Intensive care unit nurses living through COVID‐19: A qualitative study

Abstract

Aims To understand how nurses experience providing care for patients hospitalized with COVID‐19 in intensive care units. Background As hospitals adjust staffing patterns to meet the demands of the pandemic, nurses have direct physical contact with ill patients, placing themselves and their families at physical and emotional risk. Methods From June to August 2020, semi‐structured interviews were conducted. Sixteen nurses caring for COVID‐19 patients during the first surge of the pandemic were selected via purposive sampling. Participants worked in ICUs of a quaternary 1,000‐bed hospital in the Northeast United States. Interviews were transcribed verbatim, identifiers were removed, and data were coded thematically. Results Our exploratory study identified four themes that describe the experiences of nurses providing care to patients in COVID‐19 ICUs during the first surge: (a) challenges of working with new co‐workers and teams, (b) challenges of maintaining existing working relationships, (c) role of nursing leadership in providing information and maintaining morale and (d) the importance of institutional‐level acknowledgement of their work. Conclusions As the pandemic continues, hospitals should implement nursing staffing models that maintain and strengthen existing relationships to minimize exhaustion and burnout. Implications for Nursing Management To better support nurses, hospital leaders need to account for their experiences caring for COVID‐19 patients when making staffing decisions.

Clinical Ethics Consultation During the First COVID-19 Pandemic Surge at an Academic Medical Center: A Mixed Methods Analysis

“…Although frontline clinicians were experiencing unprecedented distress, including moral distress, they continued to recognize ethical challenges and sought out ethics consultation to optimize patient care (Cadge et al, 2021 ; Morley et al, 2020 ). Additionally, throughout the first surge of the COVID-19 pandemic, our ethics consultation service remained onsite responding to consults in person with the bedside clinicians and supporting “listening rounds” during which we met with clinicians to process their experience in real time.…”

How COVID‐19 has affected staffing models in intensive care: A qualitative study examining alternative staffing models (SEISMIC)

“…ICU nurses have had to quickly adapt to working in different ways, with nurse: patient ratios below those normally experienced. Research and discussion papers from the United States (Akgün et al, 2020; Cadge et al, 2021; LoGiudice & Bartos, 2021, Robinson & Stinson, 2021) and elsewhere around the world (e.g. Arabi et al, 2021, reporting from six European countries, Asia, Australasia, North and South America and Canada; Moradi et al,2021, reporting from Iran) suggest that whilst these changes have negatively impacted nurses’ well‐being (Greenberg et al, 2021; Montgomery et al, in press; Rattray et al, 2021; Sampaioa et al, 2021; Wozniak et al, 2021), they also offer opportunities to consider how best to engage our limited nursing resource.…”

“…As new waves continue to emerge across the world, and health care workers become more exhausted, it is vital that critical care nurses’ experiences and voices are heard and used to inform future planning (Cadge et al, 2021; Wynne et al, 2021). There is a clear need to examine the effect of the COVID‐19 pandemic on nurse staffing models, on both staff and patient outcomes, as well as to understand potential future implications for ICU nurse staffing, leading to the research question: what impact has COVID‐19 had on ICU nurse staffing models?…”

The Impact of the COVID-19 Pandemic on the Working Lives and Retirement Timing of Older Nurses in Ireland

“…In some cases, this poses problems for nurses; in acute hospital settings, they typically had to move to work in intensive care units in hospitals, or from the community to nursing homes where there was an outbreak of COVID-19, or to testing or vaccinating facilities [19]. While many nurses were willing to be redeployed, their accounts support previous international studies that emphasise difficulties experienced by redeployed nurses in having to upskill very quickly, join a new team and learn new procedures while simultaneously trying to control infection [20]. This suggests a need for ongoing support for redeployed and other nurses, including psychological supports.…”

“…Nurses have been significantly affected by pressures arising from the pandemic. Interviews with US ICU nurses identified challenges in adapting to safety and care procedure changes, working with new co-workers and teams, a lack of information about the virus and leaving their home units [20]. Common COVID-19 health impacts on healthcare workers internationally include fever, cough, weakness, skin damage due to use of PPE and high levels of depression, anxiety, insomnia and distress [21].…”