Nurses’ contribution during pandemic conditions: A synthesis of qualitative literature

Advanced nurse practitioner well-being: A 4-year cohort mixed methods study

AIMS

To examine changes in advanced nurse practitioner (ANP) well-being, satisfaction and motivation over a four-year period.

DESIGN

Longitudinal Cohort study.

METHODS

Surveys were carried out each year from 2019 to 2022 with the same cohort of ANPs in the United Kingdom (UK). The survey consisted of demographics, questions on contemporary issues in advanced practice, National Health Service (NHS) staff survey questions and validated questionnaires. A core set of questions were asked every year with some changes in response to the COVID-19 pandemic.

RESULTS

Response rate ranged from 40% to 59% and appeared to be affected by COVID-19. Staff satisfaction with pay and the well-being score were stable throughout. Other questions on well-being, job satisfaction and motivation saw statistically significant reductions after 4 years. Open-ended questions about ongoing well-being concerns show participants are concerned about exhaustion levels caused by workload, staffing issues, abuse from patients and colleagues' mental health.

CONCLUSION

The findings highlight a decline in ANP well-being, job satisfaction and motivation post-COVID-19. Reasons for this, explored in the qualitative data, show that ANPs have faced extremely difficult working conditions. Urgent action is required to prevent a workforce retention crisis as many nursing staff are close to retirement and may not be motivated to remain in post.

IMPACT

This study has followed ANPs through the most challenging years the NHS has ever seen. Job satisfaction, motivation and enjoyment of the job all significantly reduced over time. In many areas, the ANP role has been used to fill medical workforce gaps, and this will become harder to do if ANPs are dissatisfied, disaffected and struggling with stress and burnout. Addressing these issues should be a priority for policymakers and managers.

PATIENT OR PUBLIC CONTRIBUTION

None as this study focussed on staff. Staff stakeholders involved in the design and conduct of the study.

An uncertain time: Clinical nurses' first impressions during the COVID‐19 pandemic

The COVID‐19 pandemic overwhelmed the US healthcare system and healthcare providers. Nurses, who comprise one of the most affected groups because they are the largest group of healthcare providers, were in a unique position to speak about their perspectives. As a result of the COVID‐19 pandemic, nurses have experienced ongoing physical and psychological challenges while displaying strength and perseverance during uncertain times. In this study, we explored the perceptions and experiences of nurses in clinical practice caring for patients diagnosed with COVID‐19 during the pandemic. Researchers conducted a qualitative descriptive study with 20 clinical nurses most of whom were enrolled in a graduate program while working in healthcare settings. Semi‐structured interviews conducted through Zoom occurred between August 2020 and December 2020. Thematic analysis was used to analyze the transcripts. Five themes emerged: navigating uncertainty, managing death and loss, acknowledging emotional responses, learning opportunities, and facing community undercurrents. Lack of clinical practice guidelines, and inconsistent access to personal protective equipment when providing care to patients with COVID‐19 caused emotional strain for nurses and highlighted future learning opportunities. Providing support to dying patients was devastating to nurses. Concern about community misunderstandings of the pandemic created challenges. Evolving teamwork provided invaluable support to study participants. Nurses shared essential information for revising and creating clinical practice guidelines. Nursing interventions and strategies were used to produce humane and positive patient outcomes and provide a foundation for nurse‐driven care in possible future pandemics.