Nursing perspectives about the critical gaps in public health emergency response during the COVID‐19 pandemic

Abstract

Introduction The purpose of this qualitative study was to synthesize frontline U.S. nursing perspectives about the current state of U.S. public health emergency preparedness and response. The study findings may inform public health policy change and improve future national pandemic planning and responses. Design We conducted a secondary thematic qualitative analysis using grounded theory methodology. Methods Data collection occurred through semi‐structured, in‐depth focus groups between July and December 2020, from 43 frontline nurses working in hospitals in four states (Ohio, California, Pennsylvania, and New York). Data were analyzed deductively, aligned with Khan et al.’s Public Health Emergency Preparedness Framework and inductively for emergent themes. Results Three themes emerged: (1) Validation of the presence of health disparities and inequities across populations; (2) Perceived lack of consistency and coordination of messaging about pandemic policies and plans across all levels; and (3) challenges securing and allocating nursing workforce resources to areas of need. Conclusion From a frontline nursing perspective, this study demonstrates the critical need to address health inequities and inequalities across populations, a consistent national vehicle for communication, and national plan for securing and allocating nursing workforce resources.

The use of Community/Public Health Nursing Competencies during the COVID‐19 pandemic

“…Norful et al. (2023) reported a theme of lack of coordination and messaging across levels of organizations and various government sectors. Similarly, respondents discussed extensive challenges in communicating clear, accurate information due to the rapidly changing data and information about the pandemic.…”

“…The work of public health nurses at state and local levels paralleled the roles and contributions of CDC nurses as they addressed the acute needs of COVID‐19 response while continuing to provide essential services (Doran & Boyd, 2020). The preparedness of C/PHNs for practice and public health response policy should be interconnected (Norful et al., 2023).…”

Care‐home Nurses' responses to the COVID‐19 pandemic: Managing ethical conundrums at personal cost: A qualitative study

“…Unfinished care, a phenomenon described pre‐pandemic, is where limited resources mean that some care is missed, rationed or left undone (Jones et al, 2015). This is of particular relevance in times of crisis where many of the underpinning causes, such as staff shortages, underfunding and prioritizing increased complexity of care, are exacerbated (Norful et al, 2022). Mantovan et al, in their hospital‐based qualitative study, linked nurses' experiences of unfinished care with moral distress because of the accentuated gap between the ideal of nursing care and what is possible given the circumstances, especially when technical aspects of care are prioritized over relational aspects (Mantovan et al, 2020; Molterer et al, 2020).…”

Ethics and frontline nursing during COVID-19: A qualitative analysis

“…Emotions, including guilt, anger, sadness, and exhaustion are to be expected. 1,11,43 The experiences reported by our participants reflect the need to support both ethics decision-makers and those tasked with carrying out ethics decisions. Support is also needed to address the aftermath, particularly for emotional and mental wellbeing.…”