Aim To investigate the nurses' work environment in university hospitals during the COVID‐19 pandemic in Brazil. Background The COVID‐19 pandemic brought challenging times for nurses worldwide. In Brazil, as well as in several countries, nurses are working hard in hospital settings caring for patients infected with the virus, sometimes with unfavourable work environment conditions. Methods This study was a convergent embedded mixed methods research. The sample comprised 104 nurses from three Brazilian university hospitals. Data were collected in April–June 2020 from an online questionnaire with a self‐reporting Likert scale survey designed to measure the nurses' perceptions of their work environment. Qualitative data in the form of written comments were also collected through an open question. Data were analysed using descriptive statistics and content analysis. Results The quantitative results showed that the responses to ‘I received training on the correct use of personal protective equipment’ and ‘I am afraid of being infected’ items had the best and worst evaluations, respectively. The qualitative findings revealed five themes: feeling of insecurity, lack of personal protective equipment, lack of diagnostic tests, changes in the care flow and fear of the unknown. Conclusion The study has highlighted the challenges faced by hospital nurses while caring for patients with COVID‐19. Implications for Nursing and Nursing Policy The gaps identified will assist the policymakers and hospital managers in developing policies to enhance the support offered to nurses and improve the care provided to patients with COVID‐19 in university hospitals. The results also indicate the need for attention to the mental health of the professionals due to the increasing workload and treatment of an illness hitherto unknown.

Objective: To describe nurses' recommendations for good patient safety practices in the operating room. Method: Quantitative, descriptive and exploratory research developed from an online survey of 220 operating room nurses from different regions of Brazil. The data processing for textual analysis was performed by the software IRAMUTEQ. Results: There were eight recommendations: (1) Involvement of the multiprofessional team and the managers of the institution; (2) Establishment of a patient safety culture; (3) Use of the safe surgery checklist; (4) Improvement of interpersonal communication; (5) Expansion of nurses' performance; (6) Adequate availability of physical, material and human resources; (7) Individual search for professional updating; and (8) Development of continuing education actions. Conclusion: These recommendations can be used as care management strategies by nurses for patient safety in the operating room.

Objective: to describe the changes implemented in the work environment of nurses in university hospitals considering the COVID-19 pandemic. Methods: this qualitative and descriptive research was developed from an online survey with 75 nurses from three Brazilian university hospitals. Data processing occurred through textual analysis with the aid of software IRAMUTEQ. Results: five semantic classes were obtained: Organization of units for exclusive care of patients with COVID-19; Adaptations in the use of personal protective equipment; Physical structure adaptation; Care flow institution; Increased number of beds and training courses. Final considerations: the results show the effort of healthcare and nursing professionals/managers in the development of structural adaptations and reorganizations of care processes, in the hospital context, to respond with quality and efficiency to the demands arising from the COVID-19 pandemic.

Objective: to analyze the characteristics of the nurse's work environment in a hospital emergency service. Methods: a mixed method study with a concurrent triangulation strategy using data from a descriptiveexploratory study, with 19 nurses, and a Grounded Theory study with three sample groups totaling 21 participants. The quantitative data were collected using the Brazilian Nursing Work Index-Revised and were subjected to descriptive statistical analysis. The qualitative data were obtained from interviews and were analyzed through initial and focused coding. Results: the nurses considered that they had autonomy, good relationships with the physicians, and organizational support. However, the control over the environment was shown to be an unfavorable characteristic. Based on the results, the category: "Seeking to organize the work environment for demand which exceeds attendance capacity" is presented. Conclusion: the characteristics of the emergency environment were shown to be favorable to the nurse's work, with the exception of control over the environment. Descriptors: Working Environment; Nursing Care; Management; Emergency Nursing. Objetivo: analisar as características do ambiente de trabalho do enfermeiro em um serviço hospitalar de emergência. Métodos: estudo de método misto com estratégia triangulação concomitante de dados de um estudo descrito-exploratório com 19 enfermeiros e uma Teoria Fundamentada nos Dados com três grupos amostrais, perfazendo 21 participantes. Os dados quantitativos foram coletados por meio do Brazilian Nursing Work Index Revised e submetidos à análise estatística descritiva. Os dados qualitativos foram obtidos a partir de entrevistas e analisados mediante codificação inicial e focalizada. Resultados: os enfermeiros consideraram ter autonomia, boas relações com os médicos e suporte organizacional. No entanto, o controle sobre o ambiente mostrou-se como característica desfavorável. A partir dos resultados, apresenta-se a categoria: "Buscando organizar o ambiente de trabalho para uma demanda maior do que a capacidade de atendimento". Conclusão: as características do ambiente da emergência mostraram-se favoráveis ao trabalho do enfermeiro, exceto o controle sobre o ambiente.

O objetivo desta pesquisa foicompreender o atendimento do paciente em situação de urgência desde o serviço pré-hospitalar móvel ao serviço hospitalar de emergência. Trata-se de uma pesquisa qualitativa, com o referencial metodológico da Teoria Fundamentada nos Dados. A coleta de dados ocorreu por meio de entrevistas semi-estruturadas, entre abril a setembro de 2016, com uma amostragem teórica de 24 participantes, entre profissionais de um hospital referência em trauma, Batalhão do Corpo de Bombeiros Militar e Base Operacional Avançada do Serviço Móvel de Urgência. A análise dos dadosocorreu mediante codificação inicial e focalizada.Obtiveram-se três categorias: (1) Atendendo os chamados por atendimentos, (2) Prestando atendimento ao paciente no local de ocorrência e (3) Realizando atendimento ao paciente no serviço hospitalar, que sustentam o fenômeno: “Realizando o atendimento do paciente em situação de urgência do APH móvel para o serviço hospitalar de emergência”. Conclui-se que a acolhimento ao paciente em situação de urgência é iniciado com o acionamento do serviço de atendimento pré-hospitalar móvel. A continuidade deste atendimento ocorre no ambiente hospitalar por meio do acolhimento da equipe e realização dos cuidados necessários, conforme a gravidade do quadro clínico dos pacientes.

Objective: to understand the development of the clinical reasoning of nurses working in an emergency hospital service. Methods: qualitative research, with methodological reference of the Grounded Theory. Data collection took place through interviews, with a theoretical sample of 21 participants and analysis using substantive and theoretical coding. Results: the central category was identified as Knowing what to do, and four conceptual categories: 1) Uncovering the nurse's duties in the emergency service; 2) Improving clinical reasoning through professional experience; 3) Providing care with quality and safety for the patient; and 4) Conquering professional recognition from the health team. Conclusion: the development of nurses' clinical reasoning is a cumulative, experiential, and gradual process of knowing what to do in an emergency. It is based on the collaborative work with the health team and on the acquisition of technical-scientific knowledge to perform qualified assistance to patients.

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