Institute of Health & Neurodevelopment, College of Health & Life Sciences, Aston University, Birmingham, B4 7ET, UK.
Department of Psychiatry, University of Oxford, Oxford, UK.
Br J Health Psychol. 2023 Nov;28(4):914-929. doi: 10.1111/bjhp.12661. Epub 2023 Mar 30.
Evidence shows paediatric critical care (PCC) nurses display high rates of burnout, moral distress, symptoms associated with post-traumatic stress disorder (PTSD) and poor well-being. The COVID-19 pandemic magnified these pressures producing extremely challenging working conditions. The objective was to understand PCC nurses' lived experience of working during COVID-19 to determine the impact it had on their well-being.
A qualitative design was used with individual, semi-structured online interviews analysed using thematic analysis.
Ten nurses from six PCC units in England participated. Five themes were generated: (i) Challenges of working in Personal Protective Equipment (PPE), (ii) Adapting to redeployment to adult intensive care, (iii) Changes to staff working relationships, (iv) Being unable to attain work-life balance and (v) Unprocessed traumatic experiences of working in COVID-19. It was clear COVID-19 presented novel challenges to PCC nurses' well-being. With those came enforced changes in practice; some were temporary, for example use of PPE and redeployment, but others provided insight into the prerequisites for good staff well-being, for example strong professional relationships, work-life balance and managing one's psychological health.
Findings show authentic connections between peers, verbal and non-verbal communication and a sense of belonging were crucial to nurses' well-being. A dent in PCC nurses' perceived competence significantly affected their well-being. Finally, staff need a psychologically safe space to process distress and trauma experienced during COVID-19. Future research needs to test evidence-based, theoretically-informed well-being interventions to improve and maintain PCC nurses' well-being.
有证据表明，儿科重症监护（PCC）护士表现出高 burnout 率、道德困境、与创伤后应激障碍（PTSD）相关的症状和较差的幸福感。COVID-19 大流行加剧了这些压力，产生了极其具有挑战性的工作条件。目的是了解 PCC 护士在 COVID-19 期间的工作体验，以确定其对幸福感的影响。
采用定性设计，对来自英格兰六个 PCC 单位的 10 名护士进行了个体、半结构化在线访谈，并使用主题分析进行了分析。
来自英格兰六个 PCC 单位的 10 名护士参与了研究。生成了五个主题：（i）在个人防护设备（PPE）中工作的挑战，（ii）适应成人重症监护室的重新部署，（iii）员工工作关系的变化，（iv）无法实现工作与生活的平衡，（v）在 COVID-19 中工作的未处理的创伤经历。很明显，COVID-19 对 PCC 护士的幸福感提出了新的挑战。随之而来的是对实践的强制性改变；有些是暂时的，例如使用 PPE 和重新部署，但有些则为良好员工幸福感的必要条件提供了启示，例如强大的专业关系、工作与生活的平衡以及管理心理健康。
研究结果表明，同伴之间的真实联系、言语和非言语沟通以及归属感对护士的幸福感至关重要。PCC 护士感知能力的下降显著影响了他们的幸福感。最后，员工需要一个心理安全的空间来处理在 COVID-19 期间经历的痛苦和创伤。未来的研究需要测试基于证据、理论上有依据的幸福感干预措施，以改善和维持 PCC 护士的幸福感。
