Intensive care nurses’ experiences of working during the COVID-19 pandemic: : A Qualitative Metasynthesis

Abstract: Background: COVID-19 was declared a pandemic by WHO in March 2020. Intensive care nurses challenges were to treat critically ill infected with the virus, were the knowledge of treatment, protective gear, spread of infection and mortality was unknown. They were unsure about how the pandemic would progress and the information was inexplicit. To work as an intensive care nurse during a pandemic can lead to negative experiences and psychological distress.  Motive: By analyzing and describe experiences of working during the COVID-19 pandemic, a deeper understanding is created and can be used as basis for creating new and improved routines.   Aim: To describe intensive care nurses’ experiences of working during the COVID-19 pandemic.  Methods: Metasynthesis, sample process inspired by the SBU: s method. The databases PsycINFO, Cinahl and PubMed were used. Inclusion criteria; qualitative method including intensive care/critical care nurses, nurses working with COVID-19 patients that requires intensive care, and that the study includes experiences of working during the COVID-19 pandemic, Moderate quality according to the SBU: s Quality audit, Peer-reviewed and written in English or Swedish.  Result: The analysis was made using qualitative content analysis. Resulted in five categories; Organizational challenges, Effect on life outside the intensive care unit, Challenges of using the personal protective gear, A struggle to keep up motivation, and Challenges in providing holistic care with fourteen subcategories.  Conclusion: Intensive care nurses experienced that the COVID-19 pandemic affected them both mentally, physically, inside and outside the hospital. They experienced lack of support from the organization, struggles with the constant changes, lack of education and experience, heavy workload, fear of getting infected or infection one’s own family, lack of and use of personal protective gear. This effected the care the patient and the patients’ family in a negative way. Despite this the intensive care nurse had hope for the future and professional pride.