The impact of COVID-19 on mental health and well-being in critical care nurses - a longitudinal, qualitative study

What would have made work in the COVID-19 ICU less demanding? A qualitative study from 13 Swedish COVID-19 ICUs

BACKGROUND

The COVID-19 pandemic stretched Swedish intensive care unit (ICU) resources to an extent never experienced before, but even before the pandemic staffing was difficult and the number of staffed ICU beds was low. Studies have revealed high levels of COVID-19 ICU staff burn-out and fatigue, and as similar situations with high demands are likely to occur in the future a better understanding of resources that improve staff resilience is important. Using the job-demand resource theory as a framework, we explored ICU professionals' views on demands and resources when working in COVID-19 ICUs with the aim to highlight factors that increased the job resources.

METHODS

Data were collected via a web survey distributed to COVID-19 ICU professionals, including both regular and temporary roles, working in 13 COVID-19 ICU wards in Stockholm and Sörmland counties during the spring 2021. A total of 251 written responses to the question "What would have made work in the COVID-19 ICU less demanding?" were analyzed using thematic analysis. One year later a member-checking focus group interview was conducted to validate and further explore staff experiences.

RESULTS

The main themes were work strategy, fairness and support, continuity, accessible leadership, introduction/information, and crisis preparedness. The analysis of the focus group conducted confirmed the main results and the extreme demands on ICU staff during the initial stages of the pandemic.

CONCLUSION

To increase staff health and performance in a long-term crisis our results suggest; maintaining workplace leadership, scheduling work in advance and, when possible, schedule for recovery.

Covid-19 pandemic? Mental health implications among nurses and Proposed interventions

Background

With its abrupt and huge health and socio-economic consequences, the coronavirus disease (COVID-19) pandemic has led to a uniquely demanding, intensely stressful, and even traumatic period. Healthcare workers (HCW), especially nurses, were exposed to mental health challenges during those challenging times.

Objectives

Review the current literature on mental health problems among nurses caring for COVID-19 patients.

Methods

This is a narrative review and critical evaluation of relevant publications.

Results

Nurses experienced higher levels of stress, burnout, anxiety, depression, frustration, stigma, and depersonalization compared to other HCW. Factors that increased this symptomatology included concerns about infection or infection of family members, inadequate staff protective equipment, extended working hours, insufficient information, a reduced sense of security, and post-traumatic stress disorder. The factors that improved the psychopathology included a general positive attitude, job satisfaction, adequate information and education, harmonious group relationships, post-traumatic development, emotional intelligence, psychological counseling, mindfulness-based stress reduction, stable leadership, guidance, and moral and practical administrative support.

Conclusions

Recent studies clearly show that nurses, especially women, are the most vulnerable subgroup among HCW and are particularly prone to mental health impacts during the COVID-19 pandemic. The documented mental health vulnerability of frontline nursing staff during the COVID-19 pandemic requires preventive nursing management actions to increase resilience and to develop relevant defense mechanisms.