Voices from the COVID‐19 frontline: Nurses’ trauma and coping

Abstract

Aim To describe the experiences of frontline nurses who are working in critical care areas during the COVID‐19 pandemic with a focus on trauma and the use of substances as a coping mechanism. Design A qualitative study based on content analysis. Methods Data were collected from mid‐June 2020 to early September 2020 via an online survey. Nurses were recruited through the research webpage of the American Association of Critical Care Nurses as well as an alumni list from a large, public Midwest university. Responses to two open‐ended items were analysed: (1) personal or professional trauma the nurse had experienced; and (2) substance or alcohol use, or other mental health issues the nurse had experienced or witnessed in other nurses. Results For the item related to psychological trauma five themes were identified from 70 nurses’ comments: (1) Psychological distress in multiple forms; (2) Tsunami of death; (3) Torn between two masters; (4) Betrayal; and (5) Resiliency/posttraumatic growth through self and others. Sixty‐five nurses responded to the second item related to substance use and other mental health issues. Data supported three themes: (1) Mental health crisis NOW!!: ‘more stressed than ever and stretched thinner than ever’; (2) Nurses are turning to a variety of substances to cope; and (3) Weakened supports for coping and increased maladaptive coping due to ongoing pandemic. Conclusions This study brings novel findings to understand the experiences of nurses who care for patients with COVID‐19, including trauma experienced during disasters, the use of substances to cope and the weakening of existing support systems. Findings also reveal nurses in crisis who are in need of mental health services. Impact Support for nurses’ well‐being and mental health should include current and ongoing services offered by the organization and include screening for substance use issues.

A scoping review of COVID-19-related stress coping resources among nurses

“…Problem-based and emotion-based coping are well-known strategies to retrieve unwanted stress, which motivate self to modify the behaviors [ [40] , [41] , [42] ]. To cope psychologically with the stress of the ongoing epidemic, nurses said they had to create new ways of coping or change their pre-existing routines [ 43 ]. Self-care strategies included quiet prayer and meditation, exercise, crafts, virtual meetings with friends, time spent with loved ones, and a commitment to continue one's nursing education to make them resilient in the COVID-19 pandemic [ 44 ].…”

The lived experience of frontline nurses: COVID‐19 in rural America

“…Recent studies also describe nurses' experience of moral distress and personal trauma while caring for dying patients, 21 , 22 , 23 need for mental health support and use of maladaptive coping mechanisms, such as substance use and alcohol. 24 However, others describe perseverance and development of resilience in the workplace 10 , 17 , 25 from teamwork, collegial support, and leader involvement. 19 , 26 …”

What Have We Lost?

“…Caregivers have exited from the workforce, experienced compromises in care provision, and dealt with the interpersonal stress of loss in the workplace and daily life. Coping mechanisms have included using substances, and there has been an increase in depression and anxiety (Foli et al, 2021). The effects of the COVID-19 crisis have been a powerful, global influence on psychiatric nursing practice and on nurses coping with stress and loss personally and with their patients (Labrague & De los Santos, 2020).…”

“…Nurses have watched COVID-19 be indiscriminating and take from all, including the physically healthy, youthful, and those not usually at risk for physical health complications (McCallum et al, 2021). This grief has altered nurses’ ability to tap into their resilience as they cope with the pandemic professionally and personally (Foli et al, 2021).…”

“…The pandemic has weakened supports for coping and increased maladaptive coping. The pandemic has also resulted in many nurses questioning their work, its meaning, and the interpersonal costs and benefits (Foli et al, 2021).…”