'You can't walk through water without getting wet' UK nurses' distress and psychological health needs during the Covid-19 pandemic: A longitudinal interview study.
Burnout
COVID-19
Compassion fatigue
Longitudinal, moral distress
Mental health
Nurse wellbeing
Psychological support
Qualitative
Stigma
Journal
International journal of nursing studies
ISSN: 1873-491X
Titre abrégé: Int J Nurs Stud
Pays: England
ID NLM: 0400675
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
received:
06
07
2021
revised:
29
03
2022
accepted:
29
03
2022
pubmed:
8
5
2022
medline:
15
6
2022
entrez:
7
5
2022
Statut:
ppublish
Résumé
Pre-COVID-19 research highlighted the nursing profession worldwide as being at high risk from symptoms of burnout, post-traumatic stress disorder (PTSD) and suicide. The World Health Organization declared a pandemic on 11th March 2020 due to the sustained risk of further global spread of COVID-19. The high healthcare burden associated with COVID-19 has increased nurses' trauma and workload, thereby exacerbating pressure on an already strained workforce and causing additional psychological distress for staff. The Impact of COVID-19 on Nurses (ICON) interview study examined the impacts of the pandemic on frontline nursing staff's psychosocial and emotional wellbeing. Longitudinal qualitative interview study. Nurses who had completed time 1 and 2 of the ICON survey were sampled to include a range of UK work settings including acute, primary and community care and care homes. Interviewees were purposively sampled for maximum variation to cover a broad range of personal and professional factors, and experiences during the COVID-19 pandemic, including redeployment. Nurses participated in qualitative in-depth narrative interviews after the first wave of COVID-19 in July 2020 (n = 27) and again at the beginning of the second wave in December 2020 (n = 25) via video and audio platform software. Rigorous qualitative narrative analysis was undertaken both cross-sectionally (within wave) and longitudinally (cross wave) to explore issues of consistency and change. The terms moral distress, compassion fatigue, burnout and PTSD describe the emotional states reported by the majority of interviewees leading many to consider leaving the profession. Causes of this identified included care delivery challenges; insufficient staff and training; PPE challenges and frustrations. Four themes were identified: (1) 'Deathscapes' and impoverished care (2) Systemic challenges and self-preservation (3) Emotional exhaustion and (4) (Un)helpful support. Nurses have been deeply affected by what they have experienced and report being forever altered with the impacts of COVID-19 persisting and deeply felt. There is an urgent need to tackle stigma to create a psychologically safe working environment and for a national COVID-19 nursing workforce recovery strategy to help restore nurse's well-being and demonstrate a valuing of the nursing workforce and therefore support retention.
Sections du résumé
BACKGROUND
BACKGROUND
Pre-COVID-19 research highlighted the nursing profession worldwide as being at high risk from symptoms of burnout, post-traumatic stress disorder (PTSD) and suicide. The World Health Organization declared a pandemic on 11th March 2020 due to the sustained risk of further global spread of COVID-19. The high healthcare burden associated with COVID-19 has increased nurses' trauma and workload, thereby exacerbating pressure on an already strained workforce and causing additional psychological distress for staff.
OBJECTIVES
OBJECTIVE
The Impact of COVID-19 on Nurses (ICON) interview study examined the impacts of the pandemic on frontline nursing staff's psychosocial and emotional wellbeing.
DESIGN
METHODS
Longitudinal qualitative interview study.
SETTINGS
METHODS
Nurses who had completed time 1 and 2 of the ICON survey were sampled to include a range of UK work settings including acute, primary and community care and care homes. Interviewees were purposively sampled for maximum variation to cover a broad range of personal and professional factors, and experiences during the COVID-19 pandemic, including redeployment.
METHODS
METHODS
Nurses participated in qualitative in-depth narrative interviews after the first wave of COVID-19 in July 2020 (n = 27) and again at the beginning of the second wave in December 2020 (n = 25) via video and audio platform software. Rigorous qualitative narrative analysis was undertaken both cross-sectionally (within wave) and longitudinally (cross wave) to explore issues of consistency and change.
RESULTS
RESULTS
The terms moral distress, compassion fatigue, burnout and PTSD describe the emotional states reported by the majority of interviewees leading many to consider leaving the profession. Causes of this identified included care delivery challenges; insufficient staff and training; PPE challenges and frustrations. Four themes were identified: (1) 'Deathscapes' and impoverished care (2) Systemic challenges and self-preservation (3) Emotional exhaustion and (4) (Un)helpful support.
CONCLUSIONS
CONCLUSIONS
Nurses have been deeply affected by what they have experienced and report being forever altered with the impacts of COVID-19 persisting and deeply felt. There is an urgent need to tackle stigma to create a psychologically safe working environment and for a national COVID-19 nursing workforce recovery strategy to help restore nurse's well-being and demonstrate a valuing of the nursing workforce and therefore support retention.
Identifiants
pubmed: 35525086
pii: S0020-7489(22)00071-2
doi: 10.1016/j.ijnurstu.2022.104242
pmc: PMC8976696
pii:
doi:
Types de publication
Interview
Langues
eng
Sous-ensembles de citation
IM
Pagination
104242Informations de copyright
Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Références
J Nurs Manag. 2021 Sep;29(6):1525-1534
pubmed: 33690928
Front Psychol. 2020 Dec 16;11:611156
pubmed: 33391129
JAMA Psychiatry. 2021 Apr 14;:
pubmed: 33851982
BMC Nurs. 2015 Apr 28;14:23
pubmed: 25931986
Conn Med. 2012 Oct;76(9):525-31
pubmed: 23155671
Int J Nurs Stud. 2007 Aug;44(6):982-90
pubmed: 16793044
Can J Nurs Res. 2021 Mar;53(1):5-15
pubmed: 33342299
JAMA Netw Open. 2020 Mar 2;3(3):e203976
pubmed: 32202646
Qual Health Res. 2016 Nov;26(13):1753-1760
pubmed: 26613970
J Nurs Manag. 2020 Oct;28(7):1653-1661
pubmed: 32770780
J Intensive Care Soc. 2022 May;23(2):132-138
pubmed: 35615226
BMC Psychiatry. 2021 May 12;21(1):250
pubmed: 33980215
J Clin Nurs. 2020 Aug;29(15-16):2742-2750
pubmed: 32320509
Qual Saf Health Care. 2005 Dec;14(6):443-9
pubmed: 16326792
BMC Health Serv Res. 2017 Dec 15;17(1):824
pubmed: 29246221
Healthcare (Basel). 2016 Nov 30;4(4):
pubmed: 27916880
Int J Environ Res Public Health. 2020 Jul 14;17(14):
pubmed: 32674520
Hum Resour Health. 2020 Jun 5;18(1):41
pubmed: 32503559
J Gen Fam Med. 2020 Nov 29;22(3):134-140
pubmed: 33362984
Br J Soc Psychol. 2005 Jun;44(Pt 2):147-63
pubmed: 16004641
Int J Nurs Stud. 2015 Apr;52(4):804-16
pubmed: 25627792
Clin Med (Lond). 2021 Jan;21(1):66-72
pubmed: 33479070
Int J Nurs Stud. 2022 Mar;127:104155
pubmed: 35093740
Int J Qual Health Care. 2007 Dec;19(6):349-57
pubmed: 17872937
BMJ Qual Saf. 2014 Sep;23(9):709-13
pubmed: 25015116
Occup Med (Lond). 2021 Apr 9;71(2):62-67
pubmed: 33434920
Nurs Ethics. 2020 Aug;27(5):1297-1314
pubmed: 31566094
BMJ Open. 2020 Dec 18;10(12):e042930
pubmed: 33371046
Int J Older People Nurs. 2012 Jun;7(2):83-94
pubmed: 22531048