How the <scp>COVID</scp>‐19 crisis affected the well‐being of nurses working in paediatric critical care: A qualitative study

Pountney, Jackson; Butcher, Isabelle; Donnelly, Peter; Morrison, Rachael; Shaw, Rachel

doi:10.1111/bjhp.12661

Cited by 4 publications

(8 citation statements)

References 36 publications

(33 reference statements)

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“…Results may not transfer to other sites or countries but it clearly resonates internationally. 30,55,56 Further research in other countries would help confirm this transferability.…”

Section: Limitationsmentioning

confidence: 78%

“…54 These are described as basic psychological needs for psychological growth and well-being. 44 Previous research with PCC staff corroborated this theory 30,55 and these concepts were identified in a recent British Medical Association (BMA) report to represent the A-B-C of well-being in medical practice 29 : autonomy/control, belonging and competence.…”

Section: Discussionmentioning

confidence: 88%

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Challenges to well‐being in critical care

Shaw,

Morrison,

Webb

et al. 2024

Nursing in Critical Care

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BackgroundPaediatric critical care (PCC) is a high‐pressure working environment. Staff experience high levels of burnout, symptoms of post‐traumatic stress, and moral distress.AimTo understand challenges to workplace well‐being in PCC to help inform the development of staff interventions to improve and maintain well‐being.Study DesignThe Enhanced Critical Incident Technique (ECIT) was used. ECIT encompasses semi‐structured interviews and thematic analysis. We identified ‘critical incidents’, challenges to well‐being, categorized them in a meaningful way, and identified factors which helped and hindered in those moments. Fifty‐three nurses and doctors from a large UK quaternary PCC unit were consented to take part.ResultsThemes generated are: Context of working in PCC, which examined staff's experiences of working in PCC generally and during COVID‐19; Patient care and moral distress explored significant challenges to well‐being faced by staff caring for increasingly complex and chronically ill patients; Teamwork and leadership demonstrated the importance of team‐belonging and clear leadership; Changing workforce explored the impact of staffing shortages and the ageing workforce on well‐being; and Satisfying basic human needs, which identified absences in basic requirements of food and rest.ConclusionsStaff's experiential accounts demonstrated a clear need for psychologically informed environments to enable the sharing of vulnerabilities, foster support, and maintain workplace well‐being. Themes resonated with the self‐determination theory and Maslow's hierarchy of needs, which outline requirements for fulfilment (self‐actualization).Relevance to Clinical PracticeWell‐being interventions must be informed by psychological theory and evidence. Recommendations are flexible rostering, advanced communication training, psychologically‐informed support, supervision/mentoring training, adequate accommodation and hot food. Investment is required to develop successful interventions to improve workplace well‐being.

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“…Results may not transfer to other sites or countries but it clearly resonates internationally. 30,55,56 Further research in other countries would help confirm this transferability.…”

Section: Limitationsmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 88%

Challenges to well‐being in critical care

Shaw,

Morrison,

Webb

et al. 2024

Nursing in Critical Care

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“…We targeted newly qualified nurses (who worked for less than 5 years as a registered nurse) because existing evidence 18 had suggested that they may struggle more with their well-being than senior colleagues. Equally, we were interested to explore the experiences of senior nurses working as advanced nurse practitioners or well-being leads because they had taken on roles to support others’ well-being.…”

Section: Methodsmentioning

confidence: 99%

Managing well-being in paediatric critical care: a multiperspective qualitative study of nurses’ and allied health professionals’ experiences

Yeter,

Bhamra,

Butcher

et al. 2024

BMJ Open

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ObjectivesIt is well evidenced that healthcare professionals working in paediatric critical care experience high levels of burn-out, compassion fatigue and moral distress. This worsened during the COVID-19 pandemic. This work examines the nature of challenges to workplace well-being and explores what well-being means to staff. This evidence will inform the development of staff interventions to improve and maintain staff well-being.DesignQualitative study.SettingPaediatric critical care units in the UK.Participants30 nurses and allied health professionals took part in online interviews and were asked about well-being and challenges to well-being. Lived experiences of well-being were analysed using interpretative phenomenological analysis.ResultsThemes generated were as follows: perception of self and identity; relationships and team morale; importance of control and balance and consequences of COVID-19. They focused on the impact of poor well-being on participants’ sense of self; the significance of how or whether they feel able to relate well with their team and senior colleagues; the challenges associated with switching off, feeling unable to separate work from home life and the idealised goal of being able to do just that; and lessons learnt from working through the pandemic, in particular associated with redeployment to adult intensive care.ConclusionsOur findings align closely with the self-determination theory which stipulates autonomy, belonging and competence are required for well-being. Participants’ accounts supported existing literature demonstrating the importance of empowering individuals to become self-aware, to be skilled in self-reflection and to be proactive in managing one’s own well-being. Change at the individual and staff group level may be possible with relatively low-intensity intervention, but significant change requires systemic shifts towards the genuine prioritisation of staff well-being as a prerequisite for high-quality patient care.

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“…In pediatric nurses, pandemic-era research mirrored concerns expressed by the general nursing workforce. However, the pediatric nurse experience revealed additional considerations related to family-centered care, restrictions in (parent and family) visitation, pediatric nurses’ fear, and difficulty transitioning to care for adult patients with COVID-19 [ 65 , 66 , 67 ]. The disruption of family-centered care directly resulted from visiting restrictions on parents, siblings, friends, and extended family members [ 68 , 69 , 70 , 71 ].…”

Section: Introductionmentioning

confidence: 99%

“…During the pandemic, pediatric nurses in a variety of settings reported or met criteria for anxiety, depression, perceived stress, and psychological distress [ 73 , 74 ]. Burnout and poor quality of life resulted from caring for pediatric patients during the pandemic [ 67 , 75 , 76 ]. Pediatric nurses and other healthcare workers have described excessive workload due to co-worker illnesses, staffing shortages, patient acuity, and high patient volumes [ 41 , 67 ].…”

Section: Introductionmentioning

confidence: 99%

Our New Normal: Pediatric Nurse Residents’ Experiences with Transition to Practice during the COVID-19 Pandemic

Hinderer,

Klima,

Kellogg

et al. 2024

Healthcare

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This phenomenological qualitative study examined the lived experience of pediatric nurse residents’ transition to practice during the COVID-19 pandemic. The purposive sample included nine pediatric nurses, participating in a nurse residency program, who entered the nursing profession during the first year of the pandemic. The setting was a free-standing, Magnet-recognized, pediatric academic medical center in the Northeastern U.S. Individual interviews were audio recorded and transcribed. Narratives were analyzed using a hermeneutic phenomenological approach. Five themes emerged from the data: Our New Normal; The Rules Keep Changing; I’m Not Ready for This (transition to practice); The Toll of COVID; and Shattered Family-Centered Care. Sub-themes emerged in The Toll of COVID theme: COVID and the Nursing Care Environment, Emotional Toll of COVID, Burnout: A Universal Truth, and The Pandemic within the Pandemic. The nurse residents’ narratives uncovered the essence of their uncertainty, sorrow, growth, and resilience. Through the eyes of pediatric nurse residents, this study illuminated the experiences of these novices as they entered the nursing profession amid a pandemic.

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How the COVID‐19 crisis affected the well‐being of nurses working in paediatric critical care: A qualitative study

Cited by 4 publications

References 36 publications

Challenges to well‐being in critical care

Challenges to well‐being in critical care

Managing well-being in paediatric critical care: a multiperspective qualitative study of nurses’ and allied health professionals’ experiences

Our New Normal: Pediatric Nurse Residents’ Experiences with Transition to Practice during the COVID-19 Pandemic

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