Experiences of nurses during COVID-19 pandemic: An interpretative phenomenological analysis study

Purpose: The aim of this study was to determine the experiences of intensive care nurses who cared for patients with suspected or confirmed COVID-19. Material and Methods: The research was carried out with nurses. Data collection included in-depth interviews conducted between June-August 2020. Interviews were audio recorded, transcribed verbatim, and analysed using the Interpretative Phenomenological Analysis Results: Three main themes emerged: (a) nurses' compliance with the process; (b) factors affecting motivation; and (c) emotional responses observed in patients. While challenging situations, increase in workload, and situations that cause anxiety were the factors that negatively affected nurses' motivation to work, awareness/empathic behavior and flexible working hours were the factors that positively affected the motivation to work. Conclusion: Intensive care nurses make great efforts to prevent transmission from patients with COVID-19. It is thought that nurses should be supported in terms of the factors that negatively affect their motivation to work. It is considered that nurses' awareness/empathic behaviors affected their perceptions of the patients' fear of death and feeling of helplessness.

Keywords:

COVID-19 experience, nurse, phenomenological,

PDF

___

Al Thobaity, A., Alshammari, F. (2020). Nurses on the frontline against the COVID-19 pandemic: An integrative review. Dubai Medical Journal, 3, 87-92. https://dx.doi.org/10.1159/000509361
Boškoski, I., Gallo, C., Wallace, M.B. et al. (2020). COVID-19 pandemic and personal protective equipment shortage: Protective efficacy comparing masks and scientific methods for respirator reuse. Gastrointest Endoscopy, 92(3), 519–523. https://doi.org/10.1016/j.gie.2020.04.048
Chan, J.F.W., Yuan, S., Kok, K.H. et al. (2020). A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet, 395(10223), 514-523. https://doi.org/10.1016/S0140-6736(20)30154-9
Charlick, S., Pincombe, J., McKellar, L. et al. (2016). Making sense of participant experiences: Interpretative phenomenological analysis in midwifery research. International Journal of Doctoral Studies, 11, 205-216. http://www.informingscience.org/Publications/3486
Chen, S.C., Lai, Y.H., Tsay, S.L. (2020). Nursing perspectives on the impacts of COVID-19. Journal of Nursing Research, 28(3), e85. doi: 10.1097/jnr.0000000000000389
Chen, C.S., Wu, H.Y., Yang, P. et al. (2005). Psychological distress of nurses in Taiwan who worked during the outbreak of SARS. Psychiatric Services, 56(1), 76–79. https://doi.org/10.1176/appi.ps.56.1.76
Erdogan, S., Nahcivan N, Esin N. (2020). Hemşirelikte Araştırma: Süreç, uygulama ve kritik (4th ed.). Istanbul: Nobel Tıp Kitabevleri.
Fernandez-Castillo, R., Gonzalez-Caro, M., Porcel-Galvez, A. (2021). Intensive care nurses’ experiences during the COVID-19 pandemic: A qualitative study. Nursing in Critical Care, 26(5), 397-406. https://doi.org/10.1111/nicc.12589
Galehdar, N., Kamran, A., Toulabi, T. et al. (2020). Exploring nurses’ experiences of psychological distress during care of patients with COVID-19: A qualitative study. BMC Psychiatry, 20(1), 489. https://doi.org/10.1186/s12888-020-02898-1
Goh, Y., Tan, B.Y.Q., Bhartendu, C. et al. (2020). The face mask: How a real protection becomes a psychological symbol during Covid-19?. Brain, Behavior, and Immunity, 88, 1–5. https://doi.org/10.1016/j.bbi.2020.05.060
Goktepe, N., Turkmen, E., Bozkurt, G. et al. (2021). The views of critical care nurses participating in an adult intensive care nursing certification program. Turkish Journal of Intensive Care, 19, 123-30 DOI: 10.4274/tybd.galenos.2020.58076
Guerrero-Cantaneda, R.F., Oliva Menezes, T.M., Prado, M.L. (2019). Phenomenology in nursing research: reflection based on Heidegger’s hermeneutics. Escola Anna Nery, 23(4), e20190059. https://doi.org/10.1590/2177-9465-EAN-2019-0059
Halcomb, E., McInnes, S., Williams, A. et al. (2020). The experiences of primary healthcare nurses during the COVID-19 Pandemic in Australia. Journal of Nursing Scholarship, 52(5), 553-563. https://doi.org/10.1111/jnu.12589
Holshue, M.L., DeBolt, C., Lindquist, S. et al. (2020). First case of 2019 novel coronavirus in the United States. New England Journal of Medicine, 382, 929–936. DOI: 10.1056/NEJMoa2001191
Horrigan-Kelly, M., Millar, M., Dowling, M. (2016). Understanding the key tenets of Heidegger’s philosophy for interpretive phenomenological research. International Journal of Qualitative Methods, 15(1), 1-8. https://doi.org/10.1177/1609406916680634
Jack, K., Wibberley, C. (2014). The meaning of emotion work to student nurses: A Heideggerian analysis. International Journal of Nursing Studies, 51(6), 900-907. https://doi.org/10.1016/j.ijnurstu.2013.10.009
Karimi, Z., Fereidouni, Z., Behnammoghadam, M. et al. (2020). The lived experience of nurses caring for patients with COVID-19 in Iran: A phenomenological study. Risk Management and Healthcare Policy, 13, 1271–1278. doi: 10.2147/RMHP.S258785
Khalid, I., Khalid, T.J., Qabajah, M.R. et al. (2016). Healthcare workers emotions, perceived stressors and coping strategies during a MERS-CoV outbreak. Clinical Medicine Research, 14(1), 7–14. doi:10.3121/cmr.2016.1303
Kıraner, E., Terzi, B., Turkmen, E. et al. (2020). Experiences of Turkish Intensive Care Nurses in the COVID-19 Outbreak. Journal of Education and Research in Nursing, 17(3), 284–286. GALE|A639265806
Kim, K., Lee, O. (2016). Knowledge, Attitudes and Perceptions of Nurses on Personal Protective Equipment: Response to the Middle East Respiratory Syndrome Coronavirus. Journal of Korean Academy of Fundamentals of Nursing, 23(4), 402–410. https://doi.org/10.7739/jkafn.2016.23.4.402
Kim, Y. (2018). Nurses’ experiences of care for patients with Middle East respiratory syndrome-coronavirus in South Korea. American Journal of Infection Control, 46(7), 781–787. https://doi.org/10.1016/j.ajic.2018.01.012
Leng, M., Shi, X., Wei, Y. et al. (2020). Mental distress and influencing factors in nurses caring for patients with COVID-19. Nursing in Critical Care, 26(2), 94-101. https://doi.org/10.1111/nicc.12528
Martín-Rodríguez, F., Sanz-García, A., López-Izquierdo, R. et al. (2020). Predicting health care workers’ tolerance of personal protective equipment: An observational simulation study. Clinical Simulation in Nursing, 47, 65–72. https://doi.org/10.1016/j.ecns.2020.07.005
Oral, B., Çoban, A. (2020). Kuramdan uygulamaya eğitimde bilimsel araştırma yöntemleri. Ankara: Pegem Akademi.
Patel, A., D’Alessandro, M.M., Ireland, K.J. et al. (2017). Personal protective equipment supply chain: Lessons learned from recent public health emergency responses. Health Security, 15(3), 244–252. https://doi.org/10.1089/hs.2016.0129
Patton, M.Q. (2015). Qualitative research & evaluation methods: Integrating theory and practice (4th ed.). United States of America: Sage Publications.
Raurell-Torredà, M. (2020). Management of ICU nursing teams during the COVID-19 pandemic. Enfermeria Intensiva, 31(2), 49–51. doi: 10.1016/j.enfie.2020.04.001
Rose, J., Johnson, C.W. (2020). Contextualizing reliability and validity in qualitative research: toward more rigorous and trustworthy qualitative social science in leisure research. Journal of Leisure Research, 51(4), 432-451. https://doi.org/10.1080/00222216.2020.1722042
Scott, M., Unsworth, J. (2020). Lessons from other disciplines about communication, human performance and situational awareness while wearing personal protective equipment. SAGE Open Nursing, 6, 1-8. https://doi.org/10.1177/2377960820963766
Silverstein, W.K., Stroud, L., Cleghorn, G.E. et al. (2020). First imported case of 2019 novel coronavirus in Canada, presenting as mild pneumonia. Lancet, 395(10225), 734. https://doi.org/10.1016/S0140-6736(20)30370-6
Smith, J.A., Flowers, P., Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. London: Sage Publications.
Sperling, D. (2021). Ethical dilemmas, perceived risk, and motivation among nurses during the COVID-19 pandemic. Nursing Ethics, 28(1), 9-22. https://doi.org/10.1177/0969733020956376
Torda, A. (2006). Ethical issues in pandemic planning. Medical Journal of Australia, 14(1), 7-14.
Wang, H., Liu, Y., Hu, K. et al. (2020). Healthcare workers’ stress when caring for COVID-19 patients: An altruistic perspective. Nursing Ethics, 27(7), 1490–1500. https://doi.org/10.1177/0969733020934146
World Health Organization. (2021). WHO Coronavirus (COVID-19) Dashboard. Available from https://covid19.who.int/