A Delphi Study on the Changes in Work, Organizational Culture, and Health Issues of Nurses at Tertiary Hospitals in South Korea during the COVID-19 Pandemic.

Nurses in South Korea experience high work intensity and poor working environments, which worsened during the COVID-19 pandemic. This study aimed to evaluate the work changes and grievances of nurses who provided direct care for patients at tertiary hospitals during the pandemic. The nurses' perceptions of their organizational culture and its impact on nurses' health were also explored. A three-round Delphi study was conducted with 36 expert group participants from six South Korean tertiary hospitals. Overall, 36, 35, and 33 participants responded in the first, second, and third rounds, respectively. Nursing work was divided into three categories: "work related to COVID-19-positive and close contacts," "work related to COVID-19 negative patients," and "work related to common nursing tasks." Organizational culture had the highest average for "increased compliance," followed by "increased conflict," "decreased collegiality," and "growing sense of community." The identified health problems of nurses during the pandemic were the highest for physical health, followed by mental and social health. These results showed that the workload and work intensity of hospital nurses increased significantly, and their physical, mental, and social health deteriorated during the pandemic. To overcome the crisis, the nursing organizational culture had a strong inclination to comply with the COVID-19-related guidelines with an increased sense of community. As conflicts between employees and departments grew, these were able to be overcome through trust and communication between departments, in which the nursing leadership played an important role. To protect the health and lives of people, it is important to secure skilled nurses in preparation for future disasters. In addition, support is needed to protect the safety and health of nurses and to cultivate effective nursing leadership.