Overcoming the challenge of COVID‐19: A grounded theory approach to rural nurses' experiences

Abstract

Introduction This study inquires into nurses' changing perceptions with regard to the efforts in preparation for working in a COVID‐19 ward in the rural Japanese context. Methods Data were collected using ethnographic methods and semi‐structured interviews among 16 nurses working in the COVID‐19 ward of a rural community hospital in Japan. A grounded theory approach was used for the qualitative analysis. Results In total, 70 hours' observation and participation were completed, and 27 pages of field notes were taken and used for the analysis. In addition, 32 interviews were conducted with 16 participants. Four themes emerged from the data: pre–COVID‐work perceptions, overcoming fear, shadow cast by working in the COVID‐19 ward, and an integrated approach to the fear of COVID‐19. The nurses initially felt unpredictable fear. However, the establishment of standard approaches and practices for COVID‐19 gave them confidence in their safety and helped them regain sympathy for patients. Nevertheless, working on COVID‐19 cases negatively affected their activities outside of the ward, and some of them developed an identity crisis as they feared for the future. Conclusion Better teamwork, comprehensive understanding of COVID‐19, and continuous provision of proper knowledge in rural hospitals should be driven by appropriate understanding and sympathy for nurses and patients in COVID‐19 wards. The results of this study can be applied to mitigate nurses' fear, improve teamwork, and ensure understanding of COVID‐19 by all medical staff in rural hospitals.

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

“…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 …”

“… • The help from teams. Ohta et al ( Ohta et al, 2020 ) 2020 Japan COVID-19 ward in hospital To examine nurses' changing perceptions of preparing for COVID-19 and working in COVID-19 wards. Qualitative study • Nurses: N = 16 • Age range: NR • Mean age: NR • Work experience range: NR • Mean work experience: NR Ethnography and semi-structured interviews Grounded theory • Nurses working in COVID-19 wards had previously felt unpredictable fear regarding COVID-19.…”

The Uncertainty of COVID-19 Inducing Social Fear and Pressure on the Continuity of Rural, Community-Based Medical Education: A Thematic Analysis

“…They had to consider the possibility of being infected because of the continuous exposure to patients [ 33 ]. As stated by the participants, rural nurses also struggled with constructing the system of infection control for COVID-19 because they were not used to performing infection control while accepting medical trainees [ 34 ]. Each stakeholder in rural CBME has had to focus on different issues in this pandemic.…”

The importance of patient-centered care during the COVID-19 pandemic: lessons from a rural ward in Japan

“…In our setting, medical staff and affected patients engaged in frequent dialogue and information sharing via nursing calls and communication technologies, which enabled those affected to remain reasonably informed. To mitigate the potential negative impact on rural nurses in the COVID-19 ward, the nursing director and head nurse in the ward monitored the mental health status of staff members every week and alleviated the physical burden of work shifts 8 ) . Subsequent waves of this pandemic should be managed through various forms of information and communication technology (ICT), such as television communication tool, that help connect medical institutions with the outside world.…”