The lived experience of frontline nurses: COVID‐19 in rural America

Abstract

Aim This multisite study describes the lived experience of registered nurses (RNs) caring for coronavirus (COVID‐19) patients during the pandemic in rural America. Design A qualitative phenomenological design was used. Methods From January to June 2021, using the purposeful sampling method, 19 frontline nurses were interviewed regarding their experience caring for seriously ill COVID‐19 patients in three Upper Midwest tertiary care hospitals. Three doctoral prepared nurses transcribed and analyzed verbatim interviews with data interpreted separately and conjointly. Approved qualitative methods specific to transcendental phenomenology were used. Results This phenomenological study identified four themes describing the lived experience: (1) feeling of being overwhelmed, (2) feeling of role frustration related to chaos in the care environment, (3) feeling of abandonment by leaders, families, and communities, and (4) progressing from perseverance to resilience. Implications for Practice Significant implications include ensuring frontline RNs are in communication with leaders, and are involved in tactical planning. Leaders can provide a stabilizing presence, build resilience, confidence, and security. Recommendations for additional research are provided. Conclusion Nurses in intensive care and COVID‐19 designated medical units had experiences similar to high population United States and international cities. Their shared experience included high volumes of critically ill patients in hospitals frenzied by rapid change, uncertainty, and capacity strain. Differences in the experience of rural nurses included close social connection to patients, families, and community members. This rural connectedness had both positive and negative effects.

Lessons learned from COVID‐19 and the implications for resilience research, policy and practice

“…The authors' call is to provide necessary resources, role direction and training to enable employees to adapt effectively in a crisis. Robinson et al (2022), following their study on the experiences of registered nurses (RNs), call for the need to involve frontline staff in communication with senior management and the planning process as a means of progressing from a state of perseverance to where they can build resilience to stressors. Effective planning and prioritization of resources are critical in a crisis, as the sudden lack of resources can generate problems around needed capacity in terms of available expertise, space and financial resources; see, for example, Stephens et al (2020).…”

Future Catastrophic Event Preparation

“…Some of the 19 clinical nurses who provided feedback in this assessment took advantage of mental health services, whereas others either did not know the services were available or were too exhausted to seek the services 1 . The clinical nurses in this assessment project encountered physical and mental health problems during the crisis.…”

“…This group provided future pandemic advice for leadership and educators, which could be applied to other catastrophic events. Even though a small group was interviewed, their recommendations are congruent with The Future of Nursing 2020-2030 Report , which provides an important foundation addressing the current challenges faced by nurses during the pandemic 1,2 …”

“…Nurses play an important role in disaster and pandemic response, often at a personal cost. Interviews of frontline nurses demonstrated their willingness to help in the recent pandemic came with an expense to their own well-being 1 . Interviews were conducted with 19 nurses working in intensive care and COVID-19–designated medical units of 3 tertiary hospitals in an Upper Midwest healthcare system to gain a better understanding of their experience in caring for COVID-19 patients and balancing work and home life.…”

“…Interviews were conducted with 19 nurses working in intensive care and COVID-19–designated medical units of 3 tertiary hospitals in an Upper Midwest healthcare system to gain a better understanding of their experience in caring for COVID-19 patients and balancing work and home life. These nurses were overwhelmed by the high volume of critically ill patients, frustrated by the care environment chaos and felt abandoned at work as well as by their families and communities 1 . This group provided future pandemic advice for leadership and educators, which could be applied to other catastrophic events.…”