Lessons Learned From the Deployment of Registered Nurses to Surged Intensive Care Units During the COVID-19 Pandemic: A Qualitative Study.

AIM

To explore the perspectives of nurse educators, clinical nurse educators and nurse specialists with regard to supporting the deployed registered nurses in Australian intensive care units during the COVID-19 pandemic surge.

DESIGN

A qualitative-descriptive study design was used.

METHODS

Intensive care nurse educators, clinical nurse educators and nurse specialists who had been involved with the preparation and support of nurses for deployment to intensive care units for COVID-19 surge were purposively recruited from around Australia. Data were collected through 18 semi-structured interviews and examined using thematic framework analysis of NVivo software.

RESULTS

Participants described a number of challenges related to surge deployment including the varied skill sets and inadequate preparation for deployed staff, lack of a clear scope of practice and their general reluctance to deploy to intensive care units. Mixed communication from hospital managers about the mandatory or voluntary nature of deployments and the plans for return of nurses to their usual place of work were also considered problematic. Conversely, factors that supported effective deployment included consistently deploying the same staff, scope of practice guides, task cards and colour coding to identify the experience of nurses. The burden of the pandemic, including variable waves of surge, infection control complexities and fear of caring for patients with COVID-19, influenced the participants' experiences and perspectives. Additionally, there was a significant personal toll for participants because of the increased load of supervising deployed staff and concerns related to accountability for nursing care, and personal and patient safety.

CONCLUSION

The deployment of nursing staff to intensive care units to support increased patient numbers is necessary during surge events. Having clarity about what role those nurses perform within intensive care units is essential in order to design training and support strategies that prepare them adequately so as not to place undue burden on an already strained intensive care nursing workforce.

IMPLICATIONS FOR THE PROFESSION

The toll of the COVID pandemic on ICU nurses was immense. This was further compounded by inadequate preparation and the strain of supporting deployed nurses in surged intensive care units.

IMPACT

This research outlines the lessons learned from deploying nurses into surged intensive care units in the Australian setting. Supporting deployed nurses places a significant burden on the intensive care team; this is heavier when there is uncertainty about the scope of deployed staff and accountability for patient safety. These findings contribute to the body of evidence that will assist in for planning more effective deployment strategies for future intensive care surge events.

REPORTING METHOD

Reporting complied with the COREQ criteria for qualitative research.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public contribution.