Dying and caring on the edge: Taiwan's surviving nurses' reflections on taking care of patients with severe acute respiratory syndrome

Abstract

In 2003, Taiwan's nurses were terrified by severe acute respiratory syndrome (SARS), and four of them sacrificed their life in the course of their work with SARS patients. This study attempted to identify the stage-specific difficulties encountered by Taiwan's surviving frontline nurses during the anti-SARS process. A two-step within-method qualitative triangulation research design was used to obtain the in-depth and confidential thoughts of 200 participants during the precaring, tangible caring, and postcaring stages. Six major types of stage-specific difficulties with and threats to the quality of care of SARS patients were identified according to each specific stage of the caring process. Four themes were further explored; these are discussed to provide a background context in obtaining better understanding of the multifaceted needs of nurses during this crisis. Consequently, a conceptual framework was developed to depict this complex phenomenon.

Nurses’ preparedness for infectious disease outbreaks: A literature review and narrative synthesis of qualitative evidence

“…The events focused on were the SARS outbreak (Chung, Wong, Suen, & Chung, 2005;Liu & Liehr, 2009;Shih et al, 2007Shih et al, , 2009, the H1N1 pandemic (Lam & Hung, 2013), nonspecified emerging respiratory infectious disease outbreaks (Koh, Hegney, & Drury, 2012) and nonspecified epidemic events (O'Boyle, Robertson, & Secor-Turner, 2006). Two studies employed a two-step within-method qualitative triangulation design (Shih et al, 2007(Shih et al, , 2009; one study adopted a phenomenological approach ; one study used a descriptive exploratory method (Liu & Liehr, 2009); and three studies adopted a simple qualitative design (Koh et al, 2012;Lam & Hung, 2013;O'Boyle et al, 2006). Two studies employed a two-step within-method qualitative triangulation design (Shih et al, 2007(Shih et al, , 2009; one study adopted a phenomenological approach ; one study used a descriptive exploratory method (Liu & Liehr, 2009); and three studies adopted a simple qualitative design (Koh et al, 2012;Lam & Hung, 2013;O'Boyle et al, 2006).…”

“…Regarding the public's perception, the panicked response of the communities to outbreaks of infectious diseases was noted in four studies that an overreacting public atmosphere was delineated (Lam & Hung, 2013;O'Boyle et al, 2006;Shih et al, 2007Shih et al, , 2009. Regarding the public's perception, the panicked response of the communities to outbreaks of infectious diseases was noted in four studies that an overreacting public atmosphere was delineated (Lam & Hung, 2013;O'Boyle et al, 2006;Shih et al, 2007Shih et al, , 2009.…”

“…Moreover, Chung et al (2005) Regarding the workplace resources that were associated with nurses' preparedness, the importance of a supportive relationship among coworkers in the work environment is noted in four of the selected studies Liu & Liehr, 2009;Shih et al, 2007Shih et al, , 2009). Chung et al (2005) identified that nurses were motivated by an atmosphere of "non-hierarchical team spirit" (p. 515) across multiple disciplines in the workplace, which resulted in a greater intention to respond to an epidemic event, as a high degree of collegiality would be generated in such conditions.…”

“…This view was echoed by Shih et al (2007), whose study indicated that nurses were worried about their capacity to handle infectious patients, as the information imparted by the government and hospitals regarding the policy and facilities in combating the infectious disease was inconsistent, particularly in the beginning of the outbreak. According to the respondents, this continuance of uncertainty during an epidemic event had induced confusion and insecurity among nurses, which adversely influenced their competence and willingness to perform in outbreak management.…”

“…The capacity to respond to epidemics requires healthcare institutes to contrive management plans in meeting the challenges from potential public health emergencies (Siu, 2010). Individuals' readiness in infectious disease outbreak management consists of the skills, abilities and knowledge possessed by healthcare workers in the context of the provision of health care (Shih et al, 2007). Individuals' readiness in infectious disease outbreak management consists of the skills, abilities and knowledge possessed by healthcare workers in the context of the provision of health care (Shih et al, 2007).…”