The impact of the COVID-19 pandemic on nursing practices and patient care

https://doi.org/10.53730/ijhs.v5nS1.15043

Authors

  • Dhiyaa Munawer Alanazi KSA, National Guard Health Affairs
  • Reem Saleh Alonaz KSA, National Guard Health Affairs
  • Mohammed Ali Alanazi KSA, National Guard Health Affairs
  • Hissah Abdulkarim Alqubaysi KSA, National Guard Health Affairs
  • Bader Majed Alotaibi KSA, National Guard Health Affairs
  • Abrar Fayadh Alshammari KSA, National Guard Health Affairs
  • Noor Abdulaziz Alzuhair KSA, National Guard Health Affairs
  • Amal Alhumidy Alenizi KSA, National Guard Health Affairs
  • Saleh Zuwayel Alenezi KSA, National Guard Health Affairs
  • Albandari Khudhayr Alshammari KSA, National Guard Health Affairs
  • Sami Mohammed Al Enazi KSA, National Guard Health Affairs
  • Mohammad Abdullah Almanna KSA, National Guard Health Affairs
  • Khalid Salem Alaboush KSA, National Guard Health Affairs
  • Fayez Khalaf Alanizi KSA, National Guard Health Affairs

Keywords:

COVID-19, nursing practices, patient care, personal protective equipment (PPE), psychosomatic disturbances, healthcare challenges, thematic analysis

Abstract

Background: The COVID-19 pandemic, which began in late 2019, rapidly escalated into a global crisis, profoundly affecting healthcare systems worldwide. Nurses, as frontline workers, faced significant challenges due to the overwhelming number of COVID-19 cases, strained resources, and heightened stress levels. Despite numerous publications addressing these issues, there is a need for a systematic review to synthesize credible findings and better understand the challenges faced by nurses. Aim: This review aims to examine the impact of the COVID-19 pandemic on nursing practices and patient care, focusing on the major challenges encountered by nurses during the pandemic and the implications for nursing practice. Methods: A narrative review was conducted based on a literature search that identified 22 relevant studies, including quantitative surveys, qualitative studies, and mixed-methods research. Thematic analysis was employed to identify and synthesize recurring themes from the studies, focusing on physical and mental exhaustion, PPE-related challenges, psychosomatic disturbances, and effective mitigating strategies. Results: Key themes identified include severe physical and mental exhaustion among nurses, challenges with PPE shortages and usability, widespread psychosomatic disturbances, and various factors that could alleviate these challenges. Nurses experienced significant stress, anxiety, and physical discomfort due to extended work hours and inadequate PPE. 

Downloads

Download data is not yet available.

References

World Health Organization. (2020, March 11). WHO Director-General’s opening remarks at the media briefing on COVID-19. https://www.who.int/dg/speeches/detail

Worldometers. (2020, September 6). Coronavirus pandemic. https://www.worldometers.info/coronavirus

Sarailoo, M., Matin, S., Vosoughi, M., Dargahi, A., Gholizadeh, H., & Rajabi Damavandi, M. (2020). Investigating the relationship between occupation and SARS-CoV2. Work. https://doi.org/10.3233/WOR-2020-0103

Garosi, E., Khosravi Danesh, M., & Mazloumi, A. (2020). Nurses and coronavirus: Challenges and consequences. Iran Occupational Health, 17(1), 1-6. https://doi.org/10.22038/iosh.2020.43357.1291

Rajkumar, R. P. (2020). COVID-19 and mental health: A review of the existing literature. Asian Journal of Psychiatry. https://doi.org/10.1016/j.ajp.2020.102066

Liu, Q., Luo, D., Haase, J. E., Guo, Q., Wang, X. Q., Liu, S., et al. (2020). The experiences of health-care providers during the COVID-19 crisis in China: A qualitative study. Lancet Global Health. https://doi.org/10.1016/S2214-109X(20)30389-5

Sun, N., Shi, S., Jiao, D., Song, R., Ma, L., Wang, H., et al. (2020). A qualitative study on the psychological experience of caregivers of COVID-19 patients. American Journal of Infection Control. https://doi.org/10.1016/j.ajic.2020.06.007

Cai, H., Tu, B., Ma, J., Chen, L., Fu, L., Jiang, Y., et al. (2020). Psychological impact and coping strategies of frontline medical staff in Hunan between January and March 2020 during the outbreak of coronavirus disease 2019 (COVID-19) in Hubei, China. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 26, e924171. https://doi.org/10.12659/MSM.924171

Hick, J. L., Hanfling, D., Wynia, M. K., & Pavia, A. T. (2020). Duty to plan: Health care, crisis standards of care, and novel coronavirus SARS-CoV-2. NAM Perspectives. https://doi.org/10.31478/202003c

Wang, J., Zhou, M., & Liu, F. (2020). Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. Journal of Hospital Infection, 105(1), 100-1. https://doi.org/10.1016/j.jhin.2020.03.004

Shanafelt, T., Ripp, J., & Trockel, M. (2020). Understanding and addressing sources of anxiety among health care professionals during the COVID-19 pandemic. JAMA. https://doi.org/10.1001/jama.2020.5893

Zarocostas, J. (2020). How to fight an infodemic. The Lancet, 395(10225), 676. https://doi.org/10.1016/S0140-6736(20)30461-X

Ferrari, R. (2015). Writing narrative style literature reviews. Medical Writing, 24(4), 230-5. https://doi.org/10.1179/2047480615Z.000000000328

Lan, J., Song, Z., Miao, X., Li, H., Li, Y., Dong, L., et al. (2020). Skin damage among health care workers managing coronavirus disease-2019. Journal of the American Academy of Dermatology, 82(5), 1215-6. https://doi.org/10.1016/j.jaad.2020.03.014

Vaismoradi, M., Jones, J., Turunen, H., & Snelgrove, S. (2016). Theme development in qualitative content analysis and thematic analysis. Journal of Nursing & Healthcare of Chronic Illness, 8(1), 50-9. https://doi.org/10.1111/jonh.12172

Miles, M. B., Huberman, A. M., & Saldana, J. (2018). Qualitative data analysis: A methods sourcebook (4th ed.). Sage Publications.

Zhou, M., Tang, F., Wang, Y., Nie, H., Zhang, L., You, G., et al. (2020). Knowledge, attitude, and practice regarding COVID-19 among health care workers in Henan, China. Journal of Hospital Infection. https://doi.org/10.1016/j.jhin.2020.04.012

Mo, Y., Deng, L., Zhang, L., Lang, Q., Liao, C., Wang, N., et al. (2020). Work stress among Chinese nurses to support Wuhan for fighting against the COVID-19 epidemic. Journal of Nursing Management. https://doi.org/10.1111/jonm.13014

Saqlain, M., Munir, M. M., ur Rehman, S., Gulzar, A., Naz, S., Ahmed, Z., et al. (2020). Knowledge, attitude, practice and perceived barriers among healthcare professionals regarding COVID-19: A cross-sectional survey from Pakistan. Journal of Hospital Infection, 105(3), 419-23. https://doi.org/10.1016/j.jhin.2020.05.007

Zhang, X., Jiang, Z., Yuan, X., Wang, Y., Huang, D., Hu, R., et al. (2020). Nurses’ reports of actual work hours and preferred work hours per shift among frontline nurses during coronavirus disease 2019 (COVID-19) epidemic: A cross-sectional survey. International Journal of Nursing Studies, 108, 103635. https://doi.org/10.1016/j.ijnurstu.2020.103635

Liu, C., Yang, Y.-z., Zhang, X. M., Xu, X., Dou, Q.-L., & Zhang, W.-W. (2020). The prevalence and influencing factors for anxiety in medical workers fighting COVID-19 in China: A cross-sectional survey. medRxiv. https://doi.org/10.1101/2020.03.05.20032003

Yifan, T., Ying, L., Chunhong, G., Jing, S., Rong, W., Zhenyu, L., et al. (2020). Symptom cluster of ICU nurses treating COVID-19 pneumonia patients in Wuhan, China. Journal of Pain and Symptom Management. https://doi.org/10.1016/j.jpainsymman.2020.04.035

Yin, X., & Zeng, L. (2020). A study on the psychological needs of nurses caring for patients with coronavirus disease 2019 from the perspective of the existence, relatedness, and growth theory. International Journal of Nursing Sciences. https://doi.org/10.1016/j.ijnss.2020.04.00

Ong, J. J., Bharatendu, C., Goh, Y., Tang, J. Z., Sooi, K. W., Tan, Y. L., et al. (2020). Headaches associated with personal protective equipment–A cross-sectional study amongst frontline healthcare workers during COVID-19 (HAPPE Study). Headache: The Journal of Head and Face Pain. https://doi.org/10.1111/head.13811

Zhu, Z., Xu, S., Wang, H., Liu, Z., Wu, J., Li, G., et al. (2020). COVID-19 in Wuhan: Immediate psychological impact on 5062 health workers. medRxiv. https://doi.org/10.1101/2020.02.27.20028966

Chew, N. W., Lee, G. K., Tan, B. Y., Jing, M., Goh, Y., Ngiam, N. J., et al. (2020). A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain, Behavior, and Immunity. https://doi.org/10.1016/j.bbi.2020.04.049

Huang, Y., & Zhao, N. (2020). Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: A web-based cross-sectional survey. Psychiatry Research, 288, 112954. https://doi.org/10.1016/j.psychres.2020.112954

Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., et al. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976

Xiao, H., Zhang, Y., Kong, D., Li, S., & Yang, N. (2020). The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 26, e923549. https://doi.org/10.12659/MSM.923549

Jin, Y.-H., Huang, Q., Wang, Y.-Y., Zeng, X.-T., Luo, L.-S., Pan, Z.-Y., et al. (2020). Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: A cross-sectional survey. Military Medical Research, 7(1), 1-13. https://doi.org/10.1186/s40779-020-00243-1

Liu, C.-Y., Yang, Y.-z., Zhang, X.-M., Xu, X., Dou, Q.-L., & Zhang, W.-W. (2020). The prevalence and influencing factors for anxiety in medical workers fighting COVID-19 in China: A cross-sectional survey. Available at SSRN. https://doi.org/10.2139/ssrn.3548781

Kang, L., Ma, S., Chen, M., Yang, J., Wang, Y., Li, R., et al. (2020). Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain, Behavior, and Immunity. https://doi.org/10.1016/j.bbi.2020.03.028

Wu, Y., Wang, J., Luo, C., Hu, S., Lin, X., Anderson, A. E., et al. (2020). A comparison of burnout frequency among oncology physicians and nurses working on the front lines and usual wards during the COVID-19 epidemic in Wuhan, China. Journal of Pain and Symptom Management. https://doi.org/10.1016/j.jpainsymman.2020.06.020

Shi, Y., Wang, J., Yang, Y., Wang, Z., Wang, G., Hashimoto, K., et al. (2020). Knowledge and attitudes of medical staff in Chinese psychiatric hospitals regarding COVID-19. Brain, Behavior, & Immunity-Health, 100064. https://doi.org/10.1016/j.bbih.2020.100064

Giao, H., Han, N. T. N., Van Khanh, T., Ngan, V. K., Van Tam, V., & Le An, P. (2020). Knowledge and attitude toward COVID-19 among healthcare workers at District 2 Hospital, Ho Chi Minh City. Asian Pacific Journal of Tropical Medicine, 13(9), 36-40. https://doi.org/10.4103/1995-7645.288623

McGillis Hall, L., & Kashin, J. (2016). Public understanding of the role of nurses during Ebola. Journal of Nursing Scholarship, 48(1), 91-97. https://doi.org/10.1111/jnu.12195

Corley, A., Hammond, N. E., & Fraser, J. F. (2010). The experiences of health care workers employed in an Australian intensive care unit during the H1N1 influenza pandemic of 2009: A phenomenological study. International Journal of Nursing Studies, 47(5), 577-585. https://doi.org/10.1016/j.ijnurstu.2009.10.002

Kang, H. S., Son, Y. D., Chae, S. M., & Corte, C. (2018). Working experiences of nurses during the Middle East respiratory syndrome outbreak. International Journal of Nursing Practice, 24(5), e12664. https://doi.org/10.1111/ijn.12664

Shih, F.-J., Gau, M.-L., Kao, C.-C., Yang, C.-Y., Lin, Y.-S., & Liao, Y.-C. (2007). Dying and caring on the edge: Taiwan’s surviving nurses’ reflections on taking care of patients with severe acute respiratory syndrome. Applied Nursing Research, 20(4), 171-180. https://doi.org/10.1016/j.apnr.2006.07.004

Scott, L. D., Rogers, A. E., Hwang, W.-T., & Zhang, Y. (2006). Effects of critical care nurses’ work hours on vigilance and patients’ safety. American Journal of Critical Care, 15(1), 30-37. https://doi.org/10.4037/ajcc2006.15.1.30

Erland, E., & Dahl, B. (2017). Midwives’ experiences of caring for pregnant women admitted to Ebola centres in Sierra Leone. Midwifery, 55, 23-28. https://doi.org/10.1016/j.midw.2017.09.011

Ives, J., Greenfield, S., Parry, J. M., Draper, H., Gratus, C., & Petts, J. I. (2009). Healthcare workers’ attitudes to working during pandemic influenza: A qualitative study. BMC Public Health, 9(1), 56. https://doi.org/10.1186/1471-2458-9-56

Imai, T., Takahashi, K., Hoshuyama, T., Hasegawa, N., Lim, M. K., & Koh, D. (2005). SARS risk perceptions in healthcare workers, Japan. Emerging Infectious Diseases, 11(3), 404-410. https://doi.org/10.3201/eid1103.040671

Bell, S. A., Munro-Kramer, M. L., Eisenberg, M. C., Williams, G., Amarah, P., & Lori, J. R. (2017). “Ebola kills generations”: Qualitative discussions with Liberian healthcare providers. Midwifery, 45, 44-49. https://doi.org/10.1016/j.midw.2016.12.013

Stirling, B., Hatcher, J., & Harmston, J. (2017). Communicating the changing role of a nurse in an epidemic: The example of the MERS-CoV outbreak in Saudi Arabia. Journal of Healthcare Communications, 2(3), 30-36. https://doi.org/10.4172/2472-1654.100103

Lam, K. K., & Hung, S. Y. M. (2013). Perceptions of emergency nurses during the human swine influenza outbreak: A qualitative study. International Emergency Nursing, 21(4), 240-246. https://doi.org/10.1016/j.ienj.2012.09.002

Kim, Y. (2018). Nurses’ experiences of care for patients with Middle East respiratory syndrome-coronavirus in South Korea. American Journal of Infection Control, 46(7), 781-787. https://doi.org/10.1016/j.ajic.2018.01.017

Loeb, M., McGeer, A., Henry, B., Ofner, M., Rose, D., Hlywka, T., et al. (2004). SARS among critical care nurses, Toronto. Emerging Infectious Diseases, 10(2), 251-255. https://doi.org/10.3201/eid1002.030655

Maunder, R. G., Lancee, W. J., Balderson, K. E., Bennett, J. P., Borgundvaag, B., Evans, S., et al. (2006). Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerging Infectious Diseases, 12(12), 1924-1932. https://doi.org/10.3201/eid1212.060584

Oh, N., Hong, N., Ryu, D. H., Bae, S. G., Kam, S., & Kim, K.-Y. (2017). Exploring nursing intention, stress, and professionalism in response to infectious disease emergencies: The experience of local public hospital nurses during the 2015 MERS outbreak in South Korea. Asian Nursing Research, 11(3), 230-236. https://doi.org/10.1016/j.anr.2017.08.001

Imai, T., Takahashi, K., Todoroki, M., Kunishima, H., Hoshuyama, T., & Ide, R. (2008). Perception in relation to a potential influenza pandemic among healthcare workers in Japan: Implications for preparedness. Journal of Occupational Health, 50(1), 13-23. https://doi.org/10.1539/joh.50.13

Wong, T. Y., Koh, G. C., Cheong, S. K., Lee, H. Y., Fong, Y. T., Sundram, M., et al. (2008). Concerns, perceived impact and preparedness in an avian influenza pandemic–a comparative study between healthcare workers in primary and tertiary care. Annals of the Academy of Medicine, Singapore, 37(2), 96-101.

Kim, J. S., & Choi, J. S. (2016). Factors influencing emergency nurses’ burnout during an outbreak of Middle East Respiratory Syndrome Coronavirus in Korea. Asian Nursing Research, 10(4), 295-299. https://doi.org/10.1016/j.anr.2016.08.004

Chung, B. P. M., Wong, T. K. S., Suen, E. S. B., & Chung, J. W. Y. (2005). SARS: Caring for patients in Hong Kong. Journal of Clinical Nursing, 14(4), 510-517. https://doi.org/10.1111/j.1365-2702.2005.01197.x

Choi, S. P. P., Cheung, K., & Pang, S. M. C. (2013). Attributes of nursing work environment as predictors of registered nurses’ job satisfaction and intention to leave. Journal of Nursing Management, 21(3), 429-439. https://doi.org/10.1111/jonm.12012

Maunder, R., Hunter, J., Vincent, L., Bennett, J., Peladeau, N., Leszcz, M., et al. (2003). The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ, 168(10), 1245-1251. https://doi.org/10.1503/cmaj.1031077

Danesh, M. K., Garosi, E., Mazloumi, A., & Najafi, S. (2020). Identifying factors influencing cardiac care nurses’ work ability within the framework of system engineering initiative for patient safety. Work. https://doi.org/10.3233/WOR-203210

Tzeng, H.-M., & Yin, C.-Y. (2006). Nurses’ fears and professional obligations concerning possible human-to-human avian flu. Nursing Ethics, 13(5), 455-470. https://doi.org/10.1177/0969733006070436

Brug, J., Aro, A. R., Oenema, A., De Zwart, O., Richardus, J. H., & Bishop, G. D. (2004). SARS risk perception, knowledge, precautions, and information sources, the Netherlands. Emerging Infectious Diseases, 10(8), 1486-1491. https://doi.org/10.3201/eid1008.040167

Leiba, A., Goldberg, A., Hourvitz, A., Amsalem, Y., Aran, A., Weiss, G., et al. (2006). Lessons learned from clinical anthrax drills: Evaluation of knowledge and preparedness for a bioterrorist threat in Israeli emergency departments. Annals of Emergency Medicine, 48(2), 194-199. e2. https://doi.org/10.1016/j.annemergmed.2006.01.020

Vinson, E. (2007). Managing bioterrorism mass casualties in an emergency department: Lessons learned from a rural community hospital disaster drill. Disaster Management & Response, 5(1), 18-21. https://doi.org/10.1016/j.dmr.2007.01.005

Leigh, L., Taylor, C., Glassman, T., Thompson, A., & Sheu, J. J. (2020). A cross-sectional examination on the factors related to emergency nurses’ motivation to protect themselves against an Ebola infection. Journal of Emergency Nursing. https://doi.org/10.1016/j.jen.2020.01.005

Do Rosario Costa, N., Bellas, H., da Silva, P. R. F., de Carvalho, P. V. R., Uhr, D., Vieira, C., et al. (2020). Community health workers’ attitudes, practices and perceptions towards the COVID-19 pandemic in Brazilian low-income communities. Work. https://doi.org/10.3233/WOR-203210

Published

15-01-2021

How to Cite

Alanazi, D. M., Alonaz, R. S., Alanazi, M. A., Alqubaysi, H. A., Alotaibi, B. M., Alshammari, A. F., Alzuhair, N. A., Alenizi, A. A., Alenezi, S. Z., Alshammari, A. K., Al Enazi, S. M., Almanna, M. A., Alaboush, K. S., & Alanizi, F. K. (2021). The impact of the COVID-19 pandemic on nursing practices and patient care. International Journal of Health Sciences, 5(S1), 1029–1048. https://doi.org/10.53730/ijhs.v5nS1.15043

Issue

Section

Peer Review Articles

Most read articles by the same author(s)

1 2 > >>