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“Like fighting a fire with a water pistol”: A qualitative study of the work experiences of critical care nurses during the COVID‐19 pandemic

Miller, Jordan; Young, Ben; Mccallum, Louise; Rattray, Janice; Ramsay, Pam; Salisbury, Lisa; Scott, Teresa; Hull, Alastair; Cole, Stephen; Pollard, Beth; Dixon, Diane

Authors

Jordan Miller

Ben Young

Louise Mccallum

Janice Rattray

Pam Ramsay

Lisa Salisbury

Teresa Scott

Alastair Hull

Stephen Cole

Beth Pollard

Diane Dixon



Abstract

Aim
To understand the experience of critical care nurses during the COVID-19 pandemic, through the application of the Job-Demand-Resource model of occupational stress.

Design
Qualitative interview study.

Methods
Twenty-eight critical care nurses (CCN) working in ICU in the UK NHS during the COVID-19 pandemic took part in semi-structured interviews between May 2021 and May 2022. Interviews were guided by the constructs of the Job-Demand Resource model. Data were analysed using framework analysis.

Results
The most difficult job demands were the pace and amount, complexity, physical and emotional effort of their work. Prolonged high demands led to CCN experiencing emotional and physical exhaustion, burnout, post-traumatic stress symptoms and impaired sleep. Support from colleagues and supervisors was a core job resource. Sustained demands and impaired physical and psychological well-being had negative organizational consequences with CCN expressing increased intention to leave their role.

Conclusions
The combination of high demands and reduced resources had negative impacts on the psychological well-being of nurses which is translating into increased consideration of leaving their profession.

Implications for the Profession and/or Patient Care
The full impacts of the pandemic on the mental health of CCN are unlikely to resolve without appropriate interventions.

Impact
Managers of healthcare systems should use these findings to inform: (i) the structure and organization of critical care workplaces so that they support staff to be well, and (ii) supportive interventions for staff who are carrying significant psychological distress as a result of working during and after the pandemic. These changes are required to improve staff recruitment and retention.

Reporting Method
We used the COREQ guidelines for reporting qualitative studies.

Patient and Public Contribution
Six CCN provided input to survey content and interview schedule. Two authors and members of the study team (T.S. and S.C.) worked in critical care during the pandemic.

Citation

Miller, J., Young, B., Mccallum, L., Rattray, J., Ramsay, P., Salisbury, L., Scott, T., Hull, A., Cole, S., Pollard, B., & Dixon, D. (2024). “Like fighting a fire with a water pistol”: A qualitative study of the work experiences of critical care nurses during the COVID‐19 pandemic. Journal of Advanced Nursing, 80(1), 237-251. https://doi.org/10.1111/jan.15773

Journal Article Type Article
Acceptance Date Jun 21, 2023
Online Publication Date Jul 28, 2023
Publication Date 2024-01
Deposit Date Aug 8, 2023
Publicly Available Date Aug 8, 2023
Print ISSN 0309-2402
Electronic ISSN 1365-2648
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 80
Issue 1
Pages 237-251
DOI https://doi.org/10.1111/jan.15773
Keywords COVID-19, critical care, health workforce, intensive care units, JD-R model, mental health, nursing staff, occupational stress, qualitative research
Public URL http://researchrepository.napier.ac.uk/Output/3155410

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