A mixed methods study: The grief experience of registered nurses working on the frontlines during the COVID-19 pandemic.

AIM AND OBJECTIVE: The purpose of this study was to generate a conceptual definition and theory of grief for nurses working on the frontlines during the COVID-19 pandemic using grounded theory methodology. BACKGROUND: The COVID-19 pandemic has had a negative impact on nurses working on the frontlines. The increasing flow of diagnosed COVID-19 cases, diverse unknowns and demands in the treatment of patients with COVID-19, and depression related to countless deaths can trigger grief experiences. DESIGN: A mixed methods approach, including the qualitative method of grounded theory and a quantitative 30-question survey, was used in this study. METHODS: Eight focus group sessions were conducted with registered nurses working on the frontlines during the pandemic. Sessions were audio recorded and analysed using constant comparative data analysis. Following the interviews, a survey including demographics and self-report inventories was completed by participants. The COREQ checklist was used to assess study quality. RESULTS: Major concepts that emerged include 'facing a new reality', 'frustrations', 'stress' and 'coping'. Core concepts were combined into a conceptual definition of grief and a grounded theory of the experience of nurses working on the frontlines during the pandemic. Cross comparisons of qualitative and quantitative findings were made and compared with the literature. CONCLUSIONS: This study provides a better understanding of the grief experience of nurses working on the frontlines during the COVID-19 pandemic. It is necessary to recognise professional grief and develop intervention strategies that lead to grief reconciliation. RELEVANCE TO CLINICAL PRACTICE: Findings provide useful insights for healthcare administrators to provide support and develop interventions to reduce frustrations and stress of frontline registered nurses. PATIENT OR PUBLIC CONTRIBUTION: This study design involved registered nurses participating in focus group sessions. Participants detailed their experience working on the frontlines of the COVID-19 pandemic with patients, family and hospital administration.

Lessons Learned in Abruptly Switching from In-Person to Remote Data Collection in Light of the COVID-19 Pandemic

In light of the COVID-19 pandemic, a research study that utilized in-person focus groups to collect qualitative data was abruptly shifted to videoconference focus groups to minimize risk to subjects. Protocol amendments consisted of using an online scheduling tool to arrange focus groups by Zoom, providing electronic versions of consent forms and demographic surveys, and highlighting security features of the videoconference software. Lessons were learned from making an abrupt switch from in-person to remote focus groups. Making this type of shift is not simply a matter of switching for researcher convenience but includes determining the appropriateness of an abrupt switch for the research population of interest, fully understanding videoconference software best practices, decreasing focus group sizes, and increasing the incentive for participation.