Commentary: Exploring perceived stress from caring for coronavirus disease (COVID-19) patients in nurses: a qualitative study

Worldwide, nurses are the most significant healthcare workers. Nurses were catapulted into the frontline to fight the COVID-19 pandemic. Nurses and other healthcare workers were labelled heroes, and their struggles were celebrated during the pandemic (Mohammed et al., 2021). Nonetheless, there is a preponderance of studies that report nurses’ continued exposure to risks, scarcity of clinical resources and psychological impacts (Buchan et al., 2022). Most reported studies deal with nurses’ stress, uncertainties and fear (Bae et al., 2022; Grande et al., 2022). Thus, this study piqued my interest. It is a timely and relevant investigation as it presents the first-hand narration of nurses working directly with COVID-19 patients. Their shared stories could be a rich addition to the collective stories of nurses during the pandemic. Although there are multiple layers of reality in every experience, nurses’ demographics, culture and past experiences may affect how they interpret those experiences, specifically their reconstructed perception of stress.

In this study, researchers used a descriptive qualitative design and content analysis to examine the stories of 12 Iranian nurses working in various COVID-19 wards. The authors conducted limited face-to-face, semi-structured and audiotaped interviews between February and March 2021. A time when COVID-19 infection was on a sharp rise globally and vaccines were still in development. I could not imagine the struggles of the researchers to obtain the needed data. However, their tenacity persisted. After they collected and analysed the data, they surfaced the participants’ collective stress experiences. The main category, the process of transition from unknown conditions, resonated with the rapidly changing developments and protocols of COVID-19 management, where nurses must adapt and be flexible. Caregiving stress, an impression in all aspects of life, COVID-19 as a strange disease, stressful patient characteristics and stress reduction were the identified subcategories that were the sources of nurses’ stress. These findings compounded nurses’ stress while caring for COVID-19 patients. More than ever, these findings underscore the realities of the pandemic. Albeit the stress, nurses continued to provide care and stayed faithful to their calling. Finally, they were able to manage and reduce their stress.

We can obtain several highlights from this paper. The findings showed nurses’ human side. They, too, experience stress, fear and transition anxiety. These are universal emotions, but the expression, interpretation, magnitude and coping with these emotions may vary among individuals. Understanding nurses’ stress and other related factors (e.g. fear, anxiety, burnout, amotivation) during the pandemic is crucial. This knowledge can help make programmes that meet the needs of nurses and reduce their stress and fear.

An implication for nursing practice is to continuously monitor nurses’ status and provide relevant support. In addition, assisting them in understanding that their ethical and moral dilemmas are shared by nurses worldwide. Amid these struggles, they can use institutional support programmes (e.g. resiliency programmes, promoting positivity, psychoeducational initiatives and self-care resources). Nurse managers should recognise the nurses’ early signs of stress and implement immediate help to avert an impending crisis.

The long-term effects of COVID-19 on nurses are yet to be explored. The authors emphasised that a comprehensive action plan is vital to help reduce nurses’ stress and fears. Correspondingly, nurse managers should be proactive leaders. They are accountable for improving nurses’ working conditions and patient care outcomes. Despite the results generated in this qualitative inquiry having limited generalisability, Iranian nurses were not alone in their stress experiences due to the pandemic. Nurse managers should devise strategies to reduce nursing stress by creating a comfortable and healthy work atmosphere with breaks between duties. Although patients constantly filled hospitals during the pandemic, there were times when occupancy was low, and nurses could take a break. These interventions may improve nurses’ well-being.

Currently, the COVID-19 pandemic is still ongoing. The pandemic’s full impact cannot be overestimated. High infection rates and hospital admissions result in healthcare workers’ rapid turnover and severe staff shortages. Hence, healthcare system demands tend to escalate, which might increase the stress experienced by many nurses. Therefore, sustained and additional research into nurses’ stress levels, performance, and motivation is necessary to ensure the continued provision of compassionate care to their patients and the well-being of healthcare workers.

This study provides an intimate account of the stress of nurses during COVID-19. However, we are still learning about the long-term effects of the pandemic. Data suggest that they are widespread and frequently prolonged (Joshee et al., 2022). We should recognise that COVID-19 can interminably impact a person’s quality of life and rehabilitation and recovery paths. The individual’s post-acute effects are critical, but there may also be ramifications for the nursing workforce, health and care delivery systems, and society. Also, further research should focus on the effects of COVID-19 on families, communities, organisations, health policy and systems. Therefore, nurse researchers can add new literature about the long-term implications of COVID-19 for a person’s rehabilitation and recovery, opportunities and implications for nurses and the nursing profession, and the effects of its long-term treatment across various care contexts.

Biography

Daniel Joseph E Berdida is a faculty member and a former paediatric nurse at the Philippine General Hospital. His research interests are the intersections between nursing education (nursing students) and nursing practice (nurses). He is the current Counsellor of the Sigma-Alpha Alpha Theta Chapter.