The Role of Uncertainty in the Experiences of Nurses During the Covid-19 Pandemic: A Phenomenological Study

What is the purpose of nurse education (and what should it be)?

Can we take the purpose of nurse education for granted, and, more importantly, should we? That is the issue at stake in this paper. The question of purpose is conspicuously absent in the nursing literature; our aim here is to urge that it not be overlooked by demonstrating its importance to the future of nursing. We approach the question of nurse education's purpose in concrete and speculative terms through two distinct yet interrelated questions: what is the purpose of nurse education? and what should it be? Amidst the complexity and uncertainty of our time, we cast doubt on the adequacy of manualised and regulated approaches-ubiquitous in nurse education-to prepare nurses who can meet the challenges of contemporary practice. We also assert that transgressive approaches to education, as the antithesis of manualisation, reach the same impasse by (over)predetermining what the educational 'output' will be. To move beyond this impasse, we draw on the theory of Gert Biesta and Ron Barnett to contrast cultivation and existential-type education. In so doing, we do not seek to provide 'answers' to nurse education's purpose but, rather, raise the profile of what we believe is a right and proper question for the discipline to grapple with.

"A Certainty for you Does Not Mean That it is a Certainty for Science": A Phenomenological Analysis of Experiences of Uncertainty in Clinical Reasoning of Nurses in the Postanesthesia Care Unit

PURPOSE

To explore the experiences of uncertainty in the clinical reasoning of nurses in the postanesthesia care unit (PACU).

DESIGN

A phenomenological descriptive design, following Colaizzi's analysis.

METHODS

Semistructured interviews were conducted with 14 nurses from a PACU on their experience of uncertainty in clinical reasoning. The interviews were digitally audio-recorded and transcribed verbatim. Two researchers conducted data analysis independently and followed seven phases: (re)reading the transcripts, extracting significant statements, formulating meanings from significant statements, aggregating formulated meanings into themes, developing a description of the phenomenon's essential structure, generating of the fundamental structure of the phenomenon, validating of the findings through participant feedback. The process employed MAXQDA analytics Pro 2022 software. Consolidated Criteria for Reporting A Qualitative Research checklist was used for reporting.

FINDINGS

From uncertainty experiences in nurses' clinical reasoning, 10 themes emerged: ambiguity and decision latitude, communication, work ethic, difficulty interpreting and predicting outcomes, cognitive performance impairment, incivility, core competence vagueness of postanesthesia nurses, high-tech care, (in)security and risk, and occupational stress.

CONCLUSIONS

The experiences of uncertainty in clinical reasoning of nurses in postanesthesia care units are highly focused on patient safety. Exploring these experiences has made uncertainty more tangible and explicit, which will enable nurses in postanesthesia care units to prepare for adaptive responses to deal with uncertainty when it occurs in clinical practice.

Facing the Unknown: An Inductive Analysis of the Lived Experience of Medical Residents during the COVID-19 Pandemic

INTRODUCTION

The COVID-19 pandemic had significant repercussions for the everyday life and public health of society. Healthcare professionals were particularly vulnerable. Here, we interviewed medical residents about their lived experiences during the pandemic to offer a phenomenological analysis. To this end, we discuss their pandemic experiences considering Jaspers' "limit situation" concept - that is, a radical shift from their everyday experiences, to one causing them to question the basis of their very existence.

METHODS

We interviewed 33 medical residents from psychiatry and other specialties from the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) who either (a) worked directly with COVID-19 patients or (b) provided psychiatric care to other healthcare professionals. Semi-structured interviews were developed using the Inductive Process to Analyze the Structure of lived Experience (IPSE).

RESULTS

The descriptions of the lived experiences of medical residents during the pandemic were organized into four content themes: (a) existential defense, (b) limit situations during the COVID-19 pandemic, (c) changes in lived experience, and (d) new world meanings through lived experience.

CONCLUSION

During the COVID-19 pandemic, medical residents experienced what can be thought of as a "limit situation," as they encountered the healthcare delivery challenges coupled with the social isolation imposed by the COVID-19 pandemic. These challenges included fear of infection and potential death, uncertainty about the future, and the emotional overload caused by the sharp increase in patient deaths. That said, after facing such a limit situation, residents reported feeling strengthened by this experience. This is consistent with the notion that when confronted with limit situations, we draw on our resources to overcome adversity and, in turn, reap existential gains. Health care providers might use these experiences to energize their own professional approach.

Managing the COVID-19 Pandemic: Experience of Managers in Healthcare: A Narrative Inquiry

The pandemic represented a challenge for hospital managers at different levels, required to reorganise services without compromising care. This study aimed to analyse the experiences of hospital managers during the COVID-19 pandemic. A narrative inquiry was conducted in a multisite acute hospital. Data were collected through narratives and open-ended questions. Direct and non-direct-care managers were invited to participate. Data were analyzed considering Clandinin & Connelly's (2000) framework and Braun & Clarke, (2006). Thirty-six narratives and open-ended question responses were analysed. Participants were nurses (n = 20), doctors, technicians, administrative and hospitality service managers. Themes were grouped into three narrative dimensions: (1) personal-"the emergency engulfed us", (2) practical/professional-"managing the pandemic", (3) social-"the strength of the team and people". Different narrative threads were identified between direct-care and non direct-care managers. Problems faced, factors helpful for management and suggestions for improvement were also reported. The pandemic had an important impact on managers and their roles, in terms of the need for clear concise information, staff support, and adequate professional and technical resources. A sense of unity and belonging facilitated management.

Reframing care while enduring the traumatic nature of witnessing disrupted family-patient-nurses' relationships during COVID-19

AIM

To describe the lived experiences of nurses caring for patients and families in the context of COVID-19 in Brazil and United States.

DESIGN

A phenomenological philosophical approach following the van Manen analysis method.

METHODS

Participants were recruited in Brazil and the United States, including nurses working in health care settings caring for COVID-19 patients. Recruitment used purposive and snowball sampling. Participants completed a demographic survey and semi-structured interviews that were audio-recorded and transcribed for analysis. A cross-cultural examination occurred among researchers from each country.

RESULTS

The result was described (n = 35) by the themes, representing the essences of each lifeworld (relationship, time, space and body). The nurses' lived experience was one of reframing care while enduring repeated trauma of witnessing disrupted patient-family-nurse relationships. Themes were as follows: (a) Living a silent and lonely experience; (b) Providing connectedness for disrupted patient and family relationships; (c) Feeling the burden of the demands; (d) Being a helping connector; (e) Reshaping spaces amidst evolving interventions and policies; (f) Creating safe spaces, surrounded by turmoil, threat, and distress within an unsafe environment; (g) Reorganizing care and reframing time; (h) Reconciling losses, regrets, victories and lessons.

CONCLUSION

The nurses' lived experience of caring for patients and families during the COVID-19 pandemic prompted the need to respond to repeated traumas and distress posed by interrupted patient-family and nurse-own family relationships, vulnerable bodies, threatened space and dynamic and volatile time.

IMPACT

Cultural nuances were discovered depending on the practice setting, political discourse and the autonomy of the nurse. Innovative models of care that create structures and processes to support nurses in caring for patients in threatening environments and the commitment to connecting family members have potential to contribute to the ongoing health of the nursing profession.

Sustaining a Workforce: Reflections on Work from Home and Community Care Nurses Transitioning out of the COVID-19 Pandemic

Introduction

The COVID-19 pandemic has had an unprecedented impact on nurses' well-being and desire to practice; however, the experience of Canadian home and community care nurses remains less well understood. As the health human resources crisis in this sector persists, understanding these nurses' experiences may be vital in creating more effective retention strategies.

Objective

The aim of this study was to explore how the COVID-19 pandemic shaped the working experiences, motivations, and attitudes of home and community care nurses in the Greater Toronto Area.

Methods

Using an exploratory, descriptive, qualitative approach, 16 home and community care nurses participated in semistructured interviews. Data were analyzed using collaborative thematic analysis. Participants shared their reflections on work by detailing their experiences prepandemic, during crisis, transitioning out of crisis, and regarding pandemic recovery.

Results

During the COVID-19 pandemic inadequate staffing resources during and beyond the crisis period disrupted many desirable facets of work for home and community care nurses such as stable, balanced, and flexible work conditions, and exacerbated the unfavorable aspects such as isolation and inconsistent support. Many nurses were reevaluating their careers: for some, this meant stronger professional attachment and for others, it meant intentions to leave. Improved sector preparedness, wages, and workplace support were identified as strategies to sustain this workforce beyond the pandemic.

Conclusion

Home care organizations must consider ways to address the root cause of concerns expressed by nurses who wish to practice in a supportive environment that is sufficiently staffed and sensitive to workload expectations.

Reaching "covidianidad": A qualitative study of the impact of the COVID-19 pandemic on the perceived mental health of health care workers in the Dominican Republic

We aimed to explore how the COVID-19 pandemic affected the lives of healthcare workers (HCWs) in the Dominican Republic. We also aimed to identify the types of resources that HCWs felt were needed to support their mental health. We used purposive and convenience sampling in four health centers in the eastern Dominican Republic to recruit 28 HCWs (doctors, nurses, psychologists, and community health workers) between April 2021 and August 2021. Through semi-structured interviews, we elicited HCWs experiences during the pandemic and how they felt these experiences impacted their mental health. Interview transcripts were analyzed using an inductive/deductive thematic approach. Main stressors experienced during the pandemic by HCWs and their sequelae included anxiety due to misinformation and uncertainty, fear of the disease, the robustness of pandemic-related changes they faced in their work and daily life, and COVID-19's economic impact. HCWs reflected on protective factors that transformed their acute sense of crisis felt at the beginning of the pandemic into what HCWs referred to as "covidianidad [everyday COVID]", a situation that became manageable through mechanisms including social support, professional motivation, positive work environment and resilience. Lastly, HCWs identified stigmatization of and limited access to mental health services as challenges to supporting their mental health. While Dominican HCWs were vulnerable to the challenges posed by COVID-19 in sustaining their mental health, for many, the situation became manageable through the evolution of "covidianidad." Further research and interventions are needed to reduce stigmatization of mental health services and foment a positive environment for HCWs' mental health, to promote resiliency to future challenges.

Paradoxical experiences of healthcare workers during COVID-19: a qualitative analysis of anonymous, web-based, audio narratives

PURPOSE

To gain a deeper understanding of healthcare workers experiences during COVID-19 using an anonymous, web-based, audio narrative platform.

METHODS

Data were collected from healthcare workers in the midwestern United States using a web-enabled audio diary approach. Participant recordings were analysed using a narrative coding and conceptualization process derived from grounded theory coding techniques.

RESULTS

Fifteen healthcare workers, in direct patient care or non-patient care roles, submitted 18 audio narratives. Two paradoxical themes emerged: 1) A paradox of distress and meaningfulness, where a harsh work environment resulted in psychological distress while simultaneously resulting in new rewarding experiences, sense of purpose and positive outlooks. 2) A paradox of social isolation and connection, where despite extreme isolation, healthcare workers formed intense and meaningful interpersonal connections with patients and colleagues in new ways.

CONCLUSIONS

A web-enabled audio diary approach provided an opportunity for healthcare workers to reflect deeper on their experiences without investigator influence, which led to some unique findings. Paradoxically, amid social isolation and extreme distress, a sense of value, meaning and rewarding human connections emerged. These findings suggest that interventions addressing healthcare worker burnout and distress might be enhanced by leveraging naturally occurring positive experiences as much as mitigating negative ones.

Compassionate Nursing Care for COVID-19 Patients in the ICU in the Western Region of Saudi Arabia: A Lived Experience Study

INTRODUCTION

The rapid spread and the severity of symptoms of COVID-19 led to an increasing number of critical cases that need to be admitted to intensive care units (ICUs) worldwide. Compassion is a principle of nursing practice and indicates the meaning of providing high-quality care in all units, especially in the ICU. It means that nurses know what is important to patients and when they should be there for them when it is needed. There is a paucity of literature from Saudi Arabia that explores how critical care nurses perceive compassionate care during COVID-19.

OBJECTIVES

The aim of this study was to investigate the lived experiences of critical care nurses providing compassionate care to COVID-19 patients at King Abdulaziz Medical City, Jeddah, Saudi Arabia.

METHODS

A prospective, cross-sectional, descriptive phenomenological approach was utilized in this study. Data were collected from 13 ICU nurses through interviews. Collected data were transcribed and analyzed using Colaizzi's data analysis method.

RESULTS

 Eleven out of the 13 ICU nurses hold a Bachelor of Science in Nursing (BSN) and have more than five years of experience. Despite all the challenges surrounding the care for critically ill COVID-19 patients, nurses provide compassion in different ways to show personal interest to the patients. Data analysis revealed five themes: (1) contemporary meaning and competencies for compassionate nursing care, including communication and the inability to freely use touch; (2) physical symptoms, including discomfort, body aches and headaches, and sleep disturbances; (3) emotional turmoil, where three sub-themes emerged, including fear and anxiety, uncertainty, and isolation and loneliness; (4) role changing, including frequent guidelines change, additional roles and responsibilities, and altruism; (5) professionalism, including cultural facets of care, teamwork, and support.

DISCUSSION

The COVID-19 pandemic has caused major changes in nurses' working environment and so their experience. The results of this study indicated that nurses working in the ICU experienced remarkable and massive physical, psychological, and emotional symptoms during the COVID-19 pandemic. The nurses extended the relationships to the patients' families as they are at high risk of stress, anxiety, and depression. In addition, they were able to support them in dealing with the fear associated with the uncertainty of COVID-19. Also, results revealed that remote therapeutic relationships and psychotherapy can be credible and trustworthy alternatives to in-person care.

CONCLUSIONS

The results of this study indicated that ICU nurses provide compassionate care despite experiencing unprecedented and immense physical, psychological, and emotional symptoms during the COVID-19 pandemic.

RECOMMENDATIONS

Further study is recommended using other research methodologies. It is also recommended to conduct the same study in different cities for better generalization.

Experiences of health professionals in EU institutions during the Covid crisis

We performed a quantitative and a qualitative study, addressing the experiences of health services of 16 European Union institutions during the Covid-19 pandemic. Among the 165 eligible subjects, 114 (69%) participated in the survey. The biggest problem reported was limitation of social contacts (53%). At work, the biggest problems were workload (50%) and shortage of staff (37%). The majority were positive about teamwork. Teleworking was seen positively by 81%. Most participants felt better prepared for future situations by their recent experience (94%). Participants underlined the importance of strengthening the collaboration with the local health systems (80%), as well as with medical services and internal services within their own institution (75%). The qualitative analysis also reported participants' fear of becoming infected, and of their family members getting sick. Similarly reported were the sense of isolation and anxiety, the excessive workload and work complexity, shortage of staff, and the benefits of teleworking. Study findings highlight: i) the need to strengthen mental health support to health personnel, not only during crisis situations; ii) the need for sufficient health workers, with swift recruitment strategies in times of crisis; iii) the importance of clear protocols to ensure no shortages of personal protective equipment (PPE); iv) the importance of teleworking, which represents an opportunity for major reorganisation of work within EU medical services; v) the need to strengthen collaboration with local health systems and the medical services of EU institutions.

Original Research: The Impact of COVID-19 on Pain Care Among Older Adults

PURPOSE

In this qualitative descriptive study, we sought to understand the professional experiences and perceptions of pain management nurses who cared for older adults in the United States during the height of the COVID-19 pandemic.

METHODS

Data were collected between July 2020 and July 2021 through individual, semistructured interviews with a nonprobability sample of 18 pain management nurses. An inductive content analysis approach, in which categories were derived from a coding process based on a close reading of data extracts from the interview transcripts, was used to reveal the major theme related to the study aim.

RESULTS

Notwithstanding the variable consequences of COVID-19 on patients' health, a single overarching theme was pronounced: "Pain management for older adults remained unchanged during the pandemic despite unpredictable survival, restrictions on human interactions, and communication challenges." This theme was supported by four categories that emerged from the data: unpredictable survival, restriction-induced isolation, perceived continuity and equality of pain management, and communication challenges.

CONCLUSIONS

During the COVID-19 pandemic, pain management nurses stepped in and joined interdisciplinary teams providing general and specialized pain care to ensure that older adults, whether inpatient or outpatient, continued to receive quality care. These study findings highlight the many challenges pain management nurses faced during this unprecedented public health crisis, as well as opportunities to improve the health system and enhance nursing practice to meet the needs of older patients.

The Experience of Frontline Nurses during the COVID-19 Pandemic: A Phenomenological Study

The purpose of this phenomenological study was to describe the experience of frontline nurses working during the COVID-19 pandemic. The first author conducted two individual audiotaped interviews with 23 qualified staff nurses. All the authors analyzed the professionally transcribed data according to hermeneutic principles. The researchers identified five major themes: (a) we are family; (b) heroes work here; (c) fear of contagion; (d) mental health and well-being; and (e) new reality. Given the uncertainties of working during the COVID-19 pandemic, findings revealed the value of supportive collegial relationships and the need to support the mental health and well-being needs of frontline nurses during the pandemic. Nurses need supportive environments to help ease the challenges associated with serving on the frontline during times of crisis. Findings have implications for future public health preparedness and response efforts.

Analysis of the strategies used by iranian nurses for management of provided care for patients with COVID- 19: a qualitative study

BACKGROUND

Nurses have been at the center of managing the COVID-19 outbreak through direct bedside care in respiratory, emergency and intensive care environments, managing hospital units, providing Covid-19 testing, vaccination and contact tracing. Thus, the present study aimed to analysis the strategies used by Iranian nurses for management of Provided Care for patients with COVID- 19.

METHODS

The present study was conducted based on the conventional content analysis method and Graneheim & Lundman approach. The participants included the nurses working in the COVID-19 wards and were recruited by purposeful sampling and based on inclusion criteria. The data were collected by conducting semi-structured, in-depth, one-to-one interviews until reaching data saturation.

RESULTS

In-depth interviews with 10 nurses represented four main categories and fifteen subcategories. Four main categories emerged in this study i.e. "justice in human resources management", "The art and science of comprehensive nursing care", "managers as agents of change in crisis" and "challenges and its management".

CONCLUSION

The nurses' experiences of management strategies showed that paying attention to the financial, psychological, educational, equipment needs of nurses and maintaining their safety make the suitable environment for providing high quality care for patients with covid-19.

Nurses' adaptations to changes on a COVID-19 ward in South Korea: A qualitative study

Background

Elucidating nurses' adaptation to changes in the early stage of an infectious disease epidemic is necessary to promote nurses' coping with and adapting to situations in which new infectious diseases are predicted periodically.

Aim

To explore nurses' adaptation to changes in COVID-19 wards in South Korea.

Methods

In-depth interviews were conducted with 20 nurses through purposive sampling from May to August 2020. The collected data were transcribed verbatim, and analysis was performed using conventional content analysis.

Findings

Three categories emerged from the interviews: (a) Disruption caused by an unforeseen pandemic outbreak, (b) perseverance through the turmoil of changes as a nurse, and (c) transition from feelings of fearfulness to those of accomplishment. While the nurses initially struggled to care for patients with COVID-19, they made conscious efforts to provide emotional nursing and maintain their professionalism.

Discussion

Nurses caring for patients with COVID-19 have faced a number of challenges but have adapted to new scenarios by endeavoring to fulfil their professional roles.

Conclusion

To overcome a national disaster situation such as COVID-19, the government and healthcare organizations should prepare strategies to support the efforts of nurses to strengthen their own professionalism.

Nurses' self-esteem, self-compassion and psychological resilience during COVID-19 pandemic

AIM

This study aimed to identify self-esteem, self-compassion and psychological resilience among staff nurses during the COVID-19 pandemic in Qatar.

DESIGN

Descriptive cross-sectional survey design.

METHODS

The study was conducted on January 2022 (during the third wave in Qatar). Anonymous data were collected through an online survey using Microsoft forms from 300 nurses in 14 health facilities in Qatar. Socio-demographic information, Connor-Davidson Resilience Scale, Rosenberg Self-Esteem Scale and Self-Compassion Scale-Short Form were used to collect the data. Correlation, t-test and ANOVA analyses were conducted.

RESULTS

Participants expressed a high level of resilience, self-esteem and self-compassion. Resilience scores were positively and significantly correlated with self-esteem and self-compassion. The education level of nurses was a statistically significant contributing factor to self-esteem and resilience.

The impact of the COVID-19 pandemic on the perioperative transition to specialty practice program

AIM

To understand how the COVID-19 pandemic impacted nurse educators' and novice nurses' experience with the perioperative transition to specialty practice program.

DESIGN

A qualitative descriptive study.

METHODS

Semi-structured interviews were conducted with five perioperative nurse educators and five perioperative transition to specialty practice program participants from a major metropolitan health service in Melbourne. Data were collected between April and July 2021. Interviews were audio-recorded and transcribed verbatim, and data were analysed using reflexive thematic analysis.

RESULTS

Five themes were identified. The value of the perioperative transition to specialty practice program in supporting novice nurses was recognized in the theme 'Nurturing our novices'. Widespread changes to clinical practice were demonstrated in the theme 'Every day is different', including changes to elective surgery, redeployment of staff and the transmission risk of COVID-19. 'The perils and joys of online learning' revealed both challenges and benefits of transitioning theoretical education from face-to-face to online delivery. 'Roller coaster of emotions' represented the heightened emotions participants experienced due to the COVID-19 pandemic. 'Looking back to move forward' encompassed participants' reflections on the year, considering the challenges, adaptive strategies and the future of perioperative nursing education.

CONCLUSION

The perioperative transition to specialty practice program was significantly impacted by the COVID-19 pandemic. Participants needed to adapt to rapid and frequent changes, which contributed to feelings of emotional distress, affected consolidation of clinical learning and reduced engagement with theoretical education.

IMPACT

Perioperative nurses should acknowledge that opportunities for learning were decreased for transition to specialty practice program participants during the pandemic. Ongoing support and education should be provided, to nurture the future generation of perioperative nurses.

"I Carry the Trauma and Can Vividly Remember": Mental Health Impacts of the COVID-19 Pandemic on Frontline Health Care Workers in South Africa

We know from research that pandemics and disease outbreaks expose HCWs to an increased risk of short and long-term psychosocial and occupational impacts. We conducted qualitative research among 44 frontline health care workers (FHCWs) practicing in seven South African hospitals and clinics. FHCWs were interviewed on their experiences of working during the first-wave of the COVID-19 pandemic and its perceived impact on their wellness. In this study, FHCWs included the non-medical and medical professionals in direct contact with COVID-19 patients, providing health care and treatment services during the COVID-19 pandemic. Most of the FHCWs reported stressful and traumatic experiences relating to being exposed to a deadly virus and working in an emotionally taxing environment. They reported depression, anxiety, traumatic stress symptoms, demoralization, sleep difficulties, poor functioning, increased irritability and fear of being infected or dying from COVID-19. The mental health impacts of COVID-19 on HCWs were also associated with increased poor physical wellbeing, including fatigue, burnout, headache, and chest-pains. FHCWs reported professional commitment and their faith as critical intrinsic motivators that fostered adaptive coping while working on the frontline during the first-wave of the COVID-19 pandemic. Many alluded to gaps in workplace psychosocial support which they perceived as crucial for coping mentally. The findings point to a need to prioritize interventions to promote mental wellness among FHCWs to ensure the delivery of quality healthcare to patients during pandemics or deadly disease outbreaks.

Nursing during the COVID-19 pandemic: A reflective thematic analysis of how the hamster wheel shifted personal and professional control

AIM

The aim of this national study was to examine the experience of nurses 9-12 months after the onset of the pandemic.

DESIGN

This article reports the reflective thematic analysis of the qualitative portion of a mixed methods study of the experiences of 1319 Canadian nurses between February to May 2021.

METHODS

Data gathering occurred through open-text box questions in an online survey.

RESULTS

Three overarching themes were found: (1) the hamster wheel, (2) the shifting sense of control, and (3) the inability to leave the pandemic at work.

CONCLUSION

This research presents a national perspective of nurses which contributes to the wider global narrative. The experience of redeployment, nurses as decision-makers, communication and leadership challenges were all factors impacting mental health and intraprofessional collaboration.

IMPLICATIONS FOR THE PROFESSION

The findings revealed the immense pressure, mental health concerns, and professional implications for nurses in all domains.

PUBLIC OR PATIENT CONTRIBUTIONS

No public or patient contributions.

Emotional Labor of Nurses and Phlebotomists in a New Source Plasma Collection Site During the COVID-19 Pandemic

As uses of plasma-derived medical products increase globally, so does the demand to collect plasma from donors. There is evidence that positive interactions with center staff motivate plasma donors to return. This paper reports on a focused ethnography investigating experiences of nurses and phlebotomists in one of Canadian Blood Services' first source plasma collection center during the COVID-19 pandemic. Participants found the transition from whole blood collection to source plasma amid a global pandemic challenging, but they adapted by coming together as a team, and then worked to put the donor experience first. Their experience resonates with scholarship on emotional labor. As blood services worldwide attempt to increase source plasma collection, there is a need to understand care work that nurses and phlebotomists perform on the front-line. This study offers insight into how blood services can support staff in plasma operations by recognizing emotional labor.

Experiences, emotions, and expectations of nurse mothers during the COVID-19 process

PURPOSE

This study was designed to investigate the life experiences, emotions, and expectations of nurse mothers (NMs) during the COVID-19 process.

DESIGN AND METHODS

A phenomenological approach was used in this qualitative research. The study was carried out with 18 nurses who worked in a hospital, had at least one child in the 0-18 age group, and agreed to participate in the study. Study data were collected through individual in-depth interviews and analyzed by using the content analysis method.

RESULTS

The analysis of the findings related to the experiences, emotions, and expectations of NMs during the COVID-19 process yielded three main themes, namely, difficulties experienced, emotions experienced, and coping.

CONCLUSIONS

Nurse mothers should be supported mentally during the pandemic period so that they can maintain a healthier relationship with their children.

PRACTICE IMPLICATIONS

When we consider that NMs have experienced negative emotions in the COVID-19 period, investigation of the problems they have experienced during the pandemic, and the situation they have been in and the development of strategies and coping methods to better manage the process will support NMs.

Competencies of Nurse Managers as Predictors of Staff Nurses' Job Satisfaction and Turnover Intention

Nurse managers have played an integral role in stabilizing the nursing work environment and workforce in the face of the COVID-19 pandemic, yet the competencies required for such a feat are largely unknown. This study was conducted during the pandemic to identify the specific domains of nurse manager competencies that associate with nurse outcomes. A cross-sectional survey was conducted on a convenience sample of 698 staff nurses to measure the perceived competence of their nurse managers and their job satisfaction and turnover intention levels. The overall perceived nurse manager competency level in our sample was 3.15 out of 5 (SD = 0.859). The findings indicated that 34.3% of nurses were dissatisfied with their current jobs, and 36.3% of nurses were considering leaving their current workplace. Regression analyses identified "Team Communication and Collaboration" (β = 0.289; p = 0.002), "Staff Advocacy and Development" (β = 0.229; p = 0.019), and "Quality Monitoring and Pursuance" (β = 0.213; p = 0.031) as significant predictors of staff nurses' job satisfaction and "Staff Advocacy and Development" (β = -0.347; p < 0.000) and "Team Communication and Collaboration" (β = -0.243; p = 0.012) as significant predictors of nurses' turnover intention. The findings of the study have implications for the future recruitment, training, and performance evaluation of nurse managers.

Exploring Nurses’ Working Experiences during the First Wave of COVID-19 Outbreak

During the COVID-19 outbreak, nurses employed in the clinical sector faced a number of difficulties associated with excessive workload, increased stress, and role ambiguity, which impacted nurses themselves and patient care. The aim of the present study was to investigate how Greek hospital nurses working in non-COVID units experienced the virus outbreak during the first wave of the pandemic. A descriptive qualitative research design was applied using a content analysis approach. To recruit the study participants a purposive sampling strategy was used. Ten nurses participated in the study. Data collection was conducted through semi-structured interviews. Content analysis revealed three themes namely, (a) emotional burden, (b) professional commitment, and (c) abrupt changes. Six subthemes were formulated and assimilated under each main theme respectively. Organizational changes, emotional burdens and feelings of fear and uncertainty, appeared to have a crucial effect on nurses and patient care. However, the professional commitment and the nurses’ effort to provide excellent nursing care remained high. Nurses demonstrated that despite the burdens caused by the COVID-19 outbreak, the pandemic era created opportunities for thoroughness and accuracy in nursing care.

Protective Factors and Coping Styles Associated with Quality of Life during the COVID-19 Pandemic: A Comparison of Hospital or Care Institution and Private Practice Nurses

In France, nurses work either in hospitals and care institutions or in private practice, following physicians' prescriptions and taking care of patients at their homes. During the COVID-19 pandemic, these populations of nurses were exposed to numerous sources of stress. The main objective of the present study was to identify the protective factors they mobilized to face the crisis and how these factors contributed to sustaining their quality of life (QoL). A cross-sectional study was conducted to answer these questions. Overall, 9898 French nurses participated in the study, providing demographic information and filling out QoL (WHOQOL-BREF), perceived stress (PSS-14), resilience (CD-RISC), social support (MSPSS), and coping style (BRIEF-COPE) questionnaires. The results revealed very few differences between the two groups of nurses, which is surprising given the drastically different contexts in which they practice. Social support and two coping strategies (positive reframing and acceptance) were associated with a high QoL, whereas perceived stress and four coping strategies (denial, blaming self, substance use, and behavioral disengagement) were associated with poor QoL. In the light of these results, we recommended promoting social support and coping strategies to help nurses cope during the pandemic.

Posttraumatic stress disorder and related factors among nurses working during the COVID‐19 pandemic

Aim

To analyse the prevalence of posttraumatic stress disorder (PTSD) and examine its related factors among nurses who worked during the coronavirus disease 2019 (COVID‐19) pandemic in Daegu, South Korea.

Background

Nurses are a high‐risk population for PTSD, especially during the COVID‐19 pandemic. This study was conducted to identify the nursing work environmental factors that should be addressed to reduce PTSD.

Methods

Using a cross‐sectional design, 365 nurses were enrolled. Their characteristics (intrapersonal, interpersonal, organizational, and COVID‐19‐related) and PTSD Checklist‐5 scores were analysed.

Results

The average PTSD score was 14.98 ± 15.94, and 16.5% of the participants had a high risk of PTSD. Nurses were more likely to have PTSD if they were married (odds ratio = 3.02, p = .013) and when nurse managers' abilities, leadership, and support of nurses were low (odds ratio = 3.81, p < .001).

Conclusions

The nursing work environment was found to be associated with PTSD. Therefore, interventions are necessary to increase nurse managers' abilities, leadership, and support for nurses to reduce the risk of PTSD among nurses.

Implications for Nursing Management

Effective professional and social support and interventions to improve nurse managers' abilities, leadership, and support of nurses are needed to reduce PTSD.

COVID-19 Mental Health Stressors of Health Care Providers in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) Intervention: A Qualitative Study (Preprint)

Background

Objective

Methods

Results

Conclusions

Distanced behind the mask: The use of non-verbal communication when counselling the elderly during the COVID-19 pandemic

The stressors caused by the coronavirus disease 2019 (COVID-19) pandemic have influenced both the physical and the mental health of the elderly, increasing their vulnerability. Counselling by the mental healthcare nurse is a critical protective factor in mitigating the mental health effects of COVID-19. However, counselling is unintentionally interrupted by the effects of the mask as a barrier to non-verbal communication. This commentary aims at conscientisation of mental healthcare nursing practice interruptions to non-verbal communication, brought upon by the pandemic. Practice recommendations focus on mask-wearing becoming less of a stressor to offset the challenges experienced by both the elderly and the mental healthcare nurses.

CONTRIBUTION

The authors conclude that a need exists to revisit the fundamentals of counselling, and show initiative to addressing the practice challenges created by the wearing of masks yet simultaneously contribute to #flatten_the_mental_illness_curve.

The Role of Health Literacy among Outpatient Caregivers during the COVID-19 Pandemic

Health literacy became an important competence during the COVID-19 pandemic. Despite outpatient caregivers being a particularly vulnerable occupational group, their health literacy has hardly been examined yet, especially during the pandemic. Hence, this study aimed to explore this field and provide first empirical insights. Data were collected based on a cross-sectional online survey among 155 outpatient caregivers. In particular, health literacy (HLS-EU-Q16), diet and physical activity, pandemic-related worries, perceived information sufficiency and stress perception were examined. Descriptive and ordinal logistic regression analyses were run to test explorative assumptions. The majority of outpatient caregivers reported high values of health literacy (69% on a sufficient level). Although no significant associations between health literacy and health behaviours or perceived information sufficiency were found, perceived information sufficiency and perceived stress (OR = 3.194; 95% CI: 1.542-6.614), and pandemic-related worries (OR = 3.073; 95% CI: 1.471-6.421; OR = 4.243; 95% CI: 2.027-8.884) seem to be related. Therefore, dissemination of reliable information and resource-building measures to reduce worries may be important parameters for improving outpatient caregivers' health. Our results provide first explorative insights, representing a starting point for further research. Considering outpatient caregivers' mobile work setting, they need to be provided with adequate equipment and comprehensible information to ensure physically and mentally healthy working conditions.