Roles and Experiences of Registered Nurses on Labor and Delivery Units in the United States During the COVID-19 Pandemic

Abstract

Objective To examine the roles and experiences of labor and delivery (LD) nurses during the COVID-19 pandemic. Design Cross-sectional survey. Setting Online distribution between the beginning of July and end of August 2020 Participants Labor and delivery nurses (N = 757) responded to an open-ended question about changes to their roles during the COVID-19 pandemic as part of a larger national survey. Methods We calculated descriptive statistics on respondents’ characteristics and their hospitals’ characteristics. We applied conventional content analysis to free text comments. Results We derived four major categories from the responses: Changes in Roles and Responsibilities, Adaptations to Changes, Psychological Changes, and Perceived Effects on Labor Support. Nearly half (n = 328) of respondents reported changes in their roles and responsibilities during the COVID-19 pandemic. They described adaptations and responses to these changes and perceived effects on patient care. Infection control policies and practices and the stress of a rapidly changing work environment affected the provision of labor support and personal well-being. Conclusion The experiences described by respondents conveyed considerable changes in their roles and subsequent direct and indirect effects on quality of patient care and personal well-being. Policies and practices that can facilitate the ability of LD nurses to safely and securely remain at the bedside and provide high-touch, hands-on labor support are needed. The findings of our study can help facilitate the provision of labor support during times of disruption and foster the resiliency of the nursing workforce.

Stress load of Chinese nurses in Fangcang Shelter Hospitals during the COVID-19 pandemic: A latent profile analysis

“…Moderate stress has a motivational effect and promotes resilience, enabling nurses to cope with work-life challenges (22). Conversely, excessive stress could negatively impact patient safety, job satisfaction, environmental adaptation (the process by which the individual balances with the environment), performance, burnout, career development, physical and mental health, and turnover intention (23)(24)(25)(26)(27).…”

From the first to the fourth critical period of COVID-19: what has changed in nursing practice environments in hospital settings?

“…Nurses faced an increased workload during the pandemic, not only related to the increased care needs, but also due to the continuous need to integrate and help new colleagues [ 15 ]. Some authors confirmed that integration times were reduced and that newly integrated professionals ended up verbalising a major dissatisfaction regarding the institutional policy for professional qualification [ 29 , 30 ]. In addition, nurses who were transferred to other services and had to integrate new teams that were unaware of their professional qualifications and often had no conditions to collaborate in their integration also felt a loss of control [ 29 , 30 ].…”

“…Some authors confirmed that integration times were reduced and that newly integrated professionals ended up verbalising a major dissatisfaction regarding the institutional policy for professional qualification [ 29 , 30 ]. In addition, nurses who were transferred to other services and had to integrate new teams that were unaware of their professional qualifications and often had no conditions to collaborate in their integration also felt a loss of control [ 29 , 30 ]. In relation to the mentioned, authors recall that “more hands” are not always the best answer, particularly when competence and training are lacking [ 15 ], which reinforces once again the need to maintain professional qualification strategies [ 2 ].…”

“…The need to place PPE, at the same level as other changes in the work process, require more preparation time and, consequently, less time to plan, redesign and evaluate direct patient care [ 30 ].…”

Health Behavior Changes among Maternity Nurses during the COVID-19 Pandemic: A Cross-Sectional Study

“…The study revealed that the roles of nurses were directed toward preventing COVID-19 transmission and treating patients with or suspected of COVID-19, which affects the levels of work stress and staffing level [34]. A national US cross-sectional study that investigated the practice of labor and delivery nurses during the COVID-19 pandemic showed changes in the roles and responsibilities of nurses, as reported by half of the participants who perceived the effects of quality of patient care [35].…”