Experiences of the Nursing Professionals Hospitalized by Covid-19 in Peru: Dawning Every Day Meant one More Chance to Live

Abstract

Introduction

Nursing professionals who contracted Covid-19 went from being caregivers to victims of the infection, and they knew first-hand how dangerous it could be. The impact on these health care professionals stayed with them even after their physical health recovered.

Objective

To understand the experiences of nursing professionals hospitalized with COVID-19, regarding their illness, hospitalization and care received.

Methods

Qualitative phenomenological study, with two in-depth interviews each with six nursing professionals who had representative cases from public hospitals in Lima, Peru, was chosen until theoretical saturation was achieved.

Results

Four main themes emerged from the transcripts of the 12 interviews conducted: self-assessment about the form of infection, identification and complications of the disease, feelings about the disease-hospitalization, and perception of the care received as a patient.

Conclusion

Being hospitalized as COVID-19 patients has been a difficult experience for nursing professionals, characterized by fear of dying; where the emotional support of their family and colleagues, as well as their spiritual strength, have allowed them to achieve their recovery, so they feel satisfied with the care received.

Introduction

Since the emergence of COVID-19 in Wuhan towards the end of 2019 and the beginning of 2020, health professionals, in every part of the world, were exposed to enormous pressure due to the complexity of such an unprecedented situation (Grupo de evaluación y seguimiento del Personal de Salud, 2020). At the highest peaks of the pandemic, due to the rapid increase in cases and deaths, the presence of anxiety, depression, and stress was common, especially in nurses, and in those working with suspected or confirmed cases of COVID-19 (Huarcaya-Victoria, 2020; Lozano-Vargas, 2020). In the aftermath of the pandemic, mental well-being represents a major psychological challenge for health professionals and for the general population (Rodriguez Cahill, 2020).

In addition to insomnia, depression, and anxiety, which were higher in females than in males and in nurses than in physicians (Lozano-Vargas, 2020), professionals were concerned about the possibility of becoming infected or transmitting the infection to their family and friends (Buchholz, 2020). While there are several studies about the impact of the pandemic on healthcare professionals, and scales have been developed or adapted to conduct quantitative studies, there is less research available about the impact on those who not only contracted COVID-19, but were also hospitalized because of it. This study addresses an under-researched topic since there are very few studies that address, from a qualitative approach, the feelings of nurses hospitalized by COVID-19 and no similar studies in which Peruvian nurses have participated.

Literature Review

In this context, many nursing professionals were infected, developed complications, and others died. A systematic review and meta-analysis based on the synthesis of 97 studies estimate that 48% of health professionals infected by COVID-19 were nurses (Gómez-Ochoa et al., 2021). The vulnerability of nurses was of concern because they lacked support and care (Ferreira do Nascimento et al., 2020). In Peru, as of January 2021, 7,780 nurses had been infected by COVID-19, and by October of the same year, 175 had died (Redacción, 2021). However, there are no formal studies that have focused their attention on the emotional health of infected nurses, based on a deeper knowledge of their lived experiences.

The meaning that a person attributes to reality makes sense out of his or her contact with the world. Both meaning and intentionality are the product of individual and intersubjective experiences; they are interpretations given by the human being to what is perceived and which give rise to critical capacity (De Souza Minayo, 2010).

While quantitative instruments have been developed and used to measure the impact of the pandemic on healthcare professionals, the experience of those who not only lived with the fear of catching COVID-19 but actually contracted the infection, and had to be hospitalized as a result, deserves further study. Such a life experience cannot be easily reduced to a quantitative scale, and thus a qualitative approach would provide a more complete analysis. A qualitative exploratory study with physicians and nurses in Iran diagnosed with COVID-19 highlighted themes of fear and anxiety, feeling abandoned during home quarantine and seeing recovery as a second chance (Moghimian et al., 2022). Similarly, a descriptive qualitative study with nurses from Turkey addressed their experiences when they were diagnosed with COVID-19, where the main emotions manifested were fear, sadness, anger, feelings of loneliness, frustration, depression, and fear of death during quarantine, as well as a consequent change in spirituality, relationships with others, and appreciation for life (Aydin & Bulut, 2021).

The aforementioned studies, which address the experiences of nurses diagnosed with COVID-19, were carried out in Asia, the Middle East, and Europe (Aydin & Bulut, 2021; He et al., 2021; Moghimian et al., 2022; Simeone et al., 2022). No similar studies were found in Peru or its neighboring countries. Therefore, considering the impact of the infection on nurses who went from being caregivers to being patients, and recognizing the need to document and present the facts from the perspective of the affected professionals within a Latin American context, this study arose with the aim of understanding the experiences of nurses hospitalized due to COVID-19 in Peru.

Methods

Design

This was a qualitative phenomenological study, in which the experiences lived by nurses who were hospitalized after being infected with COVID-19 were analyzed and interpreted. A qualitative approach was chosen considering that this situation is unprecedented in impact, evolution, and prognosis from any other occupational disease registered so far, thus rendering any existing quantitative instruments ineffective of capturing the totality of the experience. Specifically, in-depth interviews were used, and the busy nature of these professional's lives combined with the limitations of conducting a study during the COVID-19 social distancing measures led to splitting these interviews into two sessions of approximately 45 min each, with each participant. The interviews lasted 45 min because that is the time the zoom platform was available for each meeting. The first interview addressed the central themes, which were complemented in the second interview. This gave the participants and researchers the opportunity to review the initial transcript and then provide additional information to further explain the experience.

Research Questions

This study was born from the need to know: What life experiences and learning are presented by nursing professionals who were hospitalized for COVID-19?

Sample, Inclusion and Exclusion Criteria

Ten nursing professionals were chosen for this study, considering as selection criteria that they were employees of a public hospital in Lima, that they were attending COVID-19 patients, that they were themselves diagnosed with COVID-19 and hospitalized for this diagnosis (without having been admitted to the intensive care unit), and that they had been discharged from the hospital. Cases of nurses who were hospitalized under sedation and/or mechanical ventilators were excluded, as well as those who chose not to participate in the interview so as not to bring back memories of such a difficult experience. All participants were contacted through the professional nursing community in Lima. Of these, six participated in the study and the remaining four were not interviewed because the study reached saturation after the first six participants, which includes three male and three female nursing professionals. The expected saturation was achieved with five participants, but it was decided to interview six to have the equality of male and female participants.

There are studies in which collective or representative cases are appropriate for the understanding of a phenomenon where some cases will be more useful than others to achieve the objectives of the study either by typicity or representativeness (Stake, 1999). The sample size of this study is justifiable considering that when it comes to cases that provide rich information allowing a deep understanding of the topic, small groups of cases are allowed, which require greater commitment to the depth in the analysis of the information (Duque & Aristizábal, 2019).

Data Collection and Analysis

The in-depth interviews were conducted through virtual Zoom meetings, with two 45-min sessions for each participant, depending on their availability. A third meeting was held in order to confirm the accuracy of the transcripts and to collect any additional input.

The units of analysis were the feelings and experiences of the nursing professionals when they were diagnosed and hospitalized with COVID-19. The content of the interviews is presented in Table 1.

Table 1.

In-Depth Interview Plan.

Stages		Questions
Initial stage. Objective: to characterize the participant, contextualize the circumstances of his or her infection.	SESSION 1	In which hospital and in which service do you work? Since when?
		How was your work since the onset of the alarm condition?
		When and how did you learn that you were infected with COVID19?
		How and when do you think you became infected?
Central scenario. Objective: To explore the lived experiences of nursing professionals.		How did you feel when you were diagnosed positive?
	SESSION 2	How did your day-to-day life change from that moment on?
		What experiences did you have during that time of hospitalization?
		What is the most difficult thing you have had to face during your illness and hospitalization?
		What is the meaning of your profession from this event in your life?
Final stage. Objective: Check the gathered information and expand on the testimonies.	SESSION 3	(*) Review and checking of the accuracy of the transcripts by the participant. What other lived experiences or reflections about this could you share with us?

As the interviews were being conducted, the information collected was organized and the respective transcriptions were made, until, by unanimous agreement of the researchers, saturation was established when six participants had been interviewed, and manual analysis began from that point onwards. The 12 interviews (two for each participant) were conducted between April and June 2021.

The analysis, carried out by each researcher independently, followed the phenomenological interpretative analysis methodology (Duque & Aristizábal, 2019), fulfilling the following stages: (a) Initial comments from the reading and rereading of the transcripts, accompanied by the colorimetry method to highlight terms of relevance that could be considered labels as a first attempt at interpretation. (b) Identification of emerging themes, from step (a), with a higher level of abstraction. The emerging themes were grouped and sub-themes were added. (d) Tables of themes were elaborated with the transcription of relevant testimonies and their respective interpretations. (e) Writing up the results.

Interpretation triangulation was applied (Duque & Aristizábal, 2019): in the first phase, the researchers carried out the entire analysis process for each interview individually; in the second phase, four meetings were held to share the findings in terms of themes, sub-themes, and interpretations; to culminate in the third phase, unifying criteria were discussed. This entire procedure was carried out between July and December 2021.

Finally, in the discussion, the findings were triangulated with the literature consulted, under the consensus of the researchers. The male participants have been identified as M1, M2, and M3, while the female participants have been identified as W1, W2, and W3.

Ethical Aspects

The principle of autonomy was respected by requesting the informed consent of each participant. The principle of beneficence is reflected in the contribution of the testimonies to broaden scientific knowledge on the subject of the study. The study did not represent any harm to the participants and confidentiality was guaranteed. As a form of assistance to the informants who agreed to be interviewed, they were offered the services of a psychologist with free consultation.

Results

Three male and three female nurses working in public hospitals in Lima, with between 5 and 20 years of service and who had to be hospitalized for having contracted Covid-19 in the peak period of the pandemic, considered the first wave, while providing their services in Covid-19 areas: emergency, intensive care and hospitalization units, as shown in Table 2, participated in the study.

Table 2.

Covid-19 Areas in Which the Participants Were Working.

Female nurses		Male nurses
W1	Emergency supervisor	M1	Inpatient nurse
W2	Intensive care unit nurse	M2	Emergency nurse
W3	Inpatient nurse	M3	Emergency nurse

In the interviews with all six participants, the most frequently expressed feelings had to do with fear (15 times); of these, 13 were to express fear of dying. In addition, 11 times they referred to feeling bad, six times the word worry (they began to worry), and six times alone (when describing how, when hospitalized, they were alone, away from their loved ones). Other common words included six references to day(s) plus four awakenings and three dawns (to awaken or see that dawn was an important fact because it meant that they were alive), four fights, four emotional (related to emotional shock), and three calms (they sought to calm themselves down or other people encouraged them to do so). Likewise, their feelings were related to God (eight times) and their loved ones (brother 11, family 10, mom eight, son eight, partner five, husband three).

Four themes emerged: self-assessment about the form of infection, identification and complications of the disease, feelings about the disease-hospitalization, and perception of the care received as a patient. The themes and sub-themes are shown in Table 3.

Table 3.

Emerging Themes and Sub-themes.

Themes	Sub-themes
Self-assessment about the form of infection	Viral load Neglect or accident in biosafety measures
Identification and complications leading to hospitalization.	Failure to pay attention to the initial signs. Decreased oxygen saturation. Negative rapid test results
Feelings about illness-hospitalization	Felt fear, dread, distress Moral support Faith in God
Perception of care received as a hospitalized patient	Received care Self-care

Theme 1: Self-Assessment About the Form of Infection

Nursing professionals attribute the infection mainly to two causes: the viral load to which they were exposed for many hours in the workplace or to some oversight or accident in biosecurity measures in the workplace. It is worth mentioning that during the year 2020, there was a shortage of personal protective equipment (PPE) in Peru, many professionals had to buy their own PPE and others had to remain with the same PPE for 12 or even 24 h. It is also important to note that in public hospitals, the number of nursing professionals was considerably reduced, which created a crisis in the capacity to respond to the high increase in patient demand.

product of the work and exposure, it was no longer the viral load of each patient, it was the viral concentration, the viral concentration was exorbitant, too high! (W1)

too many patients, I went on my days off to support because I was understaffed … when I arrived to support surgery, it was the only day I used my simple mask, the only day! I'm pretty sure that was my mistake! (W2)

the work overload, … insufficient PPE, the KN-95 s broke, … on two occasions they broke, and I stapled them with this stapler, with a small piece of paper, and so I worked two shifts, and I think that, at this moment, I could have caught the infection. (W3)

it was by mistake when I went to lunch, I came back and did not realize that I had not put on my cap (…) I only went to work with my mask, glasses and helmet, and I had not realized that I had not put on my cap, … and we had had patients in shock trauma, we had intubated patients with COVID (M2)

Interestingly, the nurses stated that they were aware that they were going to get sick at any moment and were just waiting for that moment to come. This was because they were seeing how more and more often, one by one, the colleagues with whom they shared shifts were getting infected.

I was the only male left to be infected. (*laughter*) (M1)

sometimes I used to think that I wish I would get this disease, so I wouldn't have to worry about it - I said - at any moment it will be my turn. (M2)

I was well aware that at some point my biosecurity measure was going to fail, I knew it was going to fail at some point. (W2)

Theme 2: Identification and Complications Leading to Hospitalization

During the data collection period, due to the scarcity of diagnostic tests in public hospitals, only suspected cases of COVID were tested. Nurses who started their clinical picture with back pain or fever were diagnosed with other pathologies, receiving other treatments that were not recommended for COVID-19. The negative results of the rapid test contributed to this.

I came back with a dry cough and my back hurt, the doctor told me it was just bronchitis … a few days later I saturated 95%, she told me bronchitis, … I took my rapid test and she saw that it was negative … my 3 rapid tests that I had, I came out negative. (W3)

I did the rapid test and the molecular test, the rapid test was negative … and the molecular test (after two days) was positive. (M1)

I went for an x-ray … there was nothing … the doctor just gave me treatment for muscle pain … and the next day I came back with the same tests, so that's where she (the doctor) put me as a suspect for COVID. (M2)

I went back to the doctor to be seen and the doctor told me ‘do the rapid test and depending on the rapid test we will see how you are’, … it was negative … I still felt bad and they gave me nothing, not even paracetamol. (M3)

The decrease in oxygen saturation was the main indicator taken into account by the infected professionals to qualify their seriousness and go to the hospital; this was the trigger to be hospitalized.

I have reached 83, 82 saturation. (W1)

I went in with a saturation of 74 (W2)

I ended up crawling to my room … I wanted to breathe and I couldn't, I was saturated 85 (W3)

high fever, sweating, general malaise, I just couldn't do it anymore, I was saturating 92 (M1)

Lung CT scan showed varying degrees of pulmonary involvement, which was decisive at the time of hospitalization.

with the CT scan they did there… it showed that my lungs were already 80% compromised. (W3)

I have my CT scan and 40% of my lungs were compromised. (M1)

when I underwent a CT scan, I found that my lungs were 25 to 30% compromised, it was not very serious, but I did have pneumonia. (M2)

the tomography showed that I already had between 30, 35% of my lungs were compromised. (M3)

Theme 3: Feelings About Illness-Hospitalization

The nurses, as patients, did not want to end up on the mechanical ventilator and had to do their best to follow the instructions and self-care in order to contribute to their recovery.

it was my fight … not to go on the ventilator . .., I said ‘I'm not going to use the ventilator, it's not going to win me over’, so … I was calm and kept going… I was afraid to go to intubation, I was trying to breathe by myself. (W2)

it was desperate! because … I had to be in prone position, but just by moving I was short of breath and I got desperate … they had to put a nasogastric tube and feed me through there. (M1)

I did not tolerate prone position but I had to be strict about it. (M3)

The nurses felt fear, dread, anguish at the possibility of dying, and thinking of their loved ones who could not be near. Seeing death around them accentuated that possibility. The dawn of each day meant that they had one more chance to live. Even after they recovered, a dread of re-infection lingered on.

the feeling that one is going to die! … I was sleeping and I said, maybe … I always said goodbye, right? maybe I won't wake up anymore, because the saturation goes down, down, (…) then you feel that maybe it is the last evening, the last night (W1)

I am going to die, that's it, that's all I thought, I was afraid something would happen to me, my mother being far away…. I remember I told her, doctor, I prefer to die here at the hospital (where I work). (W3)

I held his hand tightly, I told him -doctor no, please don't let me die- (W2)

I was afraid that they would take me to the ICU and I would die there. (M3)

my fear was that I would die and never see my Mom again (W1)

I was worried about my family, about my children who are small … I would see patients who could be fine, right, and the next day they would get worse or die … I would wake up like this and look at myself and look around, I would say -I'm here, I'm still here, I'm still breathing, I'm still okay-. (M1)

it is not the first time that I have been hospitalized, but I had not felt so much of the shock, as I have felt now, … to feel in a hospitalized bed and … the restlessness, the anxiety. (M2)

the feeling of dying continues with a certain dread, fear of getting infected again. (M1)

The moral support, the gestures of affection, the strong phrases transmitted by colleagues, friends, and family meant a lot to the nurses, making them feel more encouraged to fight.

the doctor told me: you are a warrior and here you have to fight … everyone was calling me warrior, you are going to get out, you are not alone … my family was there all the time. (W2)

I was saying my God, my mom is waiting for me, my sister is waiting for me, I have to fight, that motivated me more, to keep on fighting. (W3)

my colleagues were there … and the representative, she gave my wife some money, they helped me in that way. (M1)

A few of my emergency colleagues came up to see me, to see how I was doing, right? Besides the people from my group that I work with, right? (M2)

Faith in God was a weapon that helped them cope and cling to life. All participants affirmed their faith during hospitalization and maintain it to this day.

I believe in God, in the saints, I prayed to God… if I were to leave, to take care of my mother, my sister, my niece, … I asked God, please (voice breaking) I wanted to see my family once again. (W3)

and thank God they did all the tests… and my colleagues… said prayers… thank God I was able to calm down or get better in any case, they did not intubate me. (M1)

I was motivated to keep fighting, the doctor told me: I already talked to your mother, I talked to your sister, they are praying for you, they told me. (W2)

Theme 4: Perception of Care Received as a Hospitalized Patient

The care received by nursing and medical colleagues was an encouragement to face the hard moments of hospitalization and the effects of the disease. This fact is highlighted even more when the work overload and the speed of contagion were at their highest levels, leaving evidence that professionals in an institution come to form affective bonds that are consolidated in difficult circumstances.

the attention was very good, besides, I myself was hospitalized in a single room, which had a bathroom, so …I had a good time, I had a quiet and good time. (W1)

Every two hours the doctor came down to see me … having the ICU doctor at my side … they themselves have moved to make the hospitalization paperwork, to talk to the social worker … I received the love of my family, my colleagues, who never left me alone. (W2)

I was very well attended by the nurses and everything, they started the treatment immediately … I felt cared for . .. they treated me very well, … if I needed anything, well, they were there. (M2)

everyone, from the head nurse to the doctors who were on duty, everyone behaved wonderfully with me (M3)

Discussion

In this study, the nurses attributed the infection to excessive viral load or some failure of protective measures. This self-assessment forms the first theme that emerged in this study. These results coincide with those of other studies that report the same self-assessments. A study of health care personnel in Chile found that the majority reported having been in contact with an infected person (patients or coworkers) without adequate protection (Poblete Umanzor et al., 2020). Another study conducted in a hospital in Wuhan found that the main forms of exposure for workers who became infected with COVID-19 were contact with infected patients, contact with infected colleagues and infection in the community (Lai et al., 2020).

Regarding viral load, considering that the main mode of transmission is contact with respiratory microdroplets and aerosol effect of the infected person; in health personnel, aerosols generated by different procedures have been the main source of contagion. There is evidence that shows that by decreasing the viral load, the probability or aggressiveness of contagion is reduced (Cuenca-Pardo et al., 2020). Despite this, the viral behavior of infected patients is not fully determined (Pan et al., 2020). One study in China (Zou et al., 2020) and another in Italy (Cereda et al., 2020) reveal the existence of similar viral load between asymptomatic and symptomatic patients, such that being asymptomatic does not reduce the risk of infection.

The risk of contagion increases when living with several infected people for a long time, especially in closed and poorly ventilated spaces; also when the preventive measures such as use of masks, eye protection, distancing, hand hygiene, and disinfection of equipment and environments are not scrupulously applied (Cuenca-Pardo et al., 2020). Many of these factors have been evidenced in nursing professionals.

It is worth remembering that, at the beginning of the pandemic, professionals did not have adequate protection materials and methods, nor specific training for the care of COVID-19 patients (Fuentes Carrillo, 2020). Consequently, protective measures which ensure the safety of workers should be considered a priority not only at present, but also at the onset of future outbreaks (Chang et al., 2020). Considering that the prompt identification of health care personnel with suspected infection and routine examinations in asymptomatic persons are measures that protect the transmission of the virus (Lai et al., 2020), an effective program of early detection of the disease would have allowed the implementation of favorable containment measures to cut the chain of transmission and avoid complications (Poblete Umanzor et al., 2020).

Even today, the risk of contagion remains among health care professionals. It is crucial to establish protection policies in accordance with this situation. This includes raising awareness of the value of professionals, their right to work in safe conditions, and the duty of the state and health institutions to safeguard their welfare, protecting them from harm.

The second theme in this study includes the difficulties with initial diagnosis and the initial clinical condition presented by the nurses who participated in the study, including false-negative rapid tests and mistaking the earliest signs for simple fatigue. The nurses preferred to continue working and not to take heed to the first signs of discomfort. The scarcity of molecular tests and the slowness in determining the diagnosis contributed to the uncertainty and complication of the condition. In this regard, several studies listed the first clinical manifestations reported by nurses as headache, malaise, cough, nasal congestion, fever, sore throat, dorsal lumbar pain, loss of taste, and smell. (Lai et al., 2020, Poblete Umanzor et al., 2020; Wang et al., 2020).

The fact that professionals continued to work despite physical discomfort deserves particular analysis. A study conducted in Spain indicates that nurses considered it their responsibility and obligation as professionals to attend the hospital to care for their patients, despite the risk of infection (Andreu-Periz et al., 2020). Another study conducted in China found that health care professionals felt a social and professional obligation to work longer hours in hospital services (Cai et al., 2020).

In fact, during the pandemic, the inability of health systems to meet the high patient demand brought into discussion the ethical dilemma of whether nurses should work while sick (Nelson & Rushton, 2021). Especially in countries where there is a precedent of professional shortages, the death or disability of nurses could have a cumulative catastrophic effect on health services (Jackson, Anders et al., 2020), so they need to be valued, cared for, and supported (Adams & Walls, 2020). Consequently, it is the responsibility of healthcare institutions to ensure the comprehensive care of their employees, access to rapid tests, early diagnosis and timely quality treatment, so as not to have to sacrifice personnel at the expense of the existing deficient financial resources.

The third theme of this study shows that nurses hospitalized by COVID-19 felt fear, dread, and anguish when faced with the possibility of dying. Emotional support, the desire to live and faith were elements that helped them to cope with this situation. No studies have been found that state fear of dying specifically in nurses hospitalized for the disease, but the feelings are similar to those reported by those working in COVID-19 areas.

Feelings found in other studies include doubts about the differential diagnosis of COVID-19, pressure from the demands of their jobs, uncertainty about the evolution of the pandemic and fear of infecting their families. (Andreu-Periz et al., 2020; Ferreira do Nascimento et al., 2020; Fuentes Carrillo, 2020). Anxiety increased as they witnessed the high mortality of their patients (Cai et al., 2020), fear, helplessness, and frustration (Iheduru-Anderson, 2021) arose at the thought of failure in not being able to save so many lives (Jackson, Bradbury-Jones et al., 2020). Nurses felt overwhelmed by the crisis situation, they had many mixed feelings that were difficult to define (Andreu-Periz et al., 2020).

In this sense, it is important to pay attention to the protective factors of the emotional health of nurses who became hospitalized patients. The company of family and friends were key elements in the social and emotional support of patients, especially those with delicate health (Bueno Ferrán & Barrientos-Trigo, 2021); even the positive attitude of coworkers is considered one of the best stress buffering measures (Cai et al., 2020); the same as the support in their faith beliefs, which are protective experiences for nurses (Andreu-Periz et al., 2020; Sahoo, Mehra, Dua et al., 2020).

Consequently, mental health should be planned for across all health services (Sahoo, Mehra, Suri et al., 2020) and psychological interventions addressed to people who were affected by COVID-19 should be addressed according to individual mental health needs (Zhang et al., 2020). It is crucial to deploy the most effective strategies to ensure the presence of protective factors for the emotional health of each patient. In a situation where life is at risk and the patient, being a health professional, is fully aware of it, more emotional and spiritual support is required to contribute to the nurse's integral recovery.

As the fourth and final theme in this study, nurses’ perceptions of the care received as inpatients have been favorable. In this regard, when a nurse becomes a patient, he/she sees the reflection of his/her care. The support received and displays of appreciation from others within the profession produce positive effects on nurses, such as psychological growth, and the ability to value the importance of life (Deliktas Demirci et al., 2021). Today, it can be said that nursing professionals have overcome fear, have developed resilience, are more grateful for life, and continue to provide valuable contributions to the current problems (Liu et al., 2020; Pogoy & Cutamora, 2021).

This calls for reflection on the critical analytical capacity of nursing professionals, so that, from their position as a patient, they can value their strengths, but at the same time, identify opportunities for improvement in the care management of their health care institution. Often, it is only when we find ourselves in the position of the user that we become aware of the weaknesses of the system. In this way, the nursing staff can apply the emancipatory knowledge pattern that implies the ability to recognize social and political problems and propose alternative solutions (Chinn & Kramer, 2011). Therefore, it is opportune to request, and take into account, the recommendations that nurses who were in the position of hospitalized patients have to provide, since they, after going through the experience, possess a broader vision of the reality of health services.

Strengths and Limitations

The main limitation presented by the study was to obtain a sufficient number of participants, since several professionals told us that after having gone through the experience of being hospitalized, they had been left with very strong emotions, a fact that prevented them from talking about the subject in an interview. This entails serious damage that must continue to be investigated as a follow-up to nursing professionals who have been physically, emotionally, and spiritually harmed by the disease and who are the ones who must receive the best comprehensive health conditions to continue with their personal and professional lives.

Implications for Practice

The COVID-19 pandemic has meant a clear risk to holistic nursing care. Not only does the fact of the physical barriers established to reduce the risk of contagion count, but also nursing professionals, like every human being, faced serious imbalances in their integral well-being.

There is a need, for nursing professionals, to understand the importance of taking care of oneself in order to take care of others. But in the pandemic context, in the most critical period, it was impossible for nurses to take care of their physical, emotional, and spiritual integrity. Getting sick and hospitalized at risk of dying has further limited the holistic care patients were supposed to receive; but, on the other hand, it makes us assume that a nurse or nurse who has lived this experience, after overcoming it, will have greater resources to provide better holistic care.

During the COVID-19 pandemic, it was pertinent to support nurses’ self-care and resilience as ways to care for them holistically. Indeed, the experiences narrated by the participants of this study show the spirit of resilience that professionals possess the power of self-care, the strength to recover, but also their reflections and personal commitment to a greater humanization of the profession.

This study represents an initial exploration that invites us to reflect on the emotional physical integrity and repercussions on life presented by nursing professionals who, working to control the COVID-19 pandemic, became infected and were hospitalized, putting their lives at risk. This study reveals learnings suggested in difficult circumstances, useful for professionals in the world.

Conclusions

In general, being hospitalized as COVID-19 patients has been a difficult experience for the nursing professionals, in which they have lived under the fear of dying, feeling first-hand the physical and emotional pain suffered by the patients they have been caring for on a daily basis. In these circumstances, the emotional support of their families and colleagues, as well as their spiritual strength, have been the best encouragement that has allowed them to cope with the disease until they recovered, which is why they feel satisfied with the care they received.

Being hospitalized by COVID-19 has been a difficult experience for nurses, characterized by high levels of fear, which has led them to better value not only life itself but also the essence of their profession and the value of family. For some, it has also strengthened their faith; they have shown resilience in continuing to work in their vocation. It is important to facilitate spaces of support and propose strategies to strengthen the emotional component that will foster professionals integrally prepared for circumstances such as those experienced during the last pandemic.