Background of the Study
The World Health Organization declared COVID-19 a pandemic in March 2020. Reid et al. (2021) described it as a defining healthcare crisis of the 21st century and the biggest challenge humans have faced since World War II. SARS-CoV-2.1 causes the disease—SARS-CoV-2 infection with symptoms ranging from mild to severe illness. As of May 20, approximately 6 million cases of SARS-CoV-2 infection had been reported worldwide (Fernández‐Castillo et al., 2021).
The percentage of infection cases increased significantly within the first two months following the initial report of the first infection. Similarly, the mortality rate was between 23% and 33% worldwide after three months. According to Fernández-Castillo et al. (2021), more than 240,000 people were infected during the first wave of the pandemic in Spain. In addition, approximately 20,000 deaths were reported among the general infected population. The bed capacity in hospitals around the world was overwhelmed by the pandemic.
As the article demonstrates, the pandemic has compelled healthcare systems worldwide to operate under challenging conditions. On the other hand, nurses continue to play a crucial role in providing the specialized care needed in the intensive care unit (ICU). However, most are exposed to poor working conditions and psychological factors that negatively impact the quality of care provided.
In line with the above, the article on the pandemic is relevant to nursing practice. Although nursing practice has evolved significantly over the past decade, no other external factor has had a comparable impact on its regulation to COVID-19. For instance, regarding practice, the pandemic has informed care providers across disciplines of the need to focus more on patients’ needs. Similarly, the pandemic has created an opportunity for additional staff training, which was identified as the biggest challenge in COVID-19 hospital care (Foong et al., 2020). In fact, since the start of 2021, nursing as a practice has been at the forefront in introducing strategies to optimize staffing, such as position-specific training.
Overview of Research Design
The authors carried out qualitative research to explore and describe the experiences of intensive care nurses during their operations in the COVID-19 pandemic in Spain. Fernández-Castillo et al. (2021) employed an empirical approach and inductive content analysis techniques as their research design to achieve this. The empirical approach supports the use of verifiable evidence to achieve reliable research outcomes.
For instance, Fernández-Castillo et al. (2021) employed semi-structured interviews to gather reliable evidence. Content analysis techniques, on the other hand, are often employed in research to help determine the presence of specific words, themes, and concepts in qualitative data (Vaismoradi and Snelgrove, 2019). For example, in Fernández‐Castillo et al.’s (2021) study, the authors relied on the previous literature searches to establish “a priori” themes.
Later, preliminary themes were discarded, while others were modified based on the new information being analyzed. An empirical approach was suitable for this study because it enabled the authors to address empirical questions that were defined and answered based on the evidence gathered. Content analysis was equally appropriate, as it allowed Fernández-Castillo et al. (2021) to quantify the meaning and relationship of words such as “specialized care.”
Data Collection
The researchers adopted a semi-structured interview method for data collection. They relied on a predetermined script developed in line with the previous literature searches, which guided the conversation with the participants. Most importantly, Fernández-Castillo et al.’s (2021) research ensured that the formulation of the questions took into account each participant’s specific characteristics.
The authors further relied on video calls as the most appropriate interview method. Video call interviews are regarded as the most reliable method for collecting qualitative data compared to one-on-one interviews. This type of interview eliminates scheduling complications and reduces unnecessary delays.
The semi-structured interview method is suitable for this study, as it enabled the authors to gather information from participants who had personal experiences and perceptions related to COVID-19. For example, the study participants were nurses working with COVID-19 patients in the ICU. Similarly, they were all working as full-time nurses on a rotational shift.
Additionally, the semi-structured interviews were suitable as they enabled the scholars to collect qualitative, open-ended data. An example of a question that allowed for open-ended data is “What kind of challenges have you faced during the pandemic?” Most importantly, the unrestricted questions allowed participants to explore their thoughts and feelings about COVID-19.
Results
After implementing homogeneous purposive sampling, the authors identified 17 nurses who met the inclusion criteria. The 17 nurses, as described by Fernández‐Castillo et al. (2021), formed the final sampling and were within the age bracket of 34 to 51 years old. From the original sample of 101 nurses involved in the study who worked in the ICU, only three were unable to participate from the start due to potential exposure to infected individuals. Besides this, the authors identified four main themes from the data analysis. These themes include “providing nursing care,” “resources management and safety,” “psychosocial aspects and emotional liability,” and “professional relationships and fellowship.”
Furthermore, the results indicated several physical consequences, such as work overload, emotional and mental hardship, as well as psychological challenges. Similarly, the results showed that high stress levels are inversely proportional to good working conditions. All 17 nurses agreed they were constantly concerned “both during the work shift and at home, with the consequent inability to rest properly because of sleep disturbances” (Fernández‐Castillo et al., 2021, p.345).
It is clear from the results that COVID-19 generates anxiety and fear in both the care providers and patients (Turabian, 2020). This is the case because the disease is highly contagious and has a constantly increasing mortality rate. This is what informed the authors to advocate for the adoption of appropriate mental health interventions to address the emotional and mental-related challenges. Lastly, the results identified the media and social networks as key channels of perpetuating feelings of fear among health professionals.
Evidence Utilization
The summarized evidence indicates that ICU registered nurses frequently work with patients who have life-threatening conditions, such as COVID-19. While most strive to provide high-quality care based on their specialized experience, knowledge, and skills, very little has been done to improve their working conditions. Therefore, the summarized evidence informs the clinical practice of Registered Nurses of the need to continue providing adequate training for ICU nurses and psychological support.
Firstly, adequate training for ICU Nurses, as explicated in X’s study, “influences healthcare outcomes” (Leng et al., 2021, p. 94). In addition, adequate training for new nurses is necessary, as it helps address the problems of burnout and staff turnover. The COVID-19 pandemic severely impacted nurses’ work environment. Most importantly, adequate training influences their retention within the organization, especially in the intensive care units.
Lastly, the ICU nurses require psychological support because the working conditions in these units have the potential to impact them negatively. For instance, most of the registered nurses have been reported to suffer from mental-related issues such as psychological distress, moral injury, depression, and post-traumatic stress disorder (Heesakkers et al., 2021). Therefore, this evidence highlights the need for nurses to develop an informed understanding of the pandemic and natural disasters, thereby guiding them in avoiding panic and anxiety.
Personal Application
Overall, I will implement the findings of this study in clinical practice. These findings, resource management and safety, professional relationship and fellowship, and providing nursing care, will guide the practice in delivering high-quality care within the specified timeframe. Firstly, resource management should ensure proper acquisition of sufficient material, such as personal protective equipment PPE. According to Nyashanu et al. (2022), frontline healthcare workers in most hospitals struggled to find enough PPEs only four months into the COVID-19 pandemic. In fact, without proper PPE, healthcare workers were twice as likely to contract an infection.
Secondly, on the issue of professional relationships, healthcare providers must work together constantly, especially during a crisis, to deliver optimal care to patients. For example, members can cope with the physical and psychological burden by forming health teams. Lastly, the central role of ICU nurses is to provide nursing care – they monitor patients’ vital signs, nutritional treatment, and ensure proper personal hygiene.
References
Fernández‐Castillo, R. J., González‐Caro, M. D., Fernández‐García, E., Porcel‐Gálvez, A. M., & Garnacho‐Montero, J. (2021). Intensive care nurses’ experiences during the COVID‐19 pandemic: A qualitative study. Nursing in critical care, 26(5), 397-406.
Foong, T. W., Ng, E. S. H., Khoo, C. Y. W., Ashokka, B., Khoo, D., & Agrawal, R. (2020). Rapid training of healthcare staff for protected cardiopulmonary resuscitation in the COVID-19 pandemic. British Journal of Anaesthesia, 125(2), 257-280.
Heesakkers, H., Zegers, M., van Mol, M. M., & van den Boogaard, M. (2021). The impact of the first COVID-19 surge on the mental well-being of ICU nurses: A nationwide survey study. Intensive and Critical Care Nursing, 65, 103-134.
Leng, M., Wei, L., Shi, X., Cao, G., Wei, Y., Xu, H., & Wei, H. (2021). Mental distress and influencing factors in nurses caring for patients with COVID‐19. Nursing in critical care, 26(2), 94-101.
Nyashanu, M., Pfende, F., & Ekpenyong, M. S. (2022). Triggers of mental health problems among frontline healthcare workers during the COVID‐19 pandemic in private care homes and domiciliary care agencies: Lived experiences of care workers in the Midlands region, UK. Health & social care in the community, 30(2), 370-376.
Reid, M., Abdool-Karim, Q., Geng, E., & Goosby, E. (2021). How will COVID-19 transform global health post-pandemic? Defining research and investment opportunities and priorities. PLoS Medicine, 18(3), 100-564.
Turabian, J. L. (2020). Implications on mental health by the coronavirus disease 2019 (COVID-19) pandemic: The role of general practitioner. health, 7(8), 35-41.
Vaismoradi, M., & Snelgrove, S. (2019). Theme in qualitative content analysis and thematic analysis. In Forum Qualitative Sozialforschung/Forum: Qualitative Social Research (Vol. 20, No. 3). DEU.
Wong, A., Robba, C., & Mayo, P. (2022). Critical care ultrasound. Intensive Care Medicine, 1-3.