Being A Nurse in The COVID-19 Pandemic: A Qualitative Study with A Communication Dimension

Abstract

Objective: In the COVID-19 pandemic, the critical role of nurses became more visible. The COVID-19 pandemic increased staff psychological stress and has put enormous pressure on healthcare systems across the World. The purpose of this study was to investigate communication challenges that come from nurses' COVID-19 experiences. Methods: Qualitative study with a phenomenological approach using in-depth interviews was conducted to obtain data about the experiences of 16 nurses who actively participated in COVID-19 patient care. Data were analysed using content analysis. Results: In this study, the effect of the COVID-19 pandemic on the communication of nurses with their families, healthcare personnel, patients and their relatives was focused. As a consequence of the analysis, three main themes emerged: (1) keep away, (2) conflict, (3) strengths. Conclusion: Nurses faced many communication challenges. The vast majority of them appear to be caused by fear of infection. These communication struggles can reduce a peaceful and safe work environment for a nurse and jeopardize patient care. It can also lead to psychological effects for nurses. Strategies that nursing managers could use are; being fair in patient sharing and distribution of materials, such as protective equipment, and making them feel that their feelings and thoughts are important by listening to nurses.

Keywords

• Colleagues
• Communication
• COVID-19
• Nurses
• Qualitative

Being A Nurse in The COVID-19 Pandemic: A Qualitative Study with A Communication Dimension

Abstract

Amaç: COVID-19 salgınında hemşirelerin kritik rolü daha görünür hale geldi. COVID-19 salgını, personelin psikolojik stresini artırdı ve dünya genelinde sağlık sistemleri üzerinde büyük bir baskı oluşturdu. Bu çalışmanın amacı hemşirelerin COVID-19 deneyimlerinden kaynaklanan iletişim zorluklarını incelemektir. Yöntem: COVID -19’lu hasta bakımına aktif olarak katılan 16 hemşirenin deneyimlerini incelemek amacıyla derinlemesine görüşmeler kullanılarak fenomenolojik yaklaşımla nitel bir çalışma yapılmıştır. Veriler içerik analizi kullanılarak analiz edilmiştir. Bulgular: Bu çalışmada COVID -19 pandemisinin hemşirelerin aileleri, sağlık personeli, hasta ve yakınlarıyla iletişimine etkisine odaklanılmıştır. Analiz sonucunda üç ana tema ortaya çıkmıştır: (1) uzak durma, (2) çatışma, (3) güçlü yönler. Sonuç: Hemşireler birçok iletişim zorluğuyla karşı karşıya kalmıştır. Bunların büyük çoğunluğu enfeksiyon korkusundan kaynaklanıyor gibi görünmektedir. Bu iletişim mücadeleleri hemşirenin huzurlu ve güvenli çalışma ortamını azaltabilir ve hasta bakımını tehlikeye atabilir. Ayrıca hemşireler için psikolojik sorunlara da yol açabilmektedir. Hemşire yöneticilerinin kullanabileceği stratejiler; hasta paylaşımı koruyucu ekipman gibi malzemelerin dağıtımında adil olmak, hemşireleri dinleyerek duygu ve düşüncelerinin önemli olduğunu onlara hissettirmektir.

Keywords

• COVID -19
• Hemşireler
• İletişim
• Meslektaşlar
• Nitel

References

1. Andersson M, Nordin A, Engström Å. (2022). Critical care nurses’ experiences of working during the first phase of the COVID-19 pandemic – Applying the Person-centred Practice Framework. Intensive and Critical Care Nursing, 69, 103179. doi: 10.1016/j.iccn.2021.103179
2. Billings J, Ching BCF, Gkofa V, Greene T, Bloomfield M. (2021). Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: a systematic review and qualitative meta-synthesis. BMC Health Services Research, 21, 923. doi: 10.1186/s12913-021-06917-z
3. Blake N. (2021). Building a new, better normal after COVID-19. Nursing Management, 52(6), 20-23. doi: 10.1097/01.NUMA.0000752780.68152.46
4. Buheji M, Buhaid N. (2020). Nursing human factor during COVID‐19 pandemic. International Journal of Nursing Science, 10(1), 12‐24. doi: 10.5923/j. nursing.20201001.02
5. Cadge W, Lewis M, Bandini J, Shostak S, Donahue V, Trachtenberg S, et al. (2021). Intensive care unit nurses living through COVID-19: A qualitative study. Journal of Nursing Management, 29, 1965–1973. doi: 10.1111/jonm.13353
6. Cohen L, Manion L, Morrison K. (2011). Research methods in education. New York: Routledge.
7. Collins R. (2021). Protect the nurse, protect the practice: Effective communication is the foundation for keeping nurses safe. Healthcare Management Forum, 34(4), 200-204. doi: 10.1177/08404704211022144
8. Dal HE, Akpınar H. (2023). The effect of the COVID-19 pandemic on nurses' conscientious perception levels. Black Sea Journal of Health Science, 6(4), 667-674. doi: 10.19127/bshealthscience.1339762

9. da Silva Barreto, M., Leite, A. C. A. B., García-Vivar, C., Nascimento, L. C., & Marcon, S. S. (2022). The experience of coronaphobia among health professionals and their family members during COVID-19 pandemic: A qualitative study. Collegian, 29(3), 288-295. doi:10.1016/j.colegn.2022.03.006
10. Digby R, Winton-Brown T, Finlayson F, Dobson, H, Bucknall T. (2021). Hospital staff well-being during the first wave of COVID-19: StafF perspectives. International Journal of Mental Health Nursing, 30, 440–450. doi: 10.1111/inm.12804
11. Elo S, Kyngäs H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107–115. doi: 10.1111/j.1365-2648.2007.04569.x.
12. Fernandez R, Lord H, Halcomb E, Moxham L, Middleton R, Alananzeh I, et al. (2020). Implications for COVID-19: A systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International Journal of Nursing Studies, 111, 103637. doi: 10.1016/j.ijnurstu.2020.103637.
13. Francis JJ, Johnston M, Robertson C, Glidewell L, Entwistle V, Eccles MP, et al. (2010). What is an adequate sample size? Operationalising data saturation for theory-based interview studies. Psychology and Health, 25(10), 1229-1245. doi: 10.1080/08870440903194015
14. Graneheim UH, Lindgren B-M, Lundman B. (2017). Methodological challenges in qualitative content analysis: A discussion paper. Nurse Education Today, 56, 29-34. doi: 10.1016/j.nedt.2017.06.002
15. Graneheim UH, Lundman B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105-112. doi: 10.1016/j.nedt.2003.10.001
16. Grove SK, Burns N, Gray JR. (2013). The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence. (7th edition). China: Elsevier Inc.
17. Holt M, Jin F, Grulich A, Murphy D, Smith G. (2004). Syphilis, STIs and Men Who Have Sex with Men in Sydney: Understanding and Managing Risk. Australia: National Centre in HIV Social Research. Monograph 7/2004.
18. Jennings BM, Yeager KA. (2020). From fear to fortitude: Using the power within the nursing profession to fight COVID-19. Nursing Outlook, 68(4), 391-392. doi: 10.1016/j.outlo ok.2020.04.008
19. Jun J, Tucker S, Melnyk BM. (2020) Clinician mental health and well-being during global healthcare crises: evidence learned from prior epidemics for COVID-19 pandemic. Worldviews on Evidence-Based Nursing, 17(3), 182-184. doi: 10.1111/wvn.12439
20. Kagan I, Shor R, Ben Aharon I, Yerushalmi S, Kigli‐Shemesh R., Gelman S, et al. (2021). A Mixed-Methods study of nurse managers’ managerial and clinical challenges in mental health centers during the COVID-19 pandemic. Journal of Nursing Scholarship, 53(6), 663-670. doi:10.1111/jnu.12685
21. Kwaghe AV, Ilesanmi OS, Amede PO, Okediran JO, Utulu R, Balogun MS. (2021). Stigmatization, psychological and emotional trauma among frontline health care workers treated for COVID-19 in Lagos State, Nigeria: A qualitative study. BMC Health Services Research, 21, 855.doi:10.1186/s12913-021-06835-0
22. Lake ET, Narva AM, Holland S, Smith JG, Cramer E, Rosenbaum KEF, et al. (2022). Hospital nurses' moral distress and mental health during COVID-19. Journal of Advanced Nursing, 78, 799-809. doi: 10.1111/jan.15013
23. Lincoln SY, Guba EG. (1985). Naturalistic Inquiry. CA: Sage. In Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. (2014). Qualitative content analysis: a focus on trustworthiness, SAGE Open, 4(1), doi:10.1177/2158244014522633
24. Lord H, Loveday C, Moxham L, Fernandez R. (2021). Effective communication is key to intensive care nurses’ willingness to provide nursing care amidst the COVID-19 pandemic. Intensive & Critical Care Nursing, 62, 102946. doi: 10.1016/j.iccn.2020.102946
25. Maaskant JM, Jongerden IP, Bik J, Joosten M, Musters S, Storm-Versloot MN, et al. (2021). Strict isolation requires a different approach to the family of hospitalised patients with COVID-19. A rapid qualitative study. International Journal of Nursing Studies, 117, 103858. doi:10.1016/j.ijnurstu.2020.103858.
26. McCarthy B, O’Donovan M, Trace A. (2021). A new therapeutic communication model “TAGEET” to help nurses engage therapeutically with patients suspected of or confirmed with COVID-19. Journal of Clinical Nursing, 30, 1184-1191. doi: 10.1111/jocn.15609
27. Melnikov S, Kagan I, Felizardo H, Lynch M, Jakab‐Hall C, Langan L, et al. (2022). Practices and experiences of European frontline nurses under the shadow of COVID-19. Nursing & Health Sciences, 24, 405–413. doi: 10.1111/nhs.12936
28. Nelson H, Hubbard Murdoch N, Norman K. (2021). The role of uncertainty in the experiences of nurses during the Covid-19 pandemic: A phenomenological study. Canadian Journal of Nursing Research, 53(2), 124-133. doi: 10.1177/0844562121992202
29. Ness MM, Saylor J, Di Fusco LA, Evans K. (2021) Healthcare providers' challenges during the coronavirus disease (COVID-19) pandemic: A qualitative approach. Nursing & Health Sciences, 23, 389-397. doi: 10.1111/nhs.12820
30. Nogueira Galeno Rodrigues ME, Belarmino ADC, Lopes Custódio L, Lima Verde Gomes, I, Ferreira Júnior, AR. (2020). Communication in health work during the COVID-19 pandemic. Investigación y educación en enfermería, 38, e09. doi: 10.17533/udea.iee.v38n3e09.
31. O'Brien BC, Harris IB, Beckman TJ, Reed DA, Cook DA. (2014). Standards for reporting qualitative research: a synthesis of recommendations. Academic Medicine, 89, 1245-1251. doi: 10.1097/ACM.0000000000000388.
32. Spalluto LB, Planz VB, Stokes LS, Pierce R, Aronoff DM, McPheeters ML., et al. (2020). Transparency and trust during the coronavirus disease 2019 (COVID-19) pandemic. Journal of the American College of Radiology, 17, 909–912. doi: 10.1016/j.jacr.2020.04.026.
33. White EM, Wetle TF, Reddy A, RR Baier. (2021). Front-line nursing home staff experiences during the COVID-19 pandemic. Journal of the American Medical Directors Association, 22, 199-203. doi: 10.1016/j.jamda.2020.11.022
34. Zhang J, Fang Y, Lu Z, Chen X, Hong N, Wang C. (2021). Lacking communication would increase General Symptom Index scores of medical team members during COVID-19 pandemic in China: A retrospective cohort study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 58, 1-8. doi: 10.1177/0046958021997344