Back to the Roots of Nursing: Qualitative Study on the Experience of Nurses in the Front Line During the COVID-19 Pandemic

Abstract

The COVID-19 emergency has led many health facilities to reorganize themselves in a very short time to meet the urgent needs for intensive, semi-intensive or ordinary care of SARS-CoV-2 patients. In this pandemic, characterized by speed of transmission and severity of respiratory symptoms, care has been affected by the increase in volume and clinical complexity of patients, the sudden and unpredictable staff decrease and the lack of support from family members / caregivers. At the same time, experience in the field has shown how “informal” resources have been activated, which enabled to treat the highest possible number of patients above the real availability of resources. The purpose of this study was to explore the experiences of nurses involved in frontline care (COVID Centers) during the pandemic with a particular focus on professional motivation and on the development of technical-professional and personal skills. A study with a qualitative research design using focus group technique was conducted. Two focus groups were held with nine nurses. Data were analyzed with inductive content analysis. The findings can be summarized in five main categories: professional identity; motivation and sense of mission; development of professional and personal skills; spirituality; person-centered care; uniqueness of the lived experience. These findings shed new light on the correlation between motivation, professional identity and value, sense of duty and sense of belonging to the professional group. Moreover, the experience in the COVID Centers represented a valuable opportunity for participants to rediscover some specific issues related to nursing professional identity and to develop new personal and technical-professional skills in a very short time. Finally, nurses experienced once again how the nurse-patient relationship and basic care are essential to provide effective and excellent care, even and especially for patients in critical conditions. Nurses re-discovered, in a careful body care and basic care, irreplaceable elements to give back to patients, often dying, their own dignity, and all the needed closeness and attention necessary also to compensate the absence of the loved ones. These elements represent a way to concretely and deeply express the ethics of a job well done in nursing.

Vaccines Administration in the Perspective of Patient Safety and Quality of Healthcare: Lesson from the Experience of an Italian Teaching Hospital for Pandemic Preparedness

“…To improve safety and the quality of care, health systems will have to promote legislative measures to enhance the clinical governance of health organisations, expand multisector and multinational synergies, and promote the involvement of patients and their families [40]. It will also be needed to capitalise on the relationships between patient safety and other priority issues such as climate safety, HWs safety and resilience, and patient reported experiences [41].…”

Nurse–Patient Communication and Relationship When Wearing Personal Protective Equipment: Nurses’ Experience in a COVID-19 Ward

“…The overarching theme of “ the in-out relationship ” expresses the simultaneous concepts of “ in here and out there ” and “ inside me and out of me ”. This highlights how, even in conditions that seem to impede the care relationship, the basis of this relationship is the “ I ” and “ you ” living in the same context [ 38 , 39 ].…”

“…Therefore, the memory of what happened is not only a desire to preserve a meaningful experience [ 27 ], but it also becomes the only tool to face a new and unexpected situation with a complete lack of experience. However, as reported by De Benedictis et al (2022) [ 39 ], the uniqueness of the lived experience and the motivation and sense of mission that emerged from nurses may have contributed to activating superior forces to respond to a crisis that involved ethical, professional, and personal aspects of caring.…”

Clinical nurse adherence to professional ethics: A grounded theory

“…On the other hand, the experience of a health emergency may also have a significant impact on the development of professional and personal skills, strengthening the professional identity, and values of caregivers and enriching the way the nursing profession is ethically observed. 47,48…”