注册护士在 COVID-19 大流行期间在重症监护病房工作的体验。
Registered nurses' experiences of working in the intensive care unit during the COVID-19 pandemic.
机构信息
Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
Department for Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.
出版信息
Nurs Crit Care. 2021 Nov;26(6):467-475. doi: 10.1111/nicc.12649. Epub 2021 May 10.
BACKGROUND
During the pandemic, increased numbers of patients requiring intensive care unit (ICU) admission required an increase in ICU capacity, including ICU staffing with competence to care for critically ill patients. Consequently, nurses from acute care areas were called in to staff the ICU along with experienced intensive care nurses.
AIMS AND OBJECTIVES
To describe Swedish registered nurses' experiences of caring for patients with COVID-19 in ICUs during the pandemic.
DESIGN
Mixed method survey design.
METHODS
An online questionnaire was distributed through social media to registered nurses who had been working in the ICU during the COVID-19 outbreak. Data were collected for 1 week (May 2020) and analysed using content analysis and descriptive statistics.
RESULTS
Of the 282 nurses who participated, the majority were ICU nurses (n = 151; 54%). Half of the nurses specialized in ICU reported that they were responsible for the ICU care of three or more patients during the pandemic (n = 75; 50%). Among non-intensive care nurses, only 19% received introduction to the COVID-19 ICU (n = 26). The analysis of data regarding nurses' experiences resulted in three categories: tumbling into chaos, diminished nursing care, and transition into pandemic ICU care. Participants described how patient safety and care quality were compromised, and that nursing care was severely deprioritized during the pandemic. The situation of not being able to provide nursing care resulted in ethical stress. Furthermore, an increased workload and worsened work environment affected nurses' health and well-being.
CONCLUSIONS
The findings from the present study indicate that nurses perceived that patient safety and quality of care were compromised during the pandemic. This resulted in ethical stress among nurses, which may have affected their physical and psychosocial well-being.
RELEVANCE TO CLINICAL PRACTICE
The COVID-19 pandemic had a severe impact on nurses' work environment, which could result in burnout and staff turnover.
背景
在大流行期间，需要入住重症监护病房（ICU）的患者数量增加，这需要增加 ICU 容量，包括具备照顾重症患者能力的 ICU 工作人员。因此，从急症区调来护士与经验丰富的重症监护护士一起为 ICU 提供人员。
目的和目标
描述瑞典注册护士在大流行期间在 ICU 照顾 COVID-19 患者的经验。
设计
混合方法调查设计。
方法
通过社交媒体向在 COVID-19 爆发期间在 ICU 工作的注册护士分发在线问卷。数据收集了 1 周（2020 年 5 月），并使用内容分析和描述性统计进行分析。
结果
在 282 名参与的护士中，大多数是 ICU 护士（n=151；54%）。有一半的 ICU 护士报告说，在大流行期间，他们负责 3 名或更多患者的 ICU 护理（n=75；50%）。在非重症监护护士中，只有 19%（n=26）接受过 COVID-19 ICU 的介绍。对护士经验数据的分析产生了三个类别：陷入混乱、护理质量下降和过渡到大流行期间的 ICU 护理。参与者描述了如何危及患者安全和护理质量，以及在大流行期间护理严重被忽视。无法提供护理的情况导致了伦理压力。此外，工作量增加和工作环境恶化影响了护士的健康和福祉。
结论
本研究的结果表明，护士认为患者安全和护理质量在大流行期间受到了损害。这导致护士产生了伦理压力，可能影响了他们的身心健康。
临床相关性
COVID-19 大流行对护士的工作环境产生了严重影响，可能导致倦怠和人员流失。
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