Take care of our nurses too during pandemic, says study

Nurses play a critical role during a respiratory pandemic, and this systematic review further stresses the need for governments, policy makers, and nursing groups to actively engage in supporting them, both during and following a pandemic or epidemic. The absence of such support system may result in substantial psychological issues among nurses, leading to burnout and loss from the nursing workforce.

“It is vital that nurses receive clear, concise, and current information about best practice nursing care and infection control, as well as sufficient access to appropriate personal protective equipment (PPE) to optimize their safety,” the researchers said. “Adequate staffing is essential to ensure that nurses are able to take breaks during shifts, take leave when they are ill, and provide appropriate skill mix.”

This review was performed using the Joanna Briggs Institute methodology for systematic reviews. The researchers conducted a structured search using the following databases: PubMed, Embase, Medline, Cinahl, Cochrane Library, MedNar, ProQuest, Google Scholar, and Index to Theses. Studies describing nurses’ experiences, regardless of methodology used, were included.

Finally, the SUMARI data extraction tool from the Joanna Briggs Institute was used to extract themes and narrative statements from included papers.

Thirteen qualitative studies met the eligibility criteria, including 348 nurses. Their experiences generated a total of 116 findings (101 unequivocal and 15 credible), which formed seven categories based on similarity of meaning. [Int J Nurs Stud 2020;doi:10.1016/j.ijnurstu.2020.103637]

From these categories, three synthesized findings were further generated: supportive nursing teams providing quality care; acknowledging the physical and emotional impact; and responsiveness of systematized, organizational reaction.

The first category was derived specifically from a sense of duty, dedication to patient care, and personal sacrifice, as well as professional collegiality. The second category originated from concerns for their personal and family safety, as well as fear, vulnerability, and psychological issues in the face of crisis.

Finally, responsiveness of systematized, organizational reaction stemmed from three categories, namely protection and safety, knowledge and communication, and organizational preparedness—provision of adequate leadership, staffing, and policy.

“Although nurses had a deep sense of wanting to continue to provide care as a result of their strong sense of duty and wanting to do the right thing, these virtues did not preclude them from harbouring fears and concerns about the safety of themselves and their families,” the researchers said.

“Nursing practice during crisis, particularly those that place the nurse in mortal danger, meant it was important to acknowledge both the physical and emotional impacts,” they added.

Another essential factor in this systematic review is fear of transmission and contagion, which has been reported in studies on H1N1, SARS, and Ebola virus. Notably, nurses remain in the workplace and continue to provide care despite such fear. [J Infect Dev Countr 2016;10:845-850; Med Care 2005;43:676-682; J Nurs Adm 2015;45:544-550; Midwifery 2017;52:19-26]

“Support for nurses to manage competing family responsibilities and maintain safe contact and communication with family members can reduce personal stress and anxiety,” the researchers said. “Finally, the physical and psychological impact of working during a pandemic or epidemic on nurses needs to be recognized and made visible.”