Challenges nurses experienced in caring for patients with COVID-19 admitted to the Intensive Care Units: A Qualitative Study

Document Type : Original Article

Authors

1 Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

2 Department of Clinical Science and Education, Karolinska Institute, 17177 Stockholm, Sweden

Abstract

Background: Nurses working in intensive care units (ICU) have experienced numerous challenges while caring for patients with COVID-19.
Objectives: The aim of this study was to explore ICU nurses’ experiences of caring for patients with COVID-19.
Methods: This research presents part of a qualitative study conducted using a grounded theory approach. Participants consisted of nurses and physicians from the selected hospitals in Sabzevar, Neishabour, and Mashhad, Iran. Data collection was performed using semi-structured in-depth interviews. Participants were enrolled via purposive sampling during 2022–2023. A total of 21 participants were interviewed. The method of Corbin and Strauss (2015) was used to analyze the data. We used Guba and Lincoln’s four criteria of credibility, dependability, transferability, and confirmability to ensure data trustworthiness.
Results: Four main categories emerged from the data that collectively reflect the experiences of Iranian ICU nurses in caring for COVID-19 patients. These categories included ward overcrowding, changing patterns, complexity of care, and feeling exhausted. All of these categories show that Iranian ICU nurses were under intense pressure during the COVID-19 pandemic.
Conclusion: This study showed that taking care of patients was very exhausting for nurses during the COVID-19 pandemic. Hospital authorities and nursing administrators have a responsibility to support nurses and provide them facilities to feel less stress and uncertainty, while caring for patients with COVID-19.

Highlights

Hamid Reza Khankeh [Pubmed] [Google Scholar]

Keywords

Main Subjects

References

  1. Khankeh H, Farrokhi M, Roudini J, Pourvakhshoori N, Ahmadi S, Abbasabadi-Arab M, et al. Challenges to manage pandemic of coronavirus disease (COVID-19) in Iran with a special situation: a qualitative multi-method study. BMC public health 2021;21:1-9. doi:10.1186/s12889-021-11973-5 PMid:34686165 PMCid:PMC8532398
  2. Roberts NJ, Kelly CA, Lippiett KA, Ray E, Welch L. Experiences of nurses caring for respiratory patients during the first wave of the COVID-19 pandemic: an online survey study. BMJ Open Respir Res 2021;8(1):e000987. doi:10.1136/bmjresp-2021-000987
    PMid:34312256 PMCid:PMC8313305
  3. Arabi YM, Murthy S, Webb S. COVID-19: a novel coronavirus and a novel challenge for critical care. Intensive Care Med 2020; 46(5):833-6. doi:10.1007/s00134-020-05955-1
    PMid:32125458 PMCid:PMC7080134
  4. Fernández‐Castillo RJ, González‐Caro MD, Fernández‐García E, Porcel‐Gálvez AM, Garnacho‐Montero J. Intensive care nurses' experiences during the COVID‐19 pandemic: A qualitative study. Nurs Crit Care 2021;26(5):397-406. doi:10.1111/nicc.12589
    PMid:33401340
  5. Lee H, Choi S. Factors affecting fatigue among nurses during the COVID-19 pandemic. Int J Environ Res Public Health 2022;19(18):11380. doi:10.3390/ijerph191811380
    PMid:36141652 PMCid:PMC9517441
  6. Kackin O, Ciydem E, Aci OS, Kutlu FY. Experiences and psychosocial problems of nurses caring for patients diagnosed with COVID-19 in Turkey: A qualitative study. Int J Soc Psychiatry 2021;67(2):158-67. doi:10.1177/0020764020942788
    PMid:32674644
  7. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA netw open 2020;3(3):e203976-e. doi:10.1001/jamanetworkopen.2020.3976
    PMid:32202646 PMCid:PMC7090843
  8. Sun N, Wei L, Shi S, Jiao D, Song R, Ma L, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect control 2020;48(6):592-8. doi:10.1016/j.ajic.2020.03.018 PMid:32334904 PMCid:PMC7141468
  9. Schroeder K, Norful AA, Travers J, Aliyu S. Nursing perspectives on care delivery during the early stages of the covid-19 pandemic: A qualitative study. IJNS Advances 2020;2:100006. doi:10.1016/j.ijnsa.2020.100006 PMid:32864632 PMCid:PMC7446648
  10. Grasselli G, Pesenti A, Cecconi M. Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response. JAMA 2020;323(16): 1545-6. doi:10.1001/jama.2020.4031 PMid:32167538
  11. Chegini Z, Arab‐Zozani M, Rajabi MR, Kakemam E. Experiences of critical care nurses of fighting against COVID‐19: A qualitative phenomenological study. Nurs Forum 2021;56(3):571-578. doi:10.1111/nuf.12583 PMid:33895986 PMCid:PMC8250885
  12. Saedpanah D, Salehi S, Moghaddam LF. The effect of emotion regulation training on occupational stress of critical care nurses. J Clin Diagn Res 2016;10(12):VC01-VC04. doi:10.7860/JCDR/2016/23693.9042 PMid:28208981 PMCid:PMC5296554
  13. Chegini Z, Asghari Jafarabadi M, Kakemam E. Occupational stress, quality of working life and turnover intention amongst nurses. Nurs Crit Care 2019;24(5):283‐289. doi:10.1111/nicc.12419 PMid:30873678
  14. Corbin J, Strauss A. Basics of qualitative research: Techniques and procedures for developing grounded theory. New York, Sage publications; 2014.
  15. Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis: Striving to meet the trustworthiness criteria. Int J Qual Methods 2017;16(1):1609406917733847. doi:10.1177/1609406917733847
  16. World Health Organization. Iran (Islamic Republic of) Situation. 2023. Available from: https://covid19.who.int/region/emro/country/ir [Last access date: 3 Jun 2023].
  17. Sadeghi A, Eslami P, Dooghaie Moghadam A, Pirsalehi A, Shojaee S, Vahidi M, et al. COVID-19 and ICU admission associated predictive factors in Iranian patients. Caspian J Intern Med 2020; 11(Suppl 1):512-519. doi: 10.22088/cjim.11.0.512. PMid: 33425268. PMCid: PMC7780877
  18. Jabbari A, Salahi S, Hadian M, Khakdel Z, Hosseini E, Sheikhbardsiri H. Exploring the challenges of Iranian government hospitals related to Covid-19 pandemic management: a qualitative content analysis research from the nurses perspective. BMC Nurs 2022;21(1):226. doi:10.1186/s12912-022-01008-8 PMid:35962433 PMCid:PMC9372986
  19. Dadkhah-Tehrani M, Adib-Hajbaghery M. The relationship between workload and adherence to professional codes of ethics among a sample of Iranian nurses. Clin Ethics 2022;17(3):290-296. doi:10.1177/14777509211040183
  20. Kalateh Sadati A, Zarei L, Shahabi S, Heydari ST, Taheri V, Jiriaei R, et al. Ebrahimzade N, Lankarani KB. Nursing experiences of COVID-19 outbreak in Iran: A qualitative study. Nurs Open 2021; 8(1):72-79. doi:10.1002/nop2.604 PMid:32904939 PMCid:PMC7461197
  21. Peng PWH, Ho PL, Hota SS. Outbreak of a new coronavirus: what anaesthetists should know. Br J Anaesth 2020;124(5):497-501. doi:10.1016/j.bja.2020.02.008 PMid:32115186 PMCid:PMC7124191
  22. Moradi Y, Baghaei R, Hosseingholipour K, Mollazadeh F. Challenges experienced by ICU nurses throughout the provision of care for COVID‐19 patients: A qualitative study. J Nurs Manag 2021;29(5):1159-1168. doi:10.1111/jonm.13254 PMid:33480145 PMCid:PMC8014737
  23. Wax RS, Christian MD. Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients. Can J Anaesth 2020;67(5):568-76. doi:10.1007/s12630-020-01591-x PMid:32052373 PMCid:PMC7091420
  24. Sanghi P, Malik M, Hossain IT, Manzouri B. Ocular complications in the prone position in the critical care setting: the COVID-19 pandemic. J Intensive Care Med 2021;36(3):361-72. doi:10.1177/0885066620959031 PMid:32985317
  25. Asadi N, Salmani F, Asgari N, Salmani M. Alarm fatigue and moral distress in ICU nurses in COVID-19 pandemic. BMC Nurs 2022;21(1):125. doi:10.1186/s12912-022-00909-y
    PMid:35610610 PMCid:PMC9126748
  26. Remon AR, Lacanaria MGC. Compassion fatigue among nurses assigned to COVID-19 facilities: a constructivist grounded theory. Acta Med Philipp 2022. Available from: https://actamedicaphilippina.upm.edu.ph/index.php/acta/article/view/5818 [Last access date: May, 27 2023] doi:10.47895/amp.vi0.5818
  27. Jin H, Liu L, Li Y, Chen C, Fu Q. Influence of different protection levels of PPE on nurses' physical fatigue during the COVID-19 pandemic. Work 2022;72(4):1143-1152. doi:10.3233/WOR-220025 PMid:35723164
  28. Sharma N, Hasan Z, Velayudhan A, MA E, Mangal DK, Gupta SD. Personal protective equipment: challenges and strategies to combat COVID-19 in India: a narrative review. J Health Manag 2020;22(2):157-68. doi:10.1186/s12889-021-11973-5 PMid:34686165 PMCid:PMC8532398
Nursing and Midwifery Studies
Volume 12, Issue 3
September 2023
Pages 173-180

Files

History

  • Receive Date: 05 May 2023
  • Revise Date: 23 August 2023
  • Accept Date: 23 August 2023

Share

How to cite

Statistics