Critical care nurses role and scope of practice during a global crisis: a qualitative study.

BACKGROUND

Critical care nurses (CCNs) role and scope of practice include advanced nursing care for acute and critically ill patients and patients significant others. Before the pandemic, it was well-known that there was a shortage of nurses globally and a need to invest in greater self-sufficiency of nurses. The borders closed at the start of the pandemic in Norway and intensive care units were challenged with increased numbers of seriously ill patients and a shortage of CCNs. This study aimed to explore how CCNs experienced their role and scope of practice during the COVID-19 crisis in Norway.

METHODS

The study had a descriptive explorative design. Individual semi-structured interviews were conducted with fourteen CCNs working in five intensive care units from four hospitals during the pandemic in Norway. The interviews were analysed using Braun and Clarkes six-phase approach to thematic analysis.

RESULTS

The CCNs described their role and scope of clinical practice with promoting safe critical care nursing, competence in critical care nursing and their moral responsibility during the COVID-19 crisis in Norway. Promoting safe critical care nursing was challenged with. Competence in critical care nursing was useful in caring for patients with COVID-19 and in collaboration with less experienced and allocated healthcare professionals. The moral responsibility of a CCN is to contribute during a national crisis and to promote a patient and family-centred environment.

CONCLUSIONS

This study aimed to explore critical care nurses experience of their role and scope of practice when caring for patients with COVID-19 during the pandemic in Norway. The findings revealed a need to acknowledge the unique broad competence and moral responsibility of CCNs in caring for ICU patients when an unknown virus led to the lockdown of a country such as Norway. Moreover, the CCNs role and scope of a wide variety of responsibilities needs to be addressed, and their strong sense of duty needs attention and support. A sustainable qualified critical care workforce should be established and supported to prepare for future global crises.