castillo et al, 2021 ) Yes Yes Yes Yes Yes No Yes Yes Yes Yes 9/10 Ohta et al ( Ohta et al, 2020 ) Yes Yes Yes No Yes Yes Yes Yes Yes Yes …”

“… • Some family, academia, clinical services, and public related challenges were identified. Fernández-Castillo et al ( Fernández-Castillo et al, 2021 ) 2021 Spain Hospital To explore and document the experiences of nurses working in an intensive care unit where patients diagnosed with SARS-CoV2 infection were treated during COVID-19 pandemic. Descriptive qualitative study • Homogeneous purposive sampling • Nurses: N = 17 • 11 females, 6 males • Age range: 31-54 • Mean age: NR • Work experience range: 2-25 • Mean work experience: NR Semi-structured interviews Inductive content analysis • The provision of care has been influenced by the isolation of patients and the fear experienced by professionals.…”