Facilitators, Barriers, Conditions, and Recommendations of Pediatric Nurses Reassigned to Adult Care During COVID-19 Pandemic: A Mixed Methods Study

Abstract

Aims To describe the conditions, facilitators, barriers, and recommendations of pediatric nurses reassigned to adult care during the COVID-19 pandemic. Background During COVID-19 pandemic, nurses who were certified, received advanced education, and with years of experience in their fields were asked to, or mandated to, care for adult patients, often with COVID-19 and in intensive care units. Introduction Nurses struggled with this transition worldwide. Literature searches reflected no guidance in specialty reassignment during a pandemic. Methods International, mixed method, convergent study using GRAMMS Mixed Methods framework. Two instruments disseminated internationally during 2021 on Survey Monkey© in three languages: (1) Researcher-developed, validated, feelings, beliefs, circumstances, and recommendations survey, (2) Medical-surgical skills survey from Canadian Association of Schools of Nursing. Integrated quantitative and qualitative design for investigatory depth. Analysis using SocialSciences calculator© and Narrative Inquiry methodology. Meleis's Transitions theory provided framework. Results A total of 122 nurses from 12 countries responded. Sixty-four percent of pediatric nurses reported they were mandated to work with adults with no choice; 64% received no preparation for change in specialty. Respondents reported suffering, absence of training to care for adults, lack of COVID-19 related skills such as care of ventilated patient, proning, mental health support, palliative care, or comforting families of the dying. Ninety-two percent recommended improvement, advising advance planning for transition in assignments, making transitions smoother, and diminishing number of transitions. National and international policies on floating supported the participants’ recommendations. Discussion Study reports challenges experienced by nurses reassigned outside of their specialties without training or preparation and offers critical recommendations to ensure both nurse and patient safety during future disasters or pandemics. Conclusion/Implications Nursing and Health Policy Planning for quality nursing care during transitions between specialties is possible. Staff nurses must be included, trained, and prepared. Literature on floating provides solid background for moving nurses between specialties.