One-year follow-up of hospital nurses' work experiences during the COVID-19 pandemic: A qualitative study.

AIM: To follow up on the experiences of Registered Nurses (RNs) working after 1 year of the COVID-19 pandemic in Canadian and American hospitals. DESIGN: Semi-structured interviews were conducted, and transcripts were analysed through a reflexive thematic analysis (RTA). METHODS: RNs (n = 19) first interviewed in the spring of 2020 were re-interviewed 1 year after their original interviews (May 25, 2021-June 25, 2021). Participants consisted of nurses residing in Canada and working in Ontario (n = 12) or American hospitals (n = 7), i.e., both local and cross-border nurses. RESULTS: Five themes were identified: (1) "You call us heroes, but you forgot us": Nurses described experiences of disrespect and stigma from their communities, their government, and their workplaces. (2) "A whole new level of busy": Nurses reported stressors both at home and at work that had increased exponentially throughout the pandemic. (3) "Running on empty": Nurses described burnout and mental health struggles including depression, irritation, and suicidal ideation; they coped using both adaptive and maladaptive strategies. (4) "The job of nursing is painful": Ongoing pandemic issues led nurses to re-evaluate their commitments to their units, their hospitals and the profession itself. (5) "Surviving an un-survivable day": Nurses shared positive moments at work and home that helped give them the strength to carry on. CONCLUSION: Significant investments will be required from hospital organizations and governments to ensure that healthcare systems continue to function safely for patients, their families and nurses. IMPACT: The purpose of this study was to understand and describe nurses' experiences after 1 year of working during the COVID-19 pandemic. Nurses reported feeling disrespected, overwhelmed, and burned out; many were looking to leave the profession. These findings will be of interest to nurses working on the frontline of the pandemic as well as hospital managers and policy makers. NO PATIENT OR PUBLIC CONTRIBUTION: In this investigation, nurses were the participants.

"I Called us the Sacrificial Lambs": Experiences of Nurses Working in Border City Hospitals During the First Wave of the COVID-19 Pandemic.

BACKGROUND: The first wave of the COVID-19 pandemic had a significant impact on the personal and professional lives of frontline nurses. PURPOSE: The purpose of this descriptive phenomenological study was to explore the experiences of Canadian Registered Nurses (RNs) working in Ontario or United States hospitals during the first wave of the COVID-19 pandemic. METHODS: Semi-structured interviews were conducted with 36 RNs living in Ontario and employed either at an Ontario or United States hospital. Three main themes were identified across both healthcare contexts. RESULTS: 1) The Initial Response to the pandemic included a rapid onset of chaos and confusion, with significant changes in structure and patient care, often exacerbated by hospital management. Ethical concerns arose (e.g., redeployment, allocation of resources) and participants described negative emotional reactions. 2) Nurses described Managing the Pandemic by finding new ways to nurse and enhanced teamwork/camaraderie; they reported both struggle and resiliency while trying to maintain work and home life balance. Community responses were met with both appreciation and stigma. 3) Participants said they were Looking Forward to a "new normal", taking pride in patient improvements, accomplishments, and silver linings, with tempered optimism about the future. Many expressed a reaffirmation of their identities as nurses. Differences between participants working in the US and those working in Ontario were noted in several areas (e.g., initial levels of chaos, ethical concerns, community stigma). CONCLUSIONS: The COVID-19 pandemic has been very difficult for nursing as a profession. Close attention to post-pandemic issues is warranted.

Strategies for talent engagement and retention of Brazilian Nursing professionals.

OBJECTIVE: To reflect on how human resource health managers and talent managers may engage and retain experienced nursing professionals in Brazil. METHODS: Reflection based on studies on global and Brazilian-specific nursing professionals and retention, before and during the COVID-19 pandemic. RESULTS: The pandemic worsened working conditions for all health professionals. Nursing professionals were particularly affected. Nurses have been viewed as "heroes" and "essential" frontline workers during the COVID-19 pandemic. However, despite the universal praise for their efforts, it seems uncertain if they were actually considered and managed like talent. FINAL CONSIDERATIONS: In order to develop a sustainable healthcare system supported by sufficient experienced nursing talent, healthcare human resource managers and talent managers must develop and implement impactful nursing talent retention and engagement strategies. We highlight possible strategies targeting experienced nursing talent that will help to sustain the Brazilian healthcare system, post-pandemic.

Practical strategies and the need for psychological support: recommendations from nurses working in hospitals during the COVID-19 pandemic.

PURPOSE: Nurses working during the coronavirus disease 2019 (COVID-19) pandemic have reported elevated levels of anxiety, burnout and sleep disruption. Hospital administrators are in a unique position to mitigate or exacerbate stressful working conditions. The goal of this study was to capture the recommendations of nurses providing frontline care during the pandemic. DESIGN/METHODOLOGY/APPROACH: Semi-structured interviews were conducted during the first wave of the COVID-19 pandemic, with 36 nurses living in Canada and working in Canada or the United States. FINDINGS: The following recommendations were identified from reflexive thematic analysis of interview transcripts: (1) The nurses emphasized the need for a leadership style that embodied visibility, availability and careful planning. (2) Information overload contributed to stress, and participants appealed for clear, consistent and transparent communication. (3) A more resilient healthcare supply chain was required to safeguard the distribution of equipment, supplies and medications. (4) Clear communication of policies related to sick leave, pay equity and workload was necessary. (5) Equity should be considered, particularly with regard to redeployment. (6) Nurses wanted psychological support offered by trusted providers, managers and peers. PRACTICAL IMPLICATIONS: Over-reliance on employee assistance programmes and other individualized approaches to virtual care were not well-received. An integrative systems-based approach is needed to address the multifaceted mental health outcomes and reduce the deleterious impact of the COVID-19 pandemic on the nursing workforce. ORIGINALITY/VALUE: Results of this study capture the recommendations made by nurses during in-depth interviews conducted early in the COVID-19 pandemic.

"My problems aren't severe enough to seek help": Stress levels and use of mental health supports by Canadian hospital employees during the COVID-19 pandemic.

Due to the unique set of stressors associated with the COVID-19 pandemic, healthcare workers in acute care settings may be facing elevated rates of mental health symptomatology. The purpose of this study was to assess levels of depression, anxiety, and stress in a sample of healthcare employees working in hospitals and their use of formal and informal mental health supports. Data was gathered over a three-week period in December 2020 as COVID cases began to rise sharply in Ontario, Canada. Results from an online survey of 650 healthcare employees suggested that overall levels of depression, anxiety, and stress were mild. However, a significant minority of participants reported severe or extremely severe levels of depression (14.4%), anxiety (21.8%), and stress (13.5%). Levels of distress were higher among women, younger participants, those who did not work directly with COVID+ patients, and those who were redeployed. Use of formal mental health supports (e.g., Employee Assistance Plans, teletherapy) was very low (<10%), with the most frequently-reported reason for not using supports being "problems not severe enough to require this service". Implications are considered for healthcare policy decisions as hospital systems attempt to address the mental health needs of their employees.