The Impact of COVID-19 from the Perspectives of Dutch District Nurses: A Mixed-Methods Study

Abstract

Little is known about how COVID-19 affects older patients living at home or how it affects district nursing teams providing care to these patients. This study aims to (1) explore, from the perspectives of Dutch district nurses, COVID-19′s impact on patients receiving district nursing care, district nursing teams, and their organisations during the first outbreak in March 2020 as well as one year later; and (2) identify the needs of district nurses regarding future outbreaks. A mixed-methods, two-phase, sequential exploratory design was followed. In total, 36 district nurses were interviewed during the first outbreak (March 2020), of which 18 participated in the follow-up questionnaire in April 2021. Thirteen themes emerged, which showed that the COVID pandemic has substantially impacted patient care and district nursing teams. During the first outbreak, nurses played a crucial role in organising care differently and worked under high pressure, leading to exhaustion, tiredness, and psychosocial problems, including fear of infection. A year later, nurses were better prepared to provide COVID care, but problems regarding work pressure and mental complaints remained. The identified needs focus on a sustainable implementation of leadership roles for district nurses. At the organisational and national levels, more support and appreciation are needed in terms of trust and appropriate policies.

Primary care nurses during the coronavirus disaster and their struggle: Qualitative research

“…The possible causes of these anticipatory concerns include (i) most patients with COVID-19 in primary care settings presenting with common and mild symptoms, such as fever and cough, 27 (ii) drastic changes in primary care practice, from chronic care to pandemic management, creating chaotic situations, 28 and (iii) lack in preparation and strong fear of infection. 29 In addition, staff in designated wards identified many sources of social support and used self-management strategies to cope with the situation, 30 whereas our participants felt that they were not well supported. This suggests that social recognition of the difficulties that nurses face is lacking and current support remains inadequate.…”

“…Previous studies show that among staff in designated wards, the causes of anxiety in the very early stage of the pandemic were high‐intensity work and concern for patients and family members, 7,26 whereas causes of anxiety among our participants were not knowing what to do and anticipatory concerns. The possible causes of these anticipatory concerns include (i) most patients with COVID‐19 in primary care settings presenting with common and mild symptoms, such as fever and cough, 27 (ii) drastic changes in primary care practice, from chronic care to pandemic management, creating chaotic situations, 28 and (iii) lack in preparation and strong fear of infection 29 . In addition, staff in designated wards identified many sources of social support and used self‐management strategies to cope with the situation, 30 whereas our participants felt that they were not well supported.…”

Defining practice variation and exploring influencing factors on needs assessment in home care nursing: A Delphi study

“…In our study, home care nurses, in particular, participated less in the second and third Delphi rounds compared to the first round. The dropout in this group may be a result of the Covid‐19 pandemic, in which home care nurses generally experienced high work pressure (Veldhuizen et al, 2021). This high work pressure may have affected the panellists' interpretation and scores on several nurse context‐related factors such as ‘team workers' workload’ and ‘sufficient staff available’.…”

Exploring nurse‐sensitive patient outcomes in Dutch district nursing care: A survey study

“…While the DDNO survey was thoroughly developed and tested, the dropout rate was high. A possible explanation for this could be the length of the DDNO, which was relatively long, in combination with little time available in district nursing care due to COVID‐19 pandemic and pressing workforce shortages (Jarrín et al, 2019 ; Maybin et al, 2016 ; Veldhuizen, Zwakhalen, et al, 2021 ). It may be helpful for the next study with a lengthy survey to use (financial) incentives for participation, which effectively improves the response rate (Deutskens et al, 2004 ).…”